Category: School of Public Health

Movement Foundations: How can digital tools help people to become more physically active?

Dr David Salman from the School of Public Health discusses how digital interventions could help people return to fitness following a period of illness.

I am a GP, researcher, and work at the Imperial College Healthcare NHS Trust sport and exercise medicine clinic. Part of my work is to help people become more physically active – important because it is one of the few interventions that can improve health in many different ways. If we had a similar drug or intervention that reduced the risk of heart disease, diabetes, dementia, depression, risk of falls, and several cancers, then everyone would probably be on it. The problem is that almost one-third of people in the UK are not physically active enough for good health. This is partly because barriers to being physically active exist across individual and cultural factors, such as illness, pain or different conceptions of what physical activity or exercise mean; infrastructure aspects such as safety, facilities and lighting, through to national and global policy. Therefore, this wonder medicine is not equally available to all.

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Covid-19 vaccination in the UK: What does the future hold?

Covid-19 vaccination centre sign

Recently, the UK Government announced that offers of first and second Covid-19 vaccinations will come to an end after 30 June. Ahead of World Immunisation Week, Professor Azeem Majeed from the School of Public Health discusses this major change in national vaccine policy, and why it’s important to stay up to date with Covid-19 booster vaccinations.

The announcement from NHS England that first and second doses of Covid-19 vaccines will no longer be offered to adults after 30 June 2023 signifies a significant change in national vaccine policy. We will all remember the start of the Covid-19 vaccination programme in December 2020, the rapid rollout of vaccines by the NHS, and the enthusiasm for vaccination amongst most sections of the population. Vaccination curbed the impact of Covid-19, leading to large falls in hospital admissions and deaths, and allowing the government to end Covid-19 restrictions.

We are now though entering a new phase in which Covid-19 vaccination will be restricted to older people and those in medical problems that place them at higher risk of adverse outcomes such as hospitalisation and death. The very highest risk groups – such as the immunocompromised and people aged 75 years and over – have been offered booster vaccines every six months for the past two years. Other population groups – such as NHS staff, those aged 50 and over, and people with significant medical problems – have been offered annual booster vaccines.

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Expansion of London’s Ultra Low Emission Zone (ULEZ): why is it causing so much controversy?

ULEZ zone in London

There is nowhere in London that meets the World Health Organization’s (WHO) Air Quality Guidelines (AQGs). The main reason for this is road traffic. So why has the Mayor’s plan to expand the Ultra Low Emission Zone (ULEZ; an area of London that more polluting vehicles have to pay £12.50 to enter) to include the outer London boroughs sparked so much resistance? Professor Frank Kelly who leads the Environmental Research Group at Imperial explains that there are strong health grounds for expanding the ULEZ.

An overwhelming body of evidence exists that the health effects of air pollution are serious and can affect nearly every organ of the body. Recent studies and large research programmes have also shown that these harmful health effects are not limited to high exposures but can also occur at very low concentrations. Consequently, the WHO has had to update its AQGs, which now recommend substantially lower air quality limits for PM2.5, PM10 (particulate matter less than 2.5 and 10 μm in diameter respectively), and the gaseous pollutant nitrogen dioxide. One of the most significant sources of these air pollutants in urban areas is road traffic. It is also the source that has repeatedly been shown to affect our health. In London this is particularly true because of the size of its population and the density of its road network.

Lunch is up for London school kids. What are the implications of the universal free school meals policy in London?

Girl holding tray of food in school canteen

As well as providing vital relief to disadvantaged children and families, free school meals are essential to ensuring children reach their full potential, writes Dr Jennie Parnham from the School of Public Health.

On 19th February 2023, the Mayor of London, Sadiq Kahn, announced plans to provide free school meals to all primary schoolchildren (ages 4-11 years) in London.

In England only infant schoolchildren (4-7 years) are given universal free school meals (UFSM). For older children, free school meals are means-tested and are only available to households receiving Universal Credit (with incomes <£7,400/year). The remaining children must pay for school meals.

This policy will dramatically expand the current free school meal provision in London, reaching 270,000 children at a cost of £130 million. But what will this unprecedented policy announcement mean for children, their families, and our wider society?

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The future of smoking: why are young people still picking up the habit?

two hands snapping a cigeratte in half

The government is on course to miss its target of making England smoke free by 2030. Dr Charlotte Vrinten, Research Associate at the School of Public Health, highlights how this delay leads to thousands of adolescents taking up the habit in the meantime.

