CURRENT TOPICS & OPINIONS indicated that short bouts of highintensity activity provides greater protection against chronic health problems when compared to bouts of longer duration low-intensity exercise.10,11 Evolutionary fitness drives all animal
populations, including Homo sapiens, to complete a task using the least amount of energy, resulting in human societies becoming increasingly automated. However, it seems that this automation has not resulted in a decrease of total energy expenditure over time.8 The
question therefore is not whether sedentary behaviour is a cultural maladaptation causing the chronic diseases of modern society, but how does physical activity interact with other environmental influences to create the Homo sapiens of today?
References 1.
2.
3.
4.
Wadsworth D, Gleason M, Stoner L. Can sedentary behaviour be considered a cultural maladaptation? Perspectives in Public Health 2014; 134: 20–1. Martinez-Gonzalez MA, Martinez JA, Hu FB, Gibney MJ, Kearney J. Physical inactivity, sedentary lifestyle and obesity in the European Union. International Journal of Obesity and Related Metabolic Disorders 1999; 23: 1192–201. Warren TY, Barry V, Hooker SP, Sui X, Church TS, Blair SN. Sedentary behaviors increase risk of cardiovascular disease mortality in men. Medicine and Science in Sports and Exercise 2010; 42: 879–85. Hu FB, Li TY, Colditz GA, Willett WC, Manson JE. Television watching and other sedentary
5.
6.
7.
8.
behaviors in relation to risk of obesity and type 2 diabetes mellitus in women. JAMA 2003; 289: 1785–91. Loyau A, Saint Jalme M, Cagniant C, Sorci G. Multiple sexual advertisements honestly reflect health status in peacocks (Pavo cristatus). Behavioral Ecology and Sociobiology 2005; 58: 552–7. Gould SJ, Vrba ES. Exaptation-a missing term in the science of form. Paleobiology 1982; 8: 4–15. Prum RO, Brush AH. The evolutionary origin and diversification of feathers. The Quarterly Review of Biology 2002; 77: 261–95. Pontzer H, Raichlen DA, Wood BM, Mabulla AZ, Racette SB, Marlowe FW. Hunter-gatherer
energetics and human obesity. PLoS ONE 2012; 7: e40503. 9. O’Dea K. Westernization and non-insulindependent diabetes in Australian Aborigines. Ethnicity & Disease 1991; 1: 171–87. 10. Gibala MJ, Little JP, MacDonald MJ, Hawley JA. Physiological adaptations to low-volume, high-intensity interval training in health and disease. The Journal of Physiology 2012; 590: 1077–84. 1. Paoli A, Pacelli QF, Moro T, Marcolin G, Neri 1 M, Battaglia G et al. Effects of high-intensity circuit training, low-intensity circuit training and endurance training on blood pressure and lipoproteins in middle-aged overweight men. Lipids in Health and Disease 2013; 12: 131.
Addressing health inequalities: five practical approaches for local authorities Graeme Greig, of the Public Health Team at Durham County Council, and Kayleigh Garthwaite and Clare Bambra, both of the Department of Geography and the Wolfson Research Institute for Health and Wellbeing at Durham University, look at the shift of public health functions in England into local authorities and the practical opportunities available to address health inequalities across five key areas. accessible, The 2013 shift of public health functions in England to local As well as being understandable authorities, along with the evidence-based, and attractive to elected officials. introduction of local Health and there is also a This paper Wellbeing Boards, presents clear need for significant opportunities for public the interventions suggests some health, particularly in terms of the we champion to practical approaches that social determinants of health and be practical for health inequalities. As well as being local authorities local authorities could – and have evidence-based, there is also a – considered in clear need for the interventions we terms of addressing health inequalities, champion to be practical for local authorities to implement, and to be made focusing on five key areas that are within
132 Perspectives in Public Health l May 2014 Vol 134 No 3
local authority control: environment and obesity, improving active travel and reducing accidents, income maximisation, housing and health-related worklessness.
