Published 21st September 2022 

Professor Alastair Leyland will lead a new NIHR Global Health Research Unit on Social and Environmental Determinants of Health Inequalities which has received a £7 million investment for five years.

The Unit has global collaborators in Brazil and Ecuador – two Latin American countries that show marked inequalities in health. These inequalities are largely due to social determinants of health – the conditions in which people are born, grow, work, live, age and die. Many environmental factors, including urbanisation and the climate emergency, also tend to have the most harmful impacts on the most deprived in society. 

Governments in Brazil and Ecuador have introduced policies, such as conditional cash transfers or housing programmes for the very poor, to reduce the impact of social conditions such as poverty. Similarly, governments may introduce environmental policies to protect the environment and mitigate any harmful effects on living conditions. While such policies may not be primarily aimed at improving health, they may still have large impacts on health and health inequalities. 

The NIHR Global Health Research Unit on Social and Environmental Determinants of Health Inequalities will focus on discovering which policies impact health, whether they had a bigger impact on disadvantaged groups, and how the organisation and provision of the health system could optimise any positive health impacts. Specific aims include:

  • Building, developing and linking national databases covering health, social and environmental registers in Brazil and Ecuador.
  • Studying the impacts of social and environmental policies, and the effects of large-scale population movement on health and health inequalities.
  • Creating indicators of deprivation for small areas covering the whole of Brazil and Ecuador.
  • Determining how best to organise health services to improve health for all social groups and to respond to social and environmental threats in a way that minimises the damage they do to health.
  • Focusing on health outcomes that are considered priorities in Brazil and Ecuador including mental health and asthma, maternal and child health, reproductive and sexual health, COVID-19 and more.
  • Training researchers from Brazil, Ecuador and other low and middle-income countries in global health research methods by developing a research hub in Ecuador, and providing training programmes and mechanisms to share researchers’ experiences.

This work builds on the research and the existing relationships formed by the NIHR Global Health Research Group on Social Policy and Health Inequalities, which ran between 2017 and 2021.

Professor Alastair Leyland said: "We are excited to embark on this five year programme building on an established collaboration in Brazil and working with new colleagues in Ecuador. This Unit represents a substantial Investment from NIHR and we are keen to understand how different policies may work to improve health and reduce health Inequalities. We hope that our learning from Brazil and Ecuador will be applicable globally."

This research is funded by the NIHR (NIHR134801) using UK aid from the UK Government to support global health research.

First published: 21 September 2022

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