Institutionalizing health impact assessment in London as a public health tool for increasing synergy between policies in other areas

Objectives: To describe the background to the inclusion of health impact assessment (HIA) in the development process for the London mayoral strategies, the HIA processes developed, how these evolved, and the role of HIA in identifying synergies between and conflicting priorities of different strategies.Study design: Case series.Methods: Early HIAs had just a few weeks for the whole HIA process. A rapid appraisal approach was developed. Stages included: scoping, reviewing published evidence, a stakeholder workshop, drafting a report, review of the report by the London Health Commission, and submission of the final report to the Mayor. The process evolved as more assessments were conducted. More recently, an integrated impact assessment (IIA) method has been developed that fuses the key aspects of this HIA method with sustainability assessment, strategic environmental assessment and equalities assessment.Results: Whilst some of the early strategy drafts encompassed some elements of health, health was not a priority. Conducting HIAs was important both to ensure that the strategies reflected health concerns and to raise awareness about health and its determinants within the Greater London Authority (GLA). HIA recommendations were useful for identifying synergies and conflicts between strategies. HIA can be successfully integrated into other impact assessment processes.Conclusions: The HIAs ensured that health became more integral to the strategies and increased understanding of determinants of health and how the GLA impacts on health and health inequalities. Inclusion of HIA within IIA ensures that health and health inequalities impacts are considered robustly within statutory impact assessments. (C) 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved

Developing a questionnaire to assess community severance, walkability, and wellbeing: results from the Street Mobility Project in London

This working paper describes the development of the survey questionnaire component of the toolkit designed to measure community severance, and assess its potential associations with transport and health. We discuss the cognitive testing and piloting of the questionnaire in two contrasting case study areas in inner London, and present results from the survey data

Income-based inequalities in hypertension and in undiagnosed hypertension: analysis of Health Survey for England data

Objective: To quantify income-based inequalities in hypertension and in undiagnosed hypertension. Methods: We used nationally representative data from 28 002 adults (aged 16 years and older) living in private households who participated in the cross-sectional Health Survey for England 2011–2016. Using bivariate probit regression modelling, we jointly modelled hypertension and self-reported previous diagnosis of hypertension by a doctor or nurse. We then used the model estimates to quantify inequalities in undiagnosed hypertension. Inequalities, using household income tertiles as an indicator of socioeconomic status, were quantified using average marginal effects (AMEs) after adjustment for confounding variables. Results: Overall, 32% of men and 27% of women had survey-defined hypertension (measured blood pressure ≥140/90 mmHg and/or currently using medicine to treat high blood pressure). Higher proportions (38% of men and 32% of women) either self-reported previous diagnosis or had survey-defined hypertension. Of these, 65% of men and 70% of women had diagnosed hypertension. Among all adults, participants in low-income versus high-income households had a higher probability of being hypertensive [AMEs: men 2.1%; 95% confidence interval (CI): −0.2, 4.4%; women 3.7%; 95% CI: 1.8, 5.5%] and of being diagnosed as hypertensive (AMEs: men 2.0%; 95% CI: 0.4, 3.7%; women 2.5%; 95% CI: 1.1, 3.9%). Among those classed as hypertensive, men in low-income households had a marginally lower probability of being undiagnosed than men in high-income households (AME: −5.2%; 95% CI: −10.5, 0.1%), whereas no difference was found among women. Conclusion: Our findings suggest that income-based inequalities in hypertension coexist with equity in undiagnosed hypertension

The cost of the wider impacts of road traffic on local communities: 1.6% of Great Britain's GDP

This paper estimates the negative effects of motorised road traffic on the travel and walking behaviour of local residents in Great Britain and the cost of the wider negative impacts on local economic activity, external effects of motorised transport, social exclusion, neighbourhood social capital, self-rated health, and subjective wellbeing. We use the results of a survey (n = 3038) and models linking the characteristics of roads and pedestrian crossing facilities in each participant’s local area, travel and walking behaviour, and the level and monetary value of the wider impacts of travel behaviour. The costs of road traffic borne by local communities were estimated as £31.9 billion per year, i.e. 1.6% of the Gross Domestic Product, or £631 per person. This value varies within the interval £569-£698/person/year, depending on the assumptions made. The highest estimated costs of motorised road traffic are reduced neighbourhood social capital (£236) and reduced subjective wellbeing (£196/person/year). The costs for some population segments, such as London residents, city residents, and people aged 25–34 are higher than the average. The characteristic of roads causing the highest costs is volume of motorised traffic above low (£264/person/year), followed by multiple lanes (£148), traffic speeds above low (£119), and absence of a median strip (£60). By quantifying for the first time, at the national level, the costs of the negative community effects of motor vehicles, this study provides evidence supporting policies to reduce traffic volumes and speeds and reallocate roadspace to pedestrians

Control in the technical societies: a brief history

By the time control engineering emerged as a coherent body of knowledge and practice (during and just after WW2) professional engineering societies had existed for many decades. Since control engineering is an interdisciplinary branch of the profession, new sections devoted to control were quickly established within the various existing technical societies. In addition, some new bodies devoted specifically or primarily to control were established. This article, a revised version of a paper presented at the IEEE 2009 Conference on the History of Technical Societies, describes how control engineering as a distinct branch of engineering became represented in technical societies in a number of countries