All posts by LizRichardson

Alcohol and tobacco environments and adolescents’ health behaviours: future talk on CRESH research in Edinburgh

Title: Alcohol and tobacco environments in Scotland and their relationship with adolescent behaviour

Presenter: Dr Niamh Shortt
Date: Thursday 25th July 2013
Time: 11:00 am
Venue: Seminar Room, Scottish Collaboration for Public Health Research and Policy (SCPHRP), 20 West Richmond Street, Edinburgh, EH8 9DX (next door to the Mackenzie Medical Centre) Continue reading Alcohol and tobacco environments and adolescents’ health behaviours: future talk on CRESH research in Edinburgh

Tobacco and Alcohol Outlet Density and Adolescent Behaviours

Image courtesy of mack2happy / FreeDigitalPhotos.net
Image courtesy of mack2happy / FreeDigitalPhotos.net 

Tobacco and alcohol use pose significant global public health challenges and are major determinants of preventable morbidity and mortality.  Preventing tobacco and alcohol misuse in adolescence before habits are formed is an important policy goal. Previous research into the relationship between tobacco outlet density and smoking prevalence has resulted in mixed findings. Whilst some have reported increased smoking prevalence with a higher density of retail outlets around the home and school others have reported no significant associations.  For alcohol a positive association between drinking and alcohol outlet density has been reported around the home for adults, adolescents and around Universities for college students. Despite this there have been several calls for a policy response to address the tobacco retail environment, primarily by ‘restricting the number of retailers around child spaces’. We received seed funding from the Scottish Collaboration for Public Health Research and Policy (SCPHRP) to examine the density of tobacco and alcohol retail outlets in Scotland and their association with the prevalence of drinking and smoking behaviours in school aged children. Continue reading Tobacco and Alcohol Outlet Density and Adolescent Behaviours

Green space, physical activity and health in New Zealand

A new piece of CRESH research has been published online in the journal Public Health this week.  The paper “The role of physical activity in the relationship between urban green space and health” can be downloaded here.  We looked at the health of over 8000 individuals who were interviewed for the New Zealand Health Survey in 2006 and 2007 and asked whether they were likely to be healthier if they lived in greener neighbourhoods.  We found that residents of greener neighbourhoods did indeed have better cardiovascular and mental health, independently of their individual risk factors (e.g., sex, age, socioeconomic status).  Green space might benefit health because it provides greater opportunities for physical activity, and we were able to test this hypothesis because the New Zealand Health Survey included information about how physically active each individual respondent typically was.  We found that although physical activity was higher in greener neighbourhoods it did not fully explain the green space and health relationship.  Therefore, other pathways between green space and health (e.g., social contacts, attention restoration) are likely to be equally/more important.

Author: Liz Richardson

Greenwash: have the benefits of green space been exaggerated?

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Greenwash” is sometimes used to describe exaggerated or otherwise misleading claims made about a product or company’s environmental benefits.  People are understandably becoming more and more cynical about environmental friendliness claims – but the danger is that genuine environmental benefits are rejected along with the greenwash, which “threatens the whole business rationale for becoming more environmentally friendly” (Futerra 2008). 

I am concerned that the green space and health research agenda is at risk of being overtaken by a form of greenwash, as ironic as that may sound.  Green spaces – also known as natural/vegetated/open spaces – clearly have some social, environmental and economic benefits.  The research of CRESH and many other groups has demonstrated this.  But these benefits are not experienced everywhere, or by everyone.  The same wooded park may be a valued jogging or walking area for some people, but a terrifying no-go area for others.  There is much important research to be done to understand and address the barriers that prevent different groups benefitting from green spaces.  CRESH researchers are among many jointly trying to bridge this knowledge gap.

The greenwash that concerns me is the mantra that ‘green space is good’ – end of story.  At a recent GreenHealth Conference (11th March 2013, Edinburgh) the fascinating results from a four-year Scottish Government funded research programme were presented.  CRESH’s own Rich Mitchell presented on the topic “More green = better health?” and concluded that this is not always the case (see blog post).  Nonetheless, in one of the afternoon discussions one attendee called for less research and more action “because we know green space is good already”.  Additionally, some important Greenspace Scotland work – showing that investment in ten community green space projects across Scotland provides good social, environmental and economic value for money – has been misleadingly reported elsewhere as “Greenspace is good… fact!”  This is greenwash.  It is also an example of a factoid – an assumption or speculation that is reported and repeated until it is considered true (see Cummins and Macintyre’s 2002 paper on how “food deserts” made it into UK policy by such a pathway).  Policy-making based on assumptions is dangerous: Cummins and Macintyre urge policy makers to look at the facts more critically.

