Abstracts are not currently available in GtR for all funded research. This is normally because the abstract was not required at the time of proposal submission, but may be because it included sensitive information such as personal details.

Healthy Urban Places: HUP-North The places in which we live can make us healthy or ill. In the UK, 85% of people live in cities so it is important to make sure these are healthy places to live. Clean air, quality housing, parks, public transport, access to shops, arts and cultural opportunities, schools and health services all make a difference to our physical and mental health. Unfortunately, some areas have more unhealthy environments which means people living in these areas experience poorer health. By improving the places where people live, we have an opportunity to improve the health of communities in most need. But what we improve needs more consideration - for example, should we improve parks, provide more sporting facilities, build more homes, reduce traffic, regenerate high streets, reduce the number of fast-food outlets or open more libraries? HUP-North's aim is to help the people in charge of cities make the best decisions they can through a focus on research evidence, and by working with communities, researchers, and decision-makers in Bradford (West Yorkshire) and Liverpool (Cheshire and Merseyside). We have chosen these places as they both have large cohort studies including >3million people. Cohort studies follow the health of large groups of people over time to understand what causes ill-health. They do this by collecting information from people using surveys, and from information collected by GPs, hospitals and schools. In Bradford our cohorts have been running for 15 years and in Liverpool they have just started. Communities should be central to discussions and decisions about improving local places for health. HUP-North will set up two 'Community Collaboratives' in Bradford and Liverpool which will bring together communities, researchers and decision-makers to guide our work. We will work in eight different neighbourhoods in Bradford and Liverpool and train community members to be peer researchers. These peer researchers will speak to over 1000 residents to explore the relationship between health and place. Using maps, we will explore how history has shaped the places in which we live, and we will combine these maps with community-collected information about issues important to residents (e.g. youth centres, fly tipping, areas they feel unsafe, public transport times, traffic). Using our cohorts, we will look to understand those features within local places that are most important for health. By working in an inclusive way with communities we can give decision makers the information they need to improve places. To evaluate the health impact of place-based changes it is important to collect health information before and after changes have been made. In the past, opportunities for collecting this information have been missed as policy makers and researchers have not worked together. HUP-North will demonstrate different ways to evaluate place-based changes by making good use of our existing cohorts. In Bradford, we will look in detail at how the city has changed over a 10 year period (e.g. increases in cycling infrastructure, green spaces, or reductions in pollution) and how this has affected the health of the Bradford population. In Bradford, as we have strong relationships with our council, we can directly influence and evaluate changes. We will work with communities to prioritise case studies to evaluate: for example, improving housing quality, changing neighbourhoods to encourage active travel, improving local green spaces, and increasing access to cultural opportunities. Using our cohorts we will look at how health has changed before and after these changes, examining what has worked well, and what has not worked well. We will also explore whether the investments represent value for money. In Liverpool we will use learning from Bradford to develop future place-based changes. We will ensure our learning is shared widely with policy makers, researchers and communities across the UK.

