Stakeholder engagement in sustainable housing refurbishment in the UK

The UK government is committed to effectively implement a viable sustainable agenda in the social housing sector. To this end housing associations and local authorities are being encouraged to improve the environmental performance of their new and existing homes. Whilst much attention has been focused on new housing (e.g. the Code for Sustainable Homes) little effort has been focussed on improving the 3.9 (approx) million homes maintained and managed by the public sector (in England), which, given the low rate of new build and demolition (<1% in England), will represent approximately 70% of the public housing stock in 2050. Thus, if UK is to achieve sustainable public housing the major effort will have to focus on the existing stock. However, interpreting the sustainability agenda for an existing housing portfolio is not a straight foreword activity. In addition to finding a ‘technical’ solution, landlords also haveto address the socio-economic issues that balance quality of expectations of tenants with the economic realities of funding social housing refurbishment. This paper will report the findings of a qualitative study (participatory approach) that examined the processes by which a large public landlord sought to develop a long-term sustainable housing strategy. Through a series of individual meetings and group workshops the research team identified: committed leadership; attitudes towards technology; social awareness; and collective understanding of the sustainability agenda as key issues that the organisation needed to address in developing a robust and defendable refurbishment strategy. The paper concludes that the challenges faced by the landlord in improving the sustainability of their existing stock are not primarily technical, but socio-economic. Further, while the economic challenges: initial capital cost; lack of funding; and pay-back periods can be overcome, if the political will exists, by fiscal measures; the social challenges: health & wellbeing; poverty; security; space needs; behaviour change; education; and trust; are much more complex in nature and will require a coordinated approach from all the stakeholders involved in the wider community if they are to be effectively addressed. The key challenge to public housing landlords is to develop mechanisms that can identify and interpret the complex nature of the social sustainability agenda in a way that reflects local aspirations (although the authors believe the factors will exist in all social housing communities, their relative importance is likely to vary between communities) whilst addressing Government agendas.

Epidemiological and nutrition transition in developing countries: impact on human health and development

Whereas common infectious and parasitic diseases such as malaria and the HIV/AIDS pandemic remain major unresolved health problems in many developing countries, emerging non-communicable diseases relating to diet and lifestyle have been increasing over the last two decades, thus creating a double burden of disease and impacting negatively on already over-stretched health services in these countries. Prevalence rates for type 2 diabetes mellitus and CVD in sub-Saharan Africa have seen a 10-fold increase in the last 20 years. In the Arab Gulf current prevalence rates are between 25 and 35% for the adult population, whilst evidence of the metabolic syndrome is emerging in children and adolescents. The present review focuses on the concept of the epidemiological and nutritional transition. It looks at historical trends in socio-economic status and lifestyle and trends in nutrition-related non-communicable diseases over the last two decades, particularly in developing countries with rising income levels, as well as the other extreme of poverty, chronic hunger and coping strategies and metabolic adaptations in fetal life that predispose to non-communicable disease risk in later life. The role of preventable environmental risk factors for obesity and the metabolic syndrome in developing countries is emphasized and also these challenges are related to meeting the millennium development goals. The possible implications of these changing trends for human and economic development in poorly-resourced healthcare settings and the implications for nutrition training are also discussed.

Ambitious mothers – successful daughters: Mothers’ early expectations for children’s education and children’s earnings and sense of control in adult life

Background. Mothers' expectations for their children's educational attainment are related to children's educational and occupational attainment. Studies have yet to establish, however, the long-term links between maternal expectations and offspring earnings, which are not always related to occupational attainment especially in women, or between maternal expectations and offspring sense of control and self-efficacy, which are pivotal factors in career choice and development. Aims. To explore the role of mothers' expectations for their children's educational attainment in children's earnings attainment and sense of control later in life. Method. Data from sweeps of the 1970 British Cohort Study (BCS70) were used. The study sample was those cohort members with complete information on all the variables of interest. The study sample (N = 3,285) was more educated and less disadvantaged than the whole sample. If cohort members of this type are more likely to have a mother who has high expectations, then our results are biased downwards, which suggests that we underestimate the effect of expectations on our two outcome variables. Results. Mothers' expectations at the age of 10 were positively related to daughters' sense of control at the age of 30 even after controlling for ethnicity, educational attainment, and concurrent partner, parent, and labour market participation status, as well as the following confounding variables (measured at the ages of 0–10): general ability and general ability squared, locus of control, emotional and behavioural problems and emotional and behavioural problems squared, socio-economic disadvantage, parental social class, parental family structure, and mothers' education, child-rearing attitudes, and mental health. Mothers' expectations had no effect on sons' adult outcomes. Conclusions. Given that women are particularly at risk for poor psychological and economic outcomes in adulthood, and that this study likely underestimated the effect of expectations on these two outcomes, this is an important conclusion.

Fluoridation for dental public health

This article reviews the means by which fluoride is supplied to populations. Many public health authorities provide fluoridated drinking water, with typical concentrations of fluoride of between 0.5 and 1.0 ppm. This has been found to be safe and effective, though differences in caries incidence between fluoridated and non-fluoridated regions are less than they were 50 years ago, because of the wider availability of fluoridated products to the whole population. Concerns about the effect of fluoride on bone density and associated conditions are reviewed and the general conclusion from considering the literature on fluoride is that there is almost no cause for concern. Alternatives to water as a means of delivering fluoride to the general public that are being used in a number of countries are salt and milk. These alternatives are also reviewed and have been shown to give satisfactory levels of protection against caries, though milk is shown to be less satisfactory than water as a vehicle for fluoride delivery. Milk is also less effective in providing fluoride to individuals in the population, and is less likely to be consumed by people in lower socio-economic groups, precisely those who suffer most from dental caries. This study concludes that mass water fluoridation remains an important contribution to good oral health throughout the community.