Fair's Fare latest issue

... is available now from the EPHRU website.

Changes

There's an increasing wealth of research and policy output on behaviour change in public health: a timely review of grey literature (material generated by government, or business, industry or academic communites but not published commercially) offers a useful survey. A paper from the US looks at ways to improve public health through interventions targeted at specific places (including schools, neighbourhoods, restaurants or recreational areas). Finally, a review of public health interventions delivered to whole communities assesses effectiveness, particularly in terms of impact on inequalities and also cost.

Home truths

Following the publication of the Government's housing strategy, the Housing Learning and Improvement Network (LIN) has produced a toolkit to help local authorities and public and private sector developers in their approach to housing for older people. Housing LIN has also produced an evaluation of the Extra Care Housing Fund, concluding that such schemes can improve older people's health and wellbeing and offer a viable cost-effective alternative to residential care. A paper from Sunderland City Council looks at about providing reablement or intermediate care accommodation within an extra care housing scheme. A briefing from the NHS Mental Health Confederation considers the role of housing in mental health and wellbeing. And finally another paper from the Housing LIN examines the evidence base for early intervention in housing.

Weighing up the matter

There's a useful systematic review of the literature on the relationship between socioeconomic inequalities and adult obesity in BMC Public Health. The National Obesity Observatory also gathers together the data and evidence on socioeconomic status and adult and child obesity. The BERTIE project (Babies and Early Years Risk - Trying to Implement the Evidence) aimed to develop a simple evidence based means to identify babies at risk of later obesity. The study found that parental obesity, weight centile, infant weight gain and smoking in pregnancy are the most important factors. Tower Hamlets Healthy Borough Programme documents its progress towards tackling the social and environmental causes of obesity in the area.

Mapping child poverty

The End Child Poverty campaign has published a (widely reported) map of child poverty in the UK. Levels are mapped by local authority area and (for maximum impact) parliamentary constituency. The Joseph Rowntree Foundation's annual monitoring poverty and social exclusion report makes for equally uncomfortable reading, noting a rise in fuel poverty and homelessness, as well as unemployment and underemployment. In a speech last month former Labour MP and now government advisor on social mobility and child poverty, Alan Milburn, predicted a rise in child poverty rates.

Migrant health

The Health Protection Agency (HPA)'s second report on migrant health notes that a small proportion of the UK's migrant population bears "the greatest burden of infectious disease reported in the UK". The report emphasises the important role primary care practitioners play in early identification of infectious diseases. Repeating the message from the previous baseline report, the HPA calls for primary care to ensure access to culturally competent and language supported services. A recent study of participation in a cervical screening programme by Polish, Slovak and Romanian women in London confirms this need for language support.

Cancer update

A study from the Cancer Research UK Cancer Survival Group asks how many cancer deaths in England would be avoided if socioeconomic inequalities were eliminated? Based on data covering 1996-2006, the researchers conclude that while avoidable deaths have reduced, the gap between rich and poor remains substantial: "over 60% of the total number of avoidable deaths occurred within six months after diagnosis and approximately 70% occurred in the two most deprived groups." Latest data from ONS (up to 2009) confirms the persistence in geographic inequalities in survival, with the north-south divide reduced but still in evidence. A more detailed study of socioeconomic inequalities in survival from breast cancer in South West England looks at whether inequalities are present in screening-detected cancer as well as in symptomatic women. The researchers found inequalities with screening detected diagnosis, but in a less marked way. Research on cancer spending amongst primary care organisations in South East England suggests spending was not so much associated with disease burden than activity: "Lower per capita spending on cancer was associated with smaller PCT populations and a higher proportion of deprived areas within them." Finally, a major study from Cancer Research UK examines causes of cancer in the UK in 2010: lifestyle appears to be a major culprit, accounting for over 40% of cancers diagnosed.

Family circle

Working with troubled families is a target area for current government policy. The Department for Education has published a report on family interventions, an intensive, multi-agency approach to tackling anti-social behaviour, worklessness and intergenerational disadvantage. An evaluation of the Parenting Early Intervention Pathfinder compares the effectiveness of 3 parenting programmes over a 2 year period. This large scale trial involved families over 18 local authorities, using the Incredible Years, Triple P and Strengthening Families Strengthening Communities programmes. A study published in BMC Health Services Research models the cost-effectiveness of parenting programmes designed to prevent conduct disorder.