The Northern Ireland Longitudinal Study (NILS) is an important element in the ESRC data infrastructure for population and public health research in Northern Ireland and across the constituent countries of the UK. It has strategic relationships with the other UKCenLSs and, within Northern Ireland, with the Northern Ireland Statistics and Research Agency (NISRA), the Public Health Agency (PHA), and the Honest Broker Service (HBS). Its 28% sample, which combines census data with administrative data from the healthcard register, social care, and housing, will span the period 1981-2021 when the link to the 2021 Census is completed. This enables the description and analysis of changing populations in changing places, individual fortunes over the life course, household contexts, as well as progress between successive generations. The grant will fund, until 2025, the NILS Research Support Unit (NILS-RSU) which has the functions of maintaining a secure data laboratory for users to work on these data safely, of supporting users from project application to publication, of promoting NILS-based research to policymakers and the public, of seeking new users through the promotion of the NILS, and of encouraging research for the public benefit. A major highlight of our work programme will be testing, using and developing research around the 2021 Census link. The NILS-RSU will also seek to widen the social and educational base of the NILS in Northern Ireland through engaging with new stakeholders and growing its contribution to education. It will also encourage research using the NILS and the other UK longitudinal studies to contribute to national and international research agendas whilst developing new research partnerships in Northern Ireland.

The number of people worldwide living with dementia and cognitive impairment is increasing, mainly due to people living longer, so we want to figure out how where we live affects dementia and brain health as we get older. Some research suggests that where we live might influence our brain health. For example, poor air quality in towns and cities, can lead to a decline in brain health. As more of us now live in towns and cities, it is important that the environment where we live is scientifically designed and improved to maximise our brain health. The complex social and physical environments where we live make some people more vulnerable than others to developing cognitive impairment. In other words, the factors that account for who is most likely to develop cognitive ill-health due to the environment has less to do with 'how' we live and more to do with 'where' we live. We do not know how these factors interact to make urban environments a problem for brain health, nor which are the best policies and interventions for promoting healthy ageing and brain health for our poorest communities. Our project will provide evidence for policies and practices that provide supportive urban environments to promote healthy ageing, including promoting brain health. This could include using creative urban designs to support people to adopt and maintain healthier lifestyles such as being more active. However, this needs a strong evidence base with expert community advocates who can articulate how supportive urban environments can improve brain health. Our research has the following steps: 1. First, with the help of stakeholders, including those from business, industry, and local government, and a review of existing research, we will represent the relationships between our biology, our lifestyles and our environment in a diagram illustrating how they likely interact to affect brain health, because visual thinking can help stakeholders better identify possible intervention sweet-spots to improve brain health. 2. By analysing data from over 8,000 older people in Northern Ireland, and linking this to information about where they live, such as the amount of air pollution, the toxins in soil, or how walkable their neighbourhoods are, we will explore how different environmental factors relate to brain health. 3. Next, we will collect new data on a subgroup of 1,000 older people including more in-depth measures of brain health and better measures of physical activity, using GPS devices worn around the waist that monitor our locations. This will allow us to explore how the urban environment influences our brain health. 4. Then, we will explore how aspects of our biology play a role in how the urban environment affects our brain health. 5. We will host workshops with local citizens to 'sense-check' our findings and co-develop promising prevention approaches. In these, we will explore the acceptability, affordability, feasibility and sustainability of new initiatives to improve the environmental influences on brain health. This might include, for example, policies on: expanding the car-free areas of the city to reduce air pollution; increasing the number of footpaths and cycle paths to encourage walking and cycling; improving public transport to reduce car use. As a result of our research we will produce: 1. A map of the system in which our genes, lifestyle behaviours and urban environments interact to affect brain health, to help guide stakeholders towards policies and programmes that can improve brain health. 2. An evidence base exploring how where we live affects our brain health. 3. A suite of potential policies and interventions to improve brain health and promote healthy ageing 'tested' (in terms of acceptability and feasibility) with older people, business, industry, policymakers and other stakeholders.

