Abstract
In this era of increasing accountability in population‐based research, and demands for strong evidence base of clinical practice, we need to examine justifications for the study of catastrophic problems in indigenous or transitional people. One justification might be the illumination of risk factors for, and mechanisms of, disease that can be generalized to the broader population, where they might be obscured by lower disease rates and density of risk factors. A more important justification is to arrive at, and model, solutions. We report a programme which has happily done both.