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Job Opportunity at CRESH

We are looking to appoint a Postdoctoral Researcher in the field of ‘Environment and Health for a period of 4 years to contribute a UK Prevention Research Partnership (UKPRP) Consortium – SPECTRUM (Shaping Public hEalth poliCies To Reduce ineqUalities and harm) https://www.ed.ac.uk/spectrum.   SPECTRUM has an ambitious programme of research, knowledge exchange and public engagement focusing on the commercial determinants of health relating to tobacco, alcohol and food.

The successful candidate will play a lead role in a programme of work aiming to identify how the local environment can be shaped to change behaviour, prevent harm and reduce inequalities. The aim is to examine the intended and unintended impacts of (and interventions in) the local commercial environment on the consumption of unhealthy commodities. The focus of this role will be to conduct spatial and quantitative analyses, contribute to final publications and help to accelerate the impact of the research.

For further details – including how to apply – can be found here.

What next for tobacco control in Scotland?

New research from the CRESH team using data from 124,566 shopping baskets purchased in convenience stores across Scotland has found that the purchase price of tobacco is lower in more disadvantaged neighbourhoods, largely because of the higher sales of the cheapest brands in these areas.

Cigarette smoking is one of the leading causes of preventable ill-health, hospitalisations and deaths in Scotland. Approximately 19% of adults in Scotland smoke, this rises to 32% in our most deprived fifth of neighbourhoods and falls to 9% in the most affluent neighbourhoods. As Scotland moves towards a ‘Tobacco Endgame’ the Scottish Government have a target to reduce smoking prevalence to less than 5% by 2034. A recent review of smoking projections by CRUK however suggests that Scotland may miss this target by 16 years in the poorest neighbourhoods. It is important that we continue to explore all potential determinants of smoking, particularly those that drive smoking in our most deprived communities.

We know that tobacco price is one of the most important determinants of smoking behaviour and that many smokers are price sensitive. Whilst it may appear that all tobacco products are becoming increasingly expensive, research suggests that the average tobacco price in the UK has remained relatively unchanged in real terms over the past 20 years in spite of numerous tax increases. A practice, known as ‘undershifting’, has seen tobacco companies limit price increases on the cheapest brands and instead increase the price of the most expensive brands by larger margins, thus absorbing the tax increases on the cheapest cigarettes allowing them to remain cheap (Hiscock et al. 2018).  As a result, the price of the lowest priced cigarette brands has remained relatively steady and the tobacco market as a whole has become increasingly stratified by price between the cheapest ‘sub value’ , ’value’, ‘mid price’ and high priced ‘premium’ brands. We wanted to understand these differentials in price a little better, so we carried out some research that was published recently in Tobacco Control. We explored whether the price paid for tobacco (both cigarettes and roll your own tobacco) was different in different types of neighbourhoods. We compared areas by deprivation, by the density of tobacco outlets and by rurality.

We analysed tobacco purchase data provided to us by The Retail Data Partnership. We looked at more than 124,000 purchases in 274 stores across Scotland in April 2018. For cigarettes the average price paid for a pack of 20 was £8.49, ranging from £7.20 to £13.25. For roll your own tobacco (RYO) 30g the average price paid was £12.14, with prices ranging from £9.80 to £15.99. We found that the price paid for tobacco did vary by neighbourhood type. In neighbourhoods with the lowest average household income the average purchase was 50p less for a pack of 20 cigarettes, and 34p less for roll your own tobacco compared with the most affluent neighbourhoods.

We then asked whether this was driven by individual brands being cheaper in more deprived areas, or whether cheaper, sub-value, brands were just more popular in such places. We found little evidence that individual brands were priced differently. Although the cheaper brands are the most popular in all neighbourhoods and across Scotland, accounting for 52% of sales, there’s a big difference in popularity between more and less deprived areas, In the most deprived areas these brands account for 58%  of sales, but in most affluent areas it was just 39% (See Figure 1 below). So, it is the dominance of cheaper brands in more deprived areas that drives the 50p difference in average price paid per pack between deprived and affluent areas. Remember this matters because the tobacco companies work to subdue tax-based price rises on the cheapest brands.

We also explored whether the density of tobacco retailers and/or rurality had an impact on tobacco price. We found little evidence of a density effect, but we did find that the individual brands analysed were significantly cheaper in rural areas.

