Rich Mitchell has a new collaboration with the Faculty of Medicine of Porto University. Prof Maria de Fatima de Pina has a new PhD student there who will be working on mortality, morbidity and health status of the elderly across Portuguese regions. The student, Ana Ribeiro will visit CRESH in 2012.
Rich Mitchell and Andy Briggs (Glasgow Uni) have a PhD studentship available.
There is growing interest in whether contact with ‘green spaces’, including forests and parks, carries health benefits. Both Scottish and UK public health policy documents now explicitly recognise green spaces as ‘good for health’. The evidence for these effects stems from both experimental studies in lab and field, and from population level observational studies. Several experimental studies demonstrate direct effects of perceiving these environments on a variety of physiological and psychological measures. Several observational studies show independent associations between greener environments and better population health. However, this is an emerging field of research with much work still to do to confirm, quantify and qualify any positive impacts on health. If it is true that contact with nature brings health benefits, the cost of providing and accessing such environments, the subsequent health benefits and the relative merits of such ‘environmental health care’ need to be weighed carefully.
The Forestry Commission and other forest agencies are engaged in many programmes of woodland improvement and creation, with the explicit aim of increasing the use of woodlands and prompting health benefits. These programmes provide useful natural experiments through which health impacts of environmental interventions might be assessed. However, the specifics of how any health economic analysis might be applied to these situations are not clear. The prevailing methodology employed in health economic evaluation, is to use ‘Quality Adjusted Life Years (QALYs)’ to measure health benefits of interventions in favour of the more traditional monetary measures typically used for economic appraisal in areas such as environmental and transport economics. While the QALY framework may be appropriate for Health Related Quality of Life benefits of interventions relating to the woodland environment, the broader evaluative framework offered by cost-benefit analysis might be more appropriate for the broader wellbeing aspects of the environment.
The purpose of the PhD project will be to explore the potential use of economic appraisal techniques to value and evaluate woodland interventions. A broad perspective will be adopted to explore the potential to use and combine methods from environmental, health and transport economics.
Funding Notes:
Person specification:
Applicants should hold a first class or upper second class degree in economics and preferably have demonstrable interest in, and experience of health economics. A master’s qualification in a relevant discipline would be an advantage.
Award details:
This is a 3 year full time studentship and will provide an annual stipend and fees. The award is available to UK and other EU nationals only.
References:
How to Apply – Please send a full CV including the contact details of 2 referees and a covering letter explaining why you are particularly suitable for this post via email to Prof Richard Mitchell (Richard.Mitchell@glasgow.ac.uk) and Professor Andy Briggs (andrew.briggs@glasgow.ac.uk)
Further details: More details on the project, the supervisors and the departments involved is available from Professor Richard Mitchell (Richard.Mitchell@glasgow.ac.uk), Professor Andy Briggs (andrew.briggs@glasgow.ac.uk)
The CRESH symposium on mental health and the environment was one of those (quite rare) conference days that worked incredibly well. I’m not sure what it was that made the day so interesting and exciting. Perhaps it was the unusual mix of academics, practitioners, policy makers and GPs in the audience, all of whom seemed keen and willing to engage and debate. Perhaps it was the variety of interesting presentations. Whatever the magic ingredients, I came away from the day inspired and full of thoughts. I’d like to share two of them
1) There was much discussion during the day about the nature of ‘evidence’ for the influence of environment on health. There was a clear tension between the desire for evidence from ‘intervention / evaluation’ type studies, which hold the promise of identifying causal mechanisms and offer a higher standard of ‘proof’ about whether environment does or does not hold influence over health (especially if the studies are controlled in some way), and the bulk of existing evidence which stems from observational designs. It certainly feels like the balance of funding available for health research is shifting rapidly to favour study designs which are more experimental than observational. Colleagues of mine have recently had funding requests turned down because of their observational study design, and we have had papers rejected from leading medical journals specifically because of an observational design. This pressure is, rightly or wrongly, asking scientists to work further up the hierarchy of study designs. What concerns me is the extent to which we are ignoring the weakness of experimental / evaluation study designs, especially in a) the extent to which they have external validity (i.e. can we really learn anything about how the wider world works from the controlled and unusual situations that experimental studies either create or exploit) and b) the extent to which we are tempted to believe that what are often relatively short-term studies can really tell us much about how social and physical environments really influence population health and health inequalities. This is a topic to which we intend to return in the next CRESH event. What is the right balance between experimental and observational studies in a portfolio, or mixed economy, of evidence? Is it all over for observation?
2) Critical thinking is essential to the progress of science. If we don’t ask how, and for whom, our results or conclusions might not hold, our work is weaker. If we don’t question how and why we think and research in the way we do, our approaches will not develop. In one area CRESH researches, the health effects of contact with green spaces or natural environments, we frequently encounter land managers, policy makers and planners who adhere to a general orthodoxy that ‘green space is good for you’. The value of critical science is that it makes us aware that not everyone feels comfortable walking in the woods or the park, and that some people even feel threatened by open spaces in the their neighbourhoods. There is plenty of evidence from qualitative and quantitative studies that this is true.
