Using the Bristol City Council Quality of Life Survey (2011-2013) – Preliminary analysis of life satisfaction and recommendations for further analyses

The purpose of this report is to explore the utility of the Bristol Quality of Life (QoL) Survey for measuring levels of life satisfaction (as a measure of well-being and mental health) in Bristol’s population aged 55 and over. An earlier report examined the variables available to measure levels of physical activity. This report focuses on life satisfaction and its association with physical activity and other variables. Life satisfaction was higher for women (73.5%) than for men (72.2%), higher amongst non-BME (Black Minority Ethnic) (73.4%) than for BME (63.3%) respondents and highest in the most affluent North & West (Inner) sub-locality (81.1%) and lowest in Inner City (East) (67.6%). Across age groups, life satisfaction rose from 68.3% overall for those aged 55-59, through the 60-64 age group (72.8%), remained around 75% through ages 65 to 84 before falling again to 66.5% for those aged 85-89 and to a low of 65.4% overall for those aged 90+. There was an association between life satisfaction and physical activity, with 76.7% of those that undertook moderate physical exercise at least once per week reporting positive life satisfaction, compared with 56.4% of those who took moderate exercise less than once per week. This held across all age groups studied here (55-59 up to 90+). Life satisfaction amongst those who remained physically active at age 85-89 was high (78.3% for men and 78.8% for women). Life satisfaction amongst the least active (moderate exercise less than once per week) was only 46.7% among men in age group 85-89 and 49.4% for women. General health in the past 12 months was positively associated with life satisfaction, while having a limiting long-term illness, having had an accidental fall in the last 12 months and being underweight or obese were all associated with lower levels of life satisfaction. There is a negative association between deprivation and both life satisfaction and physical activity. Social interaction (e.g. meeting family and friends), neighbourhood satisfaction and a sense of belonging to the neighbourhood were positively associated with life satisfaction. Reporting that ‘something prevents me leaving that house’ and feeling unsafe outdoors were associated negatively with life satisfaction

The Bristol Twenty Miles Per Hour Limit Evaluation (BRITE) Study

This study aimed to evaluate the impact of the roll-out of 20mph speed limits across the city of Bristol. The research took a holistic, public health approach to evaluation, using a variety of data sources to examine changes in vehicle speeds, road traffic casualties, levels of walking and cycling, public perceptions and attitudes, and reported levels of health and wellbeing across the city. The study found statistically significant reductions in average traffic speeds of 2.7mph across the city of Bristol, following the introduction of 20mph speed limits. This is a larger reduction than seen in previous evaluations in other cities. The study employed a more sophisticated analysis than previous studies of 20mph limits, including using individual speed data from over 36 million vehicle observations and controlling for other factors that might affect changes in traffic speeds. There has been a reduction in the number of fatal, serious and slight injuries from road traffic collisions, equating to estimated cost savings of over £15 million per year. Although there is still majority support for 20mph speed limits in Bristol, there remains concern about compliance and behaviour of other drivers. Walking and cycling across Bristol has increased, both among children travelling to school and adults travelling to work. The introduction of 20mph speed limits in Bristol offers a model for other towns and cities across the UK, who are seeking to reduce traffic speeds, cut road traffic casualties, and promote community health and wellbeing through road danger reduction. In order to assess effectiveness of 20mph speed limits, it is vital that other towns and cities follow Bristol’s example, and prioritise the ongoing collection and analysis of appropriate data on vehicle speeds, road traffic casualties and wider public health impacts

A Fair Start? Child Mortality and Morbidity in the South West.

