Roughing it

Levels of homelessness in the UK have begun to rise, according to figures released in September by the Department for Communities and Local Government: up 17% this April-June on the same period in 2010. While figures are low in the context of the past decade, it does seem that the trend is upwards. Crisis, the homelessness charity, has published a report that looks at the likely impacts of economic downturn and weakened welfare protection on homelessness in the UK. The government's pledge to end rough sleeping and prevent homelessness, set out in the policy document No second night out nationwide, acknowledges that there is no simple solution to this complex problem. And this is also the main theme of a new study from the Joseph Rowntree Foundation, which looks at evidence from a recent programme of work on multiple exclusion homelessness.

Tangled web

The connection between income inequality and health and social problems is commonly acknowledged, but the exact nature of that link is much harder to explain. A new report from the Joseph Rowntree Foundation asks the big question: does income inequality cause health and social problems? While its authors find little evidence for an entirely affirmative answer, they do note that some research does show a causal relationship and also that income inequalities might be more harmful beyond a certain threshold (following Wilkinson and Pickett's argument in The Spirit Level). While the UK was somewhat below that threshold in the middle of the last century, since the late 1980s we've been well above it. One of the report's authors, Karen Rowlingson, offers a good summary on the LSE blog.
Japan was once the byword for social equality, but since the market liberalisation of the 1990s, things have changed. A conference paper published in the Journal of Epidemiology and Community Health (JECH) charts the widening gap between rich and poor and the relationship between the social change of the 1990s and health inequalities in the second millennium.
An essay from Clare Bambra, also in JECH, muses on the role of the welfare state as determinant of health. The essay focuses on the public health "puzzle" evidenced in international studies of health inequalities: why do Scandinavian states, with rather more generous welfare provision, not have the smallest health inequalities?

Visiting time

The Royal College of Nursing (RCN) has published a consultation paper on public health nursing and the role of health visitors, in the light of the changing NHS landscape and the planned expansion in health visitor numbers. This document builds on two earlier position papers, on community nursing and health visitors, seeking to capture views of RCN members and develop some clarity about the health visiting role. The RCN wants to be clear that the focus of health visiting is on maternal and child wellbeing in the early years (0-5) and that general public health goals should be the concern of every nurse. Responses are due by 4 November 2011.

NICE advice for alcohol service commissioning

Guidance on commissioning alcohol services from NICE aims to help with benchmarking levels of alcohol dependence and harmful drinking in populations, along with methods for working out cost effectiveness of increasing screening and brief interventions. All of this is based on existing guidelines on alcohol harm (CG 115, CG 100 and PH 24). Health Scotland has published an evaluation of implementing brief interventions in the NHS since 2008, covering primary care, A&E and antenatal care. As the Scottish government prepares to legislate for minimum alcohol pricing, a study of views amongst people in north west England on pricing found that most people surveyed though that lower prices increased drinking while higher prices would have no effect on alcohol consumption. Alcohol Research UK has published a qualitative study of attitudes to the pricing question, finding that most people surveyed were not convinced that minimum pricing would be effective (although the study also found that most people didn't fully understand how the policy might work, either). A study from the Joseph Rowntree Foundation looks at how far young people's attitudes to drinking are influenced by the media.

Home alone

There are plenty of projects that target social isolation amongst older people, but how can you tell what works? A team from the Peninsular College of Medicine and Dentistry has reviewed such interventions, finding there was "evidence of substantial heterogeneity" amongst studies and that comparatively few were well-conducted. Most effective interventions tended to offer social activity and/or some group support; those that engaged older people's active participation also tended to be more successful. A three year action research programme assessing neighbourhood approaches to loneliness from the Joseph Rowntree Foundation may be worth watching. A study considering the relationship between neighbourhood environment and positive mental health amongst older people in Hertfordshire showed that a sense of cohesion with neighbours was associated with better mental wellbeing and less reporting of neighbourhood problems, independently of socio economic and health status. Finally, a team from Birmingham University looks at older people's strategies for dealing with winter cold.

Mickey Mouse Research?

Health promotion - it's all about role models. Latest child friendly association for the NHS's Change4Life healthy living brand is ... Lazytown. According to researchers PCP, Sportacus is "the healthiest children’s character on UK television" although Scooby Doo and Tom and Jerry were also considered very active (no mention of the other Mouse). This new promotion is designed to appeal to children aged 2 to 5 and to address healthy eating and physical activity issues. The under 5 age group was included for the first time in the government's recent physical activity guidelines .

Nice cup of tea and a sit down?

...or not: a nutritional analysis survey of biscuits and similar delights from DH makes sobering reading for anyone contemplating a tea break. There's also a survey of processed foods with particular reference to trans fatty acids (anything from pizza to ice cream). An editorial in a recent issue of the Journal of Epidemiology and Community Health muses about the the global obesity epidemic and the relationship between the demand and supply sides of the food system. A study in Critical Public Health, meanwhile, looks at the evidence for menu labelling as measure for preventing obesity.