Why do some sections of society feel as if the primary care system has failed them? Conversely, how does a surgeon address the patient who asks to be operated on by a white doctor? How do we streamline services for individuals with long term/ chronic health conditions such as diabetes, high blood pressure or obesity? Will apps and AI be the future of primary care medicine and triage?

When I tell people about my work in FASD, I generally get the response ‘well I have an aunty who drank all the way through her pregnancy and my cousins are fine’ or ‘well, they just try to scare you with all sorts now’. My personal favourite actually came from a heavily pregnant senior lecturer: ‘well his brain is fully developed now anyway’. The truth is, for some pregnant women a few glasses of wine can result in a child with FASD. For other  women, heavy drinking all the way through pregnancy will not result in FASD. It really depends on the individual, their genetics and susceptibility. On top of this, conditions of social behavioural manifestation (FASD, autism, schizophrenia, ADHD, conduct disorders) are associated with the interaction between the frontal lobe (the area of the brain that processes environmental and social information) and the external world. Additionally, there is epigenetics - gene expression as a result of environmental input. Our environments - the way we live - the stresses we go through and the societal pressures on us- have the ability to alter our very genetic makeup.

That is why FASD is the intersection between nature and nurture, but it is also the reason that socioeconomic status is a significant predictor of various mental health psychopathologies in people. These are issues of public health, and behaviour change in public health institutions can be the conduit for addressing this.