Health and care in the wider context
This theme focuses on how health and care policy are impacted by the wider social, political and economic contexts.
Wider influences are important in shaping patterns of health and in designing efficient and equitable health and care systems. The economic and social environments that people live in have complex, dynamic and bi-directional relationships with their health. There is a major challenge in understanding the relationships between the health and social care system and population health in different contexts. Little is known about the boundaries between the formal care system, community assets, informal care in families, and individual health behaviours. These relationships are critical to understanding how services should be designed. In addition, there is increasing recognition of the value of care services to the local community and of the contribution of health to the economy.
There are areas of strength across the University in this topic. The Cathie Marsh Institute in FoH has a strong record of research in health inequalities, with a specific focus on socioeconomic and ethnic inequalities in health using life course and longitudinal data. On behalf of the Department of Health and Social Care and NHS England, health economists in FBMH have estimated the funding formulae that guide how the national health budget is shared between local areas for over fifteen years. This work examines how population characteristics, such as deprivation and morbidity, affect the utilisation and need for care services. Data scientists in FBMH have produced high-impact analyses of geographical variations in mortality and chronic conditions and the provision and quality of primary care services.
Researchers in both FoH and FBMH have examined links between health and wellbeing and transport systems, community assets, housing conditions, and the labour market. Collaborative work between FBMH and FoH has examined the effect of early-life investments on skills development, health, and education and employment outcomes. Ongoing collaborations with the Greater Manchester Combined Authority and with the Health and Social Care Partnership forged in response to GM Devolution are designing the devolved administration’s initiatives to improve life chances and environmental influences and the strategy for evaluating the consequences of these initiatives.
Through this work, researchers at the University of Manchester have developed excellent knowledge of administrative and survey data sources and the best methods to link and analyse them. The range of datasets available spans detailed longitudinal information on care organisation, supply and delivery, the wider determinants of health, and health and well-being outcomes.
Devolution presents a major opportunity to contribute to better health through understanding health and care in the wider context. The creation of a new cross-Faculty Institute ensures that the dispersed areas of strength across the University are brought together to maximise the benefits of co-ordinated, interdisciplinary working on data and methods and on knowledge exchange and impact-generation activities. The emergence of large-scale electronic health record (EHR) databases, the UK Primary Care Databases (PCDs) and the Quality and Outcomes Framework (QOF), has enormous potential as a resource for research into disease epidemiology, drug safety and the impact of national health policies. Combined with additional geographical data (e.g. on transport links, air pollution, fast-food availability, etc.) this makes it possible to answer important public health questions.
The work of the theme focuses in four areas:
- Effects of non-health activities on health.
Work in this area will focus on how everyday choices and major life-events affect health & wellbeing, including links between economic activity (including employment), transport, housing and health.
- Tailoring health and social care to the local context.
This area will consider how care systems should be planned and adjusted to the wider context, including the influence of local population characteristics and the wider context (e.g. local economy, local schools and transport infrastructure) with particular attention to equitable provision of care.
- Interactions between health and care and the wider environment.
Work in this area will focus on understanding the relationships between the care system and the wider context. It will consider the influence of the availability and quality of services and the boundary between formal care services and informal inputs into health and well-being, including community groups and informal care provided by families.
- The value of health and social care in local communities.
This area will focus on estimating the value of health and care services and returns to investment, including how investment in the sector contributes to directly to health and well-being as well as the wider returns (in employment, education, the economy).