Jonathan Wistow | Durham University (original) (raw)

Papers by Jonathan Wistow

Handbook of Social Policy Evaluation

BMC Public Health, 2021

Background Improving children and young people’s (CYP) health and addressing health inequalities ... more Background Improving children and young people’s (CYP) health and addressing health inequalities are international priorities. Reducing inequalities is particularly pertinent in light of the Covid-19 outbreak which has exacerbated already widening inequalities in health. This study aimed to explore understandings of inequality, the anticipated pathways for reducing inequalities among CYP and key factors affecting the development and implementation of policy to reduce inequalities among CYP at a local level. Methods We carried out a qualitative case study of one local government region in the North of England (UK), comprising semi structured interviews ( n = 16) with service providers with a responsibility for child health, non-participant observations of key meetings ( n = 6 with 43 participants) where decisions around child health are made, and a local policy documentation review ( n = 11). We employed a novel theoretical framework, drawing together different approaches to under...

People and Climate Change

Vulnerability to extreme weather events reflects the type, severity, and duration of the exposure... more Vulnerability to extreme weather events reflects the type, severity, and duration of the exposure, in addition to the attributes that make individuals and physical and social infrastructures susceptible to damage. Older populations are a demographic group likely to be at risk, despite their considerable capacity for adaptation and resilience. The vulnerability (and resilience) of older people significantly depends on the types and strengths of connections across complex systems of health and social care, upon which a substantial proportion of older people depend. In many areas of the world, there is growing emphasis on strategies to recognize, sustain, and strengthen this “nexus” of critical connections. This chapter considers people and climate change in a Western European context using illustrations from research in England, which focuses on the impacts of extreme weather events on the built infrastructure supporting older people’s health and social care delivery.

Studying health inequalities, 2015

Capital & Class

Too often, members of the working class who voted to leave the European Union in the 2016 referen... more Too often, members of the working class who voted to leave the European Union in the 2016 referendum have been framed as uneducated and unaware of their own economic interests. This article, based on 26 in-depth face-to-face interviews and a further telephone interview on Teesside in the North East of England, offers an alternative perspective that is more nuanced and less reductionist. The article critiques some of the commonly heard tropes regarding the rationale for voting leave, it then exposes how leave voters rooted their decision in a localised experience of neoliberalism’s slow-motion social dislocation linked to the deindustrialisation of the area and the failure of political parties, particularly the Labour Party, to speak for regional or working-class interests.

Environmental health : a global access science source, Dec 5, 2017

This review, commissioned by the Research Councils UK Living With Environmental Change (LWEC) pro... more This review, commissioned by the Research Councils UK Living With Environmental Change (LWEC) programme, concerns research on the impacts on health and social care systems in the United Kingdom of extreme weather events, under conditions of climate change. Extreme weather events considered include heatwaves, coldwaves and flooding. Using a structured review method, we consider evidence regarding the currently observed and anticipated future impacts of extreme weather on health and social care systems and the potential of preparedness and adaptation measures that may enhance resilience. We highlight a number of general conclusions which are likely to be of international relevance, although the review focussed on the situation in the UK. Extreme weather events impact the operation of health services through the effects on built, social and institutional infrastructures which support health and health care, and also because of changes in service demand as extreme weather impacts on hum...

