UK ENABLE Consortium vision, aims and objectives: Local government is uniquely placed to shape the environmental and social factors which fundamentally influence non-communicable diseases (NCDs) and thus our health and wellbeing. Our vision is for local government to consider the health of local populations in all policy and practice decisions and to have the best possible scientific evidence to support those decisions. We will test our vision by working with five different local authority (LA) based public health systems across the UK, learning what works best, and what can be useful for all LAs across the UK. Our consortium brings together academics, practitioners, policy makers and other stakeholders from across the UK in five centres in NE and SW England, Scotland, Northern Ireland and Wales; each with different models of public health delivery. We will develop and test a process that embeds research capacity and expertise in LAs. Working closely with our partners in each LA, we will identify a current priority for improving the health and wellbeing and reducing inequalities of people living in that area. By building relationships between academics, practitioners and policy makers we will enable the LA to access and create new evidence that is relevant for decision making about the priority issue. Scientific rationale for the proposed research: Evidence-informed policy-making aims to improve decision making by using the best available research. Organisational and cultural barriers within the current system have made this approach difficult to achieve. New methods and approaches are needed which bring together researchers, practitioners and policy makers in local government, where evidence is only one contributing factor to decision-making. Embedded researchers and knowledge brokers can help to ensure evidence is used by building understanding of the context, accessing existing, and co-producing new evidence. Intervention(s) of interest and the potential applications and anticipated benefits of the work: By the end of the project we will: 1. Increase research capacity and 'no how' in each LA, focusing on a local NCD priority issue, enabling access to evidence to inform local decision-making. We will develop and share learning which is generalisable across the UK 2. Build and support new partnerships for active and effective research use with practitioners, policy makers, and academia 3. Build knowledge and skills in local government and universities to maximise use of different kinds of evidence for policy, practice and public decision-making 4. Co-create evidence that addresses local government priorities, with a focus on prevention, by working across sectors and disciplines, utilising novel methodological approaches, including complex systems models 5. Develop a range of health and system interventions that have been co-produced and tested across LA areas 6. Create sustained change in research culture in LAs and academia so that evidence use is embedded across local government 7. Evaluate this new approach and methods to see if we made a difference to the health of people living in each area, related to their priority topic, and whether/how this approach could be rolled out across the UK We anticipate that this work will improve population health and wellbeing and increase the use of scientific research. It aims to improve quality, efficiency and effectiveness of public health interventions and services, reduce waste, and improve staff morale and retention. Consortium management: Our across-UK academic leadership brings together experience of applied translational research in prevention from four of the UKCRC funded Centres of Excellence in Public Health. Senior leaders in local government public health, bring practical experience of putting evidence into action. Other members have expertise in systems thinking, embedded research, knowledge brokerage and other skills essential to our success.

MathSys addresses two of EPSRC's CDT priority areas in Mathematical Sciences: "Mathematics of Highly Connected Real-World Systems" and "New Mathematics in Biology and Medicine". We will train the next generation of skilled applied mathematical researchers to use and develop cutting-edge techniques enabling them to address a range of challenges faced by science, industry and modern society. Our Centre for Doctoral Training will build on the experience and successes of the Complexity Science DTC at Warwick, while refining the scope of problems addressed. It will provide a supportive and stimulating environment for the students in which the common mathematical challenges underpinning problems from a variety of disciplines can be tackled. The need for mathematically skilled researchers, trained in an interdisciplinary environment, has never been greater and is viewed as a major barrier in both industry and government. This is supported by quotes from reports and business leaders: "Systems research needs more potential future leaders, both in academia and industry" (EPSRC workshop on Systems science towards Engineering, Feb 2011); Andrew Haldane (Bank of England, 2012) said "The financial crisis has taught us the importance of modelling and regulating finance as a complex, adaptive system. That will require skills currently rare or missing in the regulatory community - including, importantly, in the area of complexity science"; Paul Matthews (GlaxoSmithKline) stated "Scientists trained in statistical and computational approaches who have a sophisticated understanding of biologically relevant models are in short supply. They will be major contributors in the task of translating insights on human biology and disease into treatments and cures." Our CDT will address this need by training PhD students in the development and innovation of mathematics in the context of real-world systems and will operate in close collaboration with stakeholders from outside academia who will provide motivating problems and real-world experience. Common mathematical themes will include statistical behaviour of complex systems, tipping points, novel methods in control and resilience, hierarchical aggregation methods, model selection and sufficiency, implications of network structure, response to aperiodic forcing and shocks, and methods for handling complex data. Applications will be driven by local and external partner expertise in Epidemiology, Systems Biology, Crop Science, Healthcare, Operational Research, Systems Engineering, Network Science, Financial Regulation, Data Analysis and Social Behaviour. We believe that the merging of real-world applications with development of novel mathematics will have great synergy; applications will motivate and drive mathematical advances while novel mathematics will allow students to solve challenging real-world problems. The doctoral training programme will follow a 1+3 year MSc+PhD model that has proved successful in the Complexity Science DTC. The first year will consist of six months of taught training, followed by 3-month group research projects on problems set by external partners and a 3-month individual research project, leading to an MSc qualification. This preparation will enable the students to make rapid progress tackling their 3-year PhD research project, under the guidance of one mathematical and one application-oriented supervisor, alongside general skills training and group research projects. We have over 50 suitable supervisors with relevant mathematical expertise, all enthusiastic to contribute; they will be supported by a similar number of application-oriented supervisors from across campus and from external partners. The CDT seeks the equivalent of 7 full studentships per year from EPSRC and has commitment from non-RCUK sources for the equivalent of 3 full studentships per year.