Environment and Obesity There is an association between the concentration of fast food takeaways and levels of obesity. Levels of obesity tend to be higher in deprived areas than in wealthier areas, and lowincome groups are more likely to consume ‘energy-dense’ foods (e.g. pizzas, processed meats and fast foods) than higher income groups.1 The 2007 Foresight Report2 shows that becoming obese is much more than a matter of poor choices about diet and exercise. Individual psychology and behaviour are hugely influenced by a
CURRENT TOPICS & OPINIONS range of external social, cultural and environmental factors. Research in 2005 looking at the location of McDonald’s restaurants in England and Scotland found that there were four times as many in the most deprived areas as in the least deprived.3 The Marmot review of spatial planning4 found that environmental disadvantages affect the poor the most, with greater deprivation being linked to reduced likelihood of good-quality open space, easy walking and cycling routes, welllocated services and a good housing mix and design. National Child Measurement Programme (NCMP) data has demonstrated a strong positive correlation between deprivation and obesity prevalence for children and National Obesity Observatory (NOO) data does the same for adults.
Practical approach: restricting fast food outlets Restricting fast food outlets in terms of numbers and proximity to local schools is one measure which could have an effect on obesity in local communities. Davis and Carpenter5 found that exposure to poor-quality food environments has important effects on adolescent eating patterns and conclude that policy interventions limiting the proximity of fastfood restaurants to schools could help reduce adolescent obesity. Limiting fastfood takeaways to within 400m of schools is generally an accepted threshold, representing a five-minute walk.6 It is used by a number of London councils when restricting hot food takeaways in the vicinity of schools; in 2010, a High Court case to challenge a decision by Tower Hamlets local authority to grant planning permission to open a new hot food takeaway hit the headlines. This experience, and the process subsequently entered into, provides an illuminating example of a local authority journey to develop a comprehensive and evidence-based approach to the public health impacts of fast-food takeaways.7 Residents of deprived areas could particularly benefit from policies which aim to improve the availability of healthier food options and better access to shopping facilities. Having local shops within walking distance and a general
high accessibility to shops which stock healthy food is likely to improve health within these areas, especially when coupled with planning restrictions on the density of fast-food outlets within deprived areas.
Improving Active Travel and Reducing Accidents A growing body of literature suggests likely positive impacts of travel policies and interventions to increase walking and cycling.8 Britain has the highest percentage of pedestrian road fatalities in Europe (22.5%) and the lowest level of children walking and cycling to school.9 There are various interventions to encourage active travel, including investing in cycling routes, reducing car speed, improving road safety, better walking and improving public transport.
Practical approach: 20mph limits There is evidence that 20mph speed limits reduce overall extreme speeds and work better over areas of larger coverage, combined with engagement with road users and light enforcement. For example, the ‘20 is plenty for us’ campaign in Portsmouth demonstrated how, in comparing the three years before the scheme was implemented and the two years afterwards, the number of recorded road casualties fell by 22% from 183 per year to 142 per year.10 As well as road safety benefits, 20mph zones can encourage more physical activity such as walking and cycling by contributing towards a safer environment.11
Income Maximisation A growing body of studies suggest that welfare benefit advice, through improving the take-up of entitlements, has a positive impact on mental and physical health.12 A large proportion of welfare benefits go unclaimed due to the complexity of the benefits system. By directly increasing access to financial and other resources (such as aids and adaptations for the home), welfare rights advice improves patient outcomes and has the potential to reduce socioeconomic inequalities (e.g. in quality of life following a cancer diagnosis).13
Practical approach: accessible welfare rights advice Research shows that access to a domiciliary welfare rights service for the over 60s provided recipients with additional benefits of £55.14 For cancer patients accessing welfare rights advice at the Citizens Advice Bureau (CAB), welfare benefit claims were successful for 96% of claims made and resulted in a median increase in weekly income of £70.30. Additional resources were perceived to lessen the impact of lost earnings, help offset costs associated with cancer, reduce stress and anxiety and increase the ability to maintain independence and capacity to engage in daily activities, all of which were perceived to impact positively on wellbeing and quality of life.14
Housing Evidence suggests that living in poor housing can lead to an increased risk of cardiovascular and respiratory disease as well as anxiety and depression.15 Many aspects of internal housing conditions have the potential to influence health. In particular, cold and damp conditions may cause or exacerbate respiratory health conditions, and the absence of smoke alarms, fire extinguishers and sprinklers may further increase the risk of injury from fire.16
Practical approach: focus on improving internal housing conditions In a synthesis of systematic reviews of interventions linking housing and health, Gibson et al.15 found that overall, warmth and energy efficiency interventions seemed to have the clearest positive impacts on health, particularly for vulnerable groups, including those with existing health conditions and the elderly. Interventions to reduce house dust mites and to reduce accidents among children and elderly people17 can also be beneficial.