Children in the South West region are, overall, healthierthan their counterparts in other regions. However, many ofthe child deaths and much of the morbidity are potentiallyavoidable, suggesting that there is still considerable roomfor improvement.In order to understand how best these improvementscan be made, and which areas, causes and populationgroups should be prioritised, it is essential to understandvariations by age group, sex, deprivation and geography.This report has used readily available sources ofinformation to highlight some of these variations. Findingsof particular importance are:• Infant mortality rates are generally low in the regioncompared to England. Latest estimates suggest thatthe inequalities target for the South West is toughbut achievable by 2010. In addition, the region doesnot compare favourably to some of its Europeancounterparts on child health indicators, highlighting thefact that there is more to be done. If infant mortalityin the South West as a whole was at the level of thequintile with the lowest mortality, about 50 infant livescould be saved each year.• Mortality rates in children aged 1–19 are generallylower than in the first year of life, but these still exhibita steep socioeconomic gradient and a large proportionare potentially avoidable. The main causes of deathvary by age and sex, but injuries, suicides and cancersare the biggest contributors, making up over 50% of allcauses. Almost two-thirds of male deaths and half offemale deaths are classified as potentially avoidable.• There is also strong evidence of a steepsocioeconomic gradient for child morbidity in theregion.• Hospital admission rates in the South West are higherthan for England, and the causes of these admissionsvary by age, sex and deprivation. In younger children(aged 0–4) acute respiratory infections predominate,while the most common causes in children aged 5–14are injuries, especially in boys. The most commonreason for admissions in the 15–19 age group isneoplasms and accidents for boys, and abdominalpain, nausea and vomiting, and abortive pregnancy forgirls. Deliberate self-harm features among the reasonsfor emergency admission of girls of 15–19.• Generally, injuries, self-harm, abortive pregnancy andear, nose and throat (ENT) conditions contribute mostto childhood morbidity in the South West.These results show that, despite the fact that childrenin the South West are, on average, healthier than theircounterparts elsewhere in England, there are still largenumbers suffering from potentially avoidable conditions,which in some cases result in death. The majority of thesecases appear to be concentrated in the most deprivedcommunities. It is therefore paramount that decisionsand interventions focused on the health of children in theSouth West are targeted at the populations most at riskand at potentially avoidable causes

Association between food for life, a whole setting healthy and sustainable food programme, and primary school children’s consumption of fruit and vegetables: A Cross-Sectional study in England

© 2017 by the authors. Licensee MDPI, Basel, Switzerland. The promotion of dietary health is a public health priority in England and in other countries. Research shows that the majority of children do not consume the recommended amount of fruit and vegetables (F&V). There has been relatively little research on the impact of programmes, such as Food for Life, that (a) integrate action on nutrition and food sustainability issues, and (b) are delivered as commissions in a local authority area. The study sought to assess pupil F&V in schools engaged with the Food for Life (FFL) programme. The design was a cross-sectional study comparing pupils in FFL engaged (n = 24) and non-engaged (n = 23) schools. A total of 2411 pupils aged 8-10 completed a validated self-report questionnaire. After adjusting for confounders, pupils in schools engaged with FFL consumed significantly more servings of F&V compared to pupils in comparison schools (M = 2.03/1.54, p < 0.001). Pupils in FFL schools were twice as likely to eat five or more portions of F&V per day (Odds Ratio = 2.07, p < 0.001, Confidence Interval = 1.54, 2.77). Total F&V consumption was significantly higher (p < 0.05) amongst pupils in schools with a higher level FFL award. Whilst limitations include possible residual confounding, the study suggests primary school engagement with the FFL programme may be an effective way of improving children’s dietary health

Recruitment, employability and career development for international students undertaking the UWE MSc Public Health: Final report

Executive SummaryBackgroundOver the last decade, the MSc Public Health at UWE has successfully recruited many international students. An issue for the university in promoting the benefits of the programme internationally is that there is a good career structure in UK public health for those from backgrounds other than medicine, but this is not necessarily the case for international students.Aims and objectivesThe aims were (1) to inform the career guidance we give our international MSc PH students to better enable them to pursue their individual careers and (2) to contribute to developing the Public Health and Wellbeing Research Group’s research on international public health workforce capacity development. To achieve these aims we had two more specific objectives: (1) to map the public health career development of UWE international MSc PH alumni and (2) to map the public health career structures, professional bodies and registration requirements of countries from which students are recruited.MethodsThis was a mixed methods research project based on an online survey, telephone and face-to-face semi-structured interviews and web-searching. Element 1 focused on the public health career experiences of our MSc international students over the last ten years. A purposive sample of 97 international alumni was emailed with a request to participate in the online survey. The survey included an option to consent for a further follow up interview. Element 2 involved mapping public health career structures, professional bodies and registration in countries from which international students attended over the last ten years. For each country, an internal search was conducted for national public health bodies, associations and registers, and key informants were contacted.4ResultsForty-seven alumni responded and answered at least one question in the online survey. The majority of participants were employed by international organisations, academic institutions, and state agencies or were at different stages of PhD studies. Participants reported increased public health career experiences in public health research roles, public health leadership, and policy analysis and in planning, implementing and evaluating public health programmes. Participants had confidence in applying public health skills, especially research, critical thinking, academic writing as well as demonstrating public health leadership skills and the application of multidisciplinary approaches to address public health issues. Recommendations included provision of longer public health placements, optional courses on project management and advanced statistics, and continued internationalisation of the curriculum. Overall, alumni satisfaction was high in relation to the relevance and impact of the skills and knowledge they acquired during their MSc Public Health at UWE.Discussion and conclusionsThe results of this study were consistent with other studies of alumni of MSc Public Health programmes. The study has provided useful feedback on the UWE MSc Public Health programme and a number of helpful recommendations were made by alumni which will be addressed by the programme team. Implications for further research include studies of international employers’ perspectives on the value and limitations of the MSc Public Health and on public health registratio

