International Festival of Public Health

LT 4 - Health Promotion and Improvement

Making the case for interventions in Physical Activity within the context of funding driven by economic growth.

Presenter: Vincent Goodwin, Sustrans

Other author(s): None

Abstract Text: The international economic crisis has resulted in huge spending cuts across all government departments. Levels of austerity measures in the UK have seen funding drop to levels not seen since the 1940s. Alongside this there has been an increased emphasis on growing the economy with many potential funding streams previously accessible for public health promotion being tasked with demonstrating economic benefits over other aspects.This presentation will look at how measures to tackle the growing crisis in physical inactivity and obesity can also deliver economic vitality and growth.The presentation will explore how schemes designed to promote and encourage cycling and walking can create multiple outcomes beyond the immediate health benefits to individuals.Themes will include changes to the public realm and how this affects personal travel behaviour as well as community engagement programmes that can deliver public health themes whilst providing training and work experience opportunities for the young and unemployed. Focus will be placed on Sustrans community street design projects and our smarter choices programmes as well as interventions outside the UK.

Are inequalities in health still relevant in public health agenda: a qualitative study?

Presenter: Mzwandile Mabhala, University of Chester

Other author(s): None

Abstract Text:

Background: Nurses have long been identified as key contributors to strategies to reduce inequalities in health. However, health inequalities increased in the UK despite measures put in place to reduce them. This raise questions about: 1) the effectiveness of strategies to reduce health inequalities, and 2) nurses’ understanding of how inequalities in health are created and sustained, their nature and level of contribution to reducing inequalities, and their preparedness in terms of political consciousness and/or educational preparation.

Aim: The aim of this qualitative research project is to determine nurses’ understanding of public health as a strategy to reduce inequalities in health.

Methods: 26 semi-structured interviews were conducted with higher education institution-based public health nurse educators.

Findings: Public health nurse educators described inequalities in health as the foundation on which a public health framework should be built. Two distinct views emerged of how inequalities should be tackled: some proposed a population approach focusing on upstream preventive strategies, whilst others proposed behavioural approaches focusing on empowering vulnerable individuals to improve their own health.

Conclusion: The synthesis of data from the current study findings and data from the previous studies, informed the development of conceptual framework that describes three dimensions – science, ethics and human right that frames argument about health inequalities.

An automated 3D imaging method to select breast implants

Presenter: Stefanie Pohlmann, University of Manchester

Other author(s): Ashu Gandhi, Christopher Taylor, Susan Astley

Abstract Text: Breast cancer is the most frequent cancer in women worldwide, with 1 in 8 women in the UK affected during her lifetime. Five-year survival is over 85%, however treatment is highly invasive and often involves surgical removal of breast tissue (mastectomy). After mastectomy the breast can be reconstructed using an implant.Restoring the natural female body image can improve the quality of life for breast cancer survivors. For unilateral surgery, choosing the most appropriate implant ensures identical bra cup sizes and an aesthetically pleasing outcome. Currently surgeons rely on their experience for implant choice. Our aim is to develop an automated method for preoperative implant size measurement for patients undergoing unilateral mastectomy. We hope this can prevent unnecessary poor outcomes and re-intervention.The Microsoft Kinect, originally designed as input device for computer gaming provides 3D images of the patient's breasts before surgery from which volume is calculated and the optimum implant size determined. The accuracy of our approach was validated using a full-sized teaching torso. Mean 3D surface measurement error is below 1.5 mm. In a clinical pilot study we are evaluating the method's suitability for cancer patients including post-surgical evaluation of symmetry. Our fast, easy and inexpensive 3D imaging technology has the potential to ensure breast cancer survivors will get the optimum implants and best cosmetic outcome. We hope restoring their natural female body shape can boost their confidence, mental and physical health.

The impact of activities in green spaces on levels of physical activity

Presenter: Omer Ali, University of Manchester

Other author(s): None

Background: Green spaces were invented by the Victorians as the “lungs” of the cities, allowing people to escape from the pollution of cities. Today, they are primarily used as recreational spaces. This study aimed to look at whether the presence of recreational activities leads to increased levels of physical activities.

Methods: Data from UK cities that took part in the European Urban Health Indicator System Part 2 (EURO-URHIS 2) was analysed. Univariate analysis determined which variables were entered into the logistic regression to investigate the association between physical activities and green space. Potential confounders were account for.

Results: No relationship was found between the perceived distance of green space and obesity. However, people were more likely to exercise for 60 minutes or more if there were recreational activities at their green spaces. They were also more likely to do so if the thought their green space was safe, accessible and within walking distance. Younger people were more likely to exercise than older individuals, and men more than women. People who described their jobs as sedentary were also less likely to take part in physical activity.

Conclusion: A number of variables that affect the levels of exercise have been identified. This research allows policymakers and counsellors to target particular groups that may not feel that green spaces are accessible to them. Green spaces can be made more welcoming to these groups. Further research needs to be carried out into the particular recreational activities that are most suited to each demographic.

Association between sexual orientation identity and Body Mass Index (BMI) categories: Individual Participant Meta-Analysis of 54,736 individuals from nine health surveys in the UK

Presenter: Joanna Semlyen, London Metropolitan University

Other author(s): Gareth Hagger-Johnson

Abstract Text: Aims: To determine the association between Lesbian, Gay, Bisexual or 'Other' (LGBO) sexual orientation identity and unhealthy Body Mass Index (BMI) categories among adults in the UK. Design: Logistic regression following Individual Participant Meta-Analysis to estimate the odds of being under or overweight/obese (vs. healthy weight) for LGBO adults (vs. heterosexuals). Setting: Pooled data from nine UK health surveys (Health Survey for England 2011, 2013, Scottish Health Survey 2008-2012 and the Understanding Society cohort). Participants: Self-reported Lesbian/Gay (n = 575), Bisexual (n = 463), Other (n = 466) or heterosexual (n = 53,232) adults. Results: Provisional results suggest different patterns for men and women, adjusting for age. Gay men were more likely to be underweight (OR = 4.19, 95% CI 2.36, 7.45) and less likely to be overweight/obese than heterosexual men (OR = 0.65, 95% CI 0.51, 0.81). Lesbian women were more likely to be overweight/obese than heterosexual women (OR = 1.85, 95% CI 1.40, 2.47). Women identifying as 'Other' were more likely to be overweight/obese than heterosexual women (OR = 1.41, 95% CI 1.06, 1.87). No association found between bisexual identity and BMI categories. Conclusions: Gay men are at higher risk of being underweight, and lower risk of being overweight/obese compared to heterosexual men. Women identifying as Lesbian or Other (vs. heterosexual) are more likely to be overweight/obese. We will additionally report the associations after adjustment for covariates, including diet and physical activity. These provisional results provide evidence for inequalities across BMI categories for sexual orientation identity groups.