Landmark Research Studies

Our unique, long-running Prospective Urban and Rural Epidemiological (PURE study) involves studying 225,000 participants in detail, and 500,000 with simple information, from more than 1,000 urban and rural communities in 27 high, middle and low-income countries.

PURE is investigating the impact of modernization, urbanization, and globalization on health behaviours, how risk factors develop and influence cardiovascular disease, diabetes, lung diseases, cancers, kidney disease, brain health, and injuries.

Working with universities in 26 countries, early findings from PURE have demonstrated that a large proportion of patients who can benefit from proven and simple therapies did not receive them, especially if they were from poorer countries. Therefore, the large differences in death rates between the poor and the rich countries were likely due to differences in health care, rather than differences in risk factors. This identifies practical opportunities to improve health by the greater provision of simple but effective treatments.

All PURE publications back to 2005.

Visit the full PURE study site.

PURE Overview - Download PDF
Study Type


Study Design

Prospective cohort

NO. of Countries


NO. of Sites


NO. of Participants


Study Period

2002 - 2030



VIDEO: Overview of the PURE study

VIDEO: Salim Yusuf, ESC19, on PURE and mortality patterns around the world

London School of Hygiene and Tropical Medicine - M McKee; B Palafox; A Murphy; D Balabanova

Harvard University - S V Subramanian

The George Institute for Global Health, Australia - C Chow

University of British Columbia, School of Population and Public Health - M Brauer

Oregon State University, College of Public Health and Human Sciences - P Hystad

National University of Ireland Galway - M O'Donnell

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