Health-Related Worklessness There is a large international literature on how unemployment results in poorer health and increased mortality.18 It is also
May 2014 Vol 134 No 3 l Perspectives in Public Health 133
CURRENT TOPICS & OPINIONS of the pilot programme found that after six months, the general health of the participants improved, with particular improvements in mental health.20
Conclusion
the case that poor health increases the likelihood of worklessness. Health-related job loss has a social gradient, with adverse employment consequences more likely for those in lower socio-economic groups.19
Practical approach: consider a ‘health first’ case management service A ‘health first’ case management approach to reducing worklessness among long-term incapacity benefit recipients was piloted in County Durham. This programme used telephone and face-to-face case management programmes to identify individual health needs and any other related barriers to employment (such as debt or housing). The intention of the service was to improve the health of participants as a way of improving employability and reducing health inequalities between those in and out of work. The evaluation
There are a number of tools which can be used to implement these approaches and embed health inequalities within local authorities. These can be broadly summarised as covering policy and planning tools, training and workforce development and programme interventions: Health Impact Assessments (HIAs). These assessments are a process for finding out the health consequences of major policies and plans and improving these. HIAs can help planners to consider the broader implications of their policies and unintended negative consequences. HIAs can lead to the consideration of opportunities for developing sustainable communities, green spaces, leisure, reducing traffic, accident prevention and access to health services. A planning policy statement on addressing health inequalities. A clear planning policy statement on why addressing health inequalities matters and what action will be taken can give a clear indication of the commitment to improving health. This could be
incorporated alongside health equity into planning processes and located more centrally in the work of spatial planners. Planners can encourage community participation and cohesion by providing accessible transport and well-located services, and can ensure that services are better integrated and accessible. Better use of existing tools. Existing tools such as Joint Strategic Needs Assessments could be used to encourage and facilitate integrated local planning procedures, as well as informing development and regeneration plans. Public Health Training. There is scope to provide information and training on health equity issues, health inequalities and the social determinants of health for local authority members and officers in planning, housing, environment and transport. Training could be made mandatory around the wider determinants of health, health equity and other approaches. Overall, this piece highlights the significant opportunities available for public health practitioners to influence the social determinants of health and to reduce health inequalities following the transfer of public health functions into local authorities in England.
References 1. 2.
3.
4.
5.
6. 7.
Food Standards Agency. Low Income and Diet Survey. London: Food Safety Authority, 2007. Foresight. Tackling Obesities: Future Choices. London: Department for Business, Innovation & Skills, Government Office for Science, 2007. Available online at: http://www.bis.gov.uk/ assets/foresight/docs/obesity/17.pdf (Last accessed 10th October 2012). Cummins S, McKay L, Macintyre S. McDonald’s restaurants and neighbourhood deprivation in Scotland and England. American Journal of Preventive Medicine 2005; 4: 308–10. Geddes I, Allen J, Allen M, Morrisey L. The Marmot Review: Implications for Spatial Planning. London: The Marmot Review Team, 2011. Available online at: http://www.nice.org. uk/nicemedia/live/12111/53895/53895.pdf (Last accessed 10th October 2012). Davis B, Carpenter C. Proximity of fast-food restaurants to schools and adolescent obesity. American Journal of Public Health 2009; 99(3): 505–10. NHS Tower Hamlets (2011) Tackling the takeaways: A new policy to address fast-food outlets in Tower Hamlets. Takeaways Toolkit. The London Food Board, the CIEH and the Mayor of London, 2012. Available online at: http://www.apho.org.uk/ resource/browse.aspx?RID=120940
8.
9.
10.
11.
12.
13.