This project aims to maximise the policy impact of research already undertaken on walkability, particularly the development of a Real Walkability Network, which has initially been generated as part of the PARC project based on a study area of East Belfast. This project aims to extend the applicability of the developed policy tools to cover the two main cities of Northern Ireland, Belfast and Derry, so that the model then covers 37% of the population and some of the most deprived communities in the region. The project will disseminate the use of this model to practitioners in order to increase the evidence base for interventions in the built environment aimed at promoting physical activity. It will provide a range of benefits for both the academic community and the end users of research. For academics, it will make important contributions to ongoing research on understanding the environmental correlates of physical activity and through engagement with practitioner communities will aim to create a virtuous circle of research, implementation and feedback. For end users it will provide benefits in terms of the establishment of a useful decision-making tool that will enhance the evidence base for environmental interventions for improving physical activity and will provide training and capacity building in its use with the aim of establishing sustainability for its ongoing deployment. The value of the project is reflected in the large number of public bodies that have been willing to become partners, including Belfast and Derry City Councils, Department of Regional Development, Dept of Health Social Services and Public Safety, Public Health Agency and Belfast Healthy Cities, as well as cities in England, who have provided match funding and in kind support of over £88,000. The project will run for 12 months and employ two research assistants to help undertake three separate work packages: Work Package 1: Model consolidation and validation. (Months 1-5) This work package will involve the appointment, training and placement of 2 research assistants to be based in Belfast and Derry City Councils respectively, during which time they will consolidate and extend the model developed for East Belfast so that it has operational coverage of the entire 2 local authority areas. The model will be subject to validation using random checking of critical elements, such as land use and footpath coverage. During this time the research assistants will interact with staff of local authorities and other statutory agencies to begin to build up an understanding of the extent, form and availability of spatial data and the information needs of different partners, including potential links to regional strategies on obesity, active travel and physical activity. Work Package 2: Project integration and sustainability (Months 6-10). Work package 2 will involve a process of integrating the walkability models and other elements of spatial analysis into the existing physical activity-related programmes of the partner organisations to improve their effectiveness, efficiency and accuracy. This stage of the project will also involve developing the capacity of project partners to ensure the sustainability of the place-specific walkability models. Work Package 3: Knowledge dissemination and engagement with wider practitioner communities (Months 11-12) Work Package 3 will involve an evaluation and a report of the benefits, costs and opportunities arising from the operational deployment of walkability models and their integration with other central and local government responsibilities and initiatives. On the basis of this evaluation, a series of workshops will be run in Northern Ireland and the UK. Finally, the findings of the project will be presented at three conferences to disseminate the findings to different academic and practitioner communities.

