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Return on investment of public health interventions: a systematic review
Journal: Authors: Journal of Epidemiology and Community Health Rebecca Masters, Elspeth Anwar, Brendan Collins, Richard Cookson, Simon Capewell March 2017 This article has received 267 academic citations, and garnered 108 citations in Policy Documents and Clinical Guidelines. See the full details below. Publication Date:
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in 108 documents (105 Policy Documents, 3 Clinical Guidelines) from 11 countries with 48 different sources
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UK Intergovernmental Organization (IGO) Australia EU New Zealand USA
Canada Finland South Africa Spain Sweden
BMJ Impact Analytics Feb 2024
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Altmetric Feb 2024 and Dimensions Feb 2024
“Publishing the article via open access enhanced its accessibility to policy makers and practitioners.” Let’s hear from the team that wrote this 2017 article published in Journal of Epidemiology and Community Health
The systematic review was led by a multidisciplinary team of Public Health Consultants, Health Economists and Academics, whose day to day work aims to guide public health policy and practice. What inspired you to pursue research in this particular area? We started work on the paper in 2014/15 when the UK Government was looking to make efficiency savings to public health budgets. We were concerned that these efficiency savings represented a false economy that would generate many billions of additional future costs to the NHS and wider UK economy and wanted to articulate what the potential opportunity cost of these cuts would be. The majority of us as authors are based in and around Liverpool, and can see the day to day impact that cuts to funding has on the fabric of our great city. We can see the disparities that exist within our own communities, and wanted our public health and academic practice to shine a light on the challenges that people face. Good health is hard to achieve and maintain, and too often there is a gap between policy, practice and lived experience within public health. We wanted to highlight the significant negative impact that budget cuts would have on peoples health, and how that would cost more to fix further down the line.
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How do you envision your research contributing to the broader field or addressing real-world issues? To see how a report written in the North of England has been so instrumental in influencing global health policy has been wonderful. It quickly spread around the world and it is heartening to see how it has been used to try and bridge the science and policy interface within public health – our paper is referenced in many policy docs and in the New York Times. Publishing the article via open access enhanced its accessibility to policy makers and practitioners. Our systematic review identified that Benjamin Franklin’s belief that “an ounce of prevention is worth a pound of cure” was borne out by the costs-savings demonstrated by investment in public health. Our most conservative estimates identified that the opportunity cost of £200m cuts to public health funding in England would likely be in the region of £1.6bn. However we believe the actual figure to be considerably higher. Other studies looking at changes in spend over time, and looking at NICE modelling found similar results for the cost effectiveness of public health interventions. Recent analysis from the Health Foundation (Feb 2024) has identified that the public health grant in England has been cut by 27% on a real- terms per person basis since 2015/16 when our paper was published. Some of the greatest cuts have been to areas that are known to have very high returns economically, such as sexual health services. These cuts make no economic sense, as rates of STI’s are rising exponentially in the UK whilst sexual health services are at breaking point. Prevention spend on sexual health has reduced by 17% in England whilst demand for services has increased 36%. In the midst of this, health inequalities in the UK continue to worsen. The pandemic has highlighted the value of having a healthy population who are resilient to health shocks. The fact that a girl born today in the most deprived area of the UK will experience 20 years of poorer health compared to her more affluent neighbour is a political choice. There is ample academic literature that makes the case for investment in public health in order to improve outcomes; what we need now is the political will to deliver it. We need to see prevention on an industrial scale.
What do you see as the benefits of open access publishing compared to traditional publishing models? I think one of the benefits of open access has meant that there has been greater accessibility of the report, which in turn yields a greater reach. Many people working in public health in the UK are working in local authority or NHS settings and might not have access to library services to enable them to access scientific articles that sit behind a paywall.
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What is the impact of water sanitation and hygiene in healthcare facilities on care seeking behaviour and patient satisfaction? A systematic review BMJ Global Health Maha Bouzid, Oliver Cumming, Paul R Hunter March 2018 This article has received 70 academic citations, and garnered 45 citations in Policy Documents and Clinical Guidelines. See the full detail below. Journal: Authors: Publication Date:
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in 45 documents (Health Policy Documents) from 5 countries with 11 different sources
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Intergovernmental Organization (IGO) UK Chile Guinea Uganda
BMJ Impact Analytics Feb 2024
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Altmetric 2024 and Dimensions 2024
Let’s hear from Paul Hunter, Norwich School of Medicine, University of East Anglia, about this 2018 article published in BMJ Global Health “The main reason for me to publish this work as open access was to address the needs of individuals who may utilise this research to enhance public health in low and middle income countries (LMICs).”
Paul Hunter is a professor in Medicine at Norwich Medical School, University of East Anglia and was the first professor of health protection in the United Kingdom. He is a fellow of the Royal College of Pathologists, the Royal Society of Biology, and of the Faculty of Public Health.
What inspired you to pursue research in this particular area?
At the time, I was part of a World Health Organization group that was looking at water, sanitation and hygiene (WASH) in healthcare facilities around the world because a very high proportion of them lacked access to improved sanitation as well as reliable and safe drinking water. The WHO, United Nations and UNICEF were keen to develop a programme to try and improve this situation globally and we were looking to find good evidence to show the value of good WASH in healthcare. This was also the first systematic review to be published on this topic. How do you envision your research contributing to the broader field or addressing real-world issues? There is a critical need to improve WASH services in healthcare facilities. The Secretary-General of the United Nations made a speech at the time stressing the importance of WASH in healthcare. But the World Health Organization needed better evidence of the value of WASH and we provided that evidence. Our research has been picked up by various agencies around the world and is being used to influence national and international policies aimed at improving WASH in healthcare.
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What motivated you to publish your work in an open access format? A lot of my work is directed at low and middle income countries (LMICs) and I want people in these countries to have access to this information. I would always try to publish open access and there are other benefits, for example, in terms of it leading to more citations. The main reason for me to publish this work as open access was to address the needs of individuals who may utilise this research to enhance public health in low and middle income countries (LMICs). What advice would you give to other researchers who are considering publishing their work in open access formats for the first time? If you have the funds, then it’s always best to publish in an open access journal but check that it isn’t a predatory journal and that it’s from a reputable publisher. Also, if you are awarded a research grant, make sure that the budget allows for open access publication.
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“If you have the funds, then it’s always best to publish in an open access journal.” “...one of the benefits of open access has meant that there has been greater accessibility of [our work] which in turn yields a greater reach.” Rebecca Masters Public Health Wales
Professor Paul Hunter University of East Anglia
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