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.
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