Jane Jacobs – the influential American writer on urban planning – wrote about the greenwash surrounding green spaces (or ‘grass fetishes’ as she called it) more than 50 years ago.  In The Death and Life of Great American Cities (1961, Random House, NY) she wrote that “In orthodox city planning, neighbourhood open spaces are venerated in an amazingly uncritical fashion…” (p.90).  She qualifies that, while ”parks can and do add great attraction to neighbourhoods that people find attractive for a great variety of other uses”, they may also “exaggerate the dullness, the danger, the emptiness” (p.111).  If the barriers to green space use are not identified and addressed local people cannot be expected to use and benefit from them, regardless of the intentions of well-meaning city planners.  Informing people that ‘green space is good’ won’t help.  The danger is that when their touted benefits don’t materialise, green spaces may fall out of favour, when in truth, and with greater attention to what the evidence tells us, they may have been a great public health resource.  Instead of less research we urgently need to strengthen the evidence base and publicise our findings more widely.  Watch this space.

Author: Liz Richardson

CRESH involved in successful funding bid: ‘Mobility, Mood and Place’

Stadium Freeway in Portland, Is Shown in November, 1973, as It Looked without Street Lighting...11/1973
Jamie Pearce and Niamh Shortt, along with colleagues in the Edinburgh College of Art, the Centre for Cognitive Ageing and Cognitive Epidemiology, the Alzheimer Scotland Dementia Research Centre, School of Social and Political Science, Geriatric Medicine, Kings College London and Heriot Watt University have been successful in securing funding (£1.58 million) under the cross council Design for Wellbeing call led by the EPSRC along with the ESRC and the AHRC. The project, Mobility, Mood and Place, led by Professor Catherine Ward Thompson, will run for 3 years with Jamie and Niamh leading one of the four work packages. This work package will focus on a ‘lifecourse of place’, exploring how physical, built and social environments evolve over time and consider whether these processes are implicated in explaining inequalities in health-related mobility in older age. To get more of an idea of what we plan to do see Jamie’s recent blog post.

Improving the evidence for place effects on (children’s) health

Four members of the CRESH team attended a two-day ‘Good Places, Better Health for Scotland’s Children’ conference (November 27th and 28th 2012, at Murrayfield, Edinburgh; @gpbhscotland and #gpbhconf).  Good Places Better Health (GPBH) is the Scottish Government’s strategy on health and the environment.  The conference reported on the first phase (2008-2011), which addressed how places can help to deliver improvements in four key health challenges facing children under 9 years old in Scotland: obesity, asthma, unintentional injury, mental health and wellbeing.  In 2012 the GPBH team published the recommendations that have arisen from the work programme.

The conference started by outlining how health and place ‘intelligence’ had been brought together to inform the recommendations.  The first step involved developing a conceptual model within which each of the issues and their influences could be framed (see Scottish Government report for more info).  Subsequently, evidence for place effects on health and wellbeing was brought together from scientific literature and workshops with scientific experts, practitioners, and communities.  The need to value and learn from the ‘anecdotes’ from the workshops as well as the ‘hard science’ from the literature reviews was stressed.  When reviewing the evidence gathered the GPBH team noted that (a) the absence of evidence did not equate with absence of possible effect, and that (b) the social, economic, cultural and physical components of places influence our health in complex and intertwined ways that are very difficult to disentangle.

Interestingly, and importantly, the evidence from literature, experts and practitioners varied.  In the case of childhood obesity, experts rated the strongest scientific evidence for the influence of place as being for ‘downstream’ influences on diet (portion size, snacking, fast food and soft drinks), and determinants of sedentary behaviour and of physical activity in schools and nurseries.  But practitioners (e.g., health care, police, and councils) ranked neighbourhood attributes most highly: unattractive, unsightly and unsafe neighbourhoods were 1st, and neighbourhoods without accessible play and sports facilities were 2nd.

Community engagement approaches were used to assess how communities saw and experienced things – as ‘on-the-ground’ experts.  When asked how place impacted upon their children’s health, parents and carers concurred with the practitioners.  They highlighted mainly negative neighbourhood attributes: anti-social behaviour, dog fouling, junkies, drug dealers, hooligans, drug paraphernalia, vandalism, and the lack of appropriate neighbourhood facilities.  There was a strong sense from these meetings that what researchers often label ‘low-level incivilities’ – things like dog mess, litter and graffiti – can cause a very high level of distress and potential health detriment.  These personal insights should inform and direct our investigations of neighbourhood influences on health.

When bringing the evidence together the team noted that the evidence was mainly for downstream determinants of health, such as displaying sweets at shop tills, and that the much-needed evidence for upstream drivers (the economic, social and political driving forces) would remain elusive until we were ‘permitted’ to randomise society and conduct controlled experiments!  Fortunately for all concerned this is unlikely to happen.  But the difficulties involved in evidencing the impacts of these wider determinants are clear.

What will help are neat approaches to working with pre-existing data that have been collected for individuals or populations over time – e.g., longitudinal survey datasets such as the British Household Panel Survey, repeated cross-sectional surveys such as the Scottish Health Survey, or national death records.  These provide us with a cost-effective means of assessing how wider changes to the upstream drivers of health might influence our health and health behaviours, by exploiting what are often referred to as ‘natural experiments’.  Here we can assess how health or behaviour changed either side of a particular ‘event’ (e.g., introduction of a policy to create smoke-free public buildings: see Jamie Pearce’s work in New Zealand) without needing to establish costly monitoring programmes that might not last long enough to show any effect.  Evidence from natural experiments can be even more robust if, in addition to ‘before and after’ data, we can also identify ‘treatment and control’ sites.  In the UK we have the opportunity of survey data that include both treatment and control nations: for example smoking was banned in public places in Scotland one year before it was in England, Wales or Northern Ireland.

