Prevention research matters more than ever

The Health Foundation recently hosted four webinars presenting work from the UK Prevention Research Partnership (UKPRP). These were well-timed, in the context of the recently published levelling up white paper, and as the UK emerges from the pandemic.

The UKPRP’s vision is to generate new insights into actionable, sustainable and cost-effective ways of preventing non-communicable diseases (NCDs) that will improve population health and reduce health inequalities in the UK. There are seven consortia, each undertaking research into a specific challenge in the primary prevention of non-communicable diseases.

The webinars, which took place between October and December 2021, gave us a chance to hear about the most advanced of the seven projects, focusing on:

• health and early years (ActEarly)
• systems science in public health (SIPHER)
• the commercial determinants of health (SPECTRUM)
• health considerations in urban planning and decision-making processes (TRUUD).

Each webinar included a consortium speaker and a second presenter looking at the policy implications of the research. In this blog I share my summary of insights and themes emerging from the UKPRP webinars.

Health and early years (ActEarly)

In the first webinar, Professor John Wright introduced the work of the ActEarly consortium. The consortium has created ‘City Collaboratories’ in two areas where child poverty is high: Bradford and Tower Hamlets. The Collaboratories act as testbeds to support the co-production, implementation and evaluation of early life interventions within a whole-system city setting. The interventions include tackling air pollution, looking at the benefits of green space, work on food supply and food deserts (areas with limited access to healthy, affordable food).

The consortium brings together researchers in Yorkshire and London, from across the statutory, voluntary, cultural and commercial sectors and local communities. The whole-systems approach underpinning the work helps identify and understand feedback loops and the unintended consequences of interventions. Involving the public in the design of interventions and evaluation is providing useful opportunities for citizen science – for example, the involvement of young people in interventions concerned with green space.

Professor Ruth Dundas from MatCHNet (the Maternal and Child Health Network) commented on the willingness of governments to invest in early years interventions, but that there are few outcome evaluations of interventions, reflecting the need for a better evidence base to inform policy.

Systems science in public health (SIPHER)

In the second webinar, Julian Cox presented the work of the SIPHER consortium which brings together scientists across six universities, ten practice partner organisations, and three government partners at local, regional and national level. The team is mapping local policy systems and building system models to provide evidence about the consequences of policy decisions for health and health inequalities. They are looking specifically at four areas: inclusive economic growth, adverse childhood experiences, housing and mental health.

The consortium’s current focus on inclusive economic growth provides an opportunity to build evidence to inform the national levelling up agenda. The systems approach helps in understanding the interactions between policies and potential trade-offs. Greg Fell, Director of Public Health in Sheffield, highlighted the intersection between skills shortages, health and caring responsibilities as potential constraints on local economic growth.

Commercial determinants of health (SPECTRUM)

In the third webinar, Professor Linda Bauld introduced the SPECTRUM consortium, which is investigating the commercial determinants of health and health inequalities – focusing mainly on tobacco and alcohol, but also looking at unhealthy food. The consumption of these products has inequitable impacts on health, driven by complex systems of production, distribution and promotion which the team is seeking to understand.

The research aims to build understanding of the commercial drivers and systems that cause NCDs. Their work covers systems science, corporate conduct, economic analyses, effectiveness of policies, mental health, inequalities and new data. They have developed a smoking toolkit – a monthly survey of smokers and those who have recently quit – which is tracking changes in smoking patterns in real time. Partnering with a range of civil society organisations (such as the Poverty Alliance, the NCD Alliance, the Alcohol Health Alliance, the Obesity Health Alliance and the Smokefree Action Coalition) provides a pathway to translate findings into policy and practice.

Professor Niamh Shortt is looking at the availability and price of tobacco. She discussed the range of policy options to reduce availability of tobacco, such as retailer type, limited hours of sale, and licensing. There may be lessons from tobacco control for developing international frameworks around climate change.

Health considerations in urban planning and decision-making processes (TRUUD)

In the final webinar, Professor Sarah Ayres and Dr Krista Bondy introduced the work of TRUUD (which stands for Tackling the Root causes Upstream of Unhealthy Urban Development). The TRUUD consortium brings together researchers from real estate, planning, law, public and mental health, and other disciplines, as well as teams from Bristol City Council and Greater Manchester, to look at how to prioritise health in decision making on urban planning and development.

Taking housing and transport as exemplars in Bristol and Greater Manchester, the teams have interviewed a broad range of system actors and found general agreement about the root causes of poor health and wellbeing in urban spaces. They have identified problem spaces, such as car-centric culture, the peripheral role of health, and policy alignment and coordination. Suggested interventions include changes to regulations and standards, filling the evidence gaps, telling persuasive stories and fostering collaboration.

Angela Hands from the Healthy Places and Communities Team in the Office for Health Improvement and Disparities explained how the Healthy Places programme seeks to support better health through planning policies and guidance. The aim to reduce the contribution of the environment to ill health has resulted in the development of relationships across different government departments including the Department for Transport.

The value of prevention research

Watching the webinars has been inspiring – I was struck by the wide range of work and the enthusiasm of the researchers in the face of a challenging context. Themes around the value of systems approaches, multi-disciplinary working and co-production are common to all the consortia. It will be exciting to see how the work develops as well as how it impacts policy and practice in the next few years.

Liz Cairncross is a consultant in the research team at the Health Foundation.