When experts disagree: interviews with public health experts on health outcomes in the UK 2010-2020

Understanding Health Inequalities Research Capacities: Insights and Recommendations From Comparing Two High Income Settings

Generating evidence on health inequalities (HI) is necessary to raise awareness of these issues, describe and monitor their evolution, analyze their causes, and inform interventions aiming to improve health equity. Yet not all cities and countries have the capacity to produce this type of research. Recent research provides new contextual and causal insights into this research production process, and in-depth understanding on why and how this type of research is produced in certain settings. This article aims to analyze two recent case studies that have uniquely explored this process in two high producers of HI research and high-income country settings to identify learning and distil recommendations, which may be insightful for other settings. Expanding and investing in this line of research is critical, particularly in places with lower HI research output and related capacity, in order to identify key contextual conditions and mechanisms that may enable or hinder this process. This new knowledge could guide the development of new HI research capacity strengthening strategies to foster this research in different settings, worldwide. More understanding is also needed on the relationship between HI research, policy, and action in order to tackle HI.

How people decide who is correct when groups of scientists disagree

Uncertainty that arises from disputes among scientists seems to foster public skepticism or noncompliance. Communication of potential cues to the relative performance of contending scientists might affect judgments of which position is likely more valid. We used actual scientific disputes-the nature of dark matter, sea level rise under climate change, and benefits and risks of marijuana-to assess Americans' responses (n = 3150). Seven cues-replication, information quality, the majority position, degree source, experience, reference group support, and employer-were presented three cues at a time in a planned-missingness design. The most influential cues were majority vote, replication, information quality, and experience. Several potential moderators-topical engagement, prior attitudes, knowledge of science, and attitudes toward science-lacked even small effects on choice, but cues had the strongest effects for dark matter and weakest effects for marijuana, and general mistrust of scientists moderately attenuated top cues' effects. Risk communicators can take these influential cues into account in understanding how laypeople respond to scientific disputes, and improving communication about such disputes.

Influenza: cause or excuse? An analysis of flu's influence on worsening mortality trends in England and Wales, 2010-19

BACKGROUND

England and Wales experienced a stagnation of previously improving life expectancy during the 2010s. Public bodies cited influenza as an important cause.

SOURCES OF DATA

We used data from the Office for National Statistics to examine mortality attributed directly to influenza and to all influenza-like diseases for the total population of England and Wales 2010-19. Several combinations of ICD-10 codes were used to address the possibility of under-counting influenza deaths.

AREAS OF AGREEMENT

Deaths from influenza and influenza-like diseases declined between 2010 and 2019, while earlier improvements in mortality from all causes of death were stalling and, with some causes, worsening. Our findings support existing research showing that influenza is not an important cause of the stalling of mortality rates 2010-19.

AREAS OF CONTROVERSY

Influenza was accepted by many as an important cause of stalling life expectancy for much of the 2010s, while few in public office have accepted austerity as a key factor in the changes seen during that time.

GROWING POINTS

This adds to the mounting evidence that austerity damaged health prior to COVID-19 and left the population more vulnerable when it arrived.

AREAS FOR DEVELOPING TIMELY RESEARCH

Future research should explore why so many in public office were quick to attribute the change in trends in overall mortality in the UK in this period to influenza, and why many continue to do so through to 2023 and to deny the key role of austerity in harming population health.