So what does this mean and what can we take from this research? It is clear from the CRUK review that we need to work harder in order to reach the 2034 target of less than 5% of the population smoking. Price is a lever that we can pull, but to date this has been largely done through tax increases. This research shows us that the cheapest brands are the most popular in all neighbourhood types, but much more so in our most deprived neighbourhoods where smoking rates are highest. We found that the price paid for tobacco is lower in more deprived areas compared to more affluent areas. Our results confirm that the dominance of cheaper, so called ‘sub-value’ brands in more deprived areas, is a driving force behind the difference in price paid for tobacco between neighbourhoods. This highlights the importance of cheaper tobacco products to the consumer and the market.  Cheap tobacco may help tobacco companies to retain price sensitive consumers who live in the most deprived areas, which, in turn, contributes to health inequalities. In addition to increases to the duty rates on tobacco, more radical policy responses are likely to be required. These include a combination of minimum unit pricing (MUP) and a price cap at the upper end. The MUP would raise the cost of cheaper cigarettes and the price cap at the upper end would prevent the more expensive brands being used to ‘protect’ the cheaper ones from tax rises.

With growing international interest in the ‘Tobacco Endgame’, policymakers should identify measures that counter industry tactics that enable the continued sales of cheap tobacco. We published this paper in the first week of the COVID-19 pandemic in the UK. These are clearly strange times and we should rightly focus on the public health impacts of the global pandemic, and in particular the vast health inequalities that are arising. We must not however forget that the public health challenges we were faced with before this pandemic remain. Tobacco, and other unhealthy commodities, require our attention and the inequalities that arise from them remain a matter of social justice.

You can find the paper here:

Shortt, N., Tunstall, H., Mitchell, R., Coombes, E., Jones, A., Reid, G. & Pearce, J. Using point-of-sale data to examine tobacco pricing across neighbourhoods in Scotland. Tobacco Control, Published Online First: 19 March 2020. doi: 10.1136/tobaccocontro

References

Hiscock R, Branston JR, McNeill A, et al. Tobacco industry strategies undermine government tax policy: evidence from commercial data. Tob Control 2018;27:488 LP – 497. doi:10.1136/tobaccocontrol-2017-053891

Two Postdoctoral Researchers (Health & Environment)

We are currently seeking to recruit two Postdoctoral Researchers (Health & Environment) to join the CRESH team at the University of Edinburgh and contribute to two studies on the geography of unhealthy commodities.

The first position is part of the UK Prevention Research Partnership (UKPRP) Consortium – SPECTRUM (Shaping Public hEalth poliCies To Reduce ineqUalities and harm). SPECTRUM has an ambitious programme of research, knowledge exchange and public engagement focusing on the commercial determinants of health relating to tobacco, alcohol and food.

The second role will contribute to an ESRC funded project ‘Change in alcohol and tobacco availability, population health and the lived experience’ which will measure change in the availability of alcohol and tobacco in Scottish neighbourhoods over time and explore how this change relates to health outcomes and how residents experience the availability of alcohol and tobacco in their neighbourhoods.

Closing date for both positions is 16th October 2019.

Please get in touch with Professor Jamie Pearce or Professor Niamh Shortt to discuss either role: Jamie.Pearce@ed.ac.uk Niamh.Shortt@ed.ac.uk

https://www.jobs.ac.uk/job/BVI122/postdoctoral-researcher-health-and-environment-tobacco-and-alcohol

https://www.jobs.ac.uk/job/BVI153/postdoctoral-researcher-health-and-environment

New ESRC funded study on Tobacco and Alcohol

We are delighted to announce that we have been awarded funding from the ESRC for a project exploring tobacco and alcohol environments in Scotland. The project ‘Change in alcohol and tobacco availability, population health and the lived experience’ will be funded for 3 years, beginning December 2019 for a total of £761, 470. The project will be led by Professor Niamh Shortt with co-investigators from the University of Edinburgh (Professor Jamie Pearceand Dr Tom Clemens), Glasgow Caledonian University (Professor Carol Emslie) and the MRC/CSO Social and Public Health Sciences Unit, University of Glasgow (Professor Richard Mitchell).

This research will measure change in the availability of alcohol and tobacco in Scottish neighbourhoods over time and explore how this change relates to health outcomes and how residents experience the availability of alcohol and tobacco in their neighbourhoods. The findings will be important because smoking and alcohol consumption are leading causes of illness and death. In Scotland smoking causes one in every 5 deaths and one in 20 deaths is related to alcohol. This harm is not equally shared; those on the lowest incomes suffer the greatest harm. These illnesses and deaths are preventable. The World Health Organisation recommends that nations prioritise interventions that reduce the supply of alcohol and tobacco.

