The Impact of Introducing Low Traffic Neighbourhoods on Road Traffic Injuries

We examine the impact on road traffic injuries of introducing low traffic neighbourhoods in Waltham Forest, London. Using Stats19 police data 2012-2019, we find a three-fold decline in number of injuries inside low traffic neighbourhoods after implementation, relative to the rest of Waltham Forest and the rest of Outer London. We further estimate that walking, cycling, and driving all became approximately 3-4 times safer per trip. There was no evidence that injury numbers changed on boundary roads. Our findings suggest that low traffic neighbourhoods reduce injury risks across all modes inside the neighbourhood, without negative impacts at the boundary

Eligibility for bariatric surgery among adults in England: analysis of a national cross-sectional survey.

This study aimed to determine the number eligible for bariatric surgery and their sociodemographic characteristics.We used Health Survey for England 2006 data, representative of the non-institutionalized English population.The number of people eligible for bariatric surgery in England based on national guidance is unknown. The UK National Institute for Health and Clinical Excellence criteria for eligibility are those with body mass index (BMI) 35-40 kg/m(2) with at least one comorbidity potentially improved by losing weight or a BMI > 40 kg/m(2).Of 13,742 adult respondents (≥18 years), we excluded participants with invalid BMI (n = 2103), comorbidities (n = 2187) or sociodemographic variables (n = 27) data, for a final study sample of 9425 participants.The comorbidities examined were hypertension, type 2 diabetes, stroke, coronary heart disease and osteoarthritis. Sociodemographic variables assessed included age, sex, employment status, highest educational qualification, social class and smoking status.5.4% (95% CI 5.0-5.9) of the non-institutionalized adult population in England could meet criteria for having bariatric surgery after accounting for survey weights. Those eligible were more likely than the general population to be women (60.1% vs. 39.9%, p<0.01), retired (22.4% vs. 12.8% p<0.01), and have no formal educational qualifications (35.7% vs. 21.3%, p<0.01).The number of adults potentially eligible for bariatric surgery in England (2,147,683 people based on these results and 2006 population estimates) far exceeds previous estimates of eligibility. In view of the sociodemographic characteristics of this group, careful resource allocation is required to ensure equitable access on the basis of need

The Impact of 2020 Low Traffic Neighbourhoods on Fire Service Emergency Response Times, in London, UK

Between March and September 2020, 72 ‘Low Traffic Neighbourhoods’ (LTNs) were implemented in London. We examined the impact on fire brigade emergency response times in October 2020-February 2021 (‘post’), as compared to the same months in the previous two years (‘pre’). We found no evidence that response times inside the LTNs or on boundary roads were affected (e.g. pre/post change for first engine: -14 seconds inside LTNs; -11 seconds in the rest of London; p=0.4 for difference). Fire crews reported more delays due to ‘traffic calming measures’ in LTNs, but this was entirely offset by a decrease in delays for other reasons, particularly ‘traffic’. This was true both in LTNs that predominately blocked motor traffic using physical barriers (e.g. planters) and in LTNs using camera enforcement. These findings add to evidence that LTNs do not adversely affect emergency response times

Short-Term Association between the Introduction of 2020 Low Traffic Neighbourhoods and Street Crime, in London, UK

Between March and September 2020, 72 ‘Low Traffic Neighbourhoods’ (LTNs) were rapidly rolled out in London under emergency legislation. We examined the association between LTN implementation and street crime in October 2020 - February 2021 (‘post’), as compared to the same months in the previous two years (‘pre’). Overall crime trends in and around LTNs were more favourable than the background trend in Outer London, and similar to or slightly more favourable than the trend in Inner London. This pattern was also seen for numbers of direct attacks against the person - and this may underestimate the benefit per pedestrian, given evidence that LTN introduction is associated with increased walking

Impacts of 2020 Low Traffic Neighbourhoods in London on Road Traffic Injuries

We assessed the impacts of Low Traffic Neighbourhoods (LTNs) implemented in 2020 on road traffic injuries. We used police data from October-December 2018/2019 (pre) compared with the same period in 2020 (post). We found absolute numbers of injuries inside LTNs halved relative to the rest of London (ratio 0.51, p<0.001). Considering changes in background travel patterns, our results indicate substantial reductions in pedestrian injury risk. Risks to other road users may also have fallen, but by a more modest amount. We found no evidence of changes in injury numbers or risk on LTN boundary roads

The prevalence and socio-demographic associations of household food insecurity in seven slum sites across Nigeria, Kenya, Pakistan, and Bangladesh. A cross-sectional study

Although the proportion of people living in slums is increasing in low- and middle-income countries and food insecurity is considered a severe hazard for health, there is little research on this topic. This study investigated and compared the prevalence and socio-demographic associations of household food insecurity in seven slum settings across Nigeria, Kenya, Pakistan, and Bangladesh. Data were taken from a cross-sectional, household-based, spatially referenced survey conducted between December 2018 and June 2020. Household characteristics and the extent and distribution of food insecurity across sites was established using descriptive statistics. Multivariable logistic regression of data in a pooled model including all slums (adjusting for slum site) and site-specific analyses were conducted. In total, a sample of 6,111 households were included. Forty-one per cent (2,671) of all households reported food insecurity, with varying levels between the different slums (9–69%). Household head working status and national wealth quintiles were consistently found to be associated with household food security in the pooled analysis (OR: 0·82; CI: 0·69–0·98 & OR: 0·65; CI: 0·57–0·75) and in the individual sites. Households which owned agricultural land (OR: 0·80; CI: 0·69–0·94) were less likely to report food insecurity. The association of the household head’s migration status with food insecurity varied considerably between sites. We found a high prevalence of household food insecurity which varied across slum sites and household characteristics. Food security in slum settings needs context-specific interventions and further causal clarification

