Our research

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 economic and health impacts (value) of improving access and use of blue space for physical activity. Second, to explore criteria for priority-setting to inform economic valuation models for prioritisation of investment in blue-space that promotes population health and wellbeing.

Working closely with the organisation The Canal & River Trust and members of the public, we will hold group discussions and workshops to elicit stakeholder input on positive and negative qualities of canals for physical activity and health, and identify organisational processes in priority-setting of canal interventions. The evidence will be used to inform and pilot-test methods for developing economic valuation models of investment in blue space. Our overarching goal is to support policy-making and inform investment decisions, 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 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.

Lead researcher: Professor Emma Frew

This project was 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 tested 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”.

We provided academic support to this project and conducted a process evaluation to assess the acceptability, implementation, and uptake of the module.  This project produced two key outputs.  The first output was a guidance document to support local authorities when developing public health interventions more generally, and the second output consists of more specific guidance for the development of a health literacy training course.  Both outputs are available as 1-page documents on the Birmingham City Council website .

Lead researcher: Dr Irina Pokhilenko

The school environment plays an important role in influencing healthy behaviours of young people. This workstream focuses on interventions and policies implemented in schools that have the potential to help tackle obesity in children and adolescents by promoting healthy eating and physical activity.

One of the current projects in this workstream focuses on the evaluation of the national School Food Standards (SFS). In England, since 2006, there have been several national initiatives aimed at improving the 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. his work forms part of the FUEL study led by Dr Miranda Pallan and funded by the NIHR Public Health Research programme.

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.

Lead researcher: Professor Emma Frew

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 started in Autumn 2021 and is due to 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.

Lead researcher: Professor Emma Frew

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.

Lead researcher: Dr Lin Fu

The Mandala Consortium is focusing on transforming urban food systems for planetary and population health. Centred on the city of Birmingham and the regional economy of the West Midlands, Mandala hopes to demonstrate how food can be made healthier, more affordable and less harmful to the environment but still profitable.

Getting food from where it’s grown to people’s plates is complex, involving many companies, sectors and processes. We call this the ‘food system’. However, the food we eat is creating huge challenges for our health, environment, and climate. One in four children in Year 6 in our city are living with obesity, more people than ever are struggling to afford enough, good food and issues like food waste, pollution from agriculture and plastic packaging are causing serious harm to the planet and the systems that support life on Earth. Making this food system work better is a difficult and urgent challenge that will take a lot of thought and coordination to solve.

Working closely with Birmingham City Council, the Mandala programme aims to help find and co-ordinate a number of solutions to these pressing problems. Through our work, we want to (1) map and better understand all aspects of the city’s food system; (2) find the most powerful ways to help people eat a healthier, more environmentally friendly and affordable diet, whilst supporting, sustaining and celebrating the amazing food businesses they have on their doorsteps; (3) collect evidence on how feasible certain ideas and solutions to improve our food system are; (4) develop, co-ordinate and prioritise the most important ways to make positive changes happen; (5) and evaluate the impact that these solutions have had.

Public Advisory Group Meeting, April 2023.

The team met with our public advisory group in April to share learnings about our research on green space funding, online food shopping, social care modelling, and mental health resource use for people living with obesity.

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.

On 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.