Why might neighbourhood supply of alcohol and tobacco matter? Research suggests that when there are a lot of outlets in a neighbourhood this impacts upon consumption in three ways. 1. The outlets may be more competitive and drive prices down to attract customers. 2. Oversupply may normalise the products when they are sold alongside everyday commodities, such as bread and milk. 3. Tobacco and alcohol may simply be easier to buy in areas where there are more outlets.

In order to explore the relationship between supply, behaviour and harm we need data on the location of every outlet in Scotland selling tobacco and/or alcohol. Ideally, to be able to say something about whether the relationship may be causal, we need this data over time. We have already collected data on the specific location of every outlet selling tobacco and licensed to sell alcohol over multiple time periods (2012 and 2016 (nationwide alcohol and tobacco – see paper here) and 2008 (alcohol in four cities – see paper here)). As part of this project we will collect updated data for 2019/20. This will allow us to measure this change over time. Using an approach called trajectory modelling we will group neighbourhoods that have had a similar degree of change; some neighbourhoods may have lost, or gained, local shops or pubs, whereas some may not have changed at all. We will then identify features of these neighbourhoods that may be driving this change, for example the age profile of the population or poverty levels. This will help policy makers understand the drivers of change in our neighbourhoods.

To measure the relationship between changing supply and harm we will link these trajectories, and our measures of availability at each time point, to alcohol and tobacco health outcomes (behaviour, illness and death). We will use statistical models to see whether areas experiencing an increase or decrease in outlets have seen a corresponding increase or decrease in these outcomes. This will allow us to get a better understanding of whether an over supply of alcohol and tobacco is related to smoking and alcohol consumption and harm. These findings will provide important evidence related to the provision of such commodities in our neighbourhoods.

Although these statistics are important to report we also need to understand why an oversupply of alcohol and tobacco may influence behaviour and harm. Whilst the literature suggests the pathways listed above, we know little about the experiences of individuals living in neighbourhoods with contrasting availability. We don’t understand the individual experience of any of these pathways. Professor Carol Emslie will lead a qualitative work package and researchrs will meet with groups of individuals, in neighbourhoods of contrasting trajectories, to talk to them about the supply of alcohol and tobacco. We will explore their experiences of neighbourhood and assess how their perceived notions of their neighbourhood availability contrast with our statistical measures. Finally, we will meet with residents, retailers and policy stake-holders to explore potential interventions related to supply. Policies at this level require public, retailer and political support. We will discuss the priorities held by various groups, present our quantitative results and gauge attitudes towards potential interventions.

Throughout the project will be committed to knowledge exchange, public events and speaking with non academic partners. If you wish to know more about this research, or would like one of the researchers to come to your organisation to provide you initial findings (once the project is under way) then contact the Principal Investigator here: niamh.shortt@ed.ac.uk

Liveable urban environments: an opportunity or threat to reducing health inequities?

Creating ‘liveable’ urban environments is seen as an important way of improving the health and wellbeing of the residents in our towns and cities. Yet it is not clear whether the focus amongst planners and other policymakers on fashioning liveability is an opportunity – or threat – to reducing health inequities. On the one hand improving the resources and infrastructure in local communities might benefit everyone but particularly those who are most dependent on what is close by. On the other hand, it is possible that if liveability interventions are poorly or unevenly implemented, or inappropriate to the particular needs of the local population, then health inequities may widen. This issue was the focus of our new research recently published in Social Science & Medicine where we found evidence that some aspects of liveability have reduced inequities, whereas other aspects have not led to a reduction, or in some cases even increased, health inequities.

The notion of liveability has been around for a long while and is underpinned by the United Nation’s New Urban Agenda. The aim is to ensure equitable delivery of sustainable urban development – including local infrastructure and services, and housing amongst many other urban features – and to improve the living social and physical conditions for urban dwellers, including their health. Given these important and laudable goals it is perhaps surprising that so few studies have looked at what effects liveability has on health inequities. Health inequities continue to increase across many countries, including the UK and Australia; identifying what works in the long-term to reduce health inequities remains a policy priority for many national governments and international agencies.

In our new work we examined the international evidence to see when and where urban liveability might pose an opportunity or threat to reducing health inequities. We looked across a series of urban liveability features (education; employment; food, alcohol, and tobacco; green space; housing; transport; and walkability) and asked whether intervening on these aspects of place can serve to widen or narrow inequities.

Our findings show that the urban liveability agenda offers opportunities to help address health inequities but the effects differ from place to place. It was also clear that we need to keep in mind that urban liveability is just one part of a much broader urban system; whilst improving aspects of urban liveability can improve the health for some populations in a local area, it may not be the case for others. In some cases, the health benefits of urban liveability are restricted to specific (and sometimes more prosperous) communities. In fact, in more extreme cases urban liveability interventions can result in local people being pushed out of their community (e.g. through associated hikes in rental prices), with negative implications for their health and wellbeing.

