A long-running UK study is now tracking 14,500 people as they enter their thirties, collecting health data and biosamples from them, their children, and their parents. This matters because most health research focuses on older adults or children, leaving a gap in understanding what happens to people in their thirties—a decade when early signs of chronic disease can emerge but often go unnoticed. The Avon Longitudinal Study of Parents and Children (ALSPAC) has followed participants since before birth in 1991-1992, creating a unique resource of genetic, molecular, lifestyle, and social data across three generations. Without this kind of continuous tracking, researchers cannot connect early-life factors to health outcomes that only become measurable decades later. If the study succeeds, it will provide the evidence needed to shift healthcare from treating illness after it appears to identifying risks earlier—potentially reducing pressure on stretched NHS services and addressing health inequalities. The data will also help researchers understand how health is passed across generations, informing public health policy and clinical guidelines for a demographic that will soon become the main users of healthcare.
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Contemporary healthcare is being hugely challenged by the reality of aging populations and the logistics of care provision. Manifestations of these challenges include stretched services and the compromised management of complex health outcomes, problems exacerbated by and contributing to inequality. If we are to improve this situation, greater understanding of the factors important for health upstream of morbidity is paramount. However, this research need faces an evidence gap which can only be filled in the short term by prospective studies which already have a rich catalogue of life course resources. The Avon Longitudinal Study of Parents and Children (ALSPAC) is such a study. It has the benefits of continuity and efficiency, is a leader in generating resources to meet age specific and multi-domain research needs and is poised to remain a valued asset in the current biomedical research era. ALSPAC is a pregnancy cohort that recruited women living in the former County of Avon in the Southwest of England with an expected delivery date between April 1991 and December 1992 (>14500 viable pregnancies). The study has followed the lives of participants and provided data, biosamples and infrastructure to improve understanding of factors contributing to health and disease. Over three decades, 28 age specific face-to-face clinics, >140 questionnaires and a multitude of data linkages and bespoke studies have generated a vast collection of data and biosamples available to bona fide researchers. ALSPAC provides unrivalled opportunities to study sociodemographic, lifestyle, patho-physiological, genomic and molecular factors that influence health and is active. The study has an engaged participant base and continues to record life course health and wellbeing events and factors pertinent to the original children ("Generation 1"), their new offspring ("G2") and their parents ("G0"). Over the next 5 years, ALSPAC moves into a new phase where the defining focus will be characterisation of G1 participants as they move through their fourth decade. A programme of work has been designed to efficiently collect new data and biosamples that chart this, including life stage tailored approaches that will record new events and connect these to health trajectories and linked records. Critically, ALSPAC can measure the health and wellbeing related factors pertinent to an under studied demographic (adults in their 30s), who themselves will become the next wave of health service consumers. The structure of ALSPAC also means that measurements and biosamples taken around these events can include key players in G1 lives - G2 and G0. Therefore, deploying collection now enables unbroken longitudinal research and presents specific windows into the aetiology of multi-generational life course health. Our objective is to ensure ALSPAC delivers this and remains an internationally leading longitudinal population study (LPS). Infrastructure support will mean that ALSPAC does not miss an important life stage and that opportunities to extend records of health and social factors, capture time sensitive events and describe a moment when assumed health may conceal transitions to ill-health, are all taken. Enabled research will have personal, societal and economic implications and regular integration of ALSPAC into a connected national and international LPS landscape will enhance diversity and generalisability. ALSPAC will also be able to continue to act as a widely recognised platform for new research. This will lever the value of this proposal and allow ALSPAC to respond to the diverse needs of stakeholders over coming years.
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