Our Research

Our Research

Our research brings together a number of datasets that track changes at the neighbourhood level in health and the determinants of health to investigate what has worked and what could be done differently. This includes anonymised national datasets (e.g Hospital admissions data, prescribing data, census data, crime and welfare datasets) and data generated through the activities of the ARC NWC including the Household Health Survey that has been commissioned by the CLAHRC NWC in selected neighbourhoods across the North West Coast.
The record level data is only used to develop aggregate indicators at the Lower Super Output Area (LSOA) or GP practice (GPP) level (or higher geographies). These aggregate indicators are then used to investigate the impact on health care utilisation of risk factors, policies, and interventions.

Specifically, they are used for the following objectives:

1. To investigate the impact across England of socioeconomic changes, national health and welfare policy changes, environmental changes and infectious disease trends on healthcare utilisation and whether there are neighbourhood level characteristics that modify these effects. Analysis investigates inequalities between neighbourhoods in the consequences of these adverse trends and events.
2. To evaluate the impact of area based local authority and NHS, economic, environmental, social, governance and service redesign activities on health outcomes and demand for health and social care services.
3. To develop predictive models of the factors driving adverse health trends and increases in demand for health services at the neighbourhood level, that can then be used by local agencies to better target resources at the root causes of ill-health and health service demand and the neighbourhoods most affected.
4. To develop new approaches for monitoring progress on health inequalities at the neighbourhood level and involving the public in using data to influence local services and policies – supporting Open Data initiatives to promote transparency and accountability.

Projects:

Communities in Control Read more

Evaluating Air quality improvement actions across the North West Coast Read more

The impact of contrasting investment strategies at the local level Read more

The impact of local government budget changes on population health and inequalities Read more

Outputs – 1. The impact of trends in gastrointestinal infections on health care utilisation:

Paper 1. Rotheram, S., Clayton, S., Hungerford, D., and Barr, B. ‘Increasing Community Vulnerability to Gastrointestinal Infections in Austerity’s Shadow: A Comparative Study of Two English Local Authorities’. BMC Public Health (5 March 2026). DOI:10.1186/s12889-026-26657-1.

Paper 2. Rotheram, S., Clayton, S., Buchan, I., Ghebrehewet, S., and Barr, B. ‘A System That Is Struggling’: Understanding Health Protection Resilience in England during the COVID-19 Pandemic through the Experiences of Local Health Protection Responders’. BMC Health Services Research 24 (8 February 2024): 181. DOI:10.1186/s12913-024-10651-7.

Paper 3. Murrell, L., et al. ‘Inequalities in Local Government Expenditure on Environmental and Regulatory Services in England from 2009 to 2020: A Longitudinal Ecological Study’. BMJ Public Health 2, no. 2 (4 December 2024): e001144. DOI:10.1136/bmjph-2024-001144.

Paper 4. Murrell, L., et al. ‘Understanding the Effects of Reductions in Local Government Expenditure on Food Safety Services in England, 2009–10 to 2019–20: A Longitudinal Ecological Study’. BMJ Open 16, no. 1 (9 January 2026): e107146. DOI:10.1136/bmjopen-2025-107146.

Paper 5. Zahair, I., Rose, T., Clayton, S., Ghosh, I., Oyebode, O., and Barr, B. ‘P115 Relationship between Gastrointestinal Infections and Ethnicity in the UK: A Systematic Review of Quantitative Studies’. Journal of Epidemiology & Community Health 77, suppl. 1 (2023): A106.1–A106. DOI:10.1136/jech-2023-SSMabstracts.P115.

Paper 6.  Rose, Tanith C., Natalie L. Adams, Margaret Whitehead, Sophie Wickham, Sarah J. O’Brien, Jeremy Hawker, David C. Taylor-Robinson, Mara Violato, and Benjamin Barr. ‘Neighbourhood Unemployment and Other Socio-Demographic Predictors of Emergency Hospitalisation for Infectious Intestinal Disease in England: A Longitudinal Ecological Study’. Journal of Infection 81, no. 5 (1 November 2020): 736–42. DOI:10.1016/j.jinf.2020.08.048.

Paper 7. Wingfield, T. E., T. Rose, B. Barr, and D. Taylor-Robinson. ‘P85 Quantifying Social Inequalities in Serious Infections in England: A Longitudinal Ecological Analysis of Hospital Episode Statistics Data’. J Epidemiol Community Health 73, no. Suppl 1 (1 September 2019): A109–A109. DOI:10.1136/jech-2019-SSMabstracts.235.