We believe that the findings from this research include some important messages for policymakers and urban planners tasked with identifying ways to improve people’s health and reduce health inequities. Designing our neighbourhoods to become more liveable offers some significant opportunities to enhance health. However, it is also apparent liveability interventions need to be implemented in ways that meet the needs of all population groups living in the area, including the most vulnerable. As researchers, it is important that we continue to monitor the impact of liveability interventions on inequities and seek a better understanding of how these issue relate to the wider urban and social systems affecting our health.

Hannah Badland & Jamie Pearce

CRESH seminar – Bombarded by Booze

Title: Bombarded by Booze: Children’s real-time exposure to alcohol marketing using wearable cameras and GPS devices

Presenter: Professor Louise Signal, University of Otago, Wellington, New Zealand

Description: This presentation highlights innovative New Zealand research with children using wearable cameras and GPS devices to capture the extent and nature of their exposure to alcohol marketing.

When: Thursday 31st January, 11-12

Where: Lister Learning and Teaching Centre – 2.14 – Teaching Studio, 5 Roxburgh Pl, Edinburgh EH8 9SU

GIS job – come and work with us

We have a great job going. It’s at the MRC/CSO Social and Public Health Sciences Unit in Glasgow. Your role will be within the Neighbourhoods and Communities Programme . Your job will be to support the Programme Leader in developing research furthering our understanding of how social and physical environment might improve public health and reduce health inequalities. We’re looking for someone who can use GIS and write code. Specifically, you will be obtaining and preparing large spatial datasets, manipulating them in GIS, writing project specific code in a general purpose programming language, preferably Python or R, and carrying out research examining relationships between environment and population health. This job requires the ability to create and code innovative solutions to data handling and data analysis problems. Plenty of chances to contribute to publications and grant applications too. No need to have a PhD – we’re more interested in your skills…. 

More details, including how to apply, how much you could get paid etc here.

The closing date for applications is 22nd October.

Rich Mitchell would be delighted to discuss the post with you.

 

 Main Duties and Responsibilities

Perform the following activities in conjunction with and under the guidance of the Principal Investigator (PI):

1. Plan and conduct assigned research into environment and health, individually or jointly in accordance with the programme’s development strategy.

2. Contribute to the development and implementation of new methods and approaches to understanding how neighbourhood environments do, and might, affect health.

3. Develop, test and implement custom scripts/code to enable the handling and analysis of large spatial datasets.

4. Document research output including analysis and interpretation of all data, maintaining records and managing databases, drafting technical/progress reports and papers as appropriate.

5. Contribute to the organisation, supervision, mentoring and training of undergraduate and/or postgraduate students and less experienced members of staff of the project team to ensure their effective development.

6. Develop and enhance your research profile and reputation and that of The University of Glasgow, SPHSU and Neighbourhoods and Communities Programme, including contributing to publications of international quality in high profile/quality refereed journals, enhancing the research impact in terms of economic/societal benefit, and gathering indicators of esteem.

7. Contribute to the presentation of work at international and national conferences, at internal and external seminars, colloquia and workshops to develop and enhance our research profile.

8. Contribute to the identification of potential funding sources and assist in the development of proposals to secure funding from internal and external bodies to support future research.

9. Collaborate with colleagues and participate in team/group meetings/seminars/workshops across SPHSU/Institute of Health and Wellbeing/ University and wider community (e.g academic partners).

10. Perform administrative tasks related to the activities of the research group including budgets/expenditure.

11. Contribute to outreach activities of the University of Glasgow.

12. Carry out modest teaching activities (e.g demonstrating etc) and associated administration as assigned by the Directors of cognate Research Institutes and in consultation with Principal Investigators.

13. Keep up to date with current knowledge and recent advances in the field/discipline.

14. Engage in personal, professional and career development to enhance both specialist and transferable skills in accordance with desired career trajectory.

15. Undertake any other duties of equivalent standing as assigned by Directors of cognate Research Institutes and/or PIs.15. Contribute to the enhancement of the University’s International profile in line with the Strategic Plan, Glasgow 2020 – A Global Vision.

Salary Range£28,098 – £31,604 per annum

Why Places Matter for our Wellbeing

The following post is an interview with Professor Jamie Pearce and Professor Sarah Curtis about how our surroundings affect our health. It was originally posted in April 2017 in the build up to the Edinburgh Science Festival.

What might the audience expert to learn from this event?

