Healthy Communities Publications

Co-Creating Publicly Available Resources to Increase Awareness of and Support for Long Covid Among Ethnic Minority Communities

Smyth N, Ahmad A, Begum S, Chaudhry A, Clark S, Wright A, Gimblett K, Ridge D, Chew-Graham CA, Gopal D, Alwan NA, Kingstone T

Stigma and discrimination make healthcare challenging for people living with Long Covid, especially those from ethnic minority groups. Since their experiences are under-researched and may differ from other groups, it is crucial that healthcare guidance is informed by the lived experiences of diverse groups.

Findings from underpinning research informed the development of two resources aimed at raising awareness of the challenges faced by ethnic minority groups and offer ways to best support these groups. People living with Long Covid provided feedback on the two resources. Feedback was guided by a topic guide. Minimal changes were made following feedback.

https://onlinelibrary.wiley.com/doi/full/10.1111/hex.70596?msockid=2fbea4dc94786b0c106fb5a295076a1c

March 2026

Symptom Patterns, Recovery, and Impact of Long COVID: Findings From a Longitudinal Survey

Ziauddeen N, Pantelic M, O'Hara ME, Hastie C, Alwan NA

Long COVID is a predominantly multisystem, often disabling, condition that develops following SARS-CoV-2 infection. We aimed to characterize the pattern, triggers, and impact of Long COVID symptoms.

This study highlights the prolonged nature of Long COVID as well as the impact on work. This has the potential to widen health inequalities and increase hardship in individuals whose life circumstances and job types may not allow them to make necessary adaptations.

https://doi.org/10.1093/ofid/ofag040

March 2026

Reaching consensus on the definition of modifiable determinants of health: a Delphi study

Stannard S, Alipio K, Berrington A, Paranjothy S, Hoyle RB, Owen RK, Fraser SD, Holland E, Alwan NA

The term 'modifiable risk factor' and similar variations of the expression are common across health literature. Despite this, there is no universal definition for what would be modifiable when considering the factors that increase risk of ill health or enable good health and well-being. 

We conducted a Delphi study aiming to reach consensus among interdisciplinary experts on the definition and conceptualisation of what would be considered 'modifiable' as health determinants.

https://doi.org/10.1136/bmjph-2025-004189

February 2026

Reaching consensus on the definition of modifiable determinants of health: a Delphi study

Stannard S, Alipio K, Berrington A, Paranjothy S, Hoyle RB, Owen RK, Fraser SD, Holland E, Alwan NA

The term 'modifiable risk factor' and similar variations of the expression are common across health literature. Despite this, there is no universal definition for what would be modifiable when considering the factors that increase risk of ill health or enable good health and well-being. 

We conducted a Delphi study aiming to reach consensus among interdisciplinary experts on the definition and conceptualisation of what would be considered 'modifiable' as health determinants.

https://doi.org/10.1136/bmjph-2025-004189

February 2026

Use or no use? Young People's engagement with mental health services

Driessens   CM , Markham-Jones K, Davenport N, Hassan M, Iqbal S, Skelton F, Lacey F, Smith PWF

Mental health challenges among young people are a significant concern in the United Kingdom, with an estimated 16 % of young people experiencing common mental health problems like anxiety and/or depression on any given day, yet only one in four of these are able to access mental health services. 

This study seeks to identify the key determinants influencing young people's mental health care utilization and to examine the experiences faced by those who do not engage with mental health services, using a co-produced adaptation of Andersen's Behavioral Model of Health Care Utilization to analyze linked health care data from the NEXT STEPS cohort

https://doi.org/10.1016/j.jpsychires.2026.01.034

February 2026

The Association Between Maternal Adiposity and Breastfeeding Initiation and Duration: Evidence from the Southampton Women's Survey

Bird AG, Inskip H, Godfrey KM, Harvey NC, Crozier S, Baird J; SWS study team

Most mothers in the UK are not meeting the breastfeeding recommendations set by the World Health Organisation (https://www.who.int/health-topics/breastfeeding#tab=tab_2, 2023). Maternal obesity has variably been associated with lower initiation and shorter duration of breastfeeding, but few studies have examined the impact of maternal adiposity estimated from skinfold thicknesses.

The aim of this study was to investigate the relationship between maternal adiposity and breastfeeding initiation and duration.

https://doi.org/10.1007/s10995-025-04211-6

January 2026

The relationship between financial disruption during the COVID-19 pandemic and mental health: A systematic review and meta-analysis

Richardson T, Ashworth S, Sood M, McKell E, Maguire N, Alwan NA, Smith D

The World Health Organisation (WHO) declared that the coronavirus (COVID-19) outbreak reached global pandemic status on 11 March 2020. Over 3 years later, on 5 March 2023, the WHO announced that COVID-19 no longer constituted a public health emergency of international concern (PHEIC). This pandemic drastically altered people’s lives and has had profound consequences on society in terms of physical health, mental health, and the economy. From research regarding previous pandemics, such as that of the severe acute respiratory syndrome (SARS, 2002–2003), it is understood that the diverse and far-reaching effects of pandemics are likely to endure beyond the period of the pandemic. The effects of the COVID-19 pandemic on mental health have been suggested to follow three main routes, namely: the disease itself, the associated imposed quarantine and social measures, and the economic consequences of the pandemic.

