CORE OUTCOMES

We seek to advance the capacity of policy makers and analysts and private, public, and third-sector stakeholders to implement effective strategies, at the national and local level, to address the impact places and the exposome have on air quality and brain and cognitive health – See our Theory of Change Model.

This advance in capacity includes improving the policy process using a complex systems approach to primary prevention and through enhanced estimations of the economic benefits and risks of these strategies.

We also seek to raise public awareness about the adverse impact that air pollution and the exposome has on cognitive health and how the complex social environments in which people live plays a role in this adverse impact.

The result, looking toward 2050, will be an enduring primary prevention public health legacy focused on improving the UK’s capacity to implement cost effective, scalable upstream actions to prevent air pollution, reduce health inequalities and improve brain health (including cognitive function, mental health and dementia) across the life course.

THREE MAJOR PROGRAMMES OF RESEARCH

To generate our policy tools and toolkits we have the following objectives:

Programme A – Putting policy into practice: we will work extensively with our ecosystem of stakeholder organisations (WP1) to enact our theory of change model (WP2) and co-design and launch (WP3) our suite of policy tools and toolkits, including InSPIREd – our primary project legacy, codesigned to be a suite of user-friendly cognition/air pollution policy dashboard tools.

1. Theory of Change Model (CLICK HERE for larger online version)

In terms of reading our theory of change model, the left-hand side shows how we will move from inputs and activities to outputs, outcomes and impact. The left-hand side also highlights our engagement with stakeholders across the initial five years of the project. The upper right is colour coded for our three research programmes and their WPs. The lower right side also lists the wider context and risks we need to consider.

2. InSPIREd Platfom (See Policy Toolkits Tab)

By the end of our study stakeholders and other end-users will use InSPIREd for their short and long-term policy cycles to: (1) run a policy simulator to assess prevention schemes for different local/regional contexts; (2) explore a catalogue of innovative primary prevention recommendations; (3) learn from our four conurbation policy case studies, with a focus on health inequalities; (4) access dynamic visualisations of study outputs and datasets for future research; (5) use complex systems mapping to explore topics from a complexity perspective; and (6) access UK-wide, local authority air pollution/cognitive health risk profiles.

Programme B – Modelling social determinants, PM2.5 & cognitive/brain health: We will pioneer the first UK model of PM2.5 for 1970-2020 (WP5); link it to cognitive outcomes (e.g., dementia, neurodegenerative disease, early-life cognitive development, mental disorders) for the 1946, 1958, 1970, millennium cohorts (WP6) based on a complex systems model of how upstream social determinants (e.g., social disadvantage, risk exposure) and health inequalities (e.g., life expectancy, healthcare access) influence PM2.5‘s impact on cognitive health (WP4).

Programme C – Policy evaluation & innovation: we will assemble UK local authority air pollution/ cognitive health risk profiles for all authority districts in the UK (WP7); use methods for evaluating policy and enabling change in complex systems to produce a primary prevention policy catalogue, including economic benefits (WP8); and conduct four conurbation policy studies to create bespoke scalable, cost-effective regional strategies (Glasgow, Tyne-Wear, Manchester, Birmingham) (WP9).

PRIMARY RESEARCH QUESTIONS

A. Modifiable social determinants and health inequalities (WP4):

From a complex systems perspective, what social determinants and health inequalities are associated with the worst-to-best 50-year PM2.5 trends and cognitive health outcomes?
How do impacts differ based on conurbation and local authority level differences in social determinants, inequalities and the complex social environments in which people live?
How do these impacts further differ by gender, ethnicity and socioeconomic status?

B. Air pollution modelling (WP5):

What are the quantitative exposure estimates for all UK local authorities at key historical timepoints between 1970 and 2020? And can we extend this model into 2050?
What are the different air quality trends for PM2.5 across the UK between 1970-2020?

C. Linking PM2.5 to cognitive health and related brain and respiratory disease (WP6):

Which cognitive outcomes (e.g., dementia, ADHD, depression, etc) and neuro-developmental milestones (e.g., language, psychomotor, spatial memory) are impacted by PM2.5 and at what concentrations and durations of exposure across the life course?
What are the mechanistic pathways by which PM2.5 exposure impacts cognition
How do insights into these pathways allow us to explore related air pollution diseases?

D. Primary prevention policies and strategies (WP1-3 & 7-9):

Can we identify how different primary prevention policies (1970-2020 and into 2050) mitigate the impact upstream social determinants & health inequalities have on PM2.5 cognitive health?
Can we, with stakeholders create new and innovative UK air-pollution policy recommendations and tools that will be useful for enabling change and implementing cost effective, scalable upstream actions to prevent cognitive disorders and health inequalities across the life course?
Can we use our four UK conurbation case studies to understand how local/regional differences inform these co-produced strategies, recommendations, and primary prevention policy tools?
Can we co-design with stakeholders a policy dashboard to house our evidence and policy innovations and to understand how it should be designed to be user-friendly and impactful?

See Publications