Institute of Epidemiology & Health Care


Mifuyu Akasaki

Mifuyu Akasaki photo

PhD title:

Do adverse childhood experiences increase the risks of developing coronary heart disease later in life? What are the biological mechanisms explaining the association? 


Professor Rebecca Hardy and Professor Andrew Steptoe

Lay summary:

Coronary heart disease is the leading cause of death and disability worldwide. A large body of research has identified a series of risk factors for the development and progression of coronary heart disease. These studies usually focus on risk factors in adulthood, yet coronary heart disease has a long-term disease process, from the development of atherosclerosis, subclinical disease, to its clinical manifestations. This natural history of coronary heart disease appears to start early in life, as shown in studies of autopsy. These observations have led to research interest in childhood and adolescence to understand how coronary heart disease develops, and what factors contribute to the development throughout the life course. Although genetic variants are implicated in development, some researchers have shed light on a substantial role of modifiable risk factor, psychological stress, which can impact directly or indirectly from the stage of development to the entire period of progression. One major relevant finding to date is that more disadvantaged socioeconomic position in childhood is related to increased risks of coronary heart disease in adulthood. This association may be indirect because those who grow up in a disadvantaged circumstance are more likely to engage in health-risk behaviours than those who do not. Findings of physiological studies during the past decade, however, may suggest an underlying mechanism in this association: the biological embedding of psychologically stressful events in childhood, which are more likely to occur among those in a more disadvantaged circumstance.

Accordingly, the aim of this PhD is to investigate the biological embedding, particularly focusing on the role of the neuroendocrine and autonomic nervous systems, in the association between adverse childhood experiences (ACEs) and development of coronary heart disease.


My background:

My interest lies, broadly, in inequality. I have worked for the third sector in Ecuador and Fiji on health and social inequalities, and also with academics and government in Japan on healthy ageing.

Following my posting in a cardiology ward in Japan, I was selected by the Japan International Cooperation Agency to work in an indigenous community in collaboration with the Ecuadorian Ministry of Public Health. I conducted research in determinants of access to health care services by home visits in the community; delivered results in report form, and supported implementation measures by running a conference for local health professionals. This experience led to my strong interest in undertaking masters in social epidemiology to understand social determinants of health more systematically, and also to develop research skills in epidemiology.

In 2016, after masters degree, I was posted to the World Health Organization (WHO) in Fiji, being involved in developing a monitoring and accountability system of non-communicable diseases called the Pacific Monitoring Alliance for Non-communicable Disease Action dashboard, which included aspects of governance as well as preventive policies. Also, using the dashboard, I assessed progress on the implementation of agreed policies and actions in Fiji, Samoa and other countries.

In 2017 I joined a longitudinal ageing study group in Japan. I coordinated a collaborative project with the WHO; delivered the mid-term evaluation of the Japan national health policy; and administered a project with a local authority with the aim of reducing long-term care needs among older people. I was then awarded a PhD scholarship to undertake a programme at UCL.



PhD (expected 2021) Social Research Institute, University College London, UK

MSc Social Epidemiology (2016) Department of Epidemiology and Public Health, University College London, UK

BSc Nursing (2007) Department of Health Science, Sapporo Medical University, Japan



2019-2021: UCL Doctoral School Fellowship 

2018: PhD scholarship from Foundation for Advanced Studies on International Development 

2018: Japan Grants-in-Aid for Scientific Research, 16KT0085 



  1. Akasaki, M., Kivimäki, M., Steptoe, A., Nicholas, O., & Shipley, M. J. (2020). Association of attrition with mortality: findings from 11 waves over three decades of the Whitehall II study. J Epidemiol Community Health, 74(10), 824-830. doi:10.1136/jech-2019-213175
  2. Akasaki, M., Ploubidis, G. B., Dodgeon, B., & Bonell, C. P. (2019). The clustering of risk behaviours in adolescence and health consequences in middle age. Journal of Adolescence, 77, 188-197. doi:https://doi.org/10.1016/j.adolescence.2019.11.003
  3. Sakuraba S, Akasaki M, Kameda Y, et al. (2019). Model development of active ageing in urban settings in Japan: JAGES ‘Matsudo Project.’ Journal of Public Health Nurse, 75(8), 688-694.
  4. Kondo, K., Rosenberg, M., & World Health Organization. (2018). Advancing universal health coverage through knowledge translation for healthy ageing: lessons learnt from the Japan Gerontological Evaluation Study. (as a contributing author)



July 2020 - present: Honorary Research Associate; Bristol Medical School, University of Bristol   Research Assistant; Department of Applied Health Research, University College London

2020: Postgraduate Teaching Assistant; Department of Social Science, University College London

May - Jun 2019: Research Assistant; Centre for Longitudinal Studies, University College London

Jul - Oct 2018: Cross Cohort Research Programme Research Intern; Centre for Longitudinal Studies, University College London


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