Tobacco smoking has been declining in the UK over the last decade, but there are still nearly 7 million people who smoke.  Smoking is one of the main avoidable causes of illness and early death, and costs the NHS £2.4 billion per year. In 2019, the government pledged to make England smokefree by 2030.  However, a recent independent review found that the government is on course to miss its 2030 target by seven years. (more…)

Consulting and involving the public in the first human COVID-19 human challenge study

How do you engage members of the public with medical research? Dr Emma Smith, HIC-Vac Network Manager, outlines how consulting the public was crucial during the world’s first COVID-19 human challenge study.

It is important that health and social care research aims to improve the overall well-being of the population, from advancing treatments for patients to helping us live healthier lives. People are at the heart of medical research and so engaging and involving them is an integral part of the research process and one that is mandated by most funders.

When we set up the world’s first COVID-19 human challenge study, acceptability of research to participants and society more broadly was particularly relevant because of the study’s ethically complex nature.

With volunteer participants being deliberately exposed to coronavirus (COVID-19) and the associated risk (albeit very small) of serious illness or death, the public’s perspectives were an important element of assessing if the study was acceptable and ethical (and was stated by the WHO1  as one of the key criteria for the ethical acceptability of COVID-19 human challenge). (more…)

Don’t let a fear of the unknown limit your ambitions – my experience of studying for a Master of Public Health during the pandemic

Graduating is a significant milestone, especially if your studies have been impacted by Covid-19.  Jasmin Adebisi, now an alumni of the Master of Public Health programme, shares what it meant to walk across the stage at the Royal Albert Hall.

Graduation represents the culmination of a journey and the attainment of a goal. It is an exciting period in any student’s life which brings a long journey of hard work to a close. Graduation day can be filled with an array of varying emotions, including feelings of joy, pride and contentment but also thoughts of anxiousness, worry and concern of what’s to come next.

Having been a part of the Covid cohort of 2021, I can say with confidence that I have also experienced these emotions during my time studying. Reflecting on the start of my journey, I was bursting with excitement on getting accepted to my master’s course but was also deeply concerned because of the pandemic and the future.

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Speaking authentically within higher education

How can we foster a sense of authenticity within ethnically minoritised students? Dr Zoe Moula, Teaching Fellow at the School of Public Health, aims to raise awareness of how we can promote a more inclusive educational environment and understand the barriers which can affect a student’s sense of authenticity within higher education.

The underrepresentation of ethnically minoritised students at university, and even more so in medicine, often results in identity suppression in order to ‘fit in’. Yet, this can lead to increased anxiety, and interferes with a student’s ability to succeed academically and professionally.  Societal, structural and institutional factors, such as racism, discrimination and socioeconomic inequalities may all play a part into why a student may not be able to express their true self.  It is therefore crucial that any effort to promote Equality, Diversity and Inclusion (EDI) must also protect and promote a student’s sense of authenticity. (more…)

A portrait of loneliness: mapping social isolation

Are loneliness and social isolation the bane of living in the 21st Century? Since the early days of 2020, national lockdowns, social distancing measures and remote working have put a bright spotlight on loneliness – one of society’s rising problems that governments can no longer overlook. Dr Austen El-Osta shares how his new project to map loneliness in London hopes to highlight the scale of the issue.

The UK Government published the first Loneliness Strategy in 2018 and has since installed a Loneliness Minister to get people talking about the problem. This cross‑governmental strategy has three goals:

  1.  Improve the loneliness research evidence base
  2.  Consider loneliness in all government policy
  3.  Build a “national conversation on loneliness” to reduce the stigma associated with loneliness

Loneliness and social isolation are significant determinants of health and quality of life. They are strongly associated with psychological disorders, cardiovascular disease and are even a risk factor for the exacerbation of early mortality. For the last few decades, increasing urbanisation and over-reliance on technology has led to the ‘atomisation’ of society – think online games, virtual reality, chat rooms, AI chatbots and the recently publicised Metaverse. There is also an increasing number of services which can be accessed online including shopping and healthcare which decreases the need, and opportunity, for “in person” encounters.

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What is being done to help low-income children get a Healthy Start? And is it enough?

Jennie Parnham shares insights into an evaluation of Healthy Start, a food assistance policy in England.

Low-income children have a much lower chance of eating a healthy diet than more affluent children, as highlighted by the recent campaigning of Marcus Rashford.

The causes of this disparity are very complex. It’s also important to say that although it’s more likely, it’s not deterministic. Many children of all backgrounds have a healthy diet. However, unfortunately factors tend to cluster together, making a healthy diet less likely for some. Let’s consider a single parent with a young child. One-third of children in single parent households live in poverty and it can cost up to 75% of their disposable income to buy the recommended food for a healthy diet. This is because healthy food is three times more expensive than less healthy foods. In their neighbourhood, there might be more places to buy ultra-processed fast food than healthy food. Finally, they may have less time to prepare healthy food, as there are fewer helping hands at home. In this environment, many families find their options for healthy eating limited. (more…)