Tony Blakely

Tony Blakely
University of Otago · Department of Public Health (Wellington)

MBChB, MPH, FAFPHM, PhD

About

477
Publications
53,918
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13,646
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Introduction
I am an epidemiologist and public health researcher. My interests span research methods to content areas such as tobacco, nutrition and obesity, and health inequalities to cost-effectiveness. I lead research assessing the health impact, and cost, of interventions.
Additional affiliations
January 2010 - December 2012
The University of Edinburgh
January 2009 - present
University of Bristol
January 2008 - present
University of Canterbury

Publications

Publications (477)
Preprint
A bstract Background Identifying optimal COVID-19 policies is challenging. For Victoria, Australia (6.6 million people), we ranked 44 policy packages (two levels of stringency of public health and social measures [PHSMs]; providing respirators during infection surges; 11 vaccination schedules of current and next-generation vaccines) in the context...
Preprint
Objectives To quantify the morbidity (years lived with disability; YLDs) of long COVID in Australia during the 2021-2022 Omicron BA.1/BA.2 wave. To compare long COVID YLDs with: acute SARS-CoV-2 infection YLDs; years of life lost (YLLs) from SARS-CoV-2; and health loss from other diseases. Design Burden of disease study using inputs from previousl...
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Full-text available
Background This study compares the health gains, costs, and cost-effectiveness of hundreds of Australian and New Zealand (NZ) health interventions conducted with comparable methods in an online interactive league table designed to inform policy. Methods A literature review was conducted to identify peer-reviewed evaluations (2010 to 2018) arising...
Preprint
Objective To estimate the health gains and Māori:non-Māori health inequality reductions of the Aotearoa/New Zealand Government’s proposed endgame strategy. Design Simulation modelling: a Markov model to estimate future yearly smoking and vaping prevalence (for business-as-usual [BAU] and intervention scenarios) linked to a proportional multistate...
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Recent crises have underscored the importance that housing has in sustaining good health and, equally, its potential to harm health. Considering this and building on Howden-Chapman's early glossary of housing and health and the WHO Housing and Health Guidelines, this paper introduces a range of housing and health-related terms, reflecting almost 20...
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Full-text available
Background Exposure to cold indoor temperature (< 18 degrees Celsius) increases cardiovascular disease (CVD) risk and has been identified by the WHO as a source of unhealthy housing. While warming homes has the potential to reduce CVD risk, the reduction in disease burden is not known. We simulated the population health gains from reduced CVD burde...
Article
Immunity to SARS-CoV-2 following vaccination wanes over time in a non-linear fashion, making modelling of likely population impacts of COVID-19 policy options challenging. We observed that it was possible to mathematize non-linear waning of vaccine effectiveness (VE) on the percentage scale as linear waning on the log-odds scale, and developed a ra...
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Full-text available
Policies to mitigate climate change are essential. The objective of this paper was to estimate the impact of greenhouse gas (GHG) food taxes and assess whether such a tax could also have health benefits in Aotearoa NZ. We undertook a systemised review on GHG food taxes to inform four tax scenarios, including one combined with a subsidy. These scena...
Preprint
Immunity to SARS-CoV-2 following vaccination wanes over time in a non-linear fashion, making modelling of likely population impacts of COVID-19 policy options challenging. We observed that it was possible to mathematize non-linear waning of vaccine effectiveness (VE) on the percentage scale as linear waning on the log-odds scale, and developed a ra...
Preprint
Aim: We aimed to combine Global Burden of Disease (GBD) Study data and local data to identify the highest priority intervention domains for preventing cardiovascular disease (CVD) in the case study country of Aotearoa New Zealand (NZ). Methods: Risk factor data for CVD in NZ was extracted from the GBD using the “GBD Results Tool”. We prioritized ri...
Article
Objective Tobacco endgame policies aim to rapidly and permanently reduce smoking to minimal levels. We reviewed evidence syntheses for: (1) endgame policies, (2) evidence gaps, and (3) future research priorities. Data sources Guided by JBI scoping review methodology, we searched five databases (PubMed, CINAHL, Scopus, Embase and Web of Science) fo...
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Full-text available
Objective: In 2020, we developed a public health decision-support model for mitigating the spread of SARS-CoV-2 infections in Australia and New Zealand. Having demonstrated its capacity to describe disease progression patterns during both countries' first waves of infections, we describe its utilisation in Victoria in underpinning the State Govern...