Paper 8. Adams, Natalie L., Tanith C. Rose, Alex J. Elliot, Gillian Smith, Roger Morbey, Paul Loveridge, James Lewis, et al. ‘Social Patterning of Telephone Health-Advice for Diarrhoea and Vomiting: Analysis of 24 Million Telehealth Calls in England’. Journal of Infection 78, no. 2 (1 February 2019): 95–100. DOI:10.1016/j.jinf.2018.09.008.

Outputs – 2. Predicting adverse trends in neighbourhood health:

Paper 9. Melianova, E., Morris, T. T., Leckie, G., and Manley, D. ‘Local Government Spending and Mental Health: Untangling the Impacts Using a Dynamic Modelling Approach’. Social Science & Medicine 348 (2024): 116844. DOI:10.1016/j.socscimed.2024.116844.

Paper 10. Craig, P., Barr, B., Baxter, A. J., Brown, H., Cheetham, M., Gibson, M., Katikireddi, S. V., Moffatt, S., Morris, S., Munford, L. A., Richiardi, M., Sutton, M., Taylor-Robinson, D., Wickham, S., Xiang, H., and Bambra, C. ‘Evaluation of the Mental Health Impacts of Universal Credit: Protocol for a Mixed Methods Study’. BMJ Open 12, no. 4 (8 April 2022): e061340. DOI:10.1136/bmjopen-2022-061340.

Paper 11. Owen, G., Fahy, K., and Barr, B. ‘Evaluating the Impact on Physical Inactivity of Together an Active Future, a Partnership Approach to Physical Activity Promotion: A Difference-in-Differences Study’. Journal of Epidemiology & Community Health 78, no. 2 (2024): 115–120. DOI:10.1136/jech-2023-220891.

Paper 12. Petersen, J., Seguin, M., Alexiou, A., et al. ‘Assessing the Impact of Selective Licencing Schemes for Private Rental Housing on Mental Health and Well-Being: Protocol for a Mixed-Method Natural Experiment Study in Greater London, UK’. BMJ Open 12, no. 5 (2022): e057711. DOI:10.1136/bmjopen-2021-057711.

Paper 13. Green, Mark A., Konstantinos Daras, Alec Davies, Ben Barr, and Alex Singleton. ‘Developing an Openly Accessible Multi-Dimensional Small Area Index of “Access to Healthy Assets and Hazards” for Great Britain, 2016’. Health & Place 54 (1 November 2018): 11–19. DOI:10.1016/j.healthplace.2018.08.019.

Outputs – 3. The impact on health care utilization of health and social care redesign initiatives:

Paper 14. Piroddi, R., Astbury, A., Baker, W., et al. ‘Identifying Households with Children Who Have Complex Needs: A Segmentation Model for Integrated Care Systems’. BMC Health Services Research 25 (27 January 2025): 152. DOI:10.1186/s12913-024-12100-x.

Paper 15. Piroddi, R., McHale, P., Baker, W., Kumar, A., Fazel, M., and Barr, B. ‘Unmet Need in Adolescent Eating Disorder Services: A Comparative Analysis’. European Journal of Public Health 35, suppl. 4 (27 October 2025): ckaf161.697. DOI:10.1093/eurpub/ckaf161.697.

Paper 16. Barr, B., Head, A., Collins, B., and Kypridemos, C. ‘Unveiling the Hidden Burden: Estimating the Proportion of Undiagnosed Depression, Hypertension and Diabetes – A Modelling Study Using Survey Data from Adults in England, 2011–2019’. BMJ Public Health 3, no. 2 (30 October 2025): e001919. DOI:10.1136/bmjph-2024-001919.

Outputs – 4. Evaluating the impact of economic and “levelling up” strategies on health:

Paper 17. Johnson, A. ‘Reflections from Our Recent Workshops – How Does Local Growth Funding Impact Economic and Health Inequalities?’. NIHR School for Public Health Research (3 February 2026). Link

Paper 18. Albani V., Fahy K., Alexiou A., Holman D., Barr B, Bambra C, Poppay J. and Wildman J. ‘Investigating the Health Inequalities Impact of National Policies Aiming to Promote Local Economic Growth in Disadvantaged Places’. NIHR School for Public Health Research (6 September 2024). Link

Outputs – 5. The environmental determinants of health care utilisation:

Paper 19. Fahy, K., et al. ‘OP36 Mental Health Impact of Cuts to Local Government Spending on Cultural, Environmental, and Planning and Development Services in England: A Longitudinal Ecological Study’. Journal of Epidemiology & Community Health 76, suppl. 1 (2022): A18.1. DOI:10.1136/jech-2022-SSMabstracts.36.