The Deaf British Sign Language (BSL) using community in Wales have more challenges than hearing populations in accessing healthcare services (especially in emergency situations), health information, mental health care services and support, and family-related services and training. The Deaf in Wales also suffer from inconsistent interpreting services and poor communication in many health-care settings and, as a result, are also at greater risk of underdiagnoses and under-treatment of chronic diseases and tend to have poorer health than the general population (Sign Health, 2019; Shank & Foltz, 2019; Foltz & Shank, 2020; Foltz et al., 2022). Deaf people also have an incidence of mental health problems that is twice as high as the general population and face barriers accessing support services (Terry et al., 2021). Research has shown that access to nature and outdoor activities is a health asset (Houlden et al. 2018; Rebar et al. 2015); however, many of Wales's cultural and natural assets are not accessible because materials are rarely available in BSL. The goal of this project is to design, implement and evaluate Deaf-community-lead solutions for these known and documented health inequities and inequalities. We are a transdisciplinary team of academic and non-academic, hearing, and Deaf partners. Our project will use innovative social networking techniques, community outreach, focus groups, interviews, and custom video-based questionnaires and app technologies to identify sustainable, community-led, culturally, and linguistically driven solutions to improve the health and wellbeing of this community. We will then develop, implement, and evaluate these solutions in five areas that impact Deaf Welsh citizens' health and wellbeing. These areas are: (1) public health, (2) mental health, (3) interpreting services, (4) access to natural resources, parks, and use of natural environment resources and (5) language and communication. In the areas of (1) public health, (2) mental health, and (3) interpreting services we will work with the Deaf community as well as the NHS, Health Boards, interpreters, and other service providers to develop culturally and linguistically driven proposals to improve services at every stage of the healthcare delivery process. Solutions will focus on access to interpreters and BSL language services and improving d/Deaf awareness with respect to language and culture and d/Deaf rights with respect to the law. In the area of (4) natural resources, we will develop BSL video guide apps for better accessibility to Welsh natural resources, parks, and heritage sites at three locations across Wales. In the area of (5) language and communication, the Welsh dialect of BSL, it's lexicon and regional variations, remains undocumented and undescribed. This project will develop an on-line dictionary and corpus resources, with a particular focus on medical terminology, to aid interpreters and service providers in Wales. We will assess the potential positive impact of the resources that we are developing as part of this project and use the results obtained from this project to inform and influence current local and national health care policy, services, practices, and delivery to aid compliance with the 2010 Equality and 2015 Well-being of Future generations Acts.

