PHE-CRCE-010: Estimating Local Mortality Burdens associated with Particulate Air Pollution

The increase in mortality risk associated with long-term exposure to particulate air pollution is one of the most important, and best-characterised, effects of air pollution on health. This report presents estimates of the size of this effect on mortality in local authority areas in the UK, building upon the attributable fractions reported as an indicator in the public health outcomes framework for England. It discusses the concepts and assumptions underlying these calculations and gives information on how such estimates can be made. The estimates are expected to be useful to health and wellbeing boards when assessing local public health priorities, as well as to others working in the field of air quality and public health. The estimates of mortality burden are based on modelled annual average concentrations of fine particulate matter (PM2.5) in each local authority area originating from human activities. Local data on the adult population and adult mortality rates is also used. Central estimates of the fraction of mortality attributable to long-term exposure to current levels of anthropogenic (human-made) particulate air pollution range from around 2.5% in some local authorities in rural areas of Scotland and Northern Ireland and between 3 and 5% in Wales, to over 8% in some London boroughs. Because of uncertainty in the increase in mortality risk associated with ambient PM2.5, the actual burdens associated with these modelled concentrations could range from approximately one-sixth to about double these figures. Thus, current levels of particulate air pollution have a considerable impact on public health. Measures to reduce levels of particulate air pollution, or to reduce exposure of the population to such pollution, are regarded as an important public health initiative.

Cook 4 Life Programme

The aim of this intervention is - To contribute to improvements in health and well being by influencing food choice. The objectives are: - To work with targeted individual and groups to achieve the following outcomes - Increase cooking skills Improve nutritional knowledge Influence shopping choices - Assist budgeting for healthier food choices Raise awareness of food hygiene practices - To provide information on health and well being

Ministry of Food Leeds

This intervention aims to contribute to improvements in health and well being by influencing food choice. Objectives: To work with targeted individual and groups to achieve the following outcomes :- Increase cooking skills- Improve nutritional knowledge- Influence shopping choices- Assist budgeting for healthier food choices Raise awareness of food hygiene practices- To provide information on health and well being

Good quality parenting programmes and the home to school transition

Evidence Review 1 - Good quality parenting programmes and the home to school transition Briefing 1a - Good Quality Parenting Programmes Briefing 1b - Improving the Home to School Transition This set of documents, commissioned by Public Health England (PHE£0, and written by the UCL Institute of Health Equity, address the effects of parenting and good transition on the health and wellbeing of children aged 0-5. They also provide case studies, and examples of good practice for local areas. Evaluations from the UK and other countries show a positive effect of parenting interventions on outcomes and behaviours that we know are linked to positive health and development outcomes for children. Home to school transition programmes can be effective in improving the outcomes for children from more disadvantaged socio-economic groups more than for children from more advantaged socio-economic groups, although longer term impact on health inequalities can only be inferred because the impact on health has not been studied. The full evidence review and two shorter summary briefings are available to download above. This document is part of a series. An overview document which provides an introduction to this and other documents in the series, and links to the other topic areas, is available on the ‘Local Action on health inequalities’ project page. A video of Michael Marmot introducing the work is also available on our videos page.

Improving Access to Green Spaces

Evidence Review 8 - Improving access to green spaces Briefing 8 - Improving access to green spaces This pair of documents, commissioned by Public Health England, and written by the UCL Institute of Health Equity, address the role of green space in improving health locally. The first part of the evidence review defines ‘accessible’ green space and provides an overview of the evidence linking access to green spaces with health benefits, setting out the potential for reducing health inequalities. The second part provides an overview of interventions implemented at the local level to increase equitable access and use of good quality green spaces. Local authorities and local organisations have taken action on these issues through the implementation of interventions to: 1. Create new areas of green space and improve the quality of existing green spaces 2. Increase accessibility, engagement and use of green spaces The full evidence review and a shorter summary briefing are available to download above. This document is part of a series. An overview document which provides an introduction to this and other documents in the series, and links to the other topic areas, is available on the ‘Local Action on health inequalities’ project page. A video of Michael Marmot introducing the work is also available on our videos page.

Adult Learning Services

Evidence Review 4 - Adult learning services Briefing 4 - Adult learning services This pair of documents, commissioned by Public Health England, and written by the UCL Institute of Health Equity, address the role of participation in learning as an adult in improving health. There is evidence that involvement in adult learning has both direct and indirect links with health, for example because it increases employability. There is some evidence that those who are lower down the social gradient benefit most, in health terms, from adult learning. However, there is a gradient both in participation in adult learning and skill level, whereby the more someone would benefit from adult learning, the less likely they are to participate, and the lower their literacy and numeracy skills are likely to be. This is due to a range of barriers, including prohibitively high costs, lack of personal confidence, or lack of availability and access. These papers also show that there are a number of actions local authorities can take to increase access to adult learning, improve quality of provision and increase the extent to which it is delivered and targeted proportionate to need. The full evidence review and a shorter summary briefing are available to download above. This document is part of a series. An overview document which provides an introduction to this and other documents in the series, and links to the other topic areas, is available on the ‘Local Action on health inequalities’ project page. A video of Michael Marmot introducing the work is also available on our videos page.

