Health and the built environment: Expert seminar report for public health England

The connection between health and the built environment is not new. The sanitary revolution of the 19th century was largely based on tackling problems in the urban environment. The connection between health and issues such as housing, transport, air pollution and leisure provision is as important in relation to non-communicable disease today as it was to the infectious diseases of the past. The projection that 86% of the UK’s population will be urbanised by 2050 adds to the importance of the agenda for towns and cities.With a new public health system coming into being in England and, in particular, the move of public health responsibilities to local authorities, there exists a real opportunity to make further progress on tackling some of the social determinants of health associated with urban environments.At the invitation of Public Health England, the WHO Collaborating Centre for Healthy Urban Environments arranged a small expert seminar on health and the built environment in Bristol on the morning of 14 March 2013. The goals of the seminar were to:a)review the current situation in respect of health and the built environment;b)to develop a broad set of short and medium-term strategic actions;c)to strengthen understanding of the potential for public health interests to influence the built environment in England; andd)to establish the ground work for the PHE programme on Healthy Places.This report is a record of the activities and discussions at the seminar

Air pollution, deprivation and health: Understanding relationships to add value to local air quality management policy and practice in Wales, UK

© The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. Background Air pollution exposure reduces life expectancy. Air pollution, deprivation and poor-health status combinations can create increased and disproportionate disease burdens. Problems and solutions are rarely considered in a broad public health context, but doing so can add value to air quality management efforts by reducing air pollution risks, impacts and inequalities. Methods An ecological study assessed small-area associations between air pollution (nitrogen dioxide and particulate matter), deprivation status and health outcomes in Wales, UK. Results Air pollution concentrations were highest in 'most' deprived areas. When considered separately, deprivation-health associations were stronger than air pollution-health associations. Considered simultaneously, air pollution added to deprivation-health associations; interactions between air pollution and deprivation modified and strengthened associations with all-cause and respiratory disease mortality, especially in 'most' deprived areas where most-vulnerable people lived and where health needs were greatest. Conclusion There is a need to reduce air pollution-related risks for all. However, it is also the case that greater health gains can result from considering local air pollution problems and solutions in the context of wider health-determinants and acting on a better understanding of relationships. Informed and co-ordinated air pollution mitigation and public health action in high deprivation and pollution areas can reduce risks and inequalities. To achieve this, greater public health integration and collaboration in local air quality management policy and practice is needed

Covid-19 in the UK: policy on children and schools

Key messagesPandemic policy on children and schools reflected UK based scientific narratives that did not align with global scientific consensusGovernment relied on evidence that downplayed the seriousness of covid-19 in children, underestimated the benefits of precautionary measures, and overestimated the harms of vaccinationReturn to school in September 2020 with minimal emphasis on masking and air quality, and inadequate support for isolation may have accelerated community transmissionThe public inquiry should explore why the UK was an international outlier in its approach to protecting children and making schools and communities safe

We must look further upstream to enable planetary health-literate urban development

The gap between academic research and real-world practice in urban planning and development is a major barrier to planetary health.1 By exploring uncertainty and complexity further upstream, we might be able to narrow that gap, and make progress in tackling the urban health crisis

Vaccinating adolescents against SARS-CoV-2 in England: a risk-benefit analysis.

OBJECTIVE: To offer a quantitative risk-benefit analysis of two doses of SARS-CoV-2 vaccination among adolescents in England. SETTING: England. DESIGN: Following the risk-benefit analysis methodology carried out by the US Centers for Disease Control, we calculated historical rates of hospital admission, Intensive Care Unit admission and death for ascertained SARS-CoV-2 cases in children aged 12-17 in England. We then used these rates alongside a range of estimates for incidence of long COVID, vaccine efficacy and vaccine-induced myocarditis, to estimate hospital and Intensive Care Unit admissions, deaths and cases of long COVID over a period of 16 weeks under assumptions of high and low case incidence. PARTICIPANTS: All 12-17 year olds with a record of confirmed SARS-CoV-2 infection in England between 1 July 2020 and 31 March 2021 using national linked electronic health records, accessed through the British Heart Foundation Data Science Centre. MAIN OUTCOME MEASURES: Hospitalisations, Intensive Care Unit admissions, deaths and cases of long COVID averted by vaccinating all 12-17 year olds in England over a 16-week period under different estimates of future case incidence. RESULTS: At high future case incidence of 1000/100,000 population/week over 16 weeks, vaccination could avert 4430 hospital admissions and 36 deaths over 16 weeks. At the low incidence of 50/100,000/week, vaccination could avert 70 hospital admissions and two deaths over 16 weeks. The benefit of vaccination in terms of hospitalisations in adolescents outweighs risks unless case rates are sustainably very low (below 30/100,000 teenagers/week). Benefit of vaccination exists at any case rate for the outcomes of death and long COVID, since neither have been associated with vaccination to date. CONCLUSIONS: Given the current (as at 15 September 2021) high case rates (680/100,000 population/week in 10-19 year olds) in England, our findings support vaccination of adolescents against SARS-CoV2