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Research conducted at Strathclyde has shown that current pathways which focus on education and public information are failing to transform attitudes to mental health amongst low-income communities and black & ethnic minorities. Drawing on this research, an annual Mental Health Arts Festival has been created. Since 2008 the event has engaged over 40,000 people, and is now one of the largest arts and social justice festivals in Europe. The Festival has affected the ways in which these `hard to reach' groups are involved in addressing stigma and mental health, has changed approaches to the delivery of mental health awareness lessons in schools and communities, has led to NHS boards building the festival into their health improvement policies and strategies, and has been a central part of the Scottish Government's national anti-stigma `see me' campaign. The idea of a dedicated arts festival has been replicated elsewhere in the UK and internationally, and is transforming the attitudes and behaviour within black and minority ethnic and low-income communities to mental health.
Health inequalities are recognised as a critical UK policy issue with life expectancy gaps of up to 28 years between the least and most deprived areas. This case-study demonstrates how Durham University research has led to: (a) changing health service commissioning (with County Durham and Darlington Primary Care Trust [PCT]): (b) influencing NHS funding policy (by generating Parliamentary debate); as well as (c) contributing to the development of the new public health system in England and Wales (as part of the Strategic Review of Health Inequalities in England post-2010 [Marmot Review]).
In November 2008, Professor Sir Michael Marmot and his team at UCL were asked by the Secretary of State for Health to chair an independent review to propose the most effective evidence-based strategies for reducing health inequalities in England. The Marmot Review, published in 2010, has fundamentally shifted discourse on health inequalities in the UK and internationally. It has shaped public health services across England and around the world, guided government and international policy, and has given rise to a new commitment from service providers and health professionals to reducing health inequalities and addressing the social determinants of health.
The populations of over 250 European and near Eastern cities are benefitting from closer integration of health and planning. As a result of research undertaken at the World Health Organisation Collaborating Centre for Healthy Urban Environments (WHO CC), built environment professionals have integrated concerns about public health into their decision-making and, correspondingly, public health professionals have engaged with how urban places affect health. Based on a long-term programme of empirical study, this has happened through our development, and subsequent operationalisation, of the concept of `Healthy Urban Planning'. The adoption of our models, assessment tools and appraisal methods, has fostered a new emphasis on urban development and planning at neighbourhood level; the implementation of which has resulted in more active lives, more inclusive communities and environments that support health.
The `People in Public Health' (PIPH) study and related research on health trainers, health champions and volunteers has brought together evidence on rationales for lay engagement, effectiveness and models of support. Dissemination activities, supported by a Department of Health grant, have achieved reach into various policy arenas and national networks. At the same time there is evidence of research utilisation in public health practice. One of the impacts has been the establishment of `Active Citizens for Health', a national network of partner organisations to bring together evidence and learning that has been hosted by Leeds Metropolitan University.
Research conducted within the University of East London's Institute of Health and Human Development (IHHD) is reshaping the development, commissioning, delivery and evaluation of interventions to address the wider determinants of health and health-inequalities, and has had impacts on public policy, service design and, ultimately, public health and wellbeing. Grounded in close relationships with policy-makers and end users, UEL's primary research into community development and co-production has informed the design of health improvement interventions, delivered through the cross-institutional, community-based Well London project. Research findings have driven Big Lottery funding priorities, contributed to parliamentary debates on health, informed NICE and Local Government guidance, shaped Marmot Review Team and NESTA policy, and led health authorities to commission new services and adopt new approaches to service delivery.
University of Glasgow researchers have played a pivotal role in developing and evaluating the pioneering Childsmile oral health improvement programme. By the late 1990s, more than 50% of 5-year-olds in Scotland showed evidence of dental decay. Since implementation of Childsmile in 2006, this has decreased to 33% and, within this population dental decay in children from the most severely deprived backgrounds has experienced a striking reduction (from 79% to 55%). In 2011, Childsmile was formally incorporated into the primary care dental contract and subsequently in 2012, into the universal child health surveillance programme in Scotland. Since its introduction Childsmile's community-based, preventive approach has revolutionised dental healthcare from birth for all children up to 12 years of age in Scotland resulting in delivery of Childsmile to over 730,000 children per year.
The Department of Health seeks to distribute the NHS budget to local commissioning organisations to achieve equal access for equal need and reduce health inequalities. The formula upon which it bases this distribution must be evidence-based, robust and up-to-date. We summarise four pieces of applied econometric research undertaken at the University of Manchester (UoM) and commissioned by the Department of Health that have developed the methodology for setting budgets fairly and determined the content of the formula in use in England from 2008-date. Adoption of the findings of this research by government has led to a substantial redistribution of NHS funding between areas.
This case study highlights a body of research around health Research Priority Setting (RPS) that assists policy makers in effectively targeting research that has the greatest potential health benefit. Empirical research on RPS led to organizational changes, and new policies within the Cochrane Collaboration along with new training resources and new RPS exercises. A research gap on inequalities in the risk of oral cancer in the English South Asian population led to an evidence synthesis exercise being carried out by the National Institute for Health and Care Excellence (NICE) and the formulation of a new public health guideline.
We have been involved in initiatives to improve the health behaviour of ~20,000 people from deprived communities, with a focus on increasing levels of physical activity, dietary change, and engagement with natural environments (e.g., parks). We have worked with communities to ensure the sustainability of these positive changes. Further, we have disseminated our research widely through engagement with stakeholders to influence practice and policy and through media coverage. These impacts are based on our research which has demonstrated that to change health behaviours multiple levels of intervention are required and we have focused on two of these levels; community engagement and changing the environment.