How do you answer questions about the health of the population? How do you test ideas for policy and intervention change when the option for an experiment or randomized control trial does not exist?
High level, national public health policies can have a significant impact on shaping and creating the environments – physical, food, healthcare, etc. – that shape our health, both as individuals and as a population. However, it is often unethical and impractical to trial or test these policies in a real-world setting. So how do you responsibly implement policies when you don’t have the data to support the impact they may have? You have to rely on ‘natural experiments’ – or the data and evidence generated from other jurisdictions which have already implemented a similar policy – or modelling.
For example, microsimulation modelling was used in 2016 by the UK Health Forum* to model the impact a 20% tax on sugar-sweetened beverages would have on rates of overweight and obesity in the UK. This modelling found that a 20% tax on sugary drinks could reduce obesity rates in the UK by 5% by 2025 or equal to 3.7 million fewer obese people. The stark number of 3.7 million is equivalent to the combined populations of Birmingham, Leeds, Sheffield, Manchester, Bristol and Leicester**. This evidence was then used as an advocacy tool by the government and civil society to support the implementation of the UK Soft Drinks Industry Levy as part of a comprehensive childhood obesity strategy.
This is just one example of the vital role microsimulation modelling can play in policy decision making. In the absence of real-world data, microsimulation modelling can be an invaluable tool for building the evidence base to support high-level policy and intervention change across a range of areas to improve the health of populations.
* The UK Health Forum modelling unit was subsequently acquired by HealthLumen in 2019.
** Calculated by Cancer Research UK using ONS Population Estimates for UK, England and Wales, Scotland and Northern Ireland, Mid-2014: http://www.ons.gov.uk/ons/publications/re