Article
Background: Myocardial infarction mortality has declined since the 1970s, but contemporary drivers of this trend remain unexplained. The aim of this study was to compare the contribution of trends in event rates and case fatality to declines in myocardial infarction mortality in four high-income jurisdictions from 2002-15. Methods: Linked hospit...
Preprint
Introduction Policies to mitigate climate change are essential. The objective of this paper was to estimate the impact of greenhouse gas (GHG) food taxes and assess whether such a tax could also have health benefits and reduce ethnic inequalities in health in Aotearoa NZ. Methods We undertook a systemised review on GHG food taxes to inform four ta...
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Full-text available
Background Simulation models can be used to quantify the projected health impact of interventions. Quantifying heterogeneity in these impacts, for example by socioeconomic status, is important to understand impacts on health inequalities. We aim to disaggregate one type of Markov macro-simulation model, the proportional multistate lifetable, ensuri...
Preprint
Full-text available
Background Exposure to cold indoor temperature (<18 degrees Celsius) increases cardiovascular disease (CVD) risk and has been identified by the WHO as a source of unhealthy housing. While warming homes has the potential to reduce CVD risk, the reduction in disease burden is not known. We simulated the population health gains from reduced CVD burden...
Article
Full-text available
Background Classifying individuals at high chronic obstructive pulmonary disease (COPD)-risk creates opportunities for early COPD detection and active intervention. Objective To develop and validate a statistical model to predict 10-year probabilities of COPD defined by post-bronchodilator airflow obstruction (post-BD-AO; forced expiratory volume...
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Background Reducing disease can maintain personal individual income and improve societal economic productivity. However, estimates of income loss for multiple diseases simultaneously with thorough adjustment for confounding are lacking, to our knowledge. We estimate individual-level income loss for 40 conditions simultaneously by phase of diagnosis...
Preprint
Full-text available
Background This study compares the health gains, costs, and cost-effectiveness of hundreds of Australian and New Zealand (NZ) health interventions conducted with comparable methods in an online interactive league table designed to inform policy. Methods A literature review was conducted to identify peer-reviewed evaluations (2010 to 2018) arising...
Preprint
The COVID-19 pandemic has brought the discipline of public health, infectious disease, and policy modeling squarely into the spotlight. Never before have decisions regarding public health measures and their impacts been such a topic of international deliberation from the level of individuals and communities through to global leaders. And nor previo...
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Full-text available
Background Although the harm to health from electronic nicotine delivery systems (ENDS) compared to smoked tobacco remains highly uncertain, society and governments still need to know the likely range of the relative harm to inform regulatory policies for ENDS and smoking. Methods We identified biomarkers with specificity of association with diffe...
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Full-text available
Food price elasticities (PEs) are essential for evaluating the impacts of food pricing interventions to improve dietary and health outcomes. This paper innovates the use of experimental purchasing data from a recent New Zealand virtual supermarket experiment to estimate PEs for a large set of disaggregated foods across major food groups relevant fo...
Article
Background Measuring population health and costs effects of liberalizing access to electronic nicotine delivery systems (ENDS) is an evolving field with high persisting uncertainty. A critical area of uncertainty for policy-makers are estimates of net harms from ENDS relative to cigarettes, therefore, we model these harms using updated estimates in...
Article
Objectives To identify COVID-19 quarantine system failures in Australia and New Zealand. Design, setting, participants Observational epidemiological study of travellers in managed quarantine in Australia and New Zealand, to 15 June 2021. Main outcome measures Number of quarantine system failures, and failure with respect to numbers of travellers...
Article
Background Front-of-pack nutrition labelling (FoPL) of packaged foods can promote healthier diets. Australia & New Zealand (NZ) adopted the voluntary Health Star Rating (HSR) scheme in 2014. We studied the impact of voluntary adoption of HSR on food reformulation overall, and for more- versus less-healthy foods. Methods Annual nutrition informatio...
Preprint
Full-text available
Background and Aims The New South Wales (NSW) COVID-19 outbreak is at 478 daily cases on August 16, 2021. Our aims were to: 1) estimate the time required to reach ≤5 cases per day under three lockdown strengths (weak, moderate, strong), and four vaccination rollouts: (a) per the original plan, (b) prioritizing essential workers, (c) b plus rapid va...
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Full-text available
Importance Countries have varied enormously in how they have responded to the COVID-19 pandemic, ranging from elimination strategies (eg, Australia, New Zealand, Taiwan) to tight suppression (not aiming for elimination but rather to keep infection rates low [eg, South Korea]) to loose suppression (eg, Europe, United States) to virtually unmitigated...