European Road Safety Observatory. Road Safety Evolution in the EU. 2013. Available online at: http://ec.europa.eu/transport/road_ safety/specialist/ (Last accessed 4th December 2013). Department for Transport. Interim Evaluation of the Implementation of 20 mph Speed Limits in Portsmouth: Final Report. London: Department for Transport, 2010. Grundy C, Steinbach R, Edwards P, Green J, Armstrong B, Wilkinson P. Effect of 20 mph traffic speed zones on road injuries in London, 1986–2006: Controlled interrupted time series analysis. BMJ 2009; 339: b4469. WHO-UNECE. Transport Health and Environment Pan-European Programme (The PEP) Toolbox. Available online at: http://www. healthytransport.com/2009 (Last accessed 4th December 2013). Corden A, Sainsbury R, Irvine A, Clarke S. The impact of disability living allowance and attendance allowance: Findings from exploratory qualitative research. Research Report no. 649. London: Department of Work and Pensions, 2010, pp. 1–143. Moffatt S, Makintosh J, White M, Howel D, Sandell A. The acceptability and impact of a randomised control trial of welfare rights accessed via primary care: Qualitative study. BMC Public Health 2006; 6: 163.
134 Perspectives in Public Health l May 2014 Vol 134 No 3
14. Adams J, White M, Moffatt S, Howel D, Mackintosh J. A systematic review of the health, social and financial impacts of welfare rights advice delivered in health care settings. BMC Public Health 2006; 6: 81. 15. Gibson M, Petticrew M, Bambra C, Sowden AJ, Wright KE, Whitehead M. Housing and health inequalities: A synthesis of systematic reviews of interventions aimed at different pathways linking housing and health. Health & Place 2011; 17(1): 175–84. 16. Shaw M. Housing and public health. Annual Review of Public Health 2004; 25: 397–418. 17. Hammarquist C, Burr ML, Gotzsche PC. House dust mite control measures for asthma. Cochrane Database of Systematic Reviews 2000; 2: CD001187. 18. Bambra C. Work, Worklessness and the Political Economy of Health. Oxford: Oxford University Press, 2011. 19. Bartley M, Owen C. Relation between socioeconomic status, employment, and health during economic change, 1973–93. BMJ 1996; 313: 445–9. 20. Warren J, Bambra C, Kasim A, Garthwaite K, Mason J, Booth M. Prospective pilot evaluation of the effectiveness and cost-utility of a ‘health first’ case management service for long-term Incapacity Benefit recipients. Journal of Public Health 2014; 36: 117–25. 4
populations, including Homo sapiens, to complete a task using the least amount of energy, resulting in human societies becoming increasingly automated. However, it seems that this automation has not resulted in a decrease of total energy expenditure over time.8 The
question therefore is not whether sedentary behaviour is a cultural maladaptation causing the chronic diseases of modern society, but how does physical activity interact with other environmental influences to create the Homo sapiens of today?
References 1.
2.
3.
4.
Wadsworth D, Gleason M, Stoner L. Can sedentary behaviour be considered a cultural maladaptation? Perspectives in Public Health 2014; 134: 20–1. Martinez-Gonzalez MA, Martinez JA, Hu FB, Gibney MJ, Kearney J. Physical inactivity, sedentary lifestyle and obesity in the European Union. International Journal of Obesity and Related Metabolic Disorders 1999; 23: 1192–201. Warren TY, Barry V, Hooker SP, Sui X, Church TS, Blair SN. Sedentary behaviors increase risk of cardiovascular disease mortality in men. Medicine and Science in Sports and Exercise 2010; 42: 879–85. Hu FB, Li TY, Colditz GA, Willett WC, Manson JE. Television watching and other sedentary
5.
6.
7.
8.
behaviors in relation to risk of obesity and type 2 diabetes mellitus in women. JAMA 2003; 289: 1785–91. Loyau A, Saint Jalme M, Cagniant C, Sorci G. Multiple sexual advertisements honestly reflect health status in peacocks (Pavo cristatus). Behavioral Ecology and Sociobiology 2005; 58: 552–7. Gould SJ, Vrba ES. Exaptation-a missing term in the science of form. Paleobiology 1982; 8: 4–15. Prum RO, Brush AH. The evolutionary origin and diversification of feathers. The Quarterly Review of Biology 2002; 77: 261–95. Pontzer H, Raichlen DA, Wood BM, Mabulla AZ, Racette SB, Marlowe FW. Hunter-gatherer
energetics and human obesity. PLoS ONE 2012; 7: e40503. 9. O’Dea K. Westernization and non-insulindependent diabetes in Australian Aborigines. Ethnicity & Disease 1991; 1: 171–87. 10. Gibala MJ, Little JP, MacDonald MJ, Hawley JA. Physiological adaptations to low-volume, high-intensity interval training in health and disease. The Journal of Physiology 2012; 590: 1077–84. 1. Paoli A, Pacelli QF, Moro T, Marcolin G, Neri 1 M, Battaglia G et al. Effects of high-intensity circuit training, low-intensity circuit training and endurance training on blood pressure and lipoproteins in middle-aged overweight men. Lipids in Health and Disease 2013; 12: 131.
