Make the UK a living lab for mapping the exposome

A web of data paves the way towards mapping the “exposome”—the system of all external factors that influence our health and wellbeing trajectory

December 07, 2022
© Alamy
© Alamy

Today we understand the factors shaping our health incomparably better than a generation ago. 2023 marks 20 years since the mapping of the human genome, in which the UK played a leading role.

But now the challenges look different. A healthy future means putting prevention at the heart of healthcare: striking a better balance between treating the sick and keeping the healthy healthy. It also demands we tackle the terrible health inequality problem exposed by the pandemic, which has led to a roughly 20-year difference in healthy life expectancy between richest and poorest. 

We know that differences in health outcomes are driven more by society than biology, and in the US, at least, around 80 to 90 per cent of these social determinants have little to do with clinical care. But compared to the depth of our understanding of physiology, our understanding of how surroundings influence our health is poor. Yet now we have the tools to change this—the data revolution in every aspect of our lives means we can take science “out of the lab” and into our cities, communities and homes. This would reveal the complex patterns and vital clues that link our environment, behaviours and health.

A healthy future means putting prevention at the heart of healthcare

This world of data paves the way to another holy grail of health akin to mapping the genome: mapping the “exposome”—the system of all external factors that influence our health and wellbeing trajectory. Building on existing efforts in the US and elsewhere, charting the exposome would deliver deep insights into the underlying causes of disease itself. We do not and will not gain these insights without connecting genetic, biological, behavioural, environmental and financial data. The answers are there.

This won’t be without challenges. While the technical complexity is immense, what is more difficult will be encouraging citizens to share health-relevant data at scale, requiring serious thought and safeguards around privacy and (anonymised) data. But if open banking is possible, open health should be too. The prize is huge for both the health and wealth of the nation: by delving deep into the complexities of the ageing process that underlies many chronic diseases, we can better reduce the strain of treatment costs on our health services budget.

As with the genome, the UK is uniquely placed to lead this endeavour. With smart regulation, the UK could become the centre of this global effort—a living lab—anchored in the unmatched data opportunities offered by the NHS as the world’s largest healthcare system, and connecting this data to other health-relevant data sets across our lives to understand the intricate mechanisms keeping us in good health. These insights can be applied to infrastructure, services and policies to create environments in which people thrive.

When scientists mapped the genome 20 years ago, they couldn’t have imagined that just two decades later we would have the data and technology to make mapping the exposome possible—or that it would even be credible as a moonshot investment. Now that we do, what better way to commemorate their achievement by embarking on a “Healthy Longevity Innovation Mission”, supported by the government and private sector to nurture healthy people, a healthy planet and healthy growth?

This article first appeared in Minister for the future, a special report produced in association with Nesta.