Overview
Nia is a Postdoctoral Research Associate in Health Economics. Her research considers the impact of loneliness on health and social care, with a particular focus on young adults. She also has interests in patient preferences and valuation of health and quality of life outcomes. Nia joined the Health Economics Group as a Graduate Trainee Assistant in 2018 assisting in a number of ongoing projects across the department. Prior to joining the team Nia completed degrees in economics alongside undertaking internships with both central and local government departments.
Qualifications
- BA Economics and History, University of York (2016)
- Graduate Diploma in Economics, University of Bristol (2017)
- MSc Economics, University of Exeter (2018)
Career
2018-19 - Graduate Trainee Assistant in Health Economics
2019-20 - NIHR Pre-Doctoral Fellowship
2020-22 - NIHR Health Technology Assessment
2022-23 - Postdoctoral Research Associate in Health Economics
2023-Present - Postdoctoral Research Fellow in Health Economics
Research
Research interests
Nia's research considers the impact of loneliness on health and social care, with a particular focus on young adults. She also has interests in patient preferences and valuation of health and quality of life outcomes. She has expeience in discrete choice experiments and economic evaluation for trials in sub-Saharan Africa, adolescent mental health, and dementia.
Research projects
2018-2019 - Graduate Trainee Assistant. Two feasibility trial-based economic evaluations and a psychometric assessment of generic preference based masures.
2019-2020 - NIHR Pre-Doctoral Fellowship. Investigating loneliness, health and unemployment: systematic reviews and observational data analysis through propensity score matching.
2020-2022 - NIHR HTA project. 'Evaluating the effectiveness and cost-effectiveness of gynaecological surveillance for women with Lynch syndrome: systematic reviews and economic evaluation'.
2022-2023 - 'A comparison of usual care versus usual care plus a smartphone self-harm prevention app (BASH) in young adolescents aged 12-17 who self-harm.'
2022-2023 - 'A randomised controlled trial to reduce the burden of malaria and curable STIs / RTIs in Zambia: the ASPIRE trial.'
2023-present - 'Dementia person aligned care team (D-PACT) - dementia support study feasibility trial.'
2022-present - 'The clinical, social and cost effectiveness of a decision support tool to optimise community-based tailored management of sleep for people living with dementia or mild cognitive impairment and sleep disturbance TIMES –TaIlored ManagEment of Sleep.'
2023-present - 'Social Prescribing for people to Live ENjoyably with Dementia/memory problems In Daily life (SPLENDID).'
2023-present - 'A cluster randomised trial to evaluate the effectiveness of household alcohol-based handrub for the prevention of sepsis, diarrhoea and pneumonia in Ugandan infants (BabyGel).'
Research grants
- 2019 National Institute for Health Research
NIHR Pre-Doctoral Fellowship. Research investigated the interactions between loneliness, health and the economy. Training included causal inference, qualitative research methods, questionnaire design.
Publications
Journal articles
Snowsill T, Coelho H, Morrish N, Briscoe S, Boddy K, Smith T, Crosbie EJ, Ryan NAJ, Lalloo F, Hulme CT, et al (In Press). Effectiveness and cost-effectiveness of gynaecological cancer surveillance in Lynch syndrome: Systematic reviews and economic evaluation. Health Technology Assessment
Heather A, Goodwin E, Green C, Morrish N, Ukoumunne OC, Middleton RM, Hawton A (2023). Multiple sclerosis health-related quality of life utility values from the UK MS register.
Multiple Sclerosis Journal - Experimental, Translational and Clinical,
9(2).