Reducing the number of young people not in employment, education or training (NEET)

Evidence Review 3 - Reducing the number of young people not in employment, education or training (NEET) Briefing 3 - Reducing the number of young people not in employment, education or training (NEET) This pair of documents, commissioned by Public Health England, and written by the UCL Institute of Health Equity, examine how to help young people into employment, education or training. They describe the relationship between being NEET and health; inequalities in prevalence of being NEET; and the scale of the problem. The papers show that being NEET, particularly for prolonged periods, is associated with negative effects on health and a range of other outcomes. Furthermore, the chances of becoming NEET are not equally or randomly distributed throughout society – those who are relatively disadvantaged, from poor backgrounds, or who have had negative experiences at school are more likely to spend some time being NEET. The papers also propose actions that can be taken at a local level in order to reduce the proportion of young people who are NEET. There is good evidence on what works in order to enable and support young people to enter employment, education and training. Taking action to reduce NEET levels is both possible and necessary – both to ensure young people have opportunities, and also as an important way to improve public health and reduce inequalities. The full evidence review and a shorter summary briefing are available to download above. This document is part of a series. An overview document which provides an introduction to this and other documents in the series, and links to the other topic areas, is available on the ‘Local Action on health inequalities’ project page. A video of Michael Marmot introducing the work is also available on our videos page.

Building Children and Young People's Resilience in Schools

Evidence Review 2 - Building children and young people's resilience in schools Briefing 2 - Building children and young people's resilience in schools This pair of documents, commissioned by Public Health England, and written by the UCL Institute of Health Equity, address the role of schools in building children and young people’s resilience and capabilities. They provide a summary of evidence about the effect of resilience on health, the unequal distribution of resilience and its contribution to levels of health inequalities. The review outlines the potential actions that can be taken in schools in order to build resilience for all children and young people and reduce inequalities in resilience. Throughout, a social determinants approach to resilience is taken. Children and young people’s individual characteristics are seen as shaped by, and related to, inequities in power, money and resources, and the conditions in which they are born, grow, live, and in which they will work and age. Family and community resilience are highly significant and similarly shaped by wider social and economic factors. The full evidence review and a shorter summary briefing are available to download above. This document is part of a series. An overview document which provides an introduction to this and other documents in the series, and links to the other topic areas, is available on the ‘Local Action on health inequalities’ project page. A video of Michael Marmot introducing the work is also available on our videos page.

A Kilkenny Post-primary School Survey: A Survey of Knowledge, Attitudes and Behaviour Relevant to Noncommunicable Disease

The Kilkenny post-primary school survey was carried out in the spring of 1987 on a stratified random sample of 445 post-primary school children in county Kilkenny. The study was designed as the basis for evaluation of the Kilkenny Health Project's school health education programme. The study examined knowledge, attitudes and behaviour relevant to non-communicable disease. The results showed that levels of adolescent alcohol and tobacco use were similar to those found in neighbouring countries. Smoking and drinking increased during adolescence and were more prevalent in males. Physical activity decreased throughout adolescence and a high intake of 'snack' foods was found. Health related knowledge levels were high but were not related to behaviour; however attitudes were found to be consistent with behaviour. These and other results are discussed. Literature relevant to school health education and the aetiology of non-communicable disease is described, with particular reference to Ireland. The evidence supporting health promotion intervention programmes against non-communicable disease is examined and WHO and Irish policies on health promotion outlined. The importance of health and disease prevention programmes commencing in youth is emphasised and the suitability and efficacy of school health education programmes are noted. A number of school health education programmes world-wide are described. The role of the community physician in relation to such programmes is discussed. Finally recommendations are made and areas for further research are made.This resource was contributed by The National Documentation Centre on Drug Use.

Making the Link Between Obesity and wellbeing

Making the links between Obesity & Well-being. A briefing paper developed for Care Services Improvement Partnership (CSIP) North West. The paper covers the epidemiology and evidence of links between health and obesity. Mental well-being is a key factor of obesity and weight management. Good mental health is a protective factor for good physical health and against physical illness and is essential for making healthy lifestyle choices and behaviour changes. Poor mental health can lead to unhealthy lifestyle choices and unhealthy weight management. Obesity and physical illness can also lead to poor mental health. People with mental health problems, especially severe, are also at increased risk of obesity and related poor health. In order to ensure that strategies and programmes effectively address the relevant mental well-being factors, a mental well-being impact assessment (MWIA) could be undertaken. This process is based on health impact assessment methodology and a set of evidence based mental well-being determinants and factors, grouped under the four themes of enhancing control, increasing resilience and community assets, facilitating participation and promoting inclusion. The process also involves identifying indicators to measure progress. Evaluation shows it is effective in engaging stakeholders in service development and evaluation and it increases understanding of mental well-being and its determinants.