Addressing health inequalities: five practical approaches for local authorities Graeme Greig, of the Public Health Team at Durham County Council, and Kayleigh Garthwaite and Clare Bambra, both of the Department of Geography and the Wolfson Research Institute for Health and Wellbeing at Durham University, look at the shift of public health functions in England into local authorities and the practical opportunities available to address health inequalities across five key areas. accessible, The 2013 shift of public health functions in England to local As well as being understandable authorities, along with the evidence-based, and attractive to elected officials. introduction of local Health and there is also a This paper Wellbeing Boards, presents clear need for significant opportunities for public the interventions suggests some health, particularly in terms of the we champion to practical approaches that social determinants of health and be practical for health inequalities. As well as being local authorities local authorities could – and have evidence-based, there is also a – considered in clear need for the interventions we terms of addressing health inequalities, champion to be practical for local authorities to implement, and to be made focusing on five key areas that are within
132 Perspectives in Public Health l May 2014 Vol 134 No 3
local authority control: environment and obesity, improving active travel and reducing accidents, income maximisation, housing and health-related worklessness.
Environment and Obesity There is an association between the concentration of fast food takeaways and levels of obesity. Levels of obesity tend to be higher in deprived areas than in wealthier areas, and lowincome groups are more likely to consume ‘energy-dense’ foods (e.g. pizzas, processed meats and fast foods) than higher income groups.1 The 2007 Foresight Report2 shows that becoming obese is much more than a matter of poor choices about diet and exercise. Individual psychology and behaviour are hugely influenced by a
CURRENT TOPICS & OPINIONS range of external social, cultural and environmental factors. Research in 2005 looking at the location of McDonald’s restaurants in England and Scotland found that there were four times as many in the most deprived areas as in the least deprived.3 The Marmot review of spatial planning4 found that environmental disadvantages affect the poor the most, with greater deprivation being linked to reduced likelihood of good-quality open space, easy walking and cycling routes, welllocated services and a good housing mix and design. National Child Measurement Programme (NCMP) data has demonstrated a strong positive correlation between deprivation and obesity prevalence for children and National Obesity Observatory (NOO) data does the same for adults.
Practical approach: restricting fast food outlets Restricting fast food outlets in terms of numbers and proximity to local schools is one measure which could have an effect on obesity in local communities. Davis and Carpenter5 found that exposure to poor-quality food environments has important effects on adolescent eating patterns and conclude that policy interventions limiting the proximity of fastfood restaurants to schools could help reduce adolescent obesity. Limiting fastfood takeaways to within 400m of schools is generally an accepted threshold, representing a five-minute walk.6 It is used by a number of London councils when restricting hot food takeaways in the vicinity of schools; in 2010, a High Court case to challenge a decision by Tower Hamlets local authority to grant planning permission to open a new hot food takeaway hit the headlines. This experience, and the process subsequently entered into, provides an illuminating example of a local authority journey to develop a comprehensive and evidence-based approach to the public health impacts of fast-food takeaways.7 Residents of deprived areas could particularly benefit from policies which aim to improve the availability of healthier food options and better access to shopping facilities. Having local shops within walking distance and a general
high accessibility to shops which stock healthy food is likely to improve health within these areas, especially when coupled with planning restrictions on the density of fast-food outlets within deprived areas.
Improving Active Travel and Reducing Accidents A growing body of literature suggests likely positive impacts of travel policies and interventions to increase walking and cycling.8 Britain has the highest percentage of pedestrian road fatalities in Europe (22.5%) and the lowest level of children walking and cycling to school.9 There are various interventions to encourage active travel, including investing in cycling routes, reducing car speed, improving road safety, better walking and improving public transport.
