Title: ECONOMIC EVALUATION OF MULTI-SECTOR OBESITY POLICY
Funder: Department of Health and Social Care

Abstract: BackgroundObesity is caused by largely preventable risk factors linked to unhealthy diets and physical inactivity. Increasingly, calls have been made for system-wide action with an emphasis on prevention recognizing the multiple determinants of the disease. Policy makers working across different sectors need to allocate scarce resources in a manner that meets efficiency and equity goals. Providing evidence on value-for-money is methodologically challenging as established economic methods that work well within the health sector do not translate well to non-health settings - settings that are crucial for obesity prevention. It is essential that more evidence is generated on (i) knowing which interventions are best value-for-money in terms of obesity prevention and (ii) ensuring that all costs and benefits are properly captured so that an appropriate case can be made for obesity prevention based on evidence.Aims and ObjectivesThis application sets out a research programme for developing methods designed to capture the societal costs and consequences of obesity policy working across five sectors -h; retail, environment, transport, education and workplace. It is methodologically rigorous, timely and co-produced with decision-makers and people living with obesity; ensuring that the research has maximum impact.ObjectivesEach work stream is designed to address different but related determinants of obesity: Environmental: to estimate the cost-effectiveness of interventions that alter local green space. Economic: to measure the value of interventions designed to improve the essential lifestyle skills of young people to improve their chances of sustainable employment. Education: to generate economic evidence on the impact of the national school food standards. Retail: to embed economic evaluation into retail policy; to develop data collection that tracks retail spending; and to use economic insight to shape a food-economy. Transport: to estimate the cost-effectiveness of local active travel policy.Working across these five workstreams we will establish a world-leading Centre for the Economics of Obesity that will deliver high-quality research, liaising closely with policy partners and PPI-members co-producing research.Methods Workstream 1 uses a natural experiment to measure the cost-effectiveness of park refurbishment, capturing health, wellbeing and capability benefits within an economic framework.Workstream 2 addresses the economic determinants of obesity by measuring the value from embedding health and wellbeing training into early-career training schemes.Workstream 3 will apply modelling to extrapolate the costs and benefits associated with the national school food standards.Workstream 4 will map out how economics can shape the retail food economy and understand how vouchers can be designed to promote healthy purchasing behaviour.Workstream 5 uses economic models to estimate the cost-effectiveness of active travel policy incorporating both morbidity and mortality effects. OutputsMy ambition is to build on my existing research programme to develop a coherent, comprehensive research programme that will develop economic methods that can be applied to multi-sector policy and reduce population obesity. I will use this award to establish a strong team of researchers and to contribute to their career development. This award will enable me to become a senior leader and an international expert in the economics of obesity.

Lay abstract: Population obesity levels are still increasing, placing huge unsustainable burden on health services and society. So far, obesity policy has focused mostly on individual responsibility and only recently have government and experts turned to what the whole of society can do to address the impact of the environment people live and work in. This Professorship involves five related streams of work, to measure the impact of obesity policies in different, but related, sectors - retail, the environment, transport, education and the workplace. A key part of the research is developing methods to measure value-for-money as difficult decisions need to be made on how to spend limited funds. To help make these decisions, information is required based on economic evidence weighing up the costs and consequences of different actions. This is critical as rates keep increasing and evidence needs to be generated on what the whole of society can do so that funds can be shifted towards new interventions that might actually start to reduce rates of obesity, the ultimate measure of impact. Aims and ObjectivesMeasuring the value of interventions that target the spectrum of factors that are associated with obesity, each workstream will target different (related) factors affecting population obesity levels. What constitutes value within each workstream is explored - understanding value can be measured in different ways. These workstreams have been developed in close collaboration with local authorities, stakeholders including retailers and education providers, and the public - an overall theme is continued close-partnership working. Objectives: Urban/physical factors: estimate the economic and social value from refurbishing local green space. Economic factors: measure the cost-effectiveness from embedding health and wellbeing training into early-employment access schemes. Education factors: evaluate the short- and long-term costs and effects of the national School Food Standards. Retail factors: understand what retailers and local government can do to encourage people to buy healthy foods and to measure the impact of these initiatives on the costs and health outcomes. Transport factors: To understand the costs and effects of making changes to the environment that encourage active travel.Working across these five workstreams, a new Centre for Economics of Obesity will be established, key parts of which will be to establish the frameworks to measure the cost-effectiveness of new whole society interventions, and build the capacity in new researchers to conduct high-quality research in this area, never losing focus on the long term aim of reducing obesity levels. MethodsWorkstream 1 develops methods to measure impact of park refurbishments on activity, health and wellbeing benefits, costs and obesity risk.Workstream 2 measures costs and benefits of an initiative encouraging people into sustainable employment, providing training on lifestyle skills. Workstream 3 uses a natural experiment to measure societal costs and effects of national School Food Standards.Workstream 4 generates evidence on what retailers can do to encourage healthy food purchasing; working with local government to help shape a healthier food economy.Workstream 5 measures costs and health and wellbeing impacts of improving cycle infrastructure, encouraging active travel. OutputsNew economic-based evidence is needed to help design policy that reduces levels of obesity. This award will develop a leader in economics of obesity research by providing the opportunity and time to conduct the workstreams and establish a world class new Centre in the UK to support long term engagement in this key policy area, training the researchers and leaders of the future. It supports the vision to provide the economic evidence required for obesity policy that justifies investment and puts obesity reduction and prevention at the heart of all local and national government policy.

Research activity codes: 8.2 HEALTH AND WELFARE ECONOMICS
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;METABOLIC AND ENDOCRINE;ORAL AND GASTROINTESTINAL;STROKE