System-science Informed Public Health and Economic Research for Non-communicable Disease Prevention (the SIPHER Consortium)

The conditions in which we are born, grow, live, work and age are key drivers of health and inequalities in life chances. To maximise health and wellbeing across the whole population, we need well-coordinated action across government sectors, in areas including economic, education, welfare, labour market and housing policy.

Current research struggles to offer effective decision support on the cross-sector strategic alignment of policies, and to generate evidence that gives budget holders the confidence to change the way major investment decisions are made. This open letter introduces a new research initiative in this space.

The SIPHER (Systems Science in Public Health and Health Economics Research) Consortium brings together a multi-disciplinary group of scientists from across six universities, three government partners at local, regional and national level, and ten practice partner organisations. The Consortium’s vision is a shift from health policy to healthy public policy, where the wellbeing impacts of policies are a core consideration across government sectors.

Researchers and policy makers will jointly tackle fundamental questions about:

• The complex causal relationships between upstream policies and wellbeing, economic and equality outcomes
• The multi-sectoral appraisal of costs and benefits of alternative investment options
• Public values and preferences for different outcomes, and how necessary trade-offs can be negotiated
• Creating the conditions for intelligence-led adaptive policy design that maximises progress against economic, social and health goals.

Whilst our methods will be adaptable across policy topics and jurisdictions, we will initially focus on four policy areas: Inclusive Economic Growth, Adverse Childhood Experiences, Mental Wellbeing and Housing.

Impact

The public SIPHER's ultimate beneficiaries will be communities, initially in our partner jurisdictions and then more widely, through reductions in NCDs and health inequalities, and associated increases in wellbeing, resulting from the more evidence-informed, joined-up approaches to decision-making and policy debate that our research enables.

Policy makers, policy advisors and policy analysts SIPHER's consortium members include policy organisations who wish to develop cost-effective and implementable policy proposals that maximise gains across various policy priorities, including reducing NCDs and health inequalities. SIPHER supports our policy colleagues by addressing four central problems that have restricted UK policy progress despite a strong and growing evidence-base about the upstream causes of ill health:

1. Policy makers struggle to articulate and defend the case for taking upstream, equity orientated action to prevent downstream health crises. Combining policy studies, public health, economic and modelling expertise, SIPHER will address this by two key means: a) working in close partnership with policy organisations (e.g. embedding SIPHER analysts) to provide policy makers with a trusted and accessible means of demonstrating the the costs and benefits of specific upstream preventative policy options compared to more downstream, responsive activities; and b) providing new evidence of public preferences regarding necessary trade-offs between different policy options and across relevant health and non-health outcomes, enabling advisors to provide policy makers with a more informed sense of likely public responses.
2. Policy makers repeatedly bemoan the lack of evidence on 'best buys' for policy investment, particularly in conditions of uncertainty. SIPHER will transform the policy utility of available evidence: it brings together what scientists, policy makers and communities know about a policy area, and uses models to test causal pathways and provide the kind of quantified projections that policymakers seek. This enables them to assess multiple different scenarios where major uncertainties about future developments (e.g. Brexit) exist, and adapt policies as uncertainties resolve.
3. While the complexity and interdependencies of systems linking upstream determinants to health outcomes are widely recognised, decision-makers often regard this complexity as difficult to navigate and therefore paralysing. Our systems science approach captures the dynamics of systems in our policy areas to facilitate joined-up decision-making and budget allocations through making visible the simultaneous impacts of policy options on multiple cross-sectoral policy outcomes.
4. Policy actors consistently cite the lack of timeliness of research as a key barrier to its use. The flexible, adaptive nature of our modelling will enable SIPHER to provide policy projections that can be rapidly adjusted to incorporate shifts in policy context and priorities. politicians, public health NGOs and interest groups politicians, NGOs and others (e.g. media, professional bodies) will be able to access, independently assess and employ SIPHER's outputs, tools, and evidence base via the familiar channels of our KT partners (including PHE, LGA, NHSHS), enabling advocacy efforts for policy options that are demonstrably good for public health. Given the crucial role of politics and interests in decision-making, SIPHER's efforts to ensure that these wider policy networks can understand, access and employ our outputs will be crucial to achieving long-term impacts in hotly contested policy areas. Scientists and analysts having shown the policy utility of systems science, SIPHER will scale up its impact ambitions radiating from our investigator's networks to embed our freely accessible methods and tools into policy analysis across and beyond the UK, helping others carry out research to realise widespread reductions in NCDs and health inequalities.

Publications and outputs

Meier P, Purshouse R, Bain M, Bambra C, Bentall R, Birkin M, Brazier J, Brennan A, Bryan M, Cox J, Fell G, Goyder E, Heppenstall A, Holmes J, Hughes C, Ishaq A, Kadirkamanathan V, Lomax N, Lupton R, Paisley S, Smith K, Stewart E, Strong M, Such E, Tsuchiya A, Watkins C. 2019. The SIPHER Consortium: Introducing the new UK hub for systems science in public health and health economic research.Wellcome Open Research. 

http://eprints.whiterose.ac.uk/157466/