Practical approach: 20mph limits There is evidence that 20mph speed limits reduce overall extreme speeds and work better over areas of larger coverage, combined with engagement with road users and light enforcement. For example, the ‘20 is plenty for us’ campaign in Portsmouth demonstrated how, in comparing the three years before the scheme was implemented and the two years afterwards, the number of recorded road casualties fell by 22% from 183 per year to 142 per year.10 As well as road safety benefits, 20mph zones can encourage more physical activity such as walking and cycling by contributing towards a safer environment.11
Income Maximisation A growing body of studies suggest that welfare benefit advice, through improving the take-up of entitlements, has a positive impact on mental and physical health.12 A large proportion of welfare benefits go unclaimed due to the complexity of the benefits system. By directly increasing access to financial and other resources (such as aids and adaptations for the home), welfare rights advice improves patient outcomes and has the potential to reduce socioeconomic inequalities (e.g. in quality of life following a cancer diagnosis).13
Practical approach: accessible welfare rights advice Research shows that access to a domiciliary welfare rights service for the over 60s provided recipients with additional benefits of £55.14 For cancer patients accessing welfare rights advice at the Citizens Advice Bureau (CAB), welfare benefit claims were successful for 96% of claims made and resulted in a median increase in weekly income of £70.30. Additional resources were perceived to lessen the impact of lost earnings, help offset costs associated with cancer, reduce stress and anxiety and increase the ability to maintain independence and capacity to engage in daily activities, all of which were perceived to impact positively on wellbeing and quality of life.14
Housing Evidence suggests that living in poor housing can lead to an increased risk of cardiovascular and respiratory disease as well as anxiety and depression.15 Many aspects of internal housing conditions have the potential to influence health. In particular, cold and damp conditions may cause or exacerbate respiratory health conditions, and the absence of smoke alarms, fire extinguishers and sprinklers may further increase the risk of injury from fire.16
Practical approach: focus on improving internal housing conditions In a synthesis of systematic reviews of interventions linking housing and health, Gibson et al.15 found that overall, warmth and energy efficiency interventions seemed to have the clearest positive impacts on health, particularly for vulnerable groups, including those with existing health conditions and the elderly. Interventions to reduce house dust mites and to reduce accidents among children and elderly people17 can also be beneficial.
Health-Related Worklessness There is a large international literature on how unemployment results in poorer health and increased mortality.18 It is also
May 2014 Vol 134 No 3 l Perspectives in Public Health 133
CURRENT TOPICS & OPINIONS of the pilot programme found that after six months, the general health of the participants improved, with particular improvements in mental health.20
Conclusion
the case that poor health increases the likelihood of worklessness. Health-related job loss has a social gradient, with adverse employment consequences more likely for those in lower socio-economic groups.19
Practical approach: consider a ‘health first’ case management service A ‘health first’ case management approach to reducing worklessness among long-term incapacity benefit recipients was piloted in County Durham. This programme used telephone and face-to-face case management programmes to identify individual health needs and any other related barriers to employment (such as debt or housing). The intention of the service was to improve the health of participants as a way of improving employability and reducing health inequalities between those in and out of work. The evaluation
There are a number of tools which can be used to implement these approaches and embed health inequalities within local authorities. These can be broadly summarised as covering policy and planning tools, training and workforce development and programme interventions: Health Impact Assessments (HIAs). These assessments are a process for finding out the health consequences of major policies and plans and improving these. HIAs can help planners to consider the broader implications of their policies and unintended negative consequences. HIAs can lead to the consideration of opportunities for developing sustainable communities, green spaces, leisure, reducing traffic, accident prevention and access to health services. A planning policy statement on addressing health inequalities. A clear planning policy statement on why addressing health inequalities matters and what action will be taken can give a clear indication of the commitment to improving health. This could be
incorporated alongside health equity into planning processes and located more centrally in the work of spatial planners. Planners can encourage community participation and cohesion by providing accessible transport and well-located services, and can ensure that services are better integrated and accessible. Better use of existing tools. Existing tools such as Joint Strategic Needs Assessments could be used to encourage and facilitate integrated local planning procedures, as well as informing development and regeneration plans. Public Health Training. There is scope to provide information and training on health equity issues, health inequalities and the social determinants of health for local authority members and officers in planning, housing, environment and transport. Training could be made mandatory around the wider determinants of health, health equity and other approaches. Overall, this piece highlights the significant opportunities available for public health practitioners to influence the social determinants of health and to reduce health inequalities following the transfer of public health functions into local authorities in England.
