Public Health Economics

• COPPER: CO-designing for healthy People and Planet: food Economic policy Research is investigating the impact of tax and subsidies on people's health.
• The aim is to co-design tax and subsidy scenarios with public and policymakers.
• We will develop a research infrastructure of linked datasets and integrated health, economic and environmental models.
• This will allow us to estimate the impact of six potential tax and subsidy scenarios, and communicate our results with the public and policymakers.

• We are evaluating whether planning policies to regulate takeaway food outlets can lead to improved health in England.
• Our main research question is: “What is the impact of exclusion zones on the number of takeaways?”
• Using a dataset of all food outlets in England, we will compare takeaway numbers in areas with and without exclusion zones, two years before and after zones are introduced. We will also study areas just outside zones in case takeaways are displaced there.
• Any health impacts of zones are likely to be small and take a long time to occur. We will use statistical modelling to estimate the impact of zones on obesity and health.

• The Burden of Disease (BOD) of Chemical Contaminants and Toxins in Food study aims to understand the economic implications of contaminants and toxins in food.
• We are synthesising the current evidence to estimate the Monetary Value of Disability Adjusted Life Years (MVDALYs) lost from foodborne toxins in the UK.
• Contaminants we are looking at include foodborne aflatoxins (AFTs), lead, ochratoxin A (OTA) and seafood toxins.

• Bethany Parkes' NIHR SPHR PhD Studentship seeks to explore the affordability of healthy and unhealthy diets as a whole, and to what extent the price of food is a key driver of food choice. 

• Our study found a bi-directional (and potentially self-reinforcing) relationship between loneliness and unemployment.
• This relationship is particularly prevalent in early and middle-aged adults, and people who reported a more severe or persistent experience of loneliness.
• Loneliness impacts both current and future unemployment. We found that working-age adults who reported frequently feeling lonely were 17.5 percent more likely to be unemployed up to three years later.
• The study results were reported in The Independent.

• Disabled people face significant barriers to accessing meaningful employment (‘good work’), our research has found.
• Persistent negative attitudes, stereotypes and misperceptions are a key driver of the disability employment gap.
• Anti-discrimination legislation (e.g. the Disability Discrimination Act) has had no effect on improving disability employment.
• Disabled people benefit more from flexible working conditions –  but non-disabled people do value flexibility too.

Impact on local businesses

• This research informed the Inclusivity Project: a collaboration of perspectives, bringing academics and small businesses into conversation with the lived experience of local people in Cornwall and the Isles of Scilly.
• We worked with and researched small, medium and micro enterprises to generate a better understanding of some of the challenges and opportunities in creating inclusive places to work for people who are aged 50+, who were disabled, and/or had a long-term health condition.

• The principal objective of this study is to find out if providing alcohol-based hand rub (ABHR) to pregnant women for them to use at home after giving birth, is effective at preventing severe illness or death during their baby's first 3 months of life.
• Over 60 months, an open, 2-arm cluster randomised trial with rural villages will be conducted.
• Pregnant women will be recruited from homes within 72 study villages in Mbale region, Eastern Uganda.
• The economic component of the BabyGel trial will look at the cost and health benefits of alcohol-based hand rub and assess the health inequalities among recruited women.

• Francis Okello's Horizon 2020 PhD Studentship aims to understand the demand and supply implications of providing hand hygiene among mothers in eastern Uganda.
• Francis is exploring the availability, affordability and preference of Ugandan mothers around using hand gel, when compared to normal hand hygiene practices in rural Uganda. 

• Malaria in pregnancy can have devastating consequences for a mother and foetus.
• The ASPIRE trial: Aiming for Safe Pregnancies by Reducing Malaria and Infections of the Reproductive Tract, aims to find out whether a specific combination of drugs can reduce the impact of malaria, bacterial vaginosis (BV), and Trichomonas vaginalis (TV) infections during pregnancy, for women in Zambia.
• The trial is testing whether combining metronidazole (MTZ) with intermittent preventive treatment of malaria in pregnancy using sulphadoxinepyrimethamine (IPTp-SP) or dihydroartemisinin-piperaquine (IPTp-DP) is superior to using IPTp-SP alone.
• The economic component of the ASPIRE trial will look at the cost and health benefits of the intervention. It will also assess the relative importance of the intervention characteristics to women in Zambia.

• Sleep disturbance often affects people living with dementia or memory problems, and can make it difficult for carers to cope.
• We are investigating the cost-effectiveness of a decision support tool to produce tailored care plans that meet the sleep-related needs of people with dementia or memory problems and their carers.
• The TIMES –TaIlored ManagEment of Sleep in dementia - project is developing and testing this tool using a small initial trial of 64 people across eight sites in England.

• Currently, a range of services and roles exist to support people with dementia and their carers.
• These services are often valued, but there is a lack of evidence about what type of support is most effective, and where it is best delivered. This can make commissioners and providers reluctant to invest in services.
• The Dementia PersonAlised Care Team (D-PACT) project, led by the Universities of Plymouth and Manchester, is developing and evaluating a system for dementia support based within general practice, that will provide post-diagnosis care for people with dementia and their carers.
• Our role in the project is to research and enhance the cost-effectiveness of the D-PACT intervention. We are also measuring its potential economic value and impact. 

• Beating Adolescent Self-Harm (BASH) is a randomised controlled trial testing whether adding a smartphone self-harm prevention app (BlueIce) to usual care can reduce self-harm in young adolescents aged 12– 17.
• We worked with young people to co-design the app, to help manage urges to self-harm.
• BlueIce includes a mood diary, menu of personalised mood-lifting activities and safety checks to delay or prevent self-harm.