UKPRPICA: SPECTRUM: Shaping Public hEalth poliCies To Reduce IneqUalities and harM

The main causes of health conditions such as cancer, heart disease, respiratory diseases and diabetes (Non-Communicable Diseases, NCDs) are things we consume such as tobacco, alcohol and foods high in salt, sugar and fat. These products are often manufactured by large companies, 'Unhealthy Commodity Producers' (UCPs), who make a lot of money from their sale and whose interests can conflict with health goals. UCPs try to increase their profits by using advertising to make their products more attractive, selling them in places where they are more likely to be bought, and pricing them in ways that increase consumption. We also know that UCPs target their products at people who may be more susceptible to these tactics. As a result, the health of poorer people and communities can be more affected. Because UCPs are powerful, their actions can have an impact on governments which can mean that policies to protect health (such as taxes on unhealthy products, or advertising bans) are less likely to be put in place, or can be delayed or changed.

SPECTRUM (Shaping Public hEalth poliCies To Reduce ineqUalities and harm) is an ambitious new programme that aims to reduce NCDs by doing research that will help inform policies and practices to promote health. SPECTRUM's work will support governments, local authorities, public health bodies and other organisations in dealing with the influence of UCPs. SPECTRUM will mainly focus on tobacco and alcohol, but will also consider unhealthy food and drinks.

Our research will be conducted in eight areas of research that will focus on:

1) how thinking about and studying NCD prevention at different levels (as part of a system) can lead to better evidence, policy and practice

2) understanding and finding ways to address the actions and influence of UCPs

3) using better information from surveys and other types of data about people's behaviour which could help inform policies and practices to prevent NCDs

4) analysing the impact of unhealthy products and policies on the economy

5) identifying how changing local communities, and the availability of unhealthy products in these communities, can reduce product use and harms

6) developing and evaluating new policies and practices to prevent NCDs

7) studying how to reduce stigma and mental ill-health related to unhealthy products

8) examining what new or improved regulations or ways of working could reduce (unfair) levels of harm in relation to unhealthy products.

SPECTRUM brings together world-leading researchers from 10 UK Universities with support from academics overseas. Our work will be developed with a range of partner organisations that includes health bodies, charities, and companies who provide data and whose staff have skills that can help our research. We will involve the public through regularly meeting with groups made up of members of the public, specific meetings called 'citizen's juries', and by interviewing people from communities across the country. We will work with our partners, politicians and civil servants, health and social care professionals and others to jointly design and deliver research so that it meets their needs. We expect SPECTRUM to speed up how evidence is used to inform new and existing policy and practices to improve the health of people in the UK, and to develop research that could also support progress in other countries.

Technical Summary

The main causes of NCDs include consumption of unhealthy commodities. These exposures are preventable, but the commodities involved are highly profitable. Their consumption and health and social impacts are also inequitable and driven by complex systems of production, distribution and promotion dominated by transnational companies -Unhealthy Commodity Producers (UCPs). UCPs' economic interests often conflict with health goals and their role in determining health has received insufficient attention.

SPECTRUM aims to generate new evidence to inform the prevention of NCDs caused by unhealthy commodities and to transform policy and practice to encourage the adoption of healthy environments and behaviours.

With a principal focus on tobacco and alcohol, our work will extend to foods high in salt, sugar and fat in key studies. Approaches we develop could in future be applied to other unhealthy commodities. We will conduct research in eight integrated Work Packages: 1.using systems science to understand and prevent behavioural drivers of disease and harm; 2.understanding and countering corporate conduct and influence; 3.using new data sources to inform action; 4.conducting economic analysis to inform policy and practice; 5.shaping the environment to change harmful behaviours; 6.evaluating the effectiveness of policies and natural experiments; 7.reducing mental health inequalities; and 8.building governance for health equity.

Along with an inter-disciplinary research team, SPECTRUM's work will be co-created with research users from civil society organisations, companies and the main public health agencies in Great Britain. The public will be involved through engagement panels, citizen's juries and qualitative research. This partnership will ensure that research findings will benefit from an accelerated pathway to inform new policies and practices and will provide valuable data to assess the extent and effectiveness of approaches to addressing NCDs in the UK and beyond.

This grant is funded by the UK Prevention Research Partnership (UKPRP) which is administered by the Medical Research Council on behalf of the UKPRP's 12 funding partners: British Heart Foundation; Cancer Research UK; Chief Scientist Office of the Scottish Government Health and Social Care Directorates; Engineering and Physical Sciences Research Council; Economic and Social Research Council; Health and Social Care Research and Development Division, Welsh Government; Health and Social Care Public Health Agency, Northern Ireland; Medical Research Council; Natural Environment Research Council; National Institute for Health Research; The Health Foundation; The Wellcome Trust.