References 1. 2.
3.
4.
5.
6. 7.
Food Standards Agency. Low Income and Diet Survey. London: Food Safety Authority, 2007. Foresight. Tackling Obesities: Future Choices. London: Department for Business, Innovation & Skills, Government Office for Science, 2007. Available online at: http://www.bis.gov.uk/ assets/foresight/docs/obesity/17.pdf (Last accessed 10th October 2012). Cummins S, McKay L, Macintyre S. McDonald’s restaurants and neighbourhood deprivation in Scotland and England. American Journal of Preventive Medicine 2005; 4: 308–10. Geddes I, Allen J, Allen M, Morrisey L. The Marmot Review: Implications for Spatial Planning. London: The Marmot Review Team, 2011. Available online at: http://www.nice.org. uk/nicemedia/live/12111/53895/53895.pdf (Last accessed 10th October 2012). Davis B, Carpenter C. Proximity of fast-food restaurants to schools and adolescent obesity. American Journal of Public Health 2009; 99(3): 505–10. NHS Tower Hamlets (2011) Tackling the takeaways: A new policy to address fast-food outlets in Tower Hamlets. Takeaways Toolkit. The London Food Board, the CIEH and the Mayor of London, 2012. Available online at: http://www.apho.org.uk/ resource/browse.aspx?RID=120940
8.
9.
10.
11.
12.
13.
European Road Safety Observatory. Road Safety Evolution in the EU. 2013. Available online at: http://ec.europa.eu/transport/road_ safety/specialist/ (Last accessed 4th December 2013). Department for Transport. Interim Evaluation of the Implementation of 20 mph Speed Limits in Portsmouth: Final Report. London: Department for Transport, 2010. Grundy C, Steinbach R, Edwards P, Green J, Armstrong B, Wilkinson P. Effect of 20 mph traffic speed zones on road injuries in London, 1986–2006: Controlled interrupted time series analysis. BMJ 2009; 339: b4469. WHO-UNECE. Transport Health and Environment Pan-European Programme (The PEP) Toolbox. Available online at: http://www. healthytransport.com/2009 (Last accessed 4th December 2013). Corden A, Sainsbury R, Irvine A, Clarke S. The impact of disability living allowance and attendance allowance: Findings from exploratory qualitative research. Research Report no. 649. London: Department of Work and Pensions, 2010, pp. 1–143. Moffatt S, Makintosh J, White M, Howel D, Sandell A. The acceptability and impact of a randomised control trial of welfare rights accessed via primary care: Qualitative study. BMC Public Health 2006; 6: 163.
134 Perspectives in Public Health l May 2014 Vol 134 No 3
14. Adams J, White M, Moffatt S, Howel D, Mackintosh J. A systematic review of the health, social and financial impacts of welfare rights advice delivered in health care settings. BMC Public Health 2006; 6: 81. 15. Gibson M, Petticrew M, Bambra C, Sowden AJ, Wright KE, Whitehead M. Housing and health inequalities: A synthesis of systematic reviews of interventions aimed at different pathways linking housing and health. Health & Place 2011; 17(1): 175–84. 16. Shaw M. Housing and public health. Annual Review of Public Health 2004; 25: 397–418. 17. Hammarquist C, Burr ML, Gotzsche PC. House dust mite control measures for asthma. Cochrane Database of Systematic Reviews 2000; 2: CD001187. 18. Bambra C. Work, Worklessness and the Political Economy of Health. Oxford: Oxford University Press, 2011. 19. Bartley M, Owen C. Relation between socioeconomic status, employment, and health during economic change, 1973–93. BMJ 1996; 313: 445–9. 20. Warren J, Bambra C, Kasim A, Garthwaite K, Mason J, Booth M. Prospective pilot evaluation of the effectiveness and cost-utility of a ‘health first’ case management service for long-term Incapacity Benefit recipients. Journal of Public Health 2014; 36: 117–25. 4