Abstract:
Multiple sclerosis health-related quality of life utility values from the UK MS register
Background New interventions for multiple sclerosis (MS) commonly require a demonstration of cost-effectiveness using health-related quality of life (HRQoL) utility values. The EQ-5D is the utility measure approved for use in the UK NHS funding decision-making. There are also MS-specific utility measures – e.g. MS Impact Scale Eight Dimensions (MSIS-8D) and MSIS-8D-Patient (MSIS-8D-P). Objectives Provide EQ-5D, MSIS-8D and MSIS-8D-P utility values from a large UK MS cohort and investigate their association with demographic/clinical characteristics. Methods UK MS Register data from 14,385 respondents (2011 to 2019) were analysed descriptively and using multivariable linear regression, with self-report Expanded Disability Status Scale (EDSS) scores. Results the EQ-5D and MSIS-8D were both sensitive to differences in demographic/clinical characteristics. An inconsistency found in previous studies whereby mean EQ-5D values were higher for an EDSS score of 4 rather than 3 was not observed. Similar utility values were observed between MS types at each EDSS score. Regression showed EDSS score and age were associated with utility values from all three measures. Conclusions This study provides generic and MS-specific utility values for a large UK MS sample, with the potential for use in cost-effectiveness analyses of treatments for MS.
Abstract.
Morrish N, Mujica-Mota R, Medina-Lara A (2022). Understanding the effect of loneliness on unemployment: propensity score matching.
BMC Public Health,
22(1).
Abstract:
Understanding the effect of loneliness on unemployment: propensity score matching
Abstract
. Background
. Loneliness and unemployment are each detrimental to health and well-being. Recent evidence suggests a potential bidirectional relationship between loneliness and unemployment in working age individuals. As most existing research focuses on the outcomes of unemployment, this paper seeks to understand the impact of loneliness on unemployment, potential interaction with physical health, and assess bidirectionality in the working age population.
.
. Methods
. This study utilised data from waves 9 (2017–19) and 10 (2018–2020) of the Understanding Society UK Household Longitudinal Study. Nearest-neighbour probit propensity score matching with at least one match was used to infer causality by mimicking randomisation. Analysis was conducted in three steps: propensity score estimation; matching; and stratification. Propensity scores were estimated controlling for age, gender, ethnicity, education, marital status, household composition, number of own children in household and region. Findings were confirmed in panel data random effect models, and heterogeneous treatment effects assessed by the matching-smoothing method.
.
. Results
. Experience of loneliness in at least one wave increased the probability of being unemployed in wave 10 by 17.5 [95%CI: 14.8, 20.2] percentage points. Subgroup analysis revealed a greater effect from sustained than transitory loneliness. Further exploratory analysis identified a positive average treatment effect, of smaller magnitude, for unemployment on loneliness suggesting bidirectionality in the relationship. The impact of loneliness on unemployment was further exacerbated by interaction with physical health.
.
. Conclusions
. This is the first study to directly consider the potentially bidirectional relationship between loneliness and unemployment through analysis of longitudinal data from a representative sample of the working age population. Findings reinforce the need for greater recognition of wider societal impacts of loneliness. Given the persisting and potentially scarring effects of both loneliness and unemployment on health and the economy, prevention of both experiences is key. Decreased loneliness could mitigate unemployment, and employment abate loneliness, which may in turn relate positively to other factors including health and quality of life. Thus, particular attention should be paid to loneliness with additional support from employers and government to improve health and well-being.
.
Abstract.
Morrish N, Medina-Lara A (2021). Does unemployment lead to greater levels of loneliness? a systematic review. Social Science & Medicine, 287
Conferences
Morrish N, Medina-Lara A (2023). The cost of loneliness. Tackling Loneliness for a New Era of Connection. Campaign to end Loneliness International Conference. 2nd - 2nd Feb 2023.
Morrish N, Medina-Lara A (2021). Understanding the effect of loneliness on employment status. Loneliness Beyond Covid-19. Campaign to end Loneliness International Conference. 18th - 18th Nov 2021.
Morrish N, Medina-Lara A (2019). What is the impact of loneliness on paid work and unemployment in European OECD member countries?. International Health Economics Association. 13th - 17th Jul 2019.
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