Prevalence and correlates of achieving recommended physical activity levels among children living in rural South Asia—A multi-centre study

Background: We report the prevalence of recommended physical activity levels (RPALs) and examine the correlates of achieving RPALs in rural South Asian children and analyse its association with anthropometric outcomes. Methods: This analysis on rural South Asian children aged 5–14 years (n = 564) is a part of the Chronic Disease Risk Factor study conducted at three sites in India (Chennai n = 146; Goa n = 218) and Bangladesh (Matlab; n = 200). Data on socio-demographic and lifestyle factors (physical activity (PA); diet) were collected using an interviewer-administered questionnaires, along with objective anthropometric measurements. Multivariate logistic regression models were used to examine whether RPALs (active travel to school (yes/no); leisure-time PA ≥ 1 h/day; sedentary-activity ≤ 2 h/day) were associated with socio-demographic factors, diet and other forms of PA. Multivariate linear regression models were used to investigate associations between RPALs and anthropometrics (BMI- and waist z-scores). Results: The majority of children (71.8 %) belonged to households where a parent had at least a secondary education. Two-thirds (66.7 %) actively travelled to school; 74.6 % reported ≥1 h/day of leisure-time PA and 55.7 % had ≤2 h/day of sedentary-activity; 25.2 % of children reported RPALs in all three dimensions. Older (10–14 years, OR = 2.0; 95 % CI: 1.3, 3.0) and female (OR = 1.7; 95 % CI: 1.1, 2.5) children were more likely to travel actively to school. Leisure-time PA ≥ 1 h/day was more common among boys (OR = 2.5; 95 % CI: 1.5, 4.0), children in Matlab, Bangladesh (OR = 3.0; 95 % CI: 1.6, 5.5), and those with higher processed-food consumption (OR = 2.3; 95 % CI: 1.2, 4.1). Sedentary activity ≤ 2 h/day was associated with younger children (5–9 years, OR = 1.6; 95 % CI: 1.1, 2. 4), children of Goa (OR = 3.5; 95 % CI: 2.1, 6.1) and Chennai (OR = 2.5; 95 % CI: 1.5, 4.3) and low household education (OR = 2.1; 95 % CI: 1.1, 4.1). In multivariate analyses, sedentary activity ≤ 2 h/day was associated with lower BMI-z-scores (β = −0.3; 95 % CI: −0.5, −0.08) and lower waist-z-scores (β = −1.1; 95 % CI: −2.2, −0.07). Conclusion: Only one quarter of children in these rural areas achieved RPAL in active travel, leisure and sedentary activity. Improved understanding of RPAL in rural South Asian children is important due to rapid socio-economic transition

The Impact of 2020 Low Traffic Neighbourhoods on Levels of Car/Van Driving among Residents: Findings from Lambeth, London, UK

We examined how residents’ driving changed after the implementation of low traffic neighbourhoods (LTNs) in Lambeth, London. We used postcode plus numberplate data from controlled parking zones, matched to annual MOT records. From 2018-2020 (‘pre’) to 2021-2023 (‘post’), mean past-year driving decreased by 0.7km/day among residents living inside the new LTNs and increased by 0.6km/day among residents in control areas elsewhere in Lambeth. This represents a difference-in-differences decrease of 1.3km/day (95% confidence interval 0.3 to 2.4) in LTN versus control areas, or a 6.4% relative decrease. Our findings suggest that residents started driving less once their area became an LTN

Impact of 'high-profile' public reporting on utilization and quality of maternity care in England: a difference-in-difference analysis

Objectives To evaluate the impact of high profile public reporting on utilisation and perceived quality of maternity services in England. Methods Analysis of national hospital administrative data using difference in difference models with propensity score matching and analysis of two maternity surveys from 2007 and 2010. Outcomes were counts of women admitted for delivery of a baby and the percentage of women rating their care positively in 2007 and 2010. Results Hospitals publicised as providing the best maternity care in England had fewer admissions annually and lower occupancy rates (63.0% vs. 77.3%; p=0.09) than the national comparison group. Hospitals publicised as providing the worst maternity care were predominantly in the greater London area, with more women aged 15-34 years in their catchment areas than the national comparison group. There was no statistically significant change in overall maternity admissions in the best hospitals (+ 2.2%, p=0.40 at six months), or the worst hospitals (- 2.8%, p=0.49 at six months) during any period in the thirty-six months after public reporting relative to baseline. Compared to the national comparison group the worst rated hospitals experienced greater improvements in perceived quality after public reporting but these findings were not maintained in the matched analysis. Conclusions High profile public reporting of maternity care in England was not associated with changes in the utilisation of maternity services or improvements in patient reported quality. These findings provide further evidence that public reporting is unlikely to drive major improvements in health system performance through the mechanism of patient choice