Epidemiology: Sampling Frame Of The Whitehall Study Essay


Discuss about the Epidemiology for Sampling Frame of the Whitehall Study.


Whitehall I study sought to unmask the interconnection between coronary heart disease mortality, employment grade and factors exposing one at risk of coronary disease (Killoran & Kelly, 2010). The number of people enclosed by the longitudinal study were 17530 civil servants based in London. Initially, screening examination was attended by 18403 men. Each individual was presented with a with a standard questionnaire. The questionnaire mainly focused on employment grade and based on received feedback, men were categorized into grades. They were; executive, professional, administrative, clerical and others. However, 873 men from British council and the diplomatic service were excluded from the study. This was because their employment status’ were incomparable. The remaining sample population therefore comprised of 17530 men from other employment departments (Naidoo & Wills, 2010). Records of over 99% of the participants were identified and tagged in the national health central registry. Any participant who has therefore died henceforth have been accounted for as birth certificates are availe.

In Whitehall study II, phase one conducted between 1985-1988 saw the recruitment of 10308 people to be assessed who emanated from twenty departments of civil service based in London (Kirch, 2012). Phase 2 (1989-1990), phase 3 (1991-1993), phase 4 (1995), phase 5 (1997-1999), phase 6 (2001) and phase 7 (2002-2004) entailed data collection. In phases 2,4 & 6, postal questionnaires were used. Phases 3,5 & 7 however entailed full clinical examination (Marmot & Brunner, 2005)

Disease Risk Assessment

In the study to bring into the limelight the mechanisms associated with work stress and coronary heart disease, various criteria were used to assess the risk of the disease. Job strain questionnaires were used to collect data relating to self-reported work stress. Addition of the number of times that iso-strains were reported by participants at phases 1 and 2 enabled creation of a cumulative measure of work stress. Data analysis involved use of cumulative measures of work related stress to display the hazardous ratios of coronary heart disease occurrence. It was therefore established that there was a direct connection between higher risks of coronary heart disease and greater reports of work stress.

The second study involved establishing a relationship between the employment grades of British civil servants and the prevalence of coronary heart disease amongst them. Data was collected by issuing of questionnaires where the participants (men) were required to indicate their employment grades amongst other details. It is from collected data that grades were classified into professional, administrative, clerical, executive and the lowest work profile grade being termed as ‘others.’ Data analysis sought to explain the coronary heart disease mortality percentage amongst workers in various employment grades but in the same age limits.

The third study was based on 29 years of following up the Whitehall study. It sought to explain whether social-economic drawbacks persisted onto old age. Given prior registration during Whitehall 1 with the National Health Service Central Register, the body isolated the various health authorities through which individual members of the cohort were registered to various family doctors. Permission was granted by the chief executives of the individual health authorities to the register to avail all the addresses of the survivors. Sent to the survivors identified henceforth were invitation letters, questionnaires, two reminders and consent forms. Alongside the second reminder, a shortened version of the questionnaire entailing the crucial information was attached. Statistical analysis was conducted using heterogeneity Chi-square tests to establish univariate relationships. Odd ratios were estimated using logistics regression.

Generalization of the Results to Other Populations

Basing on the three studies, the overall results are applicable to other populations. This is because the baseline coronary heart disease prevalence is directly attributable to the amount of income being generated by the individuals in the population of choice (WHO, 2007). Pay grades determine the amount of income that an individual earns and hence aligns the individual into respective socioeconomic measures. Work stress is also prevalent to other populations and thus results from these studies could be generalized to several populations.

Feasibility of Conducting Similar Studies

The feasibility of conducting similar studies in Australia is high. The 45 and up study cohort could even prove to be more effective as it covers very large population of more than 26700 individuals at any single recruitment (Webb & Bain, 2010). Data collected would be therefore well distributed and emanating from a larger sample. The Australian Women’s longitudinal study cohort on the other hand could have a relatively low feasibility as all its participants are women and thus data collected would not be a reflection of the whole society but rather of one gender (Chang & Daly, 2012).


Chang, E., & Daly, J. (2012). Transitions in Nursing - E-Book: Preparing for Professional Practice (3 ed.). Elsevier Health Sciences.

Killoran, A., & Kelly, M. P. (2010). Evidence-based Public Health: Effectiveness and Efficiency (illustrated ed.). Patrick.

Kirch, W. (2012). Public Health in Europe: — 10 Years European Public Health Association — (illustrated ed.). Springer Science & Business Media.

Marmot, M., & Brunner, E. (2005). Cohort Profile: The Whitehall II study. International Journal of Epidemiology, 34(2). Retrieved 7 1, 2018, from

Naidoo, J., & Wills, J. (2010). Developing Practice for Public Health and Health Promotion E-Book. Elsevier Health Sciences.

Nickitas, D. M., Middaugh, D. J., & Aries, N. (2010). Policy and Politics for Nurses and Other Health Professionals. Jones & Bartlett Publishers.

Orth-Gomer, K., & Schneiderman, N. (2013). Behavioral Medicine Approaches to Cardiovascular Disease Prevention. Psychology Press.

Webb, P., & Bain, C. (2010). Essential Epidemiology: An Introduction for Students and Health Professionals (2, revised ed.). Cambridge University Press.

WHO. (2007). Prevention of Cardiovascular Disease: Guidelines for Assessment and Management of Cardiovascular Risk (illustrated ed.). World Health Organization.

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