Imperial College London

ProfessorChristopherMillett

Faculty of MedicineSchool of Public Health

Professor of Public Health
 
 
 
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Contact

 

c.millett Website

 
 
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Location

 

Reynolds BuildingCharing Cross Campus

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Summary

 

Publications

Publication Type
Year
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276 results found

Rosa MFF, da Silva EN, Pacheco C, Diogenes MVP, Millett C, Gadelha CAG, Santos LMPet al., 2021, Direct from the COVID-19 crisis: research and innovation sparks in Brazil, HEALTH RESEARCH POLICY AND SYSTEMS, Vol: 19, ISSN: 1478-4505

Journal article

Jenkins RH, Vamos EP, Taylor-Robinson D, Millett C, Laverty AAet al., 2021, Impacts of the 2008 Great Recession on dietary intake: a systematic review and meta-analysis, International Journal of Behavioral Nutrition and Physical Activity, Vol: 18

<jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>The 2008 Great Recession significantly impacted economies and individuals globally, with potential impacts on food systems and dietary intake. We systematically reviewed evidence on the impact of the Great Recession on individuals’ dietary intake globally and whether disadvantaged individuals were disproportionately affected.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>We searched seven databases and relevant grey literature through June 2020. Longitudinal quantitative studies with the 2008 recession as the exposure and any measure of dietary intake (energy intake, dietary quality, and food/macronutrient consumption) as the outcome were eligible for inclusion. Eligibility was independently assessed by two reviewers. The Newcastle Ottawa Scale was used for quality and risk of bias assessment. We undertook a random effects meta-analysis for changes in energy intake. Harvest plots were used to display and summarise study results for other outcomes. The study was registered with PROSPERO (CRD42019135864).</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Forty-one studies including 2.6 million people met our inclusion criteria and were heterogenous in both methods and results. Ten studies reported energy intake, 11 dietary quality, 34 food intake, and 13 macronutrient consumption. The Great Recession was associated with a mean reduction of 103.0 cal per adult equivalent per day (95% Confidence Interval: − 132.1, − 73.9) in high-income countries (5 studies) and an increase of 105.5 cal per adult per day (95% Confidence Interval: 72.8, 138.2) in middle-income countries (2

Journal article

Jawad M, Millett C, Nakkash R, 2021, Tobacco-control challenges among adolescents in the Eastern Mediterranean region Comment, LANCET CHILD & ADOLESCENT HEALTH, Vol: 5, Pages: 234-235, ISSN: 2352-4642

Journal article

Esposito L, Dhongde S, Millett C, 2021, Smoking habits in Mexico: Upward and downward comparisons of economic status, REVIEW OF DEVELOPMENT ECONOMICS, ISSN: 1363-6669

Journal article

Jenkins R, Aliabadi S, Vamos E, Taylor-Robinson D, Wickham S, Millett C, Laverty Aet al., 2021, The relationship between austerity and food insecurity in the UK: a systematic review, EClinicalMedicine, Vol: 33, Pages: 1-10, ISSN: 2589-5370

Background: In 2010, the UK government implemented austerity measures, involving reductions to public spending and welfare reform. We aimed to systematically review the relationship of austerity policies with food insecurity including foodbank use in the UK.Methods: We undertook a narrative systematic review (CRD42020164508) and searched seven databases, grey literature, and reference lists through September 2020. Studies with austerity policies (including welfare reform) as exposure and food insecurity (including foodbank use as a proxy) as study outcome were included. We included quantitative longitudinal and cross-sectional studies. Two reviewers assessed eligibility, extracted data directly from studies, and undertook quality assessment.Findings: Eight studies were included: two individual-level studies totalling 4129 participants and six ecological studies. All suggested a relationship between austerity and increased food insecurity. Two studies found that austerity policies were associated with increased food insecurity in European countries including the UK. Six studies found that the welfare reform aspect of UK austerity policies was associated with increased food insecurity and foodbank use. Sanctions involving delays to benefits as a response to a claimant not actively seeking work may increase food insecurity, with studies finding that increases of 100 sanctions per 100,000 people may have led to increases of between 2 and 36 food parcels per 100,000 population.Interpretation: UK austerity policies were consistently linked to food insecurity and foodbank use. Policymakers should consider impacts of austerity on food insecurity when considering how to reduce budget deficits.

Journal article

Chen DT-H, Millett C, Filippidis FT, 2021, The association of migration with multiple tobacco product use among male adults in 15 low- and middle-income countries., Eur J Public Health

Little is known about the impact of migration on tobacco use patterns among men in low- and middle-income countries (LMICs). This study aims to explore the association between migration and tobacco use among men in LMICs. We used multilevel regression models to analyze data of 154 425 men from 15 countries from the latest wave of the Demographic and Health Survey. Results showed higher risk of single tobacco product use [relative risk ratio (RRR) = 1.22; 95% confidence interval (CI): 1.19-1.26], but importantly of dual (RR = 1.41, 95% CI: 1.36-1.49) and poly-tobacco use (RR = 1.71, 95% CI: 1.57-1.86) among migrant men compared with non-migrants.

Journal article

Vineis P, Huybrechts I, Millett C, Weiderpass Eet al., 2021, Climate change and cancer: converging policies, Molecular Oncology, Vol: 15, Pages: 764-769, ISSN: 1574-7891

Intervening on risk factors for noncommunicable diseases (including cancer) in industrialized countries could achieve a reduction of between 30% and 40% of premature deaths. In the meantime, the need to intervene against the threat of climate change has become obvious. CO2 emissions must be reduced by 45% by the year 2030 and to zero by 2050 according to recent agreements. We propose an approach in which interventions are designed to prevent diseases and jointly mitigate climate change, the so‐called cobenefits. The present article describes some examples of how climate change mitigation and cancer prevention could go hand in hand: tobacco control, food production, and transportation (air pollution). Many others can be identified. The advantage of the proposed approach is that both long‐term (climate) and short‐term (health) benefits can be accrued with appropriate intersectoral policies.

Journal article

Seferidi P, Millett C, Laverty AA, 2021, Industry self-regulation fails to deliver healthier diets, again Public Health England's replacement must take bolder action, BMJ-BRITISH MEDICAL JOURNAL, Vol: 372, ISSN: 1756-1833

Journal article

Laverty AA, Hone T, Goodman A, Kelly Y, Millett Cet al., 2021, Associations of active travel with adiposity among children and socioeconomic differentials: a longitudinal study, BMJ OPEN, Vol: 11, ISSN: 2044-6055

Journal article

Levy RB, Rauber F, Chang K, Louzada MLDC, Monteiro CA, Millett C, Vamos EPet al., 2020, Ultra-processed food consumption and type 2 diabetes incidence: A prospective cohort study., Clinical Nutrition, ISSN: 0261-5614

BACKGROUND: Ultra-processed foods account for more than 50% of daily calories consumed in several high-income countries, with sales of ultra-processed foods soaring globally, especially in middle-income countries. The objective of this study is to investigate the association between ultra-processed food (UPF) consumption and risk of type 2 diabetes (T2D) in a UK-based prospective cohort study. METHODS: Participants of the UK Biobank (2007-2019) aged 40-69 years without diabetes at recruitment who provided 24-h dietary recall and follow-up data were included. UPFs were defined using the NOVA food classification. Multivariable Cox proportional hazards regression models were used to evaluate the association between UPF consumption and the risk of T2D adjusting for socio-demographic, anthropometric and lifestyle characteristics. RESULTS: A total of 21,730 participants with a mean age of 55.8 years and mean UPF intake of 22.1% at baseline were included. During a mean follow-up of 5.4 years (116,956 person-years), 305 incident T2D cases were identified. In the fully adjusted model, compared with the group in the lowest quartile of UPF intake, the hazard ratio for T2D was 1.44, 1.04-2.02 in the group with the highest quartile of UPF consumption. A gradient of elevated risk of T2D associated with increasing quartiles of UPF intake was consistently observed (p value for trend < 0.028). A significantly increased risk of T2D was observed per 10 percentage points increment in UPF consumption ([adjusted HR]: 1.12, 95% confidence interval [CI]: 1.04-1.20). CONCLUSIONS: Our findings demonstrate that a diet high in UPFs is associated with a clinically important increased risk of T2D. Identifying and implementing effective public health actions to reduce UPF consumption in the UK and globally are urgently required.

Journal article

Laverty A, Millett C, Hopkinson N, Filippidis Fet al., 2020, Introduction of standardised packaging and availability of illicit cigarettes: a difference-in-difference analysis of European Union survey data 2015-2018., Thorax, Vol: 76, Pages: 89-91, ISSN: 0040-6376

Standardised packaging of tobacco products is intended to reduce the appeal of smoking, but the tobacco industry claims this increases illicit trade. We examined the percentage of people reporting being offered illicit cigarettes before and after full implementation of standardised packaging in the UK, Ireland and France and compared this to other European Union countries. Reported ever illicit cigarette exposure fell from 19.8% to 18.1% between 2015 and 2018 in the three countries fully implementing the policy, and from 19.6% to 17.0% in control countries (p for difference=0.320). Standardised packaging does not appear to increase the availability of illicit cigarettes.

Journal article

Laverty A, Millett C, Filippidis FT, 2020, Associations between cigarette prices and consumption in Europe 2004 - 2014, Tobacco Control, Vol: 30, Pages: 111-113, ISSN: 0964-4563

IntroductionWhile tobacco price increases are known to reduce smoking prevalence, these relationships may be blunted by the availability of budget cigarettes, promoted by the tobacco industry to maintain profits. There has been limited previous research on the impact of budget cigarettes on cigarette consumption and used data from Europe 2004-2014 to investigate this.MethodsAnnual population-weighted cigarette consumption per adult data come from the International Cigarette Consumption Database. Annual tobacco price data come from Euromonitor International for 23 European countries. We examined median prices as well as price differentials, operationalised as percentages obtained by dividing the difference between median and minimum prices by median price. We used a linear random-effects model to assess associations between these and cigarette consumption within-year and with a one-year time lag.ResultsCigarette consumption per capita has declined over the study period (-29.5 cigarettes per capita per year, 95% Confidence Intervals -46.8 to -12.1). Our analysis suggests that increases in cigarette price differentials, a marker of opportunities for smokers to switch to less expensive cigarettes, are associated with greater consumption in the same year (+6.4 for a 10% increase in differential, -40.0 to 52.6) and are associated with greater consumption the following year (+67.6, 25.8 to 109.5). ConclusionThese analyses suggest that even in Europe where tobacco taxes are relatively high compared with other regions, differential cigarette pricing strategies may undermine tobacco control. Further research is needed on links between tobacco price structures and consumption and policy design to maximise the effectiveness of tobacco tax.

Journal article

Paes-Sousa R, Millett C, Rocha R, Barreto ML, Hone Tet al., 2020, Science misuse and polarised political narratives in the COVID-19 response, The Lancet, Vol: 396, Pages: 1635-1636, ISSN: 0140-6736

Journal article

Laverty AA, Vamos EP, Panter J, Millett Cet al., 2020, Road user charging: a policy whose time has finally arrived, The Lancet Planetary Health, Vol: 4, Pages: e499-e500, ISSN: 2542-5196

Journal article

Hone T, Saraceni V, Coeli CM, Trajman A, Rasella D, Millett C, Durovni Bet al., 2020, Primary health care expansion and mortality in Brazil’s urban poor: a cohort analysis of 1.2 million adults, PLoS Medicine, Vol: 17, Pages: 1-20, ISSN: 1549-1277

BackgroundExpanding delivery of primary health care to urban poor populations is a priority in many low-and middle-income countries. This remains a key challenge in Brazil despite expansion of the country’s internationally recognised Family Health Strategy (FHS) over the past two decades. This study evaluates the impact of an ambitious program to rapidly expand FHS coverage in the city of Rio de Janeiro, Brazil since 2008. Methods and FindingsA cohort of 1,241,351 million low-income adults (observed January 2010-December 2016; total person-years 6,498,607) with linked FHS utilisation and mortality records was analysed using flexible parametric survival models. Time-to-death from all-causes and selected causes were estimated for FHS users and non-users. Models employed inverse probability treatment weighting and regression adjustment (IPTW-RA).The cohort was 61% female (751,895) and had a mean age of 36 years (standard deviation 16.4). Only 18,721 individuals (1.5%) had higher education whilst 102,899 (8%) had no formal education. Two-thirds of individuals (827250; 67%) were in receipt of conditional cash transfers (Bolsa Família). A total of 34,091 deaths were analysed of which 8,765 (26%) were due to cardiovascular disease, 5,777 (17%) due to neoplasms, 5,683 (17%) due to external causes, 3,152 (9%) due to respiratory diseases, and 3,115 (9%) due to infectious and parasitic diseases. One third of the cohort (467,155; 37.6%) used FHS services. In IPTW-RA survival analysis, an average FHS user had a 44% lower hazard of all-cause mortality (HR: 0.56, 95%CI: 0.54 to 0.59, p<0.001) and a five-year risk reduction of 8.3 per 1000 (95%CI: 7.8 to 8.9, p<0.001) compared to a non-FHS user. There were greater reductions in the risk of death for FHS users who: were black (HR:0.50 (95%CI: 0.46 to 0.54, p<0.001)) or pardo (HR:0.57 (95%CI: 0.54 to 0.60, p<0.001) compared to white (HR:0.59 (95%CI: 0.56 to 0.63, p<0.001); had lower educational attainment

Journal article

Radó MK, Mölenberg FJ, Sheikh A, Millett C, Bramer WM, Burdorf A, van Lenthe FJ, Been JVet al., 2020, Impact of expanding smoke-free policies beyond enclosed public places and workplaces on children's tobacco smoke exposure and respiratory health: protocol for a systematic review and meta-analysis., BMJ Open, Vol: 10, Pages: 1-11, ISSN: 2044-6055

INTRODUCTION: Tobacco smoke exposure (TSE) has considerable adverse respiratory health impact among children. Smoke-free policies covering enclosed public places are known to reduce child TSE and benefit child health. An increasing number of jurisdictions are now expanding smoke-free policies to also cover outdoor areas and/or (semi)private spaces (indoor and/or outdoor). We aim to systematically review the evidence on the impact of these 'novel smoke-free policies' on children's TSE and respiratory health. METHODS AND ANALYSIS: 13 electronic databases will be searched by two independent reviewers for eligible studies. We will consult experts from the field and hand-search references and citations to identify additional published and unpublished studies. Study designs recommended by the Cochrane Effective Practice and Organisation of Care (EPOC) group are eligible, without restrictions on the observational period, publication date or language. Our primary outcomes are: self-reported or parental-reported TSE in places covered by the policy; unplanned hospital attendance for wheezing/asthma and unplanned hospital attendance for respiratory infections. We will assess risk of bias of individual studies following the EPOC or Risk Of Bias In Non-randomised Studies of Interventions tool, as appropriate. We will conduct separate random effects meta-analyses for smoke-free policies covering (1) indoor private places, (2) indoor semiprivate places, (3) outdoor (semi)private places and (4) outdoor public places. We will assess whether the policies were associated with changes in TSE in other locations (eg, displacement). Subgroup analyses will be conducted based on country income classification (ie, high, middle or low income) and by socioeconomic status. Sensitivity analyses will be undertaken via broadening our study design eligibility criteria (ie, including non-EPOC designs) or via excluding studies with a high risk of bias. This review will inform policymakers regarding t

Journal article

Rauber F, Chang K, Vamos E, da Costa Louzada ML, Monteiro C, Millett C, Levy Ret al., 2020, Ultra-processed food consumption and risk of obesity: a prospective cohort study of UK Biobank, European Journal of Nutrition, ISSN: 0044-264X

Objective: To examine the associations between ultra-processed food consumption and risk of obesity among UK adults. Methods: Participants aged 40-69 years at recruitment in the UK Biobank (2006-2019) with dietary intakes collected using 24-hour recall and repeated measures of adiposity - body mass index (BMI), waist circumference (WC) and percentage of body fat (% BF) - were included (N=22,659; median follow-up: 5 years). Ultra-processed foods were identified using the NOVA classification and their consumption was expressed as a percentage of total energy intake. Multivariable Cox proportional hazards regression models were used to estimate hazard ratios (HR) of several indicators of obesity according to ultra-processed food consumption. Models were adjusted for sociodemographic and lifestyle characteristics.Results: 947 incident cases of overall obesity (BMI≥30 kg/m2) and 1,900 incident cases of abdominal obesity (men: WC≥102cm, women: WC≥88cm) were identified during follow-up. Participants in the highest quartile of ultra-processed food consumption had significantly higher risk of developing overall obesity (HR: 1.79; 95%CI: 1.06─3.03) and abdominal obesity (HR: 1.30; 95%CI: 1.14─1.48). They had higher risk of experiencing a ≥5% increase in BMI (HR: 1.31; 95%CI: 1.20─1.43), WC (HR: 1.35; 95%CI: 1.25─1.45) and %BF (HR: 1.14; 95%CI: 1.03─1.25), than those in the lowest quartile of consumption.Conclusions: Our findings provide evidence that higher consumption of ultra-processed food is strongly associated with a higher risk of multiple indicators of obesity in the UK adult population. Policy makers should consider actions that promote consumption of fresh or minimally processed foods and reduce consumption of ultra-processed foods.

Journal article

Seferidi P, Scrinis G, Huybrechts I, Woods J, Vineis P, Millett Cet al., 2020, The neglected environmental impacts of ultra-processed foods, The Lancet Planetary Health, Vol: 4, Pages: e437-e438, ISSN: 2542-5196

Journal article

Hone T, Powell-Jackon T, Santos LMP, Soares RDS, Proenço de Oliveira F, Niskier Sanchez M, Harris M, Santos F, Millett Cet al., 2020, Impact of the Programa Mais médicos (more doctors Programme) on primary care doctor supply and amenable mortality: quasi-experimental study of 5565 Brazilian municipalities, BMC Health Services Research, Vol: 20, ISSN: 1472-6963

BackgroundInvesting in human resources for health (HRH) is vital for achieving universal health care and the Sustainable Development Goals. The Programa Mais Médicos (PMM) (More Doctors Programme) provided 17,000 doctors, predominantly from Cuba, to work in Brazilian primary care. This study assesses whether PMM doctor allocation to municipalities was consistent with programme criteria and associated impacts on amenable mortality.MethodsDifference-in-differences regression analysis, exploiting variation in PMM introduction across 5565 municipalities over the period 2008–2017, was employed to examine programme impacts on doctor density and mortality amenable to healthcare. Heterogeneity in effects was explored with respect to doctor allocation criteria and municipal doctor density prior to PMM introduction.ResultsAfter starting in 2013, PMM was associated with an increase in PMM-contracted primary care doctors of 15.1 per 100,000 population. However, largescale substitution of existing primary care doctors resulting in a net increase of only 5.7 per 100,000. Increases in both PMM and total primary care doctors were lower in priority municipalities due to lower allocation of PMM doctors and greater substitution effects. The PMM led to amenable mortality reductions of − 1.06 per 100,000 (95%CI: − 1.78 to − 0.34) annually – with greater benefits in municipalities prioritised for doctor allocation and where doctor density was low before programme implementation.ConclusionsPMM potential health benefits were undermined due to widespread allocation of doctors to non-priority areas and local substitution effects. Policies seeking to strengthen HRH should develop and implement needs-based criteria for resource allocation.

Journal article

Jawad M, Hone T, Vamos E, Roderick P, Sullivan R, Millett Cet al., 2020, Estimating indirect mortality impacts of armed conflict in civilian populations: panel regression analyses of 193 countries, 1990-2017, BMC Medicine, Vol: 266, Pages: 1-11, ISSN: 1741-7015

BackgroundArmed conflict can indirectly affect population health through detrimental impacts on political and social institutions and destruction of infrastructure. This study aimed to quantify indirect mortality impacts of armed conflict in civilian populations globally, and explore differential effects by armed conflict characteristics and population groups.Methods We included 193 countries between 1990 and 2017 and constructed fixed effects panel regression models using data from the Uppsala Conflict Data Program and Global Burden of Disease study. Mortality rates were corrected to exclude battle-related deaths. We assessed separately four different armed conflict variables (capturing binary, continuous, categorical and quintile exposures) and ran models by cause-specific mortality stratified by age groups and sex. Post-estimation analyses calculated the number of civilian deaths. ResultsWe identified 1,118 unique armed conflicts. Armed conflict was associated with increases in civilian mortality - driven by conflicts categorised as wars. Wars were associated with an increase in age-standardised all-cause mortality of 81.5 per 100.000 population (β 81.5, 95% CI 14.3-148.8) in adjusted models contributing 29.4 million civilian deaths (95% CI 22.1-36.6) globally over the study period. Mortality rates from communicable, maternal, neonatal, and nutritional diseases (β 51.3, 95% CI 2.6-99.9), non-communicable diseases (β 22.7, 95% CI 0.2-45.2) and injuries (β 7.6, 95% CI 3.4-11.7) associated with war increased, contributing 21.0 million (95% CI 16.3-25.6), 6.0 million (95% CI 4.1-8.0), and 2.4 million deaths (95% CI 1.7-3.1) respectively. War-associated increases in all-cause and cause-specific mortality were found across all age groups and both genders, but children aged 0-5 years had the largest relative increases in mortality. Conclusions Armed conflict, particularly war, is associated with a substantial indirect mortality impact among civilians

Journal article

van Schalkwyk M, McKee M, Been J, Millett C, Filippidis Fet al., 2020, Size matters: an analysis of cigarette pack sizes across 23 European Union countries using Euromonitor data, 2006 to 2017, PLoS One, Vol: 15, ISSN: 1932-6203

IntroductionThe tobacco industry (TI) has used small cigarette pack sizes to encourage brand-switching and consumption, and to mitigate the impacts of tobacco tax increases. Since 2016, the European Union (EU) Tobacco Products Directive (TPD) specifies a minimum pack size of 20 cigarettes. We examined cigarette pack sizes in the EU and whether pack size composition differed between cheap and expensive price segments, as well as the impact of the revised TPD.MethodsWe conducted a longitudinal analysis of pricing data from 23 EU countries between 2006–2017. We examined pack sizes over time to assess the impact of the TPD, differences in pack size composition between cheap and expensive price segments, and compared gaps in median prices between products using actual and ‘expected’ prices (price if all packs contained 20 sticks).ResultsCigarette pack sizes changed over time, across the EU. The distribution of pack sizes varied between price segments, with small pack sizes especially frequent in the cheap segment of the cigarette market, but this varied over time and across countries. Packs of <20 cigarettes almost disappeared from the data samples after implementation of the TPD.ConclusionImplementation of the TPD appears to have virtually eliminated packs with <20 cigarettes, restricting their use by the TI. Our analysis suggests pack sizes have been used differentially across the EU. Country-level analyses on the industry’s use of pack sizes, consumer responses, and evaluations of restricting certain pack sizes are needed to confirm our findings and strengthen policy.

Journal article

Seferidi P, Laverty AA, Collins B, Bandosz P, Capewell S, O'Flaherty M, Millett C, Pearson-Stuttard Jet al., 2020, Potential impacts of post-Brexit agricultural policy on fruit and vegetable intake and cardiovascular disease in England: a modelling study, BMJ Nutrition, Prevention & Health, Vol: 3, ISSN: 2516-5542

Background Current proposals for post-Brexit agricultural policy do not explicitly incorporate public health goals. The revised agricultural policy may be an opportunity to improve population health by supporting domestic production and consumption of fruits and vegetables (F&V). This study aims to quantify the potential impacts of a post-Brexit agricultural policy that increases land allocated to F&V on cardiovascular disease (CVD) mortality and inequalities in England, between 2021 to 2030.Methods We used the previously validated IMPACT Food Policy model and probabilistic sensitivity analysis to translate changes in land allocated to F&V into changes in F&V intake and associated CVD deaths, stratified by age, sex and Index of Multiple Deprivation. The model combined data on F&V agriculture, waste, purchases and intake, CVD mortality projections and appropriate relative risks. We modelled two scenarios, assuming that land allocated to F&V would gradually increase to 10% and 20% of land suitable for F&V production.Results We found that increasing land use for F&V production to 10% and 20% of suitable land would increase fruit intake by approximately 3.7% (95% uncertainty interval: 1.6% to 8.6%) and 17.4% (9.1% to 36.9%), and vegetable intake by approximately 7.8% (4.2% to 13.7%) and 37% (24.3% to 55.7%), respectively, in 2030. This would prevent or postpone approximately 3890 (1950 to 7080) and 18 010 (9840 to 28 870) CVD deaths between 2021 and 2030, under the first and second scenario, respectively. Both scenarios would reduce inequalities, with 16% of prevented or postponed deaths occurring among the least deprived compared with 22% among the most deprived.Conclusion Post-Brexit agricultural policy presents an important opportunity to improve dietary intake and associated cardiovascular mortality by supporting domestic production of F&V as part of a comprehensive strategy that intervenes across the supply chain.

Journal article

Laverty AA, Millett C, Majeed A, Vamos EPet al., 2020, COVID-19 presents opportunities and threats to transport and health, Journal of the Royal Society of Medicine, Vol: 113, Pages: 251-254, ISSN: 0141-0768

Journal article

Anindya K, Lee JT, McPake B, Wilopo SA, Millett C, Carvalho Net al., 2020, Impact of Indonesia's national health insurance scheme on inequality in access to maternal health services: A propensity score matched analysis, JOURNAL OF GLOBAL HEALTH, Vol: 10, ISSN: 2047-2978

Journal article

McKay A, Negi NS, Murukutla N, Laverty A, Puri P, Uttekar BV, Mullin S, Millett Cet al., 2020, Trends in tobacco, alcohol and branded fast-food imagery in Bollywood films, 1994-2013, PLoS One, Vol: 15, ISSN: 1932-6203

Background and aimsExposure to tobacco, alcohol and fast-food use in films is associated with initiation of these behaviours. India is the world’s largest film producer, but the extent of such imagery in Bollywood (Hindi cinema) films is unclear. We therefore aimed to describe the extent of and trends in tobacco, alcohol and fast-food imagery in Bollywood films, between 1994–2013.MethodsFor the 15 top-grossing films each year between 1994–2013, the number of five-minute intervals containing product images were determined separately for tobacco, alcohol and fast-food. Both the proportion of films containing at least one image occurrence, and occurrences per film, were described overall and by year. Negative binomial regression described associations between film rating and occurrences/film, and estimated time-trends in occurrences/film, adjusted for rating.ResultsWe analysed 93 U-rated (unrestricted), 150 U/A-rated (parental guidance for children aged <12 years) and 55 A-rated (restricted to adult audience) films, containing 9,226 five-minute intervals (mean intervals/film 30.8, SD 4.0). 70% (n = 210), 93% (n = 278) and 21% (n = 62) of films contained at least one tobacco, alcohol and fast-food occurrence, respectively. Corresponding total mean occurrences/film were 4.0 (SD 4.9), 7.0 (4.7) and 0.4 (0.9). Tobacco occurrences were more common in U/A films (incidence rate ratio 1.49, 95% confidence interval 1.06–2.09) and A films (2.95; 1.95–4.48) than U-rated films. Alcohol occurrences were also more common in A-rated films than U-rated films (1.48; 1.15–1.85). Tobacco occurrences/film became less common over the observed period (adjusted trend -4% per annum; -2 to -7%; p <0.001), while alcohol (+2%; 0–3%; p = 0.02), and fast food (+8%; 2–14%; p = 0.01) occurrences/film became more common.ConclusionsAlthough the extent of tobacco imagery in Bollywood films fell over 1994–2013, it is still frequently observed.

Journal article

Jawad M, Millett C, Sullivan R, Alturki F, Roberts B, Vamos Eet al., 2020, The impact of armed conflict on cancer among civilian populations in low- and middle-income countries: a systematic review, Ecancermedicalscience, Vol: 14, ISSN: 1754-6605

Commitee On Publication EthicsecancermedicalscienceSubmit articleArticlesEditorialsSpecial