Size at birth and growth in childhood are thought to be important stages of development in our lifespan and are known to be important to the risk of infant and childhood health and development problems. Over recent years these important phases of early development have also been linked to our risk of illness in later life, particularly diabetes and coronary heart disease. South Asian populations are known to be at particular risk of diabetes (2 - 4 fold higher) and coronary heart disease (50 - 80% higher) and this may be due to them having a tendency for more fat compared to lean mass. At birth, South Asian babies are generally smaller and lighter but recent studies show that like South Asian adults, they have more fat than White British individuals. This greater fatness for a given weight could be very important to the risk of diabetes and coronary heart disease but so far the reasons for it are not very clear. It is possible that being diabetic during pregnancy, which is more common in South Asian women, 'overfeeds' the infant leading to greater fatness at birth and possibly throughout life. If this is true then later generations would also overfeed their infants during pregnancy and a cycle of poor health and development could be set in motion. This continuation of risk could be made worse by the changes in environment and lifestyle experienced by South Asians who migrate to the UK such as the availability of high energy diets, a culture of less exercise and rising rates of obesity. How patterns of growth from birth to childhood differ in South Asian and White British children could also affect differences in health between these two groups in relation to childhood infections and other childhood health problems and could even affect how well children do in school. However research in this area has often used poorly designed studies with too few participants to give accurate results. Using data and information from the Born in Bradford birth cohort study I will: 1.Look at whether how much a woman weighs at the start of pregnancy, how much weight she gains during pregnancy, her glucose (sugar) levels in pregnancy and whether she develops gestational diabetes, affect how much her child weighs and how fat they are at birth and also at age 4/5 years. I will look at whether the effect of any of these measurements is different depending on whether the mother and child are of Pakistani or White British origin. 2.Describe patterns of growth and differences in adiposity and blood pressure in UK born Pakistani origin children and UK born White British children 3.Look at whether different patterns of growth in UK born Pakistani origin and UK born White British children result in different rates of childhood infection and hospital admissions between these two groups. I will also look at whether different patterns of growth affect how well the children do in school. 4.Find out whether weight and fatness at birth and in childhood is different depending on whether parents and grandparents of Pakistani infants are born in the UK or South Asia. To do this I will combine existing information from the BiB cohort with new information collected for the first time as part of this proposal. I will train and support school nurses in Bradford to collect skinfold measurements (used to estimate fatness) and blood pressure alongside the height and weight measurements recorded for all reception age children in the UK, including good coverage in Bradford. These measurements will be collected over 2 consecutive school years (2013/2014 and 2014/2015) and will involve approximately 8000 children. Cord blood samples for the whole BiB cohort will be used to compare fat mass in Pakistani and White British infants at birth (approx 9000 samples). In addition I will merge information from routine health and education systems with the existing BiB data.

Abstracts are not currently available in GtR for all funded research. This is normally because the abstract was not required at the time of proposal submission, but may be because it included sensitive information such as personal details.

In developed countries such as the UK, we spend 90% of our time indoors with approximately two thirds of this in our homes. Despite this fact, most air pollutant regulation focuses on the outdoor environment. There is increasing evidence that exposure to air pollution causes a range of health effects, but uncertainties on the causal effects of individual pollutants on specific health outcomes still exist partly due to crude exposure metrics. Nearly all studies of health effects to date have used measurements from fixed outdoor air pollution monitoring networks, a procedure that ignores the modification effects of indoor microenvironments where people spend most of their time. There are consequently large uncertainties surrounding human exposure to indoor air pollution, which means we are currently unable to identify the most effective solutions to design, operate and use our homes to minimise our exposure to air pollution within them. In the UK, there are virtually no data to quantify indoor air pollutant emissions, building-to-building variability of these, chemical speciation of indoor pollutants, ingress of outdoor pollution indoors or of indoor generated pollutants outdoors, or the social, economic or lifestyle factors that can lead to elevated pollutant exposures. Without a fundamental understanding of how indoor air pollution is caused, transformed and distributed in UK homes, research aiming to develop behavioural, technical or policy interventions may have little impact, or at worst be counterproductive. For example, energy efficiency measures are broadly designed to make buildings more airtight. However, given that the concentrations of many air pollutants are often higher indoors than outdoors, reducing ventilation rates may increase our exposure to air pollution indoors and to any potentially harmful effects of the resulting pollutant mixture. Further, if interventions are introduced without sufficient consideration of how occupants actually use and behave in a building, they may fail to achieve the desired effect. To understand and improve indoor air quality (IAQ), we must adopt a systems approach that considers both the home and the human. There is a particular paucity of data for the most deprived households in the UK. There is a facile assumption that poorer homes are likely to experience worse IAQ than better off households, although the reality may be considerably more nuanced. Lower quality housing may be leakier than more expensive homes allowing indoor emissions to escape more easily, whilst large, expensive town-houses converted to flats can be badly ventilated following poor retrofitting practices. Differences in cooking practices, smoking rates, internal building materials and the usage of solvent containing products indoors will also be subject to wide variations across populations and hence have differential effects on IAQ and pollutant exposure. In fact, differences in individual behaviour lead to large variations in indoor concentrations of air pollutants even for identical houses, typically driven by the frequency and diversity of personal care product use. The INGENIOUS project will provide a comprehensive understanding of indoor pollution in UK homes, including i) the key sources relevant to the UK ii) the variability between homes in an ethnically diverse urban city, with a focus on deprived areas (using the ongoing Born in Bradford cohort study) iii) the effects of pollutant transformation indoors to generate by-products that may adversely affect health iv) the drivers of behaviours that impact on indoor air pollution (v) recommendations for interventions to improve IAQ that we have co-designed and tested with community members.