Tackling inequality through data: the professor of primary care

As a medical student, Azeem Majeed didn’t think he would end up becoming a professor. “That would never have occurred to me at that time,” he says.

Now he is a professor and the head of the department of primary care and public health at Imperial College London. He says he found a desire to tackle the wider social determinants of health early on in his clinical career, after seeing health problems that were rooted in deprivation and occupational hazards.

“That made me realise that, while medicine is important, there are important things beyond medicine—such as poverty, housing, and occupation,” he says. “That drove my interest in public health.”

Majeed developed his research skills during an outbreak of hepatitis A in Gloucester where he worked in the community doing contract tracing and outbreak control. This then led to the publication of his first articles and a lecturing role.

Most doctoral students focus on clinical trials or studies for their thesis. Majeed decided to work with primary care data—a move that was uncommon at the time, he recalled. This piqued his interest in what were considered to be routine data sources and how they shed light on the problems communities face.

As a researcher, he drew on data from the census and health authorities as well as primary and secondary care to study the link between socioeconomic factors and healthcare. He strives to use these data to measure inequalities between population groups, look into health outcomes, and analyse how best to tackle disparities.

“We need to guide the NHS and our public health system and that’s best done by using data,” he says. “Otherwise, it’s like driving a car with a blindfold on. You’re not really sure where you’re going.”

Getting data ready for a research project is more straightforward than it was in the past—Majeed recalls going through paper based records and having to clean and code data before analysis. But there are still gaps in today’s primary care datasets. Information about people’s occupation, education, and housing is not often linked to their medical data or recorded in any logistic data system, Majeed says, making it more challenging to study their impact on health outcomes.

What makes Majeed most proud of his work is seeing his team members grow from junior researchers, doctoral students, and clinical fellows into professors. “Since I’ve been a professor, I’ve aimed to develop my team members,” he says. “I’m proud that I’ve mentored and supported and advised a lot of people who’ve gone on to become professors in their own right.”

Medicine can be an unstable career option at times, but he offers three pieces of advice to those doubting the path they are on. “Firstly, medicine remains a good career,” he says. “It’s a rewarding career both professionally and personally. Secondly, don’t worry if you haven’t got a plan, because I had no plan and I’m doing quite well. And thirdly, don’t obsess too much about doing well at a young age.”

Although today’s fast paced world may come with pressure to reach certain benchmarks of success early on, Majeed advises young doctors go easier on themselves. “Don’t worry,” he says. “Just pursue your career. Things will often work out for you.”