One of the weaknesses of critical thinking in the field at the moment however is that the critique seems to stop at ‘not everyone benefits from green space’. My question is, what do we do with that knowledge? If we can understand how and for whom benefits are not realised, that could help adjust expectations about what green space can deliver, and also help us think through how benefits could be brought to a wider range of people. Perhaps the real value of critical approaches to thinking about environment and health is that they pose these questions.
News about the next CRESH symposium will appear on the site soon. In the meantime, if any attendees want to post their thoughts on the mental health and environment day, please use the form below.
This is a personal post, written by Rich Mitchell. It doesn’t represent the views of ‘CRESH’
The CRESH team and colleagues from Portsmouth and Liverpool are currently collaborating to produce a ‘blueprint’ for measuring Big Society. You can read more about the work and funders on the project page.
To design a measure of Big Society begs a question… what is Big Society? Actually defining it is not easy. Although the general idea has been quite clearly articulated by David Cameron, a huge range of supporters, detractors and commentators have been writing and blogging about what it means since the coalition government took power. Opinions vary about what Big Society is and is not. There are also strong views about whether it’s a good thing or not. The government is also now encountering the realities of putting an idea developed in opposition into practice. Tony Blair has some interesting things to say about the difference between having an idea in opposition, and delivering change in government…
Although debates continue about what a Big Society should look like and what policies the coalition need to build it, its key principle is clear; it represents a desire for a society in which citizens and communities take a vastly increased role in managing, shaping and delivering social and physical infrastructure. As Number 10 wrote in May 2010, their aim is “to create a climate that empowers local people and communities…[to] ‘take power away from politicians and give it to people’” .
We have a sense that some in government believe their job will be done once they change the law to empower people to run local services or to have a say on how their neighbourhood will be developed. The ‘offer’ to participate in a Big Society will have been made and it doesn’t matter who, or if anyone, takes up the offer. Others, however, want to see evidence of changes wrought. Will it alter how much people like you and I are aware of, care about, and get involved in, what’s happening in our local areas? Which communities will do well from it, and which will not? The fact that Big Society has the potential to affect everyone makes it an important thing to monitor and measure.
At the start of the project, we focused on designing a framework for understanding ‘Big Society’ and identifying the set and sequence of changes which expect to see if it’s ‘successful’. Then, we looked for datasets and indicators to measure each of these things. It’s remarkable how many surveys which would have been useful to monitor and measure the progress of Big Society, have been cut. On Friday, we will visit the Department for Communities and Local Government to present our work so far and hear what they have to say about it. Sometime after that, we will post information about our ‘model’ of Big Society and how it might be measured.
New CRESH research has found that fast food outlets tend to cluster around schools. The work published in the American Journal of Preventive Medicine demonstrated that fast food vendors are five times more likely to cluster around New Zealand schools than in other areas. Using data from four cities, the authors found that outlets are also more likely to be situated in poorer neighbourhoods. The results suggest that the geographical distribution of fast food outlets may be one factor in explaining the increase in obesity rates amongst youths, and its social distribution.
The work has been covered in the New Zealand media. See:
http://www.stuff.co.nz/dominion-post/news/4575897/Schools-out-and-the-junk-foods-in
The academic paper can be found here:
http://dx.doi.org/10.1016/j.amepre.2010.10.018
THE DEADLINE FOR APPLICATIONS HAS NOW PASSED.
We have a new PhD studentship available, based in Glasgow. The closing date for applications is 1st Nov. Please get in touch with Rich Mitchell for details on how to apply.
Title: Does the development of Glasgow’s city structure over time explain its excess mortality?
Duration: 3 year PhD, full time from Jan 2011 (or sooner)
Supervisors: Prof Rich Mitchell, Dr Mark Livingston (Urban Studies, University of Glasgow), David Walsh (Glasgow Centre for Population Health)
Research: Glasgow has particularly poor population health relative to other cities in the UK, and elsewhere in Europe. This apparent ‘Glasgow effect’ is not explained by the high levels of poverty. One possible explanation lies in the physical size of the city’s poorer areas. Some are now so large that residents have to travel quite a long way to experience anywhere that is not deprived. It has been suggested that this spatial pattern of deprivation contributes to poor health in its own right, perhaps explaining why the city has worse health than others with the same deprivation levels. This studentship will trace development of the spatial structure of deprivation in Glasgow, Manchester and Liverpool from 1971 to 2010 to identify any inter-city differences in this development and examine how these are related to Glasgow’s mortality rates. The precise methods and focus will be developed and agreed by the supervisors and student, but the general approach will use GIS. The studentship presents an opportunity for training in researching social geography, public health and health inequalities, and using GIS.
Person specification: Applicants should hold a first class or upper second class degree in a relevant, numerate social science (such as geography) or clinical discipline. Some experience of GIS is essential. A master’s qualification in a relevant discipline would be an advantage.