Studying health inequalities

Journal of Public Health

Background: Extreme Weather Events (EWEs) can significantly impact on mortality and morbidity in ... more Background: Extreme Weather Events (EWEs) can significantly impact on mortality and morbidity in the UK. The extent to which EWE guidance is disseminated and filters across health and social care systems, to the local, operational level, is not well understood. Methods: This study develops tools and resources to assist local stakeholders to cascade national 'all weather' EWE guidance across local systems. These resources are also used to evaluate the local interpretation and implementation this advice and guidance within three local authority areas. In total five discussion group meetings were held and 45 practitioners took part in the study. A thematic analysis was conducted. Results: The main themes emerging from the analysis related to: awareness of PHE guidance for EWE preparedness; data sharing feasibility; community engagement; specific conditions in remote rural areas; capacity of frontline staff. Conclusions: The relative difficulty in finding where the study 'best fits' on local stakeholders' agendas suggests that year-round and preparedness planning for EWEs may not have been considered a high priority in participating areas. This study adds to the relatively limited evidence internationally concerning the practical implementation at local level of national adaptation advice and guidance and potential barriers to achieving this. Key words: Extreme weather events; public health; policy implementation Background Extreme Weather Events (EWEs), including heatwaves, cold weather and flooding, can significantly impact on mortality and morbidity in the UK 1-6. Since 2002-03 there have been on average 26,500 excess winter deaths a year in the UK, approximately twice the rate of excess deaths occurring in Finland, and severe winter weather has caused significant disruption to services in recent years 7. The 2003 heatwave caused approximately 2,000 excess deaths in England, with heat also associated with other health hazards such as air pollution 4. Floods are known to cause significant harm to mental health, and may, more rarely, be associated with drowning, infectious diseases and carbon monoxide poisoning 6. All population groups are affected, but certain groups are particularly vulnerable to the risks of EWE hazards 4-6. Table 1 provides details of those identified as the most 'vulnerable' in relation to each of the three weather events focused on here. (insert table 1 roughly here) Under the 2004 Civil Contingencies Act in the UK, there is a duty to warn and inform the public before, during and after an emergency. Public Health England (PHE), which is an executive agency of the Department of Health, publishes annual heatwave and cold weather plans 4,5 which aim to prepare for, alert people to, and prevent, the major avoidable effects on health during periods of severe heat or cold in England. The heatwave and cold weather plans provide end users (the NHS, local authorities, social care, and other public agencies; professionals working with people at risk; individuals, local communities and voluntary groups) with a series of alerts giving guidance about what action to take when a heatwave or extreme cold event is expected or occurring. These alerts range from level 0 (year-round planning) to Level 4 (major incident-emergency response). Research reported here focused on the implementation of the advice and guidance provided for year-round and preparedness planning (levels 0 and 1 respectively). This is based on the expectation that by improving resilience and preparedness the adverse health effects of EWEs will be reduced 4,8,9. The extent to which EWE guidance is disseminated and filters across health and social care systems, to the local, operational level, is not well understood. The Intergovernmental Panel on Climate Change 10(p.97) concluded that, 'most assessments of adaptation have been restricted to impacts, vulnerability, and adaptation planning, with very few assessing the processes of implementation or the effects of adaptation actions.' There is a demand in local public health systems for knowledge and advice on extreme event management 11,12. It is important that iterative risk management approaches are developed 10 and that the place-based nature of resilience is acknowledged, being 'rooted in linked social, economic and environmental systems that are always in some ways unique to a particular place'. 13(p.723) The PHE 4 advice and guidance adopts just such an approach stating that, 'all local organisations should consider this document [the Heat Wave Plan (HWP)] and satisfy

An applied approach, 2015

Environment and Planning C: Politics and Space

Adaptation to extreme weather events in complex local health care systems: the example of older p... more Adaptation to extreme weather events in complex local health care systems: the example of older people's health and care services in England (pre-publication version: please note there may be minor differences between this version and the published version in Environment and Planning C: Politics

Background This paper explores the value of qualitative comparative analysis (QCA) in public heal... more Background This paper explores the value of qualitative comparative analysis (QCA) in public health research using the example of a pilot case management intervention for long-term incapacity benefit recipients. It uses QCA to examine how the ‘health improvement’ effects of the intervention varied by individual and service characteristics.

Methods Data for 131 participants receiving the intervention were collected over 9 months. Health improvement was measured using the EuroQual Visual Analogue Scale. Socio-demographic, health behaviour data were also collected. Data on service use was obtained from the provider's client records. Crisp set QCA was conducted to identify which individual and service characteristics were most likely to produce a health benefit after participation in the intervention.

Results Health improvement was most likely amongst younger participants, men aged over 50 and those with an occupational history of skilled manual work or higher and less likely amongst older women, those with a musculoskeletal condition and those with semi- or un-skilled backgrounds. Service characteristics had no impact.

Conclusions The QCA identified potential causal pathways for health improvement from the intervention with important potential implications for health inequalities. QCA should be considered as a viable and practical method in the public health evaluation tool box.

We use theories of formal and informal networks of care, within a local governance system, to int... more We use theories of formal and informal networks of care, within a local governance system, to interpret networks supporting older people during extreme weather events. Drawing on international literatures about network governance and emergency management this paper outlines an approach which considers the views of older people and service providers to explore resilience of infrastructures and service agencies. During emergencies, links between different networks of care are important to avoid discontinuities that could endanger older people’s health and well-being.
This paper explores the scope to draw on local knowledge and local caring networks to inform preparedness for extreme weather.

Social Science & Medicine, Jan 1, 2011

Journal of Integrated Care, Jan 1, 2005

Introduction Under the Health and Social Care Act 2001 and the Local Authority (Overview and Scru... more Introduction Under the Health and Social Care Act 2001 and the Local Authority (Overview and Scrutiny Committees Health Scrutiny Functions) Regulations 2002, NHS bodies are subject to a degree of local accountability. This article provides a brief introduction to the role both of ...