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Full-text available
We aimed to estimate the risk of COVID-19 outbreaks associated with air travel to a COVID-19-free country [New Zealand (NZ)]. A stochastic version of the SEIR model CovidSIM v1.1, designed specifically for COVID-19 was utilised. We first considered historical data for Australia before it eliminated COVID-19 (equivalent to an outbreak generating 74...
Article
Background Many studies have reported an inferred causal association of income poverty with physical health among children; but making causal inference is challenging due to multiple potential sources of systematic error. We quantified the short-run effect of changes in household poverty status on children’s health (asthma and ear infections) and s...
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Full-text available
Background The World Health Organization launched the Global Action Plan for Physical Activity (GAPPA) in 2018, which set a global target of a 15% relative reduction in the prevalence of physical inactivity by 2030. This target, however, could be acheived in various ways. Methods We use an established multi-state life table model to estimate the h...
Preprint
Policies to restrict movements and contact between people have been a common response to control the spread of SARS-CoV-2 in many countries around the world, in varying degrees of stringency. However, there have been concerns on the possible negative effects of these restrictions such as stay-at-home orders and lockdowns. In this analysis we attemp...
Article
In this viewpoint, we suggest that policymakers should prioritise health interventions by using evidence around health gain, impact on equity, health-system costs and cost-effectiveness. We take the example of the new cancer control agency in New Zealand, Te Aho o Te Kahu, and argue that its decision-making can now be informed by many methodologica...
Preprint
Full-text available
Aim: With increasing global use of hotel-based quarantine as part of COVID-19 border control efforts, we aimed to assess its risk of failure. Methods: We searched official websites in both Australia and New Zealand (NZ) to identify outbreaks and border control failures associated with hotel quarantine (searches conducted up to 12 February 2021). We...
Preprint
Full-text available
Background Simulation models can be used to quantify the projected health impact of interventions. Quantifying heterogeneity in these impacts, for example by socioeconomic status, is important to understand impacts on health inequalities.We aim to disaggregate one type of Markov macro-simulation model, the proportional multistate lifetable, ensurin...
Article
Aim: We aimed to estimate the risk of COVID-19 outbreaks in a COVID-19-free destination country (New Zealand) associated with shore leave by merchant ship crews who were infected prior to their departure or on their ship. Methods: We used a stochastic version of the SEIR model CovidSIM v1.1 designed specifically for COVID-19. It was populated wi...
Preprint
Full-text available
Simulation models can be used to quantify the projected health impact of interventions. Quantifying heterogeneity in these impacts, for example by socioeconomic status, is important to understand impacts on health inequalities. We aim to disaggregate one type of Markov macro-simulation model, the proportional multistate lifetable, ensuring that und...
Article
Background: Myocardial infarction mortality has declined since the 1970s, but contemporary drivers of this trend remain unexplained. The aim of this study was to compare the contribution of trends in event rates and case fatality to declines in myocardial infarction mortality in four high-income jurisdictions from 2002–15. Methods: Linked hospitali...
Preprint
Full-text available
Introduction Although the harm to health from electronic nicotine delivery systems (ENDS) use relative to smoked tobacco remains highly uncertain, society and governments still need to know the likely range of the relative harm to inform regulatory policies for ENDS and smoking. Methods We identified biomarkers with specificity of association with...
Article
Full-text available
Background Front-of-pack nutrition labelling (FoPL) of packaged foods can promote healthier diets. Australia and New Zealand (NZ) adopted the voluntary Health Star Rating (HSR) scheme in 2014. We studied the impact of voluntary adoption of HSR on food reformulation relative to unlabelled foods and examined differential impacts for more-versus-less...
Article
Burden of Disease studies—such as the Global Burden of Disease (GBD) Study—quantify health loss in disability-adjusted life-years. However, these studies stop short of quantifying the future impact of interventions that shift risk factor distributions, allowing for trends and time lags. This methodology paper explains how proportional multistate li...
Preprint
Full-text available
Aim: We aimed to estimate the risk of COVID-19 outbreaks in a case study COVID-free destination country, associated with shore leave for merchant ship crews. Methods: A stochastic version of the SEIR model CovidSIM v1.1, designed specifically for COVID-19 was utilised. It was populated with parameters for SARS-CoV-2 transmission, shipping character...
