Celebrating public health research in the South West

PictureHearing about research on heatwaves reminded delegates that, even in the South West, it sometimes stops raining.

By James Redmore

Last Wednesday, my fellow DECIPHerers and I ventured to Weston-super-Mare, to attend the 2014 South West Public Health Scientific Conference (SWPHSC). This friendly conference showcases practice- and academic-led public health research from universities, local authorities and other organisations throughout the region. 

The torrential rain and Moscow-esque winds that greeted us at Weston-super-Mare didn’t do much for delegates’ spirits, but the high standard of research and presentations soon defrosted our brains. 

In the first plenary, Dr. Rebecca Ghosh gave a fascinating insight into work on the harmful effects of aircraft noise. Research by the Small Area Health Statistics Unit found links between aircraft noise and both increased hospital admissions and mortality from stroke, cardio-vascular disease and coronary heart disease, for individuals living near Heathrow airport. However, being a cross-sectional study (one which looks at data from a whole population at a specific point in time), there could be other reasons for these associations, meaning we shouldn’t be too quick to assume the existence of simple cause-effect relationships. 

The second presentation was from Michael Sanderson of the Met Office, whose research found an increase in emergency hospital admissions in infants, and those aged 65 years and older, throughout heat wave periods in the UK. Although the presentation was engaging, I couldn’t help but feel that  modelling the health impacts of heavy rain and floods might be more pertinent to those of us based in the south west – possibly something for next year’s programme?

As much of my work relates to schools-based health improvement, I opted to spend the remainder of the morning in presentations relating to educational settings. Kate Blackburn presented the results of an intervention aiming to challenge students’ misconceptions of how much their peers smoked. This led to a 17% reduction in perceived smoking prevalence, and it seemed that much of the project’s success was down to the heavy involvement of students and staff in the study’s design and implementation. 

The next two parallel sessions I attended related to work carried out within DECIPHer. First, Beki Langford presented the results of her Cochrane Review on the effectiveness of the WHO’s Health Promoting Schools framework, which is increasingly being adopted in schools. This has concluded that although the framework has positive effects in improving certain health outcomes, evidence of impacts on academic-related outcomes is lacking.

Jonny Currie then presented the results of a qualitative study exploring teachers’ views on school-based health promotion. This found that despite identifying clear links between health and education, teachers primarily saw themselves as educators, rather than promoters of health. Many believed it to be parents’ role to teach their children the ‘life skills’ necessary for health, such as how to cook healthy meals. For me, this highlighted the importance of funding external agencies, as well as universities and professionals working in health promotion, to promote wellbeing in its widest sense, and to address gaps in knowledge provision. In addition to the increasing lack of funding, barriers to achieving effective health promotion in schools included staff time, and a results-driven environment that hinders more ‘holistic’ work within schools.

PictureE-cigarette manufacturers have quickly learned to make their products look as much like cigarettes as possible.
The afternoon parallel sessions I attended focused on multiple risk behaviours. First, Hayley Jones presented preliminary results of work to estimate the prevalence of injecting drug use in Bristol. DECIPHer’s Heide Busse then presented the findings of a fascinating systematic review on self-asphyxial behaviour (SAB, also known as ‘the choking game’ – where an individual intentionally cuts off oxygen to their brain, to cause fainting and/or feelings of euphoria) in young people. I was surprised to hear that much of the research on SAB in adolescence has been carried out in North America and France, where between 5-11% of young people have reported engaging in the behaviour, and up to 68% of young people are aware of it as a method of gaining a momentary ‘high’. The usual conclusion of ‘more research is required’ is definitely applicable here; despite SAB posing severe health risks, little is known of the extent of the issue in the UK or the awareness of its existence by public health professionals. As with many risk behaviours, caution also needs to be applied to ensure that any future work on SAB doesn’t perpetuate this worrying phenomenon.  

To open the final plenary presentations, Dr. Petra Manley spoke on the associations between perceived neighbourhood environment and weight loss. Her work found that individuals who thought walking was unsafe due to either crime or heavy traffic were less likely to lose weight than people without these perceptions. The method of linking data collected as part of a different study to data on the built environment (at little additional cost) was particularly innovative. 

Arguably the most controversial topic of discussion was left to close the conference, with Professor Anna Gilmore’s passionate and balanced presentation on whether e-cigarettes are a threat or an opportunity for public health. E-cigarettes do not contain the tars or other toxins found in tobacco, so are significantly less harmful than cigarettes, and a small number of studies have shown that they may be effective in helping smokers to quit. However, regulation, and the associated testing for safety and efficacy, are currently lacking for e-cigarettes. They hence contain varying quantities of nicotine and, perhaps more worryingly, may contain a range of unknown substances. Professor Gilmore explained that big tobacco companies are investing in alternative ways of delivering nicotine, such as snus and e-cigarettes, primarily due to profit margins rather than on health grounds. At present, the number of young people using e-cigarettes is minimal. However, given the huge increase in marketing of these products, and glamorisation by celebrities and the media, future monitoring of e-cigarettes’ uptake by adolescents is essential.  Importantly, Professor Gilmore warned that public health should not take its focus off smoking, which kills one in two, as a result of this emerging product. 

What was my take on the conference? First, it was heartening to see the engagement, collaboration and dialogue between researchers and participants demonstrated throughout the day’s presentations. Second, many of the interventions discussed were multi-component, emphasising the importance of ensuring behaviour change interventions work at the level of the individual, school/family, and wider environment. Finally, it highlighted the high standard and rigour of public health research carried out in the South West, towards which DECIPHer makes a key contribution. 

James Redmore is a research assistant at DECIPHer, based at the University of Bristol. He tweets at @jjredmore. James attended the South West Public Health Scientific Conference, which took place on 5 February 2014 at the Winter Gardens in Weston-super-Mare. Full information on the conference, including the programme, is available here. A Storify of tweets from the conference is here.

Image sources: Photo of Weston-super-Mare – Bruce Stokes, via Flickr

Photo of e-cigarettes – Mark Gregory, via Flickr

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