Evaluation of Food for Life 2013-15: Summary and synthesis report

This is the final report of the phase two evaluation of Food for Life undertaken by the University of the West of England, Bristol 2013-15. The research encompassed five workstreams: 1.Long term impacts and durability - understanding how and why the Food for Life approach is embedded in schools for the medium to long-term. 2.Review of local commissions - understanding strategic support for Food for Life, and recommending monitoring and evaluation systems.3.Cross sectional study of pupils’ diets in Food for Life local commissions - evaluating Food for Life’s impact on healthy eating behaviours in schools in local commission areas. 4.New settings - exploring innovative approaches to extending the Food for Life whole setting approach beyond schools.5.Social value of Food for Life in local authority commissions – understanding the social, health, economic and environmental value of Food for Life commissions. The report presents summaries of the findings of each workstream, discusses themes emerging across the research, and sets out recommendations for Food for Life and associated evaluation activity

Methods of identifying and recruiting older people at risk of social isolation and loneliness: A mixed methods review

BackgroundLoneliness and social isolation are major determinants of mental wellbeing, especially among older adults. The effectiveness of interventions to address loneliness and social isolation among older adults has been questioned due to the lack of transparency in identifying and recruiting populations at risk. This paper aims to systematically review methods used to identify and recruit older people at risk of loneliness and social isolation into research studies that seek to address loneliness and social isolation.MethodsIn total, 751 studies were identified from a structured search of eleven electronic databases combined with hand searching of reference bibliography from identified studies for grey literature. Studies conducted between January 1995 and December 2017 were eligible provided they recruited community living individuals aged 50 and above at risk of social isolation or loneliness into an intervention study.ResultA total of 22 studies were deemed eligible for inclusion. Findings from these studies showed that the most common strategy for inviting people to participate in intervention studies were public-facing methods including mass media and local newspaper advertisements. The majority of participants identified this way were self-referred, and in many cases self-identified as lonely. In most cases, there was no standardised tool for defining loneliness or social isolation. However, studies that recruited via referral by recognised agencies reported higher rates of eligibility and enrolment. Referrals from primary care were only used in a few studies. Studies that included agency referral either alone or in combination with multiple forms of recruitment showed more promising recruitment rates than those that relied on only public facing methods. Further research is needed to establish the cost-effectiveness of multiple forms of referral.ConclusionFindings from this study demonstrate the need for transparency in writing up the methods used to approach, assess and enrol older adults at risk of becoming socially isolated. None of the intervention studies included in this review justified their recruitment strategies. The ability of researchers to share best practice relies greatly on the transparency of research

Bayesian projections: What are the effects of excluding data from younger age groups?

Bayesian age-period-cohort models are used increasingly to project cancer incidence and mortality rates. Data for younger age groups for which rates are low are often discarded from the analysis. The authors explored the effect of excluding these data, in terms of the precision and accuracy of projections, for selected cancer mortality data sets. Projections were made by using a generalized Bayesian age-period-cohort model. Smoothing was applied to each time scale to reduce random variation between adjacent parameter estimates. The sum of squared standardized residuals was used to assess the accuracy of projections, and 90% credible intervals were calculated to assess precision. For the data sets considered, inclusion of all age groups in the analysis provided more precise age-standardized and age-specific projections as well as more accurate age-specific projections for younger age groups. An overall improvement in the accuracy of age-standardized rates was demonstrated for males but not females, which may suggest that analysis of the full data set is beneficial when projecting cancer rates with strong cohort effects. Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health. All rights reserved