On this page you can find out about some of the projects that have been suggested.
Health equity project proposals
Diabetes
Diabetes disproportionately impacts those in West Yorkshire who have Southeast Asian heritage – how can we ensure that healthcare provision in West Yorkshire is impacting these citizens as effectively as possible? Do we need different approaches to the general offer?
Use of hospital services
Use of hospital services varies substantially between those citizens in Index of Multiple Deprivation (IMD)1 and IMD5. Use of emergency department services is 71% higher by those in IMD1 than IMD5, use of non-elective services 49% higher, while the use of elective services is 66% lower. Given that 36% of West Yorkshire’s citizens are in IMD1, the impact of the difference in using these services is likely significant both for citizens and the acute sector. Understanding the causes for these differences and any impact might lead to improvement of outcomes for those in IMD1, and reduction of burden on the acute sector.
Ultra-processed foods (UPF)
Background
One potential fellow has recently read quite a bit of information and published research articles about ultra-processed foods (UPF). These articles have indicated that:
- UPF may be linked to an increased risk of obesity, high blood pressure, high cholesterol, some cancers, and coronary heart disease
- Examples of UPF are soft drinks, mass processed bread, flavoured yogurts, most breakfast cereals/bars, packaged sweet and savoury snacks, chicken and fish nuggets, many ready meals
- Around 50% of the daily energy intake for people in Britain is from UPF
- More than 60% of children’s daily energy intake in Britain is from UPF
- One in five children in Britain get 78% of their calories from UPF
- The National Institute for Health Research (NIHR) quotes the following definition for UPF: “UPF are not technically foods, but edible industrial substances.”
Concern
Since UPF tend to be cheaper and more convenient than unprocessed / minimally processed foods, they are quite likely to be more popular in areas of higher deprivation – such as Bradford. Bradford has higher than average occurrences of many of the health problems said to be associated with UPF.
Possible project(s):
- Determine how the consumption of UPF in Bradford compares with other areas
- Determine the level of awareness of the possible dangers of UPF among the population in Bradford. Include the fact that many processed vegetarian and vegan options are often UPF
- Look at the availability of UPF compared with healthier options at NHS facilities such as hospitals and health centres, as well as shopping areas and food banks
- Look at whether more could be done to make healthy food choices more available to people in an area of high deprivation
- Other ideas associated with UPF
Links to articles:
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Housing quality
Housing quality is poor in poor areas and housing quality is a big determinant of health - could we have a project to look at improving housing quality in poorer areas. This could be as simple as making people aware of support available to improve their house or creating a landlords’ charter.
Discharge from hospital
Discharging older patients from hospital to home is a big problem right now and housing quality comes up again as a big problem. Could we set up a project to bring together system partners to improve housing quality to improve flow of patients outside of hospital
Mental health during pregnancy
One of the partnerships 10 big ambitions is to achieve a 50% reduction in stillbirths, neonatal deaths, brain injuries and a reduction in maternal morbidity and mortality by 2025. There are a number of projects here.
- Women from black and Asian ethnic groups were six times more likely to die at child birth compared to women from white backgrounds. Could we set up a project to look into reasons for this and solutions?
- Women from a Pakistani background appear to have higher incidences of mental health problems during maternity - could we set up a project looking at mental health services and adequate provision to meet the cultural needs of our population?
Supporting economic regeneration
Economic re-generation doesn’t always benefit those living in the poorer areas of West Yorkshire and this can be seen by reduced job opportunities in those areas. Could we set up projects to improve the connections between local businesses and public sector organisations in those areas to support people into employment and bring economic regeneration?
Palliative and end of life care
In order to develop our vision of palliative and end of life care (PEoLC) across West Yorkshire and to meet our statutory requirement to assess ourselves against the PEoLC ambitions framework, we are exploring how PEoLC health needs assessments can be completed across the five places within West Yorkshire.
We really want health needs assessments to identify areas of inequality and inequity in access to PEoLC to inform future priorities. Reducing inequalities is central to our PEoLC vision. Potential for five Health Equity Fellows to lead on completing health needs assessments in each of our five places and to work with our PEoLC steering group to inform our WY PEoLC vision.
Groundswell report
Possible project based on the Groundswell Health Now West Yorkshire Report_A4.cdr (groundswell.org.uk).
Equitable access to LARC across Kirklees
Almost half of all pregnancies (45%) are unplanned or ambivalent (NATSAL). A Public Health England return on investment (ROI) analysis of publicly funded contraception estimates a ROI across the public sector of £9 for each £1 invested, over 10 years.
Unplanned pregnancy has greater adverse outcomes for those living in disadvantaged areas with lower educational attainment and poor dietary intake. Unplanned pregnancy is associated with a higher rate of depression and parenting stress (Bahk et al, 2015) and is also an important determinant of maternal and child health outcomes. According to Gipton et al, 2008, compared to pregnant women with pregnancy intention, pregnant women without pregnancy intention had greater exposure to cigarette smoking, drinking alcohol, taking medications and illicit drugs, and X-ray during pregnancy and were less likely to take folic acid and attend antenatal care.
The proposed project would include:
- Health needs assessment of access to contraception in Kirklees including a review of current activity across the district, focussing particularly on primary care provision (GPs and pharmacy) and maternity settings
- Engagement with local women regarding their experiences of access to contraception
- Working with sexual health services, primary care and maternity settings to improve access
The target audience would be women aged between 15 to 45 living in Kirklees. We know that access to LARC is worse in North Kirklees which is also an area of high deprivation and higher teenage pregnancy so this would be a priority area for any implementation of recommendations. When working with maternity services, a phased approach may be required focussing first on women who are more vulnerable, for example, teenage mothers, women with substance misuse issues, women with mental health issues or women who have had previous children taken into care.
Success measures need to be defined but could include:
- Completion of a health needs assessment and key recommendations
- Progress towards implementing some of the key recommendations
- Improved partnership working with primary care and maternity around contraception
Adversity, trauma and resilience project proposals
Trauma survivors
A Survivor [citizenship] Assembly feasibility study and sustainability analysis (think of it as taking co-production/design to a new level and allowing the Integrated Care Board to access and engage with a diverse client / patient / users population for their collective informed knowledge and wisdom on strategic trauma informed development issues etc)
Barriers and opportunities for GP practices
Might lend itself well to a qualitative research methodology like interpretative phenomenological analysis (IPA) (http://
My Body Back scheme in London that campaigns for trauma informed women’s health
They offer cervical screening, contraceptive care, and sexually transmitted infection (STI) testing for people who’ve experienced sexual violence. My Body Back Project - Rape and sexual assault support in London
Could this be replicated in Leeds?