Private water supplies (PWS) are used by a significant proportion of households in some British regions. Chemical and physical factors both have the potential to impact upon the well-being of PWS users. The chemical quality of PWS can vary greatly, dependent on the composition of the surface or groundwater from which they are drawn, and the infrastructure and treatment of the water supply. Recent Public Health England/NERC-BGS research has shown that PWS users often do not treat to improve chemical quality, or do not maintain their treatment systems. PWS tap water quality cannot be assumed to be improved from its natural state, and may be significantly worse than drinking water standards. It is important stakeholders across all scales (household, local and national) better understand the distribution of factors which influence water quality. We have established that current efforts to assess national and regional water quality priorities in Wales are hindered by a two-way knowledge barrier. Stakeholders are unaware of the large NERC data resource which could be used in their assessments, whilst NERC data holders do not have sufficient understanding of stakeholders' needs, and how the data can be most usefully presented and disseminated. Barriers to direct uptake of this NERC data include: the current format (hard-copy or digital documents); chemical element mapping formats (which may divide the concentration range into arbitrary intervals and not show thresholds of relevance to users); bespoke indices using more than one variable are needed (e.g. plumbosolvency); and, resource pressures on public body officers (e.g. time, expertise, computing, GIS). A further problem exists which NERC data can contribute to resolving. Assembling the evidence base to determine what, if any, action should be undertaken at national or regional scales is compromised by the lack of systematic registration, in any database, of the most prevalent type of PWS, i.e. "Single Domestic Dwellings" (SDDW). SDDW users are not compelled to register their supply with the Local Authority, and in Wales, 85% of registered PWS are SDDWs. There is widespread awareness, at all levels of governance, that there are considerably more than the officially recorded 12,242 SDDWs. Improved estimates of the locations of these properties, can help national and local government assess, and prioritise, risks arising from geospatially controlled factors (e.g. high metal concentration and vulnerability to drought). Recent NERC-funded research has built a spatially resolved, predictive model of the likely occurrence of PWS in Wales. In order to fulfil its potential impact, this work now needs to be shared with the key stakeholders at regional and national level. Specific examples will be developed that indicate regions where large numbers of PWS users coincide with expected high risks of events (e.g. flooding, drought) under future weather scenarios, and allow an improved understanding of pressures on marginal aquifers. Sustained inter-organisational and inter-personal communication will ensure the successful progress of this project. At an overarching level this will be achieved through active participation in an existing national forum, the Water Health Partnership, and by undertaking short-term secondments into key Local Authority and public body offices (Public Health Wales, Dwr Cymru Welsh Water, Natural Resources Wales, Powys County Council). Outward facing communication, of agreed key messages, is embedded into later activities. Web, mobile and selected more traditional mechanisms will be used to ensure that outreach is as equitable and widespread across private water supply users as possible. Project reports will be available in both English and Welsh. KEYWORDS: private water supply; lead; drought; flooding; manganese; public health.

THE PROBLEM There is strong evidence that the social and economic conditions in which we grow, live, work and age determine our health to a much larger degree than lifestyle choices. These social determinants of health, such as income, good quality homes, education or work, are not distributed equally in society, which leads to health inequalities. However, we know very little about how specific policies influence the social conditions to prevent ill health and reduce health inequalities. Also, most social determinants of health are the responsibility of policy sectors other than "health", which means policymakers need to promote health in ALL their policies if they are to have a big impact on health. SIPHER will provide new scientific evidence and methods to support such a shift from "health policy" to "healthy public policy". OUR POLICY FOCUS We will work with three policy partners at local, regional and national level to tackle their above-average chronic disease burden and persistent health inequalities: Sheffield City Council, Greater Manchester Combined Authority and Scottish Government. We will focus on four jointly agreed policy priorities for good health: - Creating a fairer economy - Promoting mental wellbeing - Providing affordable, good quality housing - Preventing long-term effects of difficult childhoods. OUR COMPLEX SYSTEMS SCIENCE APPROACH Each of the above policy areas is a complex political system with many competing priorities, where policy choices in one sector (e.g. housing) can have large unintended effects in others (e.g. poverty). There is often no "correct" solution because compromises between different outcomes require value judgements. This means that to assess the true benefits and costs of a policy in relation to health, policy effects and their interdependencies need to be assessed across a wide range of possible outcomes. However, no policymaker has knowledge of the whole system and future economic and political developments are uncertain. Ongoing monitoring of expected and unexpected effects of policies and other system changes is crucial so failing policies can be revised or dropped. We propose to use complex systems modelling, which has been developed to understand and make projections of what might happen in complex systems given different plausible assumptions about future developments. Our models will be underpinned by the best available data and prior research in each policy area. Our new evidence about likely policy effects across a wide range of outcomes will help policy partners decide between alternative policies, depending on how important different outcomes are to them (e.g. improving health or economic growth). We will develop support tools that can visualise the forecasts, identify policies that achieve the desired balance between competing outcomes and update recommendations when new information emerges. Whilst new to public health policy, these methods are well-established in engineering and climate science. We will 1. Work with policy partners to understand the policy systems and evidence needs 2. Bring together existing data and evidence on each policy system (e.g. links between policies and outcomes, interdependencies between outcomes) 3. Explore citizens' preferences for prioritising when not all outcomes can be achieved 4. Link policies and their health and non-health effects in computer models to analyse benefits and costs over time 5. Build an interactive tool to help policy decision-making, inform advocacy action and support political debate. SIPHER's MAIN OUTCOME We will provide policymakers with a new methodology that allows them to estimate the health-related costs and benefits of policies that are implemented outside the health sector. This will be useful to our partners, and others, who want to assess how scarce public sector resources can be spent to maximise the health and wellbeing benefits from all their activities.