Our research

Our research is organised across six workstreams

Workstream 1: The Environment

Blue Space

Lead researcher: Ms Nafsika Afentou

Currently there is evidence to support that living near and regularly visiting surface bodies of water (i.e. blue space) is associated with better physical health, mental wellbeing, and increased levels of physical activity. Furthermore, improved access and quality of blue space infrastructure are considered key to provide sustainable benefits and reduce socioeconomic-related inequalities in health.

The aim of this project is twofold; first, to generate evidence on the cost-effectiveness of changes in blue space infrastructure to better understand the cost, mortality and morbidity effects. Second, to explore existing equity considerations in the distribution of health outcomes across population groups and regions.

Working closely with The Canal & River Trust, data will be collected for different geographical areas, which will be matched with comparison sites based on size and demographic characteristics, to observe changes in outcomes. Our goal is to support policy-making and inform prioritisation of investment through knowledge co-production.

Green Space

Lead researcher: Ms Humera Sultan

COVID-19 has highlighted the importance of green spaces for population physical activity, health and wellbeing.  Despite increasing evidence for the relationship between green space and wellbeing, there is insufficient economic evidence to justify investment in these spaces as part of a population-wide prevention programme to help boost physical activity, promote quality of life and wellbeing, and save long term health and social care costs.  Given the multi-sectoral nature of how green spaces are developed and maintained, tracking the flow of resources and resulting impact from investments is complex. This workstream forms part of a NIHR pre-doctoral fellowship awarded to Ms Humera Sultan with the aim of developing a competitive PhD fellowship application to work with all stakeholders within green space to justify investment.  This is an area of priority for local authorities to ‘build back better’ and crucially ‘build back fairer’ following the COVID-19 pandemic. This work will consider cost-effectiveness, equity, and affordability of investments within the green space context.

Workstream 2: The Workplace

Lead researcher: Professor Emma Frew

This project is in collaboration with Birmingham City Council who was selected as one of the five childhood obesity trailblazer local authorities to progress an intervention designed to test their powers and develop local solutions to tackle childhood obesity. 

Birmingham City Council are testing a ‘health literacy’ training module that is focused on apprenticeships with the aim of upskilling a workforce to apply their knowledge at home and as (future) parents.  Health literacy translates to lifestyle decisions for self-management and is defined by the World Health Organisation as “The personal characteristics and social resources needed for individuals and communities to access, understand, appraise and use information and services to make decisions about health”.

Our aim is to evaluate the impact of this module upon the health literacy levels of the workforce, and health and wellbeing outcomes.  A pilot outcome evaluation and detailed process evaluation are being conducted to assess the acceptability, implementation, and uptake of the module, and to use these findings to further develop the module for future ‘roll-out’. 

Workstream 3: Schools

Lead researcher: Ms Irina Pokhilenko

The school environment plays an important role with influencing the diet of young people and in England, since 2006, there have been several national initiatives aimed at improving the School Food Standards (SFS).

Working as part of a multi-disciplinary team, this project will estimate the impact of the SFS upon eating behaviours, health, and dental outcomes among secondary school pupils.  The economic evaluation will measure the resource requirements to implement the SFS and assess outcomes using health-related quality of life tools, as well as ‘natural’ units such as dietary and dental outcomes.  This work forms part of the FUEL study led by Dr Miranda Pallan and funded by the NIHR Public Health Research programme. 

The data collected from the FUEL study will be combined with data from other sources to   develop a model to track the long-term effect of the SFS upon costs, adolescent health and wellbeing, and productivity outcomes. 

Workstream 4: Retail

Lead researcher: Ms Hamideh Mohtashami Borzadaran

This workstream is designed to understand how retailers can contribute to a system wide strategy that tackles population obesity.

It has two main objectives: 

  • To understand retail companies’ role in creating a healthier society.
  • To identify interventions to promote healthier purchasing behaviour.

In collaboration with a leading supermarket, we are exploring the impact of varying voucher designs upon consumer purchasing behaviours.   A series of experiments are being conducted across the retail stores to assess how different types of vouchers vary spending habits, controlling for external factors.  This workstream will contribute an understanding of the effectiveness of these vouchers and equity impact by exploring variation by store and geographical location.   It will offer further evidence on impact of providing financial incentives to increase fruit and vegetable purchasing.

Workstream 5: Active travel

Lead researcher: Dr Paolo Candio

Based on an integrated partnership with Coventry City Council, we plan to conduct a comprehensive economic analysis of the creation of a new segregated cycleway in Coventry. The Binley Cycleway will extend from Coventry city centre to University Hospital Coventry and Warwickshire via the Binley Business Park on Harry Weston. Construction is due to start in Autumn 2021 and be completed by March 2023. The aim of this intervention is to encourage the uptake of regular cycling and active travel among residents who use motorised transport to commute or do not usually cycle. A natural experiment study will be conducted to estimate the changes in cycling, overall physical activity and mode of travel induced by this initiative in the local population. The societal costs and benefits therefore derived, including impacts on health and wellbeing, carbon emissions and productivity, will be estimated using validated economic models.

Workstream 6: Economic modelling

Lead researcher: Dr Paolo Candio

This project will estimate the economic burden of obesity in England from a local authority perspective. Although country-level estimates have been produced, disparities in population demographics (e.g., age and ethnicity), dynamics (e.g., birth rates and migration) and local economies mean that they cannot adequately support local decision makers in priority setting. Working with international academic collaborators, we will develop an economic model by adapting an existing validated epidemiological model. The epidemiological model, a hybrid individual-level simulation model combined with survey estimation techniques, will be populated with England local authority-specific parameters to reflect heterogeneity. The model will generate local-level estimates of the current economic burden of obesity. Forecast techniques will then be applied to predict future changes in the burden of disease and resulting impacts on local authority budgets.

Research Dissemination – Conferences and Meetings

European Health Economics Association (EuHEA) Conference, University of Oslo, July 2022.

The CEO team presented an organised session at the EuHEA conference in July 2022.  The session offered a comprehensive review of the methodological research being conducted across several workstreams that are designed to address different but related determinants of obesity.  Throughout, attention was drawn to the evidence needs of the decision makers.  Overall the session offered an exciting interactive opportunity to discuss the economics of obesity on the wide-ranging methodological issues that are linked to undertaking research in this area.  

The Centre for Economics of Obesity team at the European Health Economics Association

The Centre for Economics of Obesity team at the European Health Economics Association.

CEO strategy meeting The ExchangeOn 14 September 2022, the team held a strategy away day at The Exchange, University of Birmingham.  Amazing productive day with lots of ideas for future research direction of the Centre.