In the past few decades, there has been a surge of international interest in the role of the arts and culture in healthcare, public health and health promotion, on an individual and community level. However, the vast majority of research studies have focused on the effects of targeted, time-limited arts interventions on particular patient groups. Yet, much of the arts and cultural engagement across the UK is not confined to specific interventions but involves a more general, ubiquitous participation that can be harder to measure through experimental studies. A select number of public health studies have found associations between cultural participation (including attending concerts, museums and galleries) and self-reported health, as well as inverse associations between cultural participation and mortality risk. However, important questions remain, and to date, there have been no large-scale public health studies examining the impact of the arts in the UK. This project is led by the Centre for Performance Science, an internationally distinctive partnership of the Royal College of Music and Imperial College London, with an extensive track record in arts, health and social research. It explores the effect of (i) activities that involve actively 'doing' (e.g. music, dance, art, photography and drama) and (ii) activities that require physical attendance (e.g. attending concerts, monuments, museums, galleries, cinemas, heritage archives and theatre); (iii) 'home-based' activities (e.g. listening to the radio, watching TV, reading, storytelling, using arts-based apps, digital arts experiences, online music co-production). Our research questions identify the impact of the arts and culture on individual, social and economic measures of health and wellbeing, as well as explore how associations vary between different socioeconomic, geographical and ethnic populations within the UK. To explore these questions, the project is organised into four work packages. Work package 1 will involve assessing existing data including undertaking a meta-analysis of previous studies and exploring a UK cohort study that includes some questions on the arts. However, recognising the limited data currently available, work packages 2 and 3 are based on a large-scale national survey to be carried out during our study. Open to all adults in the UK, the survey will target the general population as well as participants diagnosed with one of four major health conditions facing the UK: mental health, cancer, cardiovascular disease and chronic respiratory diseases. These conditions have all previously been researched in smaller arts-in-health intervention studies but not at a public health level, and their inclusion will facilitate understanding of the relationships between culture and the individual, social and economic facets of health and wellbeing. A total of 25,000 participants will be recruited to complete an anonymous online questionnaire consisting of demographic questions, validated psychological scales and economic metrics, assessments of arts and cultural participation and self-reporting of health. Work package 2 will explore the questions with a cross-sectional analysis of these data with nested case-control studies; work package 3 will monitor a sub-section of the sample as a cohort for the following year with 6-monthly updates to track longitudinal change in arts engagement. Recognising the complexity of cultural engagement and health, work package 4 will add context to the survey data, with a sub-sample of survey participants taking part in qualitative telephone interviews to explore motivations for, and experiences of, arts engagement across the UK and how this is reported to intersect with health behaviours, perceptions and outcomes. Through the extensive epidemiology methods proposed, an ambitious sample size and nested qualitative data, the findings promise to redefine the value of the arts and culture for public health in the UK.

In the UK and elsewhere, people with severe mental illness die prematurely, up to 20 years younger than the general population, a mortality often associated with modifiable medical risk factors. The substantial costs to the health system and the wider economy caused by smoking, obesity, physical inactivity, alcohol misuse and substance abuse are well established. For example, smoking rates among people with a mental illness are three times higher than among the general population. However, while smokers living with severe mental illnesses are just as likely to want to quit as the general population, they are generally more addicted, and face greater barriers to quitting. Similarly, weight gain and obesity are major problems for people with mental health problems, increasing the risk of developing diabetes or cardiovascular diseases, all contributing to low quality of life and exacerbating psychiatric symptoms. Other interwoven and modifiable risk factors associated with the poor physical health of people with mental health problems include low self-esteem, unemployment, loneliness, the low expectations of others, and social exclusion. For a range of social and psychological reasons, including the damage done by stigma, people with mental health problems have relatively limited access to local cultural and natural resources which could improve their physical and mental health. In recent years, greater attention has been focussed on the physical health of people living with mental illnesses but services remain fragmented and uncoordinated. This disconnect may be particularly true in the relationship between statutory health and social care services, and the community and voluntary sector organisations. Moreover, many lifestyle interventions exist that are of potential benefit to people with SMI these are seldom implemented in community settings and there is a lack of evidence on the development of effective interventions to help people with SMI. The CHOICE project aims to build a community coalition of agencies and people across Northern Ireland to maximise the resources, skills and knowledge held collectively. We will use Community-Based Participatory Research (CPBR), a powerful 'bottom-up' approach which uses innovative and inclusive approaches to empower disadvantaged communities and populations in the co- design and implementation of solutions to address health disparities. CBPR helps bridge research and practice by engaging the community to tackle disparities in population health and has been used in diverse and disadvantaged settings as an efficient means of challenging power imbalances. Importantly, our coalition will assist in identifying and exploiting all the assets and resources that exist in our communities but remain generally underused. Working with the experts by experience, we will use arts-based approaches to highlight the experience of living with mental illness, and the relationship between exclusion and physical health. By the end of the project we will have developed a strong community coalition and an agreed strategic plan to improve the lives of people living with mental illness.