If we remain fixated on the idea that ‘randomised controlled trials’ are the only evidence that counts (see Rich Mitchell’s blog post for discussion) we risk seeing public health policies being made on little or no research evidence (see Dunn and Bobak).  Alternatively, accepting the value of what we can learn from natural experiments and other longitudinal study designs will enable us to provide policy-makers with evidence for how upstream drivers influence our health.   The wealth of already-collected data available in the UK and elsewhere gives us a great opportunity to ‘add value’ to these investments and uncover important lessons about environment and health relationships.  We should continue to utilise these data, improve our use of them, and support the continuation of their collection.

Author: Elizabeth Richardson

Measuring the Big Society: stakeholder consultation

We’ve produced a draft proposal for measuring the baseline and future progress of Big Society at a local level.  We would value thoughts and comments from interested parties on:

  • our approach,
  • our selection of variables with which to measure the Big Society and
  • the methods we propose to use to develop the measure.

Please download the document here and comment by Friday April 22nd.  Many thanks for your involvement.

Forthcoming symposium: Mental Health and the Environment

CRESH are pleased to announce an interdisciplinary symposium to be held at the University of Edinburgh on 31st March 2011. The event is being organised with the University’s Human Geography Research Group, in the School of GeoSciences.

It is well recognised that mental health and illness are significant causes of human disability and impairment. Academic researchers and policy makers are increasingly concerned with the relationship between the environment and various mental health related outcomes. It is acknowledged that risk and resilience to mental illness and distress is a strongly linked to characteristics of the environments in which we live, work and play. This symposium will draw on work from a number of fields to consider the role of the physical, social, built and healthcare environments in understanding human mental health and wellbeing. This interdisciplinary symposium will be of interest to policy makers, students and academic researchers working in the field of mental health and wellbeing.

Confirmed speakers:
Professor Sarah Curtis, Durham University
Dr Anne Ellaway, MRC Glasgow.
Professor Christine Milligan, Lancaster University
Prof Richard Mitchell, University of Glasgow
Dr Liz Twigg, University of Portsmouth

The programme of talks for the day is available here.

Date: 31st March 2011
Time: 1000 to 1800 hrs
Venue: Edinburgh

 

Please sign up before 28th February 2011 by contacting:

Anna Kenyon (A.Kenyon@sms.ed.ac.uk)

New grant for environment and health inequalities study

CRESH members Drs Jamie Pearce and Elizabeth Richardson are part of a multidisciplinary team of researchers recently awarded interdisciplinary funding to examine the role of pollution and weather events in shaping health and inequalities in the UK. In collaboration with Edinburgh colleagues Ruth Doherty (Edinburgh PI), Mat Heal, David Stevenson and Massimo Vieno they have secured a grant entitled “Air pollution and weather-related health impacts: methodological study based on spatio-temporally disaggregated multi-pollutants models for present day and future”, awarded under the UK cross-council Environmental Exposure and Health Initiative. The project involves 5 institutions with atmospheric scientists at the Universities of Edinburgh and Strathclyde, epidemiologists at the London School of Hygiene and Tropical Medicine (LSHTM) and St. Georges Hospital, University of London, health geographers and social scientists at Edinburgh and LSHTM and experts in building physics at University College London. The total award is £1.8M over 4 years. The project will examine the spatial variations in health outcomes related to mixtures of air pollutants and weather in the UK, and the relationship to socio-economic inequalities. The WRF (meteorology) and EMEP (atmospheric chemistry) models will be used to simulate weather and composition at 5km by 5km resolution across the UK.

CRESH work presented at national statistics event

Elizabeth Richardson presented our regional-level environmental deprivation work to the ScotStat Small Area Statistics event on 5th October 2010.  The programme of talks can be found here, along with links to the talks: http://www.scotland.gov.uk/Topics/Statistics/sns/SNSEve/051010SmallAreaStatistics

She gave a talk entitled “Multiple Environmental Deprivation in South Lanarkshire: Does It Influence Health?” which can be found here: http://www.scotland.gov.uk/Topics/Statistics/sns/SNSEve/051010MultipleEnvDep

The event provided a useful overview of small area statistics in Scotland, including the Scottish Index of Multiple Deprivation, the Scottish Neighbourhood Statistics web portal and a range of interesting talks from other users of the data such as ourselves.  Useful links were made with ScotStat, the Scottish Government, NHS Scotland and other users.  A key part of the day was a consultation on potential changes to Scotland’s key small area geography: the data zone.  The process involves trading off the advantages of maintaining comparable populations between the areas but also keeping the area boundaries consistent through time.