Award details: This is a 3 full time studentship and will provide an estimated stipend of £13,590 per annum. The award is available to UK and other EU nationals only. The award also covers fees. The award is provided by the Glasgow Centre for Population Health (www.gcph.co.uk)
Further details: More details on the project, the supervisors and the departments involved is available from Prof Rich Mitchell (Richard.Mitchell@glasgow.ac.uk), Dr Mark Livingston (m.livingston@socsci.gla.ac.uk ) or David Walsh (David.Walsh@glasgow.gov.uk ). See also www.gcph.co.uk
CRESH has been awarded a grant from the AHRC Connected Communities programme to look at The Big Society, a key idea underpinning the UKs coalition government. The work will start in January 2011
In a ‘Big Society’, citizens and communities take a vastly increased role in managing, shaping and delivering social and physical infrastructure. The idea is closely allied to notions of community activism and civic participation, and thereby to concepts of social capital and social cohesion. The idea behind Big Society is that not only do social and community problems get ‘fixed’ without direct state intervention; those involved draw social and health benefits from their roles. Measurement of community participation, social support, social capital and civic engagement is well developed at the individual level. However, Big Society places a focus on geographically defined communities such as ‘the neighbourhood’ or ‘your square mile’. Measuring and comparing community participation within neighbourhoods across the country is much harder and less well developed.
Existing literature provides compelling reasons for wanting to follow the progression of Big Society over time. The nature and size of social and environmental problems faced varies between communities. Some communities currently have greater levels of civic engagement than others, and some are probably better placed to begin or grow that kind of participation than others. If Big Society is to become a major route through which problems are solved and life in the UK is improved, it is essential that we understand who and where might benefit most, which communities might lead the way and which might need most help in adapting to the new policy. Monitoring where we start from, and where we go, is an essential component of this important change in the balance between citizens and the state.
If we want to learn whether a policy emphasis on Big Society changes participation in our neighbourhoods and communities, we need to know about how people currently participate. We also need to know this in a way which allows us to monitor how things may change. There is no contemporary picture of existing patterns of engagement, or indeed potential for engagement, across the UK. There is however, a range of existing methods for measuring and estimating levels of social capital or civic engagement within small geographically defined communities.
The objectives of the project are to
A) Identify sources of data on civic engagement, community participation, volunteering and community cohesion which either describe geographical variation in these characteristics across the UK, or which are suitable for producing estimates
B) Consider the candidacy for each of the identified characteristics as a contributor to measuring ‘Big Society’, and determine the small-area units best suited to capturing ‘community’ in this context
C) Identify the most suitable methods for deriving small area measures of community participation and action
Duncan Lee and Rich Mitchell have been awarded a grant from ESRC to try and solve a problem with the methods used to investigate spatial variation in health.
There is great interest in how and why the risks of good or poor health seem to vary from place to place. There are lots of studies which have tried to work out how the characteristics of places and the people who live there may explain why health is worse in some areas than in others. When scientists do this kind of work, they need to take into account the fact that places which are physically closer together tend to be similar to each other; this similarity can have an influence on the statistical tests used and if this problem is ignored, it can lead to the wrong conclusions about how the characteristics of places and the people who live there are related to risks of poor health.
There is a problem however, in that the existing techniques are not sophisticated enough to tell the difference between places that are right next to each other and which actually are very similar, and those which are right next to each other but which are actually quite different. This is a particular problem in cities, where you can get two neighbouring areas that have very different characteristics.
In this project, we intend to develop a method which is able to spot when areas are close together but have different characteristics and when areas which are close together are indeed quite similar. The method will then apply the right kind of statistical approach in each situation. Our project has three parts. First, we will develop the new method. Then we will test it in a way that allows us to see how much better our new approach is than the existing technique. Finally, we will use the method to look at how and why the risks of three different health problems vary in the central belt of Scotland. The health problems will be alcohol problems, lung problems and breast cancer. For each of these health problems we will use our new technique to explore what characteristics of places and the people who live in them, might raise or lower risk. Rather than discovering new factors that might be involved in the risks of these disease, we expect to be able to gain a better understanding of the relative importance of factors which have already been identified. This might help the health service to know what level of ill health to expect in an area, given its characteristics, and hence plan services better, or it might help to identify what aspects of places and their residents need to be changed or helped to reduce risk of poor health.
So, overall the project will make a contribution to methods in this kind of science and will also provides a useful study of some big health problems.
The project starts in October 2010 and will run for 2 years.
Dr Jamie Pearce was part of a team of researchers considering the impact of the introduction of legislation in New Zealand that restricted the places where people can smoke. The results of the study, published recently, suggested that whilst the introduction of the smoking legislation has reduced the rate of hospital admissions due to heart attacks, this effect may be greater in males, older age groups and those living in more affluent neighbourhoods. The research was published in the Australia and New Zealand Journal of Public Health. Reports on the findings have appeared on the BBC, ITV, national newspapers as well as various international media outlets. For example, see:
CRESH 