An established and expanding body of research has focussed on the relationship between mental health and economic concepts such as socioeconomic status (SES) and unemployment. While research has focussed broadly on SES and mental health, recent research has focussed on specific socioeconomic variables. For example, studies show that financial hardship (difficulty meeting financial obligations) is a stronger predictor of depression than other socioeconomic variables such as educational attainment and household income while controlling for differences in household demographic composition, size, and subsequent financial requirements. Research has also distinguished objective and subjective financial impact, with the former describing measurable financial impact (e.g. income loss, debt amount) and the latter describing perceived financial impact (e.g. financial stress/worry). Research shows that subjective financial worries have a greater impact on mental health than objective economic impact.

A recent systematic review assessed the impact of the COVID-19 pandemic, previous pandemics, previous epidemics, and the 2008 economic crisis on mental health. The review showed that socioeconomic factors and unemployment resulting from the 2008 economic crisis had negative effects on mental health, including an increase in affective disorders. The main risk factors mediating the effects of the economic crisis on poor mental health included unemployment, indebtedness, precarious working conditions, inequalities, housing instability and lack of social connectedness. Another review examining the impact of economic decline on mental health found that while the effects of economic crises most negatively impacted individuals who were considered poor, less educated, or unemployed, these also affected the general population and individuals in employment, indicating that the negative impact on mental health is experienced widely by diverse groups.

While several systematic reviews have examined the psychological impact of the COVID-19 pandemic, to our knowledge, no systematic review and meta-analysis has investigated the relationship between COVID-19 related financial changes and mental health. A recent review looks at the association between socioeconomic condition indicators (e.g. education, economic factors) and anxiety and depression; the present review offers a more focussed and detailed examination of how financial change during the pandemic relates to mental health. As COVID-19 has caused significant detrimental economic consequences on individual, community, and wider societal levels, and given the established association between financial hardship and mental health difficulties, it is imperative that this area is examined and understood to inform local and national policy and intervention, resource, and support planning.

The objective of this review is to synthesise the existing evidence from cross-sectional and longitudinal quantitative studies that examine the relationship between COVID-19 related financial change and mental health.

https://doi.org/10.1177/22799036251395263

January 2026

The Food (Promotion and Placement) regulations are beginning to shift the onus for healthier choices from individuals to businesses: in-depth perspectives from health experts

Dhuria   P, Muir S, Bird A, Lawrence W, Roe E, Baird J, Vogel C

Retail food environments in the UK use intense marketing strategies to promote the purchase and consumption of less-healthy foods that are associated with ill-health. To help address this issue, the Food (Promotion and Placement) regulations were introduced in England from October 2022, banning the placement of foods high in fat, salt, or sugar (HFSS) at checkouts, aisle-ends, and entrances in qualifying retail settings. Ahead of their introduction, this study examined health experts' (i) perspectives on the likely effectiveness of these regulations and (ii) recommendations to enhance their impact.

https://doi.org/10.1186/s12916-025-04484-2

December 2025

Safety implications of remote assessments for suspected COVID-19: qualitative study in UK primary care

Wieringa S, Neves AL, Rushforth A, Ladds E, Husain L, Finlay T, Pope C, Greenhalgh T

The introduction of remote triage and assessment early in the pandemic raised questions about patient safety. We sought to capture patients and clinicians' experiences of the management of suspected acute COVID-19 and generate wider lessons to inform safer care.

https://doi.org/10.1136/bmjqs-2021-013305

December 2023

Exploring the use of social network interventions for adults with mental health difficulties: a systematic review and narrative synthesis

Brooks H, Devereux-Fitzgerald A, Richmond L, Caton N, Cherry MG, Bee P, Lovell K, Downs J, Edwards BM, Vassilev I, Bush L, Rogers A

People with mental health difficulties often experience social isolation. The importance of interventions to enhance social networks and reduce this isolation is increasingly being recognised. However, the literature has not yet been systematically reviewed with regards to how these are best used. This narrative synthesis aimed to investigate the role of social network interventions for people with mental health difficulties and identify barriers and facilitators to effective delivery. This was undertaken with a view to understanding how social network interventions might work best in the mental health field.

https://doi.org/10.1186/s12888-023-04881-y

July 2023

Normalisation of alcohol misuse and alcohol-related harms: a mixed methods analysis exploring alcohol misuse, morbidity and healthcare engagement in people experiencing homelessness

Wells   C, Dewar-Haggart R, Glyn-Owen K, Stevens H, Parkes J, Kim Y, Buchanan RM

The aim of this study is to understand the views and experiences of homeless adults who drink hazardously around alcohol use, alcohol harms and access to liver healthcare, and to quantify the prevalence of alcohol-related morbidity in this population.

https://doi.org/10.1093/alcalc/agaf071

November 2025

"Am I normal? Is this normal?": Supporting a community approach to grief.

Myall M,   Lund S, Campling N

The grief literacy movement promotes normalizing and regaining conversations about death, dying and grief within communities and networks. Enhancing grief literacy enables the public to identify grief, seek relevant information and adopt appropriate support. 

Historically families have been the primary provider of such support, but recently in the Global North these skills and knowledge have been lost. Families and communities need to be supported to regain ownership and relearn these skills. An online resource was developed and evaluated to explore its value in supporting the knowledge, skills and values required to embed grief literacy in family and friends-based networks. This paper presents findings from qualitative and group interviews. 

These rich datasets confirmed the resource to be an effective mechanism by increasing knowledge and skills to enhance grief literacy and supporting collective grief, where loss transcends the individual and becomes a social or cultural experience for the majority who deal with their grief with the support of family and friends rather than bereavement professionals.

https://doi.org/10.1080/07481187.2025.2598312

December 2025