Title: Wellbeing Impact Study of HS2 (WISH2)
Funder: Department of Health and Social Care

Abstract: AIMS: The aim of this study is to understand how the High-Speed Rail 2 development (HS2), a large national transport project, might affect the mental health and wellbeing of people who live near the railway line. We will investigate whether any impacts on mental health and wellbeing vary by groups within these communities, including people who already have mental health conditions._x000D_ _x000D_ BACKGROUND: Little is known about the impact of large transport projects on people’s mental health and wellbeing and what we do know is mainly about transport projects once they are finished, focusing on people who use the new transport system. We know less about how the planning and construction of these projects may affect mental health and wellbeing, particularly for people who experience the inconvenience of planning and construction stages but do not benefit by using the transport system. Without understanding how large transport projects might affect mental health and wellbeing it is difficult to know how to support people who live near them. HS2 is a good opportunity for learning about how these projects may affect mental health and wellbeing because phase 2 of the project is only just starting so different stages can be studied, and there will be people who are potentially affected by the route but are unlikely to use HS2 because there will be no station close to them._x000D_ _x000D_ DESIGN & METHODS: We will look at how HS2 may affect mental health and wellbeing over time from initial planning to the point where it is being used by passengers. We will do three things: (i) survey people asking questions about their physical and mental health and wellbeing, including things that may affect this like having a job or good relationships with friends and family; (ii) group meetings and interviews with people who complete the survey and local GPs and nursing staff to discuss issues raised in the survey in more detail; (iii) analysis of anonymous information that GP practices provide to the government about the health and wellbeing of their patients. We will do this multiple times during the development of HS2. _x000D_ This information will tell us whether the mental health and wellbeing of people living near HS2 changes over time (during planning, construction, and use), and we will compare this to changes in other communities that are very similar apart from not being near HS2. If changes over time are the same no matter how close people live to HS2 then this suggests it is not the cause of any changes._x000D_ _x000D_ PUBLIC INVOLVEMENT & DISSEMINATION: We will involve members of the public throughout this project. We will involve two members of the public in our research team who will organise an Advisory Group including people from communities near HS2. The group will work with the research team to decide how to collect and analyse data, understand study results, and share results with people potentially affected by HS2 or who are interested in health impacts of transport projects in general. _x000D_ _x000D_ WHAT HAPPENS NEXT: What we learn from this study will contribute to the design and assessment of later phases of the HS2 scheme. Overall, this research will develop a new way of understanding how transport projects can affect people’s mental health and wellbeing and help to develop ways of supporting communities where these projects are built.

Lay abstract: RESEARCH QUESTION:_x000D_ Do individuals and communities exposed to the High-Speed Rail 2 development (HS2), a large national transport infrastructure project, experience positive or negative mental health and wellbeing (MHW) impacts._x000D_ _x000D_ BACKGROUND: _x000D_ The need to study Phase 2 of HS2 was identified by the House of Commons Select Committee, driven by petitioners’ concerns about the impact of HS2 on their MHW, the lack of evidence on the topic, and the need for community support to mitigate any negative impacts. Most research on transport infrastructure has not considered MHW separate from physical health, or the impact of pre-operational stages (e.g. planning, construction). With a stronger evidence base, public health interventions could be developed to mitigate negative or enhance positive MHW impacts. This study will address this evidence gap. _x000D_ _x000D_ AIMS: This project has 4 aims: (i) identify positive or negative MHW impacts of HS2; (ii) determine if impacts change over time and what drives them; (iii) investigate whether MHW impacts are experienced differently across population groups or affect health inequalities or social inclusion; (iv) determine whether any MHW impacts affect the economic case for HS2._x000D_ _x000D_ DESIGN & METHODS: _x000D_ We will look at how HS2 may affect MHW over time from initial planning, through construction phases, to operation (HS2 timeline permitting) using a longitudinal mixed-methods approach incorporating: (i) general population survey on MHW, social inclusion, healthcare utilisation, and any local changes due to HS2; (ii) focus groups and interviews with people who complete the survey, and local stakeholders including healthcare providers, mental health charities, local government and public health authorities to explore issues raised in the survey; (iii) analysis of administrative data at the GP practice level on mental health, deprivation, housing, air quality and environmental noise to explore change over time prior to the study and in a wider geographical area. _x000D_ We will collect data in 3 waves that correspond to HS2 Phase 2 construction stages. We will collect data from communities close to the HS2 Phase 2 route and matched control regions, enabling us to use a difference-in-differences approach to estimate the impact of HS2 development on MHW._x000D_ The research team will include 2 members of the public who will convene an advisory group of people from communities near HS2 to provide input on methodology, interpretation of findings, and dissemination of results. _x000D_ _x000D_ TIMELINES FOR DELIVERY: _x000D_ The project will run for 10 years to facilitate investigating impacts of different phases of the HS2 development. Interim findings will be delivered at 5 years after 2 waves of data collection._x000D_ _x000D_ ANTICIPATED IMPACT AND DISSEMINATION: _x000D_ This study will contribute to the design and assessment of later phases of the HS2 scheme; the entire scheme is due for completion in 2035-40, making this study directly relevant for at least 20 years. This will be the only controlled, prospective study of the MHW impacts of transport infrastructure from planning to completion, filling an evidence gap on HS2 and transport projects more broadly. Study findings will support development of strategies to reduce negative impacts or enhance positive impacts on MHW, which are also relevant to other infrastructure projects. Findings will be disseminated via academic papers, conferences, community workshops, policy briefings, and blogs/podcasts.

Research activity codes: 3.2 INTERVENTIONS TO ALTER PHYSICAL AND BIOLOGICAL ENVIRONMENTAL RISKS
Health categories: GENERIC HEALTH RELEVANCE