While there are many things we can do as individuals to improve our health and wellbeing, action to create a healthier environment also requires community, societal and political responses. We will report on research that explores how and why the places where we live, work and play affect our mental health, and, with the help of the audience, identify some likely ways to make our environment healthier.

green_space_image

People might expect that being in pleasant surroundings can lift our moods, but please can you briefly outline how your research goes beyond this?

We know from lots of research over many years that the places in which we live, work and play can be both beneficial and detrimental to our health and mental wellbeing. Our research has shown that ‘therapeutic’ properties of places include high levels of community cohesion, availability and accessibility of high quality green spaces, and investment in infrastructure to support physical activity, such as cycle paths.

On the other hand, places can be damaging to our mental health if, for example, they are characterised by high levels of crime, pollution, poor physical conditions and a lack of secure and rewarding employment opportunities. Our research also explores how different groups vary in their response to their environment. For instance, the mental health benefits of living in a greener environment are greater for those who are relatively poor, as compared with for wealthier groups. This finding is important, since the Scottish Government and other policymakers need to know what works in terms of environmental planning to reduce health inequalities.

Why is now a good time to highlight the findings of your work?

Like many other countries, mental health in Scotland is a major public health challenge. We know that many mental health outcomes are significantly poorer in Scotland than they are in England. It is estimated that around one in three people are affected by mental illness in any one year. People in the most socially disadvantaged communities are disproportionately affected. For example, our work has shown that adults living in the most deprived parts of Scotland are almost three times as likely to have common mental health problems as those in the least deprived areas.

It is no wonder that improving mental health is a priority for the Scottish Government and is one of 55 national indicators chosen to chart the country’s progress towards the achievement of our National Outcomes – wellbeing targets set by the Scottish Government.

Can you give one or two examples of how people might make simple changes to their surroundings to improve their wellbeing?

Our research has shown very clearly that so much to do with our health is outside of our personal control. To make substantial improvements to our health – including mental wellbeing – requires us to think and act collectively. As individuals, we can get involved in helping to make the places we live more supportive for mental health and wellbeing through getting involved in community initiatives, making therapeutic spaces more accessible, and ensuring our workplaces are supportive.

Can you highlight one or two outcomes from your research that have surprised you?

One of the most fascinating findings from our recent research is that the circumstances early in our lives can have lasting lifelong implications. For example, we have found that characteristics of the places we live during our childhood years can affect mental health and cognitive ageing much later in life. These findings change the way in which we think about the relationships between places and health; to date we have probably not appreciated quite how important places are for our health over our whole lives. It also means that changes we make to our environment now to make places better for mental health are likely to benefit the next generation as well as ourselves.

What is your motivation for bringing your research to the Science Festival?

We think that improving mental health is a major challenge for Scotland and other countries in the UK. To make substantial and sustained progress will require some joined-up thinking, which recognises that mental health is influenced by a range of social, political and environmental factors in our communities. Having conversations about these issues, and identifying possible solutions to such important challenges, is an important way of helping to make sure that important research findings are acted on.

Call for papers – Health & place across the life course – AAG, Boston, April 2017

We’re organising a session entitled Health and Place Across the Life Course at the Association of American Geographers Annual Meeting in Boston, MA, April 5-9 2016. If you’re interested in contributing a paper then please get in touch. Further details here:

Session title: Health and place across the life course
Session organisers: Niamh K Shortt and Jamie Pearce, Centre for Research on Environment, Society & Health, University of Edinburgh.

Life course research has been instrumental in establishing that social, economic and cultural factors can influence health in later life either through, for example, an accumulation of effects or through critical periods.  There has however been little work by health geographers that has considered how factors that are rooted in place accumulate to influence health and wellbeing through the life course. Reasons for this may include the lack of readily available historical environmental data and the challenges that their collection pose. The absence of such research is problematic because it is likely to restrict our understanding of the ways in which places matter for health, including: the accumulative effects of place over the life course; the critical periods in people?s lives when places are particularly pertinent for health and wellbeing; and, for quantitative work, identifying causal relationships.

This session calls for research papers that incorporate environmental and/or social life course perspectives in order to answer these critical questions.  We welcome both empirical (quantitative or qualitative) and theoretical papers. We particularly welcome papers that consider the challenges of merging historical and contemporary data in health and place research.  Abstracts (maximum of 250 words) should be submitted to Niamh Shortt niamh.shortt@ed.ac.uk  by September 30th 2016.

All accepted participants will be required to register and submit your abstract to the AAG following the AAG guidelines http://www.aag.org/cs/annualmeeting/register and to send your PIN number to niamh.shortt@ed.ac.uk  by October 27, 2016.