Paper 20. Fahy, K., Alexiou, A., Daras, K., et al. ‘Mental Health Impact of Cuts to Local Government Spending on Cultural, Environmental and Planning Services in England: A Longitudinal Ecological Study’. BMC Public Health 23 (28 July 2023): 1441. DOI:10.1186/s12889-023-16340-0.

Paper 21. Fahy, K., Alexiou, A., Mason, K., et al. ‘Inequalities in Local Government Spending on Cultural, Environmental and Planning Services: A Time-Trend Analysis in England, Scotland, and Wales’. BMC Public Health 23 (28 February 2023): 408. DOI:10.1186/s12889-023-15179-9.

Paper 22. Murrell, L., Clough, H., Gibb, R., et al. ‘Understanding the Impact Funding Cuts on Environmental and Regulatory Services and Gastrointestinal Infections: A Longitudinal Ecological Study [Version 2; Peer Review: 2 Approved]’. NIHR Open Research 3 (5 January 2024): 41. DOI:10.3310/nihropenres.13426.2.

Paper 23. Murrell, L., Hungerford, D., Clough, H. E., et al. ‘Understanding the Impact of Local Authority Resource Allocation on Gastrointestinal Infections in England’. Preprint (22 December 2025). DOI:10.64898/2025.12.19.25342456.

Paper 24. Murrell, L., Clough, H., Gibb, R., Zhang, X., Green, M. A., Buchan, I. E., Barr, B., and Hungerford, D. ‘Understanding the Impacts of Reductions in Local Government Expenditure on Food Safety Services, England 2009/10 – 2019/20’. Preprint (4 April 2025). DOI:10.1101/2025.04.04.25325088.

Paper 25. Rose, Tanith C., Konstantinos Daras, Jane Cloke, Sarah Rodgers, Paul Farrell, Saiqa Ahmed, and Benjamin Barr. ‘Impact of Local Air Quality Management Policies on Emergency Hospitalisations for Respiratory Conditions in the North West Coast Region of England: A Longitudinal Controlled Ecological Study’. International Journal for Equity in Health 20, no. 1 (13 December 2021): 254. DOI:10.1186/s12939-021-01598-w.

Outputs – 6. Understanding the impact of social, educational, welfare interventions:

Paper 26. Akanni, L., et al. ‘Inequalities in School Spending across Local Authorities in England: A Time-Trend Analysis’. British Educational Research Journal (2025). DOI:10.1002/berj.70052.

Paper 27. Amo-Agyei, S., Munford, L., Daras, K., Bambra, C., Barr, B., Baxter, A., Brown, H., Cheetham, M., Craig, P., Katikireddi, S. V., Marimpi, M., Morris, S., Richiardi, M., Wickham, S., and Sutton, M. ‘The Health and Economic Costs of Welfare Reform: A Quasi-Experimental Evaluation of the Roll-out of Universal Credit in England’. SSRN (2026). DOI:10.2139/ssrn.6293290.

Paper 28. NIHR Public Health Interventions Responsive Studies Teams (PHIRST). ‘Liverpool Funded Local Welfare Schemes Evaluation’. Evaluation page (completed August 2025). Link

Outputs – 7. The effect of changes in local government funding on health care utilization:

Paper 29.  Bennett, Davara Lee, Kate E. Mason, Daniela K. Schlüter, S. Wickham, Eric Tc Lai, Alexandros Alexiou, Ben Barr, and David Taylor-Robinson. ‘Trends in Inequalities in Children Looked After in England between 2004 and 2019: A Local Area Ecological Analysis’. BMJ Open 10, no. 11 (23 November 2020): e041774. DOI:10.1136/bmjopen-2020-041774.

Paper 30. Alexiou, Alexandros, Kate Mason, Katie Fahy, David Taylor-Robinson, and Benjamin Barr. ‘Assessing the Impact of Funding Cuts to Local Housing Services on Drug and Alcohol Related Mortality: A Longitudinal Study Using Area-Level Data in England’. International Journal of Housing Policy 0, no. 0 (30 November 2021): 1–19. DOI:10.1080/19491247.2021.2002660.

