My career in epidemiology began in the late 1970s when I was employed by a London Hospital to identify which bladder cancer patients they treated had been exposed to chemicals known to cause this malignancy and to also identify other unknown risk factors. Having a first degree in sociology and philosophy I quickly realised that I needed a new set of skills, which led me to visit LSHTM. Eventually in 1985 I joined LSHTM as a lecturer working on occupational cancer (the topic of my PhD) and also on socio-demographic differences in cancer incidence using a pioneering Census linkage project now known as the ONS Longitudinal Study. In the 1990s I set up and led a series of widely cited studies on the fetal origins of adult disease in Sweden. At the same time I became interested in health in the former communist countries of Europe. From the mid-1990s I started working on mortality and health in Russia drawn to the challenge of understanding why the collapse of the Soviet Union led to huge falls in life expectancy at the time. This work led me to establishing long-term creative collaborations at the interface of epidemiology and demography.

I have sat on and chaired numerous advisory and funding panels in the UK and elsewhere, and have been particularly involved with the work of UK Medical Research Council. I currently co-chair the LSHTM Ethics Committee and am Head of the Department of Non-Communicable Diseases Epidemiology.