Clare Bambra’s research while affiliated with Newcastle University and other places

Background Globally, there is increasing evidence of resistance to government-led public health interventions in areas such as vaccination, climate change mitigation, sexual and reproductive healthcare, and the implementation of non-pharmaceutical infection control measures. One potential explanation for this could be the documented global rise in populist attitudes, characterised by distrust of scientific, government and other perceived ‘elites.’ While the effect of such attitudes on engagement with COVID-19-related interventions has been extensively considered and researched, their association with the receipt of other public health interventions is currently underexplored. Methods To understand how populist-aligned views might influence the receipt of public health interventions addressing areas other than COVID-19, we systematically reviewed quantitative research published across thirteen bibliographic databases and relevant websites between 2008 and 2024. All studies were set in member countries of the Organisation for Economic Co-operation and Development (OECD). Results Across 30 included studies, the vast majority of which were cross-sectional, we found evidence that populist-aligned attitudes have a negative impact on the receipt of public health interventions including vaccinations, sexual and reproductive health care and preventive health care. We also found preliminary evidence of the negative role of populist-aligned attitudes on the receipt of disease screening related to HIV/AIDS and adherence to non-pharmaceutical interventions during times of public health emergency, such as the 2009 H1N1 pandemic. Conclusions Although providing limited evidence of causality, the findings from this review suggest the need for future policy in many OECD countries to focus on trust-building between the public and political, scientific, and medical establishments. They also indicate the need for mitigation strategies to overcome the potentially negative impact of populist-style hostility towards out-groups on attitudes related to pressing public health issues such as abortion and family planning, for example by drawing on empathy-centred approaches. Systematic review registration PROSPERO registration number CRD42024513124.

Objectives (1) Determine geographical access to community pharmacy in England, (2) explore the relationship between community pharmacy access and urbanity and multiple deprivation and (3) understand any changes in access over time. Design An area-level spatial analysis study exploring the relationship between spatial access to and availability of community pharmacies over the past 10 years from 2014 to 2023, deprivation and urbanicity, using Geographic Information System and descriptive statistics on a Middle layer Super Output Area level. Primary outcome measure Availability per 10 000 people of a community pharmacy in their local area. Results For geographical access, in 2014, 91.3% of people lived within a 20-minute walk to a community pharmacy and, in 2023, this number increased to 91.7%. There was a positive relationship between geographical community pharmacy access and urbanity and geographical community pharmacy access and deprivation. For availability, the median number of community pharmacies per 10 000 people in 2014 was 1.60, while in 2023, the number reduced to 1.51 community pharmacies per 10 000 people. The most deprived areas were more likely to lose a pharmacy, compared with the least deprived areas (OR 1.65 (1.38, 1.98)). Conclusions There is high access to community pharmacies in England with access to a community pharmacy greatest in the most deprived areas, showing that the ‘positive pharmacy care law’ remains. However, the ‘positive pharmacy care law’ is eroding as the availability of community pharmacies has reduced over time—particularly in deprived areas, with more people reliant on each community pharmacy.

Introduction Health interventions that require significant change to individual lifestyles or social norms can pose a challenge for widespread public acceptability and uptake. At the same time, over the last two decades, there has been increasing attention paid to the rise of populist movements globally, defined by ‘the people’ pushing against ‘an elite’ viewed as depriving the people of their sovereignty. To understand potential overlap in these two areas, this study aims to synthesise existing international evidence on linkages between populist attitudes and reduced uptake, acceptability, adherence and/or effectiveness of public health interventions. The goal of this work is to create a conceptual framework that can be used to inform policy strategies aimed at widening the impact of public health interventions. Methods and analysis A systematic review will be performed via searches across databases and websites relevant to public health and social science research, informed by preliminary searches on the topic. There will be no language restrictions, but included studies will be limited to those produced since 2008, the year of the global financial crisis, from which most current literature on populism dates. Risk of bias will be assessed using validated tools according to study design. Due to expected heterogeneity across included studies, this will be a systematic review without meta-analysis. Findings will be synthesised narratively, and the strength of the evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. The review will be reported according to the Systematic Reviews without Meta-Analysis reporting guidelines. Ethics and dissemination Ethical review is not required for this study. Public dissemination will be informed via consultation with our Patient and Public Involvement and Engagement Strategy Group, along with reporting via peer-reviewed publication, relevant international conferences, a policy brief and a workshop with public health and communications experts. PROSPERO registration number CRD42024513124.

After fourteen years of Conservative government, we rightly ask what changed for the better or worse during this prolonged period of power? The country experienced significant challenges including austerity, Brexit and Covid: did they militate against the government's making more lasting impact? Bringing together some of the leading authorities in the field, this book examines the impact of Conservative rule on a wide range of economic, social, foreign and governmental areas. Anthony Seldon, Tom Egerton and their team uncover the ultimate 'Conservative effect' on the United Kingdom. With powerful insights and fresh perspectives, this is an intriguing study for anyone seeking to understand the full scope of the Conservative government's influence on our nation. Drawing the immediate lessons from the last fourteen years will be pivotal if the country is to rejuvenate and flourish in the future.

This article examines historical trends in health inequalities over the 20th and 21st centuries. Drawing on studies from the United States, United Kingdom, Sweden, and Western Europe, it concludes that there is evidence of a u-shaped curve in (relative) health inequalities. These trends in health inequalities broadly parallel those identified by economists with regards to the u-shaped curve of income and wealth inequalities across the 20th and 21st centuries. The article argues that—as with income inequalities—health inequalities generally decreased across the twentieth century through to the early 1980s. They then started to increase and accelerated further from 2010, particularly in the United Kingdom and the United States. The article sets out four distinct policy periods that shaped the evolution of trends in health inequalities: the Interbellum Era, 1920–1950; the Trente Glorieuse, 1950–1980; Neoliberalism, 1980–2010; and the Crisis Age, 2010–present. The u-shaped curve of health inequalities over this period suggests that social policies, health care access, and political incorporation have driven changes over time. Taking this long view of changes in health inequalities emphasizes the importance of politics and policy for future health improvement.

Social protection can buffer the negative impacts of unemployment on health. Have stimulus packages introduced during the COVID-19 pandemic mitigated potential harms to health from unemployment? We performed a systematic review of the health effects of job loss during the first year of the pandemic. We searched three electronic databases and identified 49 studies for inclusion. Three United States-based studies found that stimulus programs mitigated the impact of job loss on food security and mental health. Furloughs additionally appeared to reduce negative impacts when they were paid. However, despite the implementation of large-scale stimulus packages to reduce economic harms, we observed a clear pattern that job losses were nevertheless significantly associated with negative impacts, particularly on mental health, quality of life, and food security. We also observe suggestive evidence that COVID-related job loss was associated with child maltreatment, worsening dental health, and poor chronic disease outcomes. Overall, although we did find evidence that income-support policies appeared to help protect people from the negative health consequences of pandemic-related job loss, they were not sufficient to fully offset the threats to health. Future research should ascertain how to ensure adequate access to and generosity of social protection programs during epidemics and economic downturns.