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Full-text available
Background In many countries smoking rates have declined and obesity rates have increased, and social inequalities in each have varied over time. At the same time, mortality has declined in most high-income countries, but gaps by educational qualification persist—at least partially due to differential smoking and obesity distributions. This study u...
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Full-text available
Background One possible policy response to the burden of diet-related disease is food taxes and subsidies, but the net health gains of these approaches are uncertain because of substitution effects between foods. We estimated the health and cost impacts of various food taxes and subsidies in one high-income country, New Zealand. Methods In this mo...
Article
Background To prioritise tobacco control interventions, simulating their health impacts is valuable. We undertook a systematic review of tobacco intervention simulation models to assess model structure and input variations that may render model outputs non-comparable. Methods We applied a Medline search with keywords intersecting modelling and tob...
Article
Background Physical activity smartphone apps are a promising strategy to increase population physical activity, but it is unclear whether government mass media campaigns to promote these apps would be a cost-effective use of public funds. Objective We aimed to estimate the health impacts, costs, and cost-effectiveness of a one-off national mass me...
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Full-text available
Reducing motorized transport and increasing active transport (i.e. transport by walking, cycling and other active modes) may reduce greenhouse gas (GHG) emissions and improve health. But, active modes of transport are not zero emitters. We aimed to quantify GHG emissions from food production required to fuel extra physical activity for walking and...
Article
Aims: Increases in cancer survival may increase cancer prevalence and demand for healthcare. We aimed to estimate cancer prevalence in the New Zealand population. Methods: We used national linked health, social and census datasets from the Stats NZ Integrated Data Infrastructure to identify the number of New Zealand residents who had at least on...
Article
Objectives The cost-effectiveness of low-dose computed tomography (LDCT) screening for lung cancer is uncertain. This study estimated the health gains, costs (net health system, and including ‘unrelated’) and cost-effectiveness of biennial LDCT screening among 55−74 years olds with a smoking history of at least 30 pack years, and (if a former smoke...
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Full-text available
Background Food taxes and subsidies are one intervention to address poor diets. Price elasticity (PE) matrices are commonly used to model the change in food purchasing. Usually a PE matrix is generated in one setting then applied to another setting with differing starting consumptions and prices of foods. This violates econometric assumptions resul...
Article
Full-text available
Background: The Health Research Council of New Zealand is the first major government funding agency to use a lottery to allocate research funding for their Explorer Grant scheme. This is a somewhat controversial approach because, despite the documented problems of peer review, many researchers believe that funding should be allocated solely using...
Preprint
BACKGROUND Physical activity smartphone apps are a promising strategy to increase population physical activity, but it is unclear whether government mass media campaigns to promote these apps would be a cost-effective use of public funds. OBJECTIVE We aimed to estimate the health impacts, costs, and cost-effectiveness of a one-off national mass me...
Article
Background Interventions that reduce morbidity, in addition to mortality, warrant prioritisation. It is important to understand the magnitude of potential morbidity and health gains from changing risk factor distributions. We quantified the impact of tobacco compared with overweight/obesity eradication on future morbidity and health-adjusted life e...
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Full-text available
Background: Increasing active transport is proposed as a means to address both health and environmental issues. However, the associations between specific modes, such as cycling, walking and public transport, and health outcomes remain unclear. We examined the association between mode of travel to work and mortality. Methods: Cohort studies of t...
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Full-text available
Cardiovascular disease (CVD) is the leading cause of death internationally. We aimed to model the impact of CVD preventive double therapy (a statin and anti-hypertensive) by clinician-assessed absolute risk level. An established and validated multi-state life-table model for the national New Zealand (NZ) population was adapted. The new version of t...
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Full-text available
Objective We aimed to estimate the cost-effectiveness of brief weight-loss counselling by dietitian-trained practice nurses, in a high-income-country case study. Design A literature search of the impact of dietary counselling on BMI was performed to source the ‘best’ effect size for use in modelling. This was combined with multiple other input par...
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Full-text available
Background: National linked mortality and census data have not previously been available for Australia. We estimated education-based mortality inequalities from linked census and mortality data that are suitable for international comparisons. Methods: We used the Australian Bureau of Statistics Death Registrations to Census file, with data on de...
Preprint
Full-text available
Background Food taxes and subsidies are one intervention to address poor diets. Price elasticity (PE) matrices are commonly used to model the change in food purchasing. Usually a PE matrix is generated in one setting then applied to another setting with differing starting consumption and prices of foods. This violates econometric assumptions result...