Paper 31. Bennett, Davara L., Calum J. R. Webb, Kate E. Mason, Daniela K. Schlüter, Katie Fahy, Alexandros Alexiou, Sophie Wickham, Ben Barr, and David Taylor-Robinson. ‘Funding for Preventative Children’s Services and Rates of Children Becoming Looked after: A Natural Experiment Using Longitudinal Area-Level Data in England’. Children and Youth Services Review 131 (1 December 2021): 106289. DOI:10.1016/j.childyouth.2021.106289.

Paper 32. Alexiou, Alexandros, Katie Fahy, Kate Mason, Davara Bennett, Heather Brown, Clare Bambra, David Taylor-Robinson, and Benjamin Barr. ‘Local Government Funding and Life Expectancy in England: A Longitudinal Ecological Study’. The Lancet Public Health 6, no. 9 (1 September 2021): e641–47. DOI:10.1016/S2468-2667(21)00110-9.

Paper 33. Katie Fahy, Kate Mason Mental, David Taylor-Robinson, and Benjamin Barr. Mental health impact of cuts to local government spending on cultural, environmental and planning services in England: a longitudinal ecological study. BMC Public Health. 23, 1441 (2023). DOI: 10.1186/s12889-023-16340-0.

Paper 34. Mason, Kate E., Alexandros Alexiou, Ben Barr, and David Taylor-Robinson. ‘Impact of Cuts to Local Authority Spending on Cultural, Environmental and Planning Services on Inequalities in Childhood Obesity in England: A Longitudinal Ecological Study’. Health & Place 80 (1 March 2023): 102999. DOI:10.1016/j.healthplace.2023.102999.

Outputs – 8. The health inequalities impact of initiatives to promote neighbourhood resilience:

Paper 35. Popay, Jennie, Glenn Simpson, Adele Ring, Ana Porroche-Escudero, Ben Barr, Vivien Holt, Sarah Mosedale, Gill Sadler, and Paula Wheeler. ‘Improving Health and Reducing Health Inequalities through a Systems Resilience Approach’. Morecambe Bay Medical Journal 7, no. 12 (1 April 2018): 292–94. DOI:10.48037/mbmj.v7i12.74.

Paper 36. Popay, J., H. Kaloudis, L. Heaton, B. Barr, E. Halliday, V. Holt, K. Khan, et al. ‘System Resilience and Neighbourhood Action on Social Determinants of Health Inequalities: An English Case Study’. Perspectives in Public Health 142, no. 4 (July 2022): 213–23. DOI:10.1177/17579139221106899

Paper 37. Popay J., Halliday E., Mead R., Townsend A., Akhter N., Bambra C., Barr B., Anderson de Cuevas R., Daras K., Egan Matt, Gravenhorst K., Janke K., Kasim A.S., McGowan V., Ponsford R., Reynolds J., Whitehead M. Investigating health and social outcomes of the Big Local community empowerment initiative in England: a mixed method evaluation. Public Health Res 2023;11(9). DOI: 10.3310/GRMA6711

Paper 38. T. Rose, K. Daras, J. Manley, M. McKeown, E. Halliday, T. Lloyd Goodwin, B. Hollingsworth, B. Barr ‘The mental health and wellbeing impact of a Community Wealth Building programme in England: a difference-in-differences study’. The Lancet Public Health, April 21, 2023. DOI:10.1016/S2468-2667(23)00059-2

Outputs – 9. The impact on health care utilisation of new models of out of hospital treatment and care and community orientated primary care:

Paper 39. Downing, Jennifer, Tanith C. Rose, Pooja Saini, Bashir Matata, Zoe McIntosh, Terence Comerford, Keith Wilson, et al. ‘Impact of a Community-Based Cardiovascular Disease Service Intervention in a Highly Deprived Area’. Heart, 22 August 2019, heartjnl-2019-315047. DOI:10.1136/heartjnl-2019-315047.

Paper 40. Saini, Pooja, Tanith Rose, Jennifer Downing, Bashir Matata, Samantha Pilsworth, Allan Pemberton, Terence Comerford, et al. ‘Impact of Community-Based Chronic Obstructive Pulmonary Disease Service, a Multidisciplinary Intervention in an Area of High Deprivation: A Longitudinal Matched Controlled Study’. BMJ Open 10, no. 5 (1 May 2020): e032931. DOI:10.1136/bmjopen-2019-032931.

Paper 41. Khedmati Morasae, Esmaeil, Tanith C. Rose, Mark Gabbay, Laura Buckels, Colette Morris, Sharon Poll, Mark Goodall, Rob Barnett, and Ben Barr. ‘Evaluating the Effectiveness of a Local Primary Care Incentive Scheme: A Difference-in-Differences Study’. Medical Care Research and Review, 29 July 2021, 10775587211035280. DOI:10.1177/10775587211035280.

Paper 42. Alfirevic, Ana, Jennifer Downing, Konstantinos Daras, Terence Comerford, Munir Pirmohamed, and Ben Barr. ‘Has the Introduction of Direct Oral Anticoagulants (DOACs) in England Increased Emergency Admissions for Bleeding Conditions? A Longitudinal Ecological Study’. BMJ Open 10, no. 5 (1 May 2020): e033357. DOI:10.1136/bmjopen-2019-033357.

Paper 43. Giebel, Clarissa, Jason Cameron McIntyre, Konstantinos Daras, Mark Gabbay, Jennifer Downing, Munir Pirmohamed, Fran Walker, Wojciech Sawicki, Ana Alfirevic, and Ben Barr. ‘What Are the Social Predictors of Accident and Emergency Attendance in Disadvantaged Neighbourhoods? Results from a Cross-Sectional Household Health Survey in the North West of England’. BMJ Open 9, no. 1 (1 January 2019): e022820. DOI:10.1136/bmjopen-2018-022820.

Paper 44. Rosemary H. Jenkins, Eszter P Vamos, Kate E. Mason, Konstantinos Daras, David Taylor-Robinson, Clare Bambra, Christopher Millett, Anthony A. Laverty.’ Local area public sector spending and nutritional anaemia hospital admissions in England: a longitudinal ecological study’ – BMJ Open,  2022; 12(9): e059739. DOI:10.1136/bmjopen-2021-059739.

Outputs – 10. Evaluating the impact of COVID-19 area based control measures including Mass Testing in Liverpool:

Paper 45– Zhang, Xingna, Gwilym Owen, Mark A. Green, Iain Buchan, and Ben Barr. ‘Evaluating the Impacts of Tiered Restrictions Introduced in England, during October and December 2020 on COVID-19 Cases: A Synthetic Control Study’. BMJ Open 12, no. 4 (1 April 2022): e054101. DOI:10.1136/bmjopen-2021-054101.

Paper 46– Zhang X., Tulloch J.S.P., Knott S., Allison R., Parvulescu P., Buchan I.E., Garcia-Finana M., Piroddi R., Green M.A., Baird S., Barr B. Evaluating the impact of using mobile vaccination units to increase COVID-19 vaccination uptake in Cheshire and Merseyside, UK: a synthetic control analysis BMJ Open 2023;13:e071852. DOI: 10.1136/bmjopen-2023-071852

Paper 47. Zhang, Xingna, Ben Barr, Mark Green, David Hughes, Matthew Ashton, Dimitrios Charalampopoulos, Marta García-Fiñana, and Iain Buchan. ‘Impact of Community Asymptomatic Rapid Antigen Testing on Covid-19 Related Hospital Admissions: Synthetic Control Study’. BMJ 379 (23 November 2022): e071374. DOI:10.1136/bmj-2022-071374.

Paper 48.  Daras, Konstantinos, Alexandros Alexiou, Tanith C. Rose, Iain Buchan, David Taylor-Robinson, and Benjamin Barr. ‘How Does Vulnerability to COVID-19 Vary between Communities in England? Developing a Small Area Vulnerability Index (SAVI)’. J Epidemiol Community Health, 4 February 2021. DOI:10.1136/jech-2020-215227.

Paper 49. Green, Mark A., Marta García-Fiñana, Ben Barr, Girvan Burnside, Christopher P. Cheyne, David Hughes, Matthew Ashton, Sally Sheard, and Iain E. Buchan. ‘Evaluating Social and Spatial Inequalities of Large Scale Rapid Lateral Flow SARS-CoV-2 Antigen Testing in COVID-19 Management: An Observational Study of Liverpool, UK (November 2020 to January 2021)’. The Lancet Regional Health – Europe 6 (1 July 2021). DOI:10.1016/j.lanepe.2021.100107