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Impact: Health and welfare; raised awareness of childhood pneumonia as the largest single cause of global childhood mortality, which has led to increased investment and action. Global deaths have reduced from 2.01M (in 2002) to 1.58M (2008) and 1.26M (2011).
Significance: Global child pneumonia mortality (2008-2013) showed about 1M deaths fewer than if 2008 levels had persisted throughout this period.
Attribution: Campbell and Rudan (UoE) derived global pneumonia incidence and mortality estimates as the pneumonia technical experts for the WHO / UNICEF Child Health Epidemiology Reference Group.
Beneficiaries: Young children and families, international agencies, Ministries of Health.
Reach: Global (>170 countries on all continents, especially low- and middle-income countries).
LSHTM research led to the development of a computer-based tool known as the Lives Saved Tool (LiST), which has been made available to international organisations, governments and NGOs free of charge. It allows policy-makers and programme managers in the 75 countries with the highest number of child deaths to identify which policy and programme choices are likely to have the greatest impact in cutting neonatal and child mortality. Since its 2008 launch, LiST has been used widely by international agencies, foundations, bilateral agencies, large NGOs and individual countries to determine investment priorities and programme choices.
Health Technology Assessment (HTA) is a systematic approach to evaluating the safety, clinical and cost effectiveness of a drug/medical intervention into the NHS. Research and practice of HTA enabled Liverpool University to significantly impact and influence national and international health policy by optimising NHS decision-making on drug adoption and other clinical interventions, as well as disseminating HTA expertise and application around the globe. Reach is both geographical and organizational, spanning the UK NHS, the European, African and Asian healthcare systems, as well as with members of the Pharmaceutical industry. Numerous populations, from patients of the UK NHS, to world-citizens, benefit as a consequence of the application of health economics research.
Impact type: Public Policy
Significance: The research provided evidence for formulation of government policies to ameliorate poor air quality, to which fine particulate matter (PM2.5), O3 and NO2 are the most important contributors; PM2.5 alone reduces average life expectancy in the UK by 6 months and costs £9bn-£20bn a year. The research has been incorporated into UK national guidance and policy-evidence documents for Defra, the Health Protection Agency, and the Environment Agencies.
Beneficiaries are the public and the environment.
Research; date; attribution: EaStCHEM research (1995-2011) (a) established reliable techniques to measure NO2 for a national protocol, and (b) quantified the impact of pollutant emissions on PM2.5 and O3 concentrations, and on hospital admissions and deaths. Heal (EaStCHEM) led the research and wrote, collaboratively in some cases, the reports and the work cited.
Reach: UK wide.
A sustained programme of epidemiological research at St George's, spanning 20 years, has informed air pollution control policies in the UK and internationally. Time-series studies of the acute health effects of daily fluctuations in air pollutants, initially in London, were extended to Europe-wide collaborations, trans-Atlantic comparisons and studies in Asian cities. Publication bias has been explored systematically in meta-analyses of published time-series results, and the adverse effects of different particulate fractions compared in a UK setting. This evidence base has contributed substantially to the current UK Air Quality Strategy and informs ongoing debates about health impacts of shorter-lived "greenhouse" pollutants.
Research conducted by Davies et al within the UCL Bartlett's Complex Built Environment Systems (CBES) group on built environment choices and their implications — particularly for energy use and health — has contributed to a fundamental shift in global understanding of the possible health impacts of carbon mitigation measures, and has informed key policy formulation relating to this. At regional and national levels, research by CBES has informed London's Climate Change Adaptation Strategy, and led to changes in the Building Regulations for England and Wales, and produced a tool used by the UK Department of Energy and Climate Change to inform aspects of its Energy Efficiency Strategy. The international impacts of CBES arise both from its broad influence on policy-makers' awareness and understanding of the implications of energy efficiency policies, and from more specific contributions to the development of World Health Organisation guidance.
Every year over 5,000 children and young people in the UK die. Previous research suggests that 20-25% of these deaths may be preventable, and in comparison to many other European countries, the UK has higher child mortality rates. Child Death Review processes, introduced in the USA in the 1970s have been proposed as a means of learning from child deaths and driving prevention initiatives. Prior to 2008, the UK had no national system for reviewing and learning from children's deaths.
From 2006 to 2007, a team from Warwick Medical School led by Dr Peter Sidebotham undertook government-funded research examining a number of Local Authorities across England who had set up pilot Child Death Overview Panels (CDOPs). The findings from this research were instrumental in developing national policy and procedures for child death reviews. The Warwick research emphasised the importance of a multi-agency approach to reviewing all child deaths, with a strong public health focus on learning lessons for prevention, and robust systems for notification and gathering information. This, together with other research by Warwick Medical School on fatal child maltreatment published between 2009 and 2011, has contributed to updated national policy and interagency practice to safeguard children.
Although it is too early in the process to demonstrate any impact on the ultimate goal of reducing preventable child deaths, CDOPs have now been established in every Local Authority in England, as well as an all-Wales panel, and current work in Scotland and Northern Ireland is considering how best to implement such reviews. These panels are reviewing all child deaths in England, resulting in local prevention initiatives, and national returns enabling a clearer picture of the nature of preventable child deaths.
Research carried out at Newcastle has developed the understanding of the economic value of the risks to human life across a range of public services, especially transport and health. The model pioneered at Newcastle changed the way in which the risk to human life is calculated. Rather than simply calculating the loss of economic output as a result of injury or death, it takes into account individuals' `willingness to pay' in order to reduce mortality risk. The model has dominated the terms of UK policy discussion in areas in which safety is a central concern. The research has directly shaped the development of government policy and associated guidelines for a range of departments and organisations, particularly through its inclusion in the HM Treasury Green Book.
Many research groups around the world have produced evidence that cardiovascular disease (CVD) can be prevented by dietary salt reduction. The specific contribution of the University of Warwick consists of primary research carried out between 2005 and 2013 by Professor Francesco Cappuccio, who has demonstrated that lower salt intake can lead to a reduction in strokes and total cardiovascular events. These results have informed public health awareness and policy- making both nationally and globally. The research contributed directly to the development of a national policy for salt reduction by the UK National Institute for Health and Care Excellence (NICE) in 2010 by indicating the likely health gains of a population strategy. The research also influenced global policies set out by the World Health Organization (WHO) in 2007, 2010 and 2012. Population-wide reductions in dietary salt are now the second priority after tobacco control set by the United Nations in 2011 for the prevention of non-communicable disease worldwide.
Research in the area of childhood obesity has focussed on the development, implementation and evaluation of interventions. The APPLES Study (1996-99), the first UK school-based RCT was key in contributing to the evidence-base through wide dissemination including 3 BMJ (2001) publications, cited in NICE (2006) and WHO guidance (2004). Collaborations with academics, practitioners and the RCPCH led to the development of further community-based obesity treatment and prevention interventions including WATCH IT; early programmes e.g. EMPOWER, HELP and HAPPY and more recently innovative school-based initiatives involving school gardening. There is evidence of results being disseminated and influencing research, practice and policy.