Tag: Policy

Closing the Gender Health Gap: A Call for Sex and Gender Equity in Biomedical Research Policies

When it comes to healthcare, there are clear and stark inequalities between women and men. Marina Politis, Alice Witt, and Kate Womersley explain how, at its root, this gender health gap derives from a research and data gap, and how the MESSAGE project is working to improve accounting of sex and gender dimensions in medical research.

Everyone aspires to receive gold standard treatment when seeking medical care. What if, however, this standard, was only ever set out to be gold for one group of people? Much of our medical evidence base has been based on a male norm, with women underrepresented at all stages of the research pipeline. Subsequently, when a woman suffers an out-of-hospital cardiac arrest, she is less likely to receive bystander CPR than a man. Once in the hospital, she continues to be less likely to receive optimal care than her male counterpart.

The gender health gap in cardiovascular disease – poorer outcomes women experience due to the “male default” in health research and healthcare – is just one of many conditions for which there are disparities between women and men. From dementia to diabetes, and osteoporosis to obesity, sex and gender differences and similarities remain neglected in UK and international research.

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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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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…)

A public health Insight into the UK’s new obesity strategy

Public health researcher Charan Gill provides an inside look at the Government’s new obesity strategy and discusses if it’s the way to tackle the obesity crisis.

In July the UK government released the ‘Tackling Obesity: empowering adults and children to live healthier lives strategy’. As a public health researcher, I was eagerly waiting for this to be published and I know many others were also anticipating what was going to be released in the document.  This new strategy has received a great deal of criticism, and although it does raise valid and important points, it has left many confused. Despite this, there have also been several important issues raised which needed to be addressed. Over recent years, several obesity strategies have been published, but I want to highlight some key positives from this strategy and how I see it working.

Firstly, I want to recognise how great it is to see the government emphasising on public health and prevention. Acknowledging that there are public health services that can offer huge benefits to the public and will in turn have beneficial impacts and reduced strain on the NHS. The strategy claims that the government will expand weight management services and the NHS Diabetes Prevention Programme which are a few services which can offer preventative support.  These suggestions are fantastic and offer practical resources to support individuals who want to make healthy lifestyle changes. (more…)

Embracing change as an immunologist in the time of Covid-19

Professor Danny Altmann explores how the pandemic has offered new perspectives on his research, leading to new collaborations and engaging with policy.

If any of us ever wished for greater prominence, respect, or public understanding of our scientific contributions to society, this is not the way we would have wished to achieve it. For so many at Imperial working in diverse aspects of infection, immunity and global health, this has been a time of much urgent soul-searching as to how we can best bring our skill sets to bear on the problem most effectively, whether as clinicians, disease modellers, vaccinologists or basic immunologists. It’s hard to turn on a news broadcast or open a newspaper without seeing opinions from Imperial colleagues, clinical and scientific.

At a time when the mantra is ‘policy led by the science’, this is absolutely as it should be. We often have it ingrained as scientists to keep our heads down lest we be accused of showboating or playing ‘Johnny-Big-Potato’ by making inflated claims about our research. Yet, this is a time when it’s OK and even laudable to stick your head above the parapet: when it genuinely matters, and people genuinely want to know, what are these different types of antibody tests, is antibody protective and how long does it last, which may be the most effective vaccines. This surely is the time to step up to the plate, whether by adapting the research focus of our labs to the current issues, by communicating and trying to clarify the nuances, and of course, by remembering our commitments to our students and trying to work out how to keep them stimulated and scientifically productive despite lockdown. (more…)

Governments need scientists to shape a brighter, evidence-based future

Dr Julia Makinde
This festive period Three Wise Women from the Faculty of Medicine will be giving us the gift of wisdom.

Our second is Dr Julia Makinde, an HIV researcher at the IAVI Human Immunology Lab, who makes the case for translating science into policy.

A dearth of advisers

A section of the nativity story portrays Herod the Great as something of a tyrant. A man who sanctioned an order to wipe out every male infant born in and around Bethlehem in a pre-emptive action to eliminate the threat of a new-born king. As difficult as it is to imagine anyone, let alone a political leader, endorsing the massacre of innocent children, the story presents an interesting metaphor of complex political motivations and the outcome of a breakdown in the process of policy making.

With vaccinations, climate change and access to healthcare taking centre stage in the global debate, the intersection between science and policy has never been more relevant. Whilst I started out in research with the desire to help create solutions to global healthcare challenges, I have come to understand that the actions taken to disseminate research outcomes are just as important as the process of discovery itself. (more…)

News worth celebrating for the cystic fibrosis community

Professor Jane Davies reflects on the positive news for those affected by cystic fibrosis on both sides of the Atlantic – access to Orkambi on the NHS and FDA Approval of ‘triple combination’ in the US.

Last week marked a milestone for people living with cystic fibrosis (CF) in the UK after NHS England announced that new drugs – Orkambi and Symkevi – will be made available on the NHS after securing a deal with the drug manufacturers, Vertex. After four years of community and patient organisation campaigns, I am delighted with this outcome which will be transformative for young people with CF.

There are over 10,000 people in the UK and over 100,000 worldwide estimated to be living with cystic fibrosis (CF). The condition is caused by a faulty gene encoding for a cell surface ion channel called Cystic Fibrosis Transmembrane Conductance Regulator (CFTR). Ion channels are integral for regulating salt and water transport across mucosal surfaces, particularly in the lungs for defence against infections and in the digestive system. People with CF have a shorter life expectancy than healthy people and a hugely burdensome treatment regime just to keep as well as possible. (more…)