ESRC Centre for Evidencebased Public Health Policy

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ESRC Centre for Evidence-based Public Health
Policy
Mark Petticrew MRC Social and Public Health
Sciences Unit University of Glasgow
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• Co-ordinating centre QMW (London)
• What Works For Children (London,York)
• Centre for Neighbourhood Research
  (Glasgow/Bristol)
• Centre for Economic Evaluation(IFS, London)
• Research Unit for Research Utilisation (RURU)
  (St. Andrews)
• Centre for Evidence in Ethnicity, Health and
  Diversity (Warwick/De Montfort)
• Social Policy and Social Care(YORK)
• Centre for Comparative European Policy Evaluation
  (London)
• Centre for Evidence-Based Public Health Policy
  (Glasgow/Lancs/Liverpool)

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• Glasgow (Mark Petticrew, Sally Macintyre, Matt
  Egan, Sian Thomas, Val Hamilton)
• Liverpool (Margaret Whitehead, Frances Drever,
  Beth Milton)
• Lancaster (Hilary Graham, Liz McDermott, Pam
  Attree)
• Sheffield (Clare Bambra)

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• 1. To explore the wider evidence base for
  improving the public health and reducing
  inequalities in health
• 2. To collate and synthesise the evidence base
  (improving public health and reducing
  inequalities in health) and
• 3. Engage with policy/practitioner/and academic
  users.

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Systematic reviews Housing and regeneration

• Housing improvement and health (Thomson et al
  BMJ 2001).
• Are national area-based initiatives a public
  health investment? A systematic review (Hilary
  Thomson Rowland Atkinson est Jan 2005)
• Using systematic review methodology, we have
  examined the national evaluations of UK
  regeneration programmes (1980-2004) to assess how
  the effectiveness of two decades of regeneration
  investment has been evaluated

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Transport

• Health impacts of new road building (Egan et al.,
  Am J Public Health 2003)
• Systematic review of reviews of transport
  policies (Morrison, J Epidemiol Comm Health 2003)
• Promoting walking and cycling as an alternative
  to using cars (modal shift) (Ogilvie et al., Br
  Med J 2004)

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Employment

• The health and employment impacts of
  state-subsidies (Egan et al., submitted)
• The health impacts of workplace re-organisation
  a systematic review (Egan, Bambra et al., Jan
  2005)
• How effective are labour market interventions in
  helping disabled people gain employment? (Bambra,
  Whitehead In press, Soc Sci Med)
• The epidemiology of sickness absence a
  systematic review. (Bambra, Whitehead, In press)

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Childhood disadvantage Systematic Reviews

• Social consequences of poor health in childhood
  (Milton, Whitehead)
• Childhood disadvantage health inequalities
  (Raine Graham, In press Child).
• Other
• Young women contraceptive use SR of research
  on uptake, choice, discontinuation among
  adolescent girls (Williamson, et al., ongoing)
• Teenage mothers smoking systematic review of
  qualitative research (McDermott, Graham Journal
  of Youth Studies Vol. 8 (1))

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Increasing utility

• A systematic review is not the end product (or
  even the most useful product)
• ...Because research evidence on its own is often
  not very useful to users

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Housing systematic review
Academic paper (evaluations of interventions)
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New roads review
Academic paper (evaluations of health and social
impacts of new roads)
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Problems with public health evidence

• Problems with high concept notions of evidence
  preferred by academics
• In policy circles a mixed economy of evidence
  prevails, with different types of scientific and
  non-scientific evidence used
• Research that is explanatory, rather than
  evaluative
• Evidence that lacks an equity dimension
• Little information on costs

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Evidence with an equity dimension

• Systematic reviews assessing differential
  effectiveness of interventions
• Do the effects vary by social class, gender,
  education, ethnicity, etc?
• Pilot study of differential effects of community
  level smoking cessation/prevention interventions
• Based on existing Cochrane reviews

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DH-funded project, collaboration between CRD
MRC SPHSU University of Liverpool, Glasgow
CDSR
DARE
etc
etc
Systematic reviews
Primary studies
Unpublished analyses
New analyses
Evidence on smoking inequalities
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Methodological challenges

• Post hoc analysis of primary studies
• Sub group analyses underpowered
• Within study (direct) comparisons between social
  groups are probably rare
• Between study (indirect) comparisons are possible
  but biased
• Primary versus secondary outcomes
• Cochrane/Campbell Equity Methods group

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No bricks without straw...

• Little recent history in the UK of outcome
  evaluation of social interventions...
• Need to carry out new primary research

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1. SHARP Scotlands Housing and Regeneration
Project

• Scotland-wide, prospective, controlled study of
  housing renewal (Intervention300 Control300)
• Two-year follow up (postal, then face to face)
• Qualitative interviews
• ...To finish 2006

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2. The Springburn Supermarket study
Funded through the DH Health Inequalities
Initiative
(Cummins S, Higgins C Petticrew, M Sparks L,
Findlay A)
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3. Study of the health impacts of Edinburghs
Congestion Charging scheme
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• www.evidencenetwork.org