Title: 21/527 Development Award – Local authority-level research priorities on climate change.
Funder: Department of Health and Social Care

Abstract: Local authorities, public health and climate change Local governments are responsible for public health. It’s their job to help citizens stay healthy and protect them from threats to their health. Climate change is one of those threats. Many councils have declared a climate emergency and aim to cut emissions that contribute to climate change. They also aim to keep people safe from harmful effects of climate change on their health - now and in the future. Research findings can help local governments decide what actions they need to take to reach these goals. However, it’s unclear whether all of the relevant research information that they need is available. So the National Institute for Health Research (NIHR) has asked researchers for proposals on how to find out what research still needs to be done and will be most helpful for local authorities. What do local authorities need to know? We will study the most important UK policies on climate change and public health to find out the most important themes on which local authorities are expected to take action. We do this via a so-called rapid review. This is a systematic but quick, and relatively inexpensive way, to uncover these themes. We will discuss our findings with Climate Change Leads from Integrated Care Systems*. We will then put together a top 15 to 20 of the most important themes. Next, we will send out a survey to all Directors of Public Health who work in local government. We will ask them to rank the top 15-20 in terms of relevance to their local population. This includes people who may be more vulnerable to the effects of climate change, such as children, older people and those from migrant and minority communities. The themes that receive the highest average ranking from the directors will rank the highest overall. Do priorities differ per community? We will also ask the Directors of Public Health about local climate action strategies and the health profile of their local population. (A health profile describes the strengths, weaknesses, needs and problems of a community to make decisions about health services). This will help us understand if there is some relation between the health profile and climate action strategies in a community on the one hand and a director’s ranking on the other hand. We may consider adjusting the ranking if we find such relations. In addition, we will discuss the ranking with up to six members of the public from both urban and rural areas, including those at heightened vulnerability to climate-related risks to their health. Through this public involvement, we aim to gain greater insight into how much and why the top ranked themes matter to members of the public. What research questions need to be answered first? Next we will take a close look at up to the top seven themes in the ranking via more rapid reviews. We will search some of the most trusted global research databases to see what type and how much research information is already available on each theme. That will help us find out which research questions still need answers. Answers that will help local governments take effective climate change action that benefits public health. The National Institute of Health Research can then ask researchers in the UK to submit proposals to find the answers. * The 42 ICS in the UK bring together local governments, NHS and other healthcare providers to coordinate all public healthcare in a given area.

Lay abstract: Research question: What are the key research priorities to support action by local authorities to address the health impacts of climate change? Background: The mission of public health is to ensure the conditions in which people can live healthy lives. Driven by increasing greenhouse gas emissions, climate change is undermining these conditions. Climate change mitigation (reducing greenhouse gas emissions) and adaptation are both essential to deliver a managed climate transition that protects public health. Locally-based systems have a critical role to play. However, despite their strategic position in climate action and public health, local government lacks access to ‘useable knowledge’: tools and information that can be applied locally to inform evidence-based decisions. Aims and objectives: the project will focus on scoping and prioritising research gaps relating to effective local-level action with respect to (i) Climate change mitigation (reducing emissions) to reduce current and future health impacts of climate change and (ii) Climate change adaptation to protect people’s health from climate-related exposures, including anticipatory adaptation to protect future lives. Methods: Our research plan has two stages (1) identifying and prioritising research information that local authorities need to support actions and policies to address the health impacts of climate change and (2) rapid reviews of existing research to identify important evidence gaps. In stage 1, a rapid review of key UK policy documents will be conducted, in order to generate an initial set of research priorities (n=15-20) to inform action by local authorities. Feedback on this list will be sought from Climate Change Leads across all 43 Integrated Care Systems. This list of priorities will then be ranked by Directors of Public Health (DsPH) (n=135). The highest-ranking options overall will be derived by averaging DsPH’s rankings with subgroup analyses to explore how the preferences reflect the needs and constraints of their local areas. Feedback on the rankings will be sought from members of the public. In stage 2, up to five of the highest-ranked priorities will be assessed via rapid reviews to identify those for which UK-relevant evidence is most limited. The review-validated evidence on the priority gaps will be integrated into a summary to inform a PHR commissioned call, taking into consideration the likely evidence requirements and economic considerations for each of the priority gaps. Timeline for delivery: 6 months Anticipated impact and dissemination: The research will have three outputs: 1) a description of research priorities in a format that can be used for a PHR commissioned call; 2) key considerations for quantifying the economic impact of the priority areas and 3) a supporting report describing methodology and findings, covering identified research priorities and questions with supporting evidence (including uncertainties).

Research activity codes: 8.3 POLICY, ETHICS AND RESEARCH GOVERNANCE
Health categories: GENERIC HEALTH RELEVANCE