Publications

@article{Kalbus2025,

title = {Calorie labelling regulations in England: menu change not behaviour change?},

author = {Alexandra Kalbus and Chiara Rinaldi},

url = {https://www.cambridge.org/core/journals/public-health-nutrition/article/calorie-labelling-regulations-in-england-menu-change-not-behaviour-change/B49E7A4D5DCB2ECB35FDFCC0696DA483},

doi = {https://doi.org/10.1017/S1368980025100682},

year  = {2025},

date = {2025-08-12},

urldate = {2025-08-12},

journal = {Public Health Nutrition },

keywords = {Food, Food Policy, Government, health, Health economics, health improvement},

pubstate = {published},

tppubtype = {article}

}

@article{Morris2024,

title = {Estimating the effect of transitioning to a strength-based alcohol tax system on alcohol consumption and health outcomes: a modelling study of tax reform in England},

author = {Damon Morris, Colin Angus, Abigail K Stevely, Robert Pryce, Luke Wilson, Madeleine Henney, Prof Petra S Meier, Prof John Holmes and Prof Alan Brennan},

url = {https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(24)00191-9/fulltext},

doi = {https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(24)00191-9/fulltext},

year  = {2024},

date = {2024-09-16},

urldate = {2024-09-16},

journal = {The Lancet Public Health},

keywords = {Alcohol, alcohol consumption, Alcohol pricing, health, Health economics, health improvement, Taxation},

pubstate = {published},

tppubtype = {article}

}

@article{McGowan2021b,

title = {Examining the effectiveness of place-based interventions to improve public health and reduce health inequalities: an umbrella review.},

author = {McGowan, V.J., Buckner, S., Mead, R. et al.},

url = {https://doi.org/10.1186/s12889-021-11852-z},

doi = {https://doi.org/10.1186/s12889-021-11852-z},

year  = {2021},

date = {2021-10-19},

journal = {BMC Public Health 21},

keywords = {Health economics, Health inequalities},

pubstate = {published},

tppubtype = {article}

}

@article{Keeble2021,

title = {Socioeconomic inequalities in food outlet access through an online food delivery service in England: a cross-sectional descriptive analysis},

author = {Keeble, M., Adams, J., Bishop, T., Burgoine, T.},

url = {https://doi.org/10.1016/j.apgeog.2021.102498},

doi = {https://doi.org/10.1016/j.apgeog.2021.102498},

year  = {2021},

date = {2021-06-29},

journal = {Applied Geography},

volume = {133},

keywords = {Food outlet, Health economics, Health inequalities, Nutrition},

pubstate = {published},

tppubtype = {article}

}

@article{Martínez-Jiménez2020,

title = {Effects of macroeconomic fluctuations on mental health and psychotropic medicine consumption},

author = {Martínez-Jiménez, M., Vall Castelló, J.},

url = {https://doi.org/10.1007/s10754-020-09281-3},

doi = {https://doi.org/10.1007/s10754-020-09281-3},

year  = {2020},

date = {2020-04-19},

journal = {International Journal of Health Economics and Management },

volume = {20},

pages = {277–297},

keywords = {Health economics, Mental Health, Physical activity},

pubstate = {published},

tppubtype = {article}

}

@article{,

title = {Assessing the potential return on investment of the proposed UK NHS diabetes prevention programme in different population subgroups: an economic evaluation},

author = {Chloe Thomas, Susi Sadler, Penny Breeze, Hazel Squires, Michael Gillett, Alan Brennan.},

doi = {10.1136/bmjopen-2016-014953},

year  = {2017},

date = {2017-08-21},

journal = {BMJ Open},

volume = {7},

number = {8},

abstract = {Objectives 

To evaluate potential return on investment of the National Health Service Diabetes Prevention Programme (NHS DPP) in England and estimate which population subgroups are likely to benefit most in terms of cost-effectiveness, cost-savings and health benefits.



Design

Economic analysis using the School for Public Health Research Diabetes Prevention Model.



Setting

England 2015–2016.



Population

Adults aged ≥16 with high risk of type 2 diabetes (HbA1c 6%–6.4%). Population subgroups defined by age, sex, ethnicity, socioeconomic deprivation, baseline body mass index, baseline HbA1c and working status.



Interventions

The proposed NHS DPP: an intensive lifestyle intervention focusing on dietary advice, physical activity and weight loss. Comparator: no diabetes prevention intervention.



Main outcome measures 

Incremental costs, savings and return on investment, quality-adjusted life-years (QALYs), diabetes cases, cardiovascular cases and net monetary benefit from an NHS perspective.



Results 

Intervention costs will be recouped through NHS savings within 12 years, with net NHS saving of £1.28 over 20 years for each £1 invested. Per 100 000 DPP interventions given, 3552 QALYs are gained. The DPP is most cost-effective and cost-saving in obese individuals, those with baseline HbA1c 6.2%–6.4% and those aged 40–74. QALY gains are lower in minority ethnic and low socioeconomic status subgroups. Probabilistic sensitivity analysis suggests that there is 97% probability that the DPP will be cost-effective within 20 years. NHS savings are highly sensitive to intervention cost, effectiveness and duration of effect.



Conclusions

The DPP is likely to be cost-effective and cost-saving under current assumptions. Prioritising obese individuals could create the most value for money and obtain the greatest health benefits per individual targeted. Low socioeconomic status or ethnic minority groups may gain fewer QALYs per intervention, so targeting strategies should ensure the DPP does not contribute to widening health inequalities. Further evidence is needed around the differential responsiveness of population subgroups to the DPP.},

keywords = {behaviour, Diabetes, Health economics, NHS},

pubstate = {published},

tppubtype = {article}

}

@article{,

title = {Cost‐effectiveness of population‐based, community, workplace and individual policies for diabetes prevention in the UK},

author = {P. R. Breeze, C. Thomas, H. Squires, A. Brennan, C. Greaves, P. Diggle, E. Brunner, A. Tabak, L. Preston, J. Chilcott.},

doi = {10.1111/dme.13349 },

year  = {2017},

date = {2017-03-10},

journal = {Diabetic Medicine},

abstract = {Aim

To analyse the cost‐effectiveness of different interventions for Type 2 diabetes prevention within a common framework.



Methods

A micro‐simulation model was developed to evaluate the cost‐effectiveness of a range of diabetes prevention interventions including: (1) soft drinks taxation; (2) retail policy in socially deprived areas; (3) workplace intervention; (4) community‐based intervention; and (5) screening and intensive lifestyle intervention in individuals with high diabetes risk. Within the model, individuals follow metabolic trajectories (for BMI, cholesterol, systolic blood pressure and glycaemia); individuals may develop diabetes, and some may exhibit complications of diabetes and related disorders, including cardiovascular disease, and eventually die. Lifetime healthcare costs, employment costs and quality‐adjusted life‐years are collected for each person.



Results

All interventions generate more life‐years and lifetime quality‐adjusted life‐years and reduce healthcare spending compared with doing nothing. Screening and intensive lifestyle intervention generates greatest lifetime net benefit (£37) but is costly to implement. In comparison, soft drinks taxation or retail policy generate lower net benefit (£11 and £11) but are cost‐saving in a shorter time period, preferentially benefit individuals from deprived backgrounds and reduce employer costs.



Conclusion

The model enables a wide range of diabetes prevention interventions to be evaluated according to cost‐effectiveness, employment and equity impacts over the short and long term, allowing decision‐makers to prioritize policies that maximize the expected benefits, as well as fulfilling other policy targets, such as addressing social inequalities.},

keywords = {Cardiovascular disease, Diabetes, Economic modelling, Exercise, health, Health economics, Policy, Screening},

pubstate = {published},

tppubtype = {article}

}

@article{,

title = {The impact of Type 2 diabetes prevention programmes based on risk‐identification and lifestyle intervention intensity strategies: a cost‐effectiveness analysis},

author = {P. R. Breeze , C. Thomas, H. Squires, A. Brennan, C. Greaves, P. J. Diggle, E. Brunner, A. Tabak, L. Preston, J. Chilcott.},

doi = {10.1111/dme.13314},

year  = {2017},

date = {2017-01-11},

journal = {Diabetic Medicine},

abstract = {Aims

To develop a cost‐effectiveness model to compare Type 2 diabetes prevention programmes targeting different at‐risk population subgroups with a lifestyle intervention of varying intensity.



Methods

An individual patient simulation model was constructed to simulate the development of diabetes in a representative sample of adults without diabetes from the UK population. The model incorporates trajectories for HbA1c, 2‐h glucose, fasting plasma glucose, BMI, systolic blood pressure, total cholesterol and HDL cholesterol. Patients can be diagnosed with diabetes, cardiovascular disease, microvascular complications of diabetes, cancer, osteoarthritis and depression, or can die. The model collects costs and utilities over a lifetime horizon. The perspective is the UK National Health Service and personal social services. We used the model to evaluate the population‐wide impact of targeting a lifestyle intervention of varying intensity to six population subgroups defined as high risk for diabetes.



Results

The intervention produces 0.0003 to 0.0009 incremental quality‐adjusted life years and saves up to £1.04 per person in the general population, depending upon the subgroup targeted. Cost‐effectiveness increases with intervention intensity. The most cost‐effective options are to target individuals with HbA1c > 42 mmol/mol (6%) or with a high Finnish Diabetes Risk (FINDRISC) probability score (> 0.1).



Conclusion

The model indicates that diabetes prevention interventions are likely to be cost‐effective and may be cost‐saving over a lifetime. In the model, the criteria for selecting at‐risk individuals differentially impact upon diabetes and cardiovascular disease outcomes, and on the timing of benefits. These findings have implications for deciding who should be targeted for diabetes prevention interventions.},

keywords = {Cardiovascular disease, Diabetes, Diet, Education, Exercise, Health economics, Nutrition, Policy},

pubstate = {published},

tppubtype = {article}

}

@article{,

title = {The potential value of priority-setting methods in public health investment decisions: qualitative findings from three English local authorities},

author = {D. J. Hunter, L. Marks, J. Brown, S. Scalabrini, S. Salway, L. Vale, J. Gray, N. Payne. },

doi = {10.1080/09581596.2016.1164299},

year  = {2016},

date = {2016-03-28},

journal = {Critical Public Health},

volume = {26},

number = {5},

pages = {578-587},

abstract = {This paper reports on an action-oriented research study providing decision support to three local authorities in England on the prioritisation of public health investment and disinvestment decisions. We adopted a political science perspective, using the multiple streams framework to investigate the use of prioritisation tools in public health spending decisions at a time of severe financial constraints. The challenges and implications of their potential use in everyday practice were explored. Twenty-nine interviews were conducted before the targeted decision support occurred and 19 interviews after the decision support had been delivered. Interviews were held with locally elected politicians, officers and public health professionals based within local government, NHS commissioners and the local independent consumer watchdog for health and social care. Targeted workshops with local stakeholders were facilitated in each site by health economist members of the project team. Structured observational notes were recorded during these workshops and integrated with the interview data. Many respondents expressed an interest in prioritisation tools although some scepticism was expressed about their value and impact on decision-making. This paper analyses the enablers and barriers to adopting priority-setting tools in a local government environment that by definition is political. The findings suggest that the adoption of priority-setting tools in decision-making processes in public health poses some significant challenges within local government and that certain enabling factors have to be present.},

keywords = {Decision making, Health economics, Local Government, Priority setting, Public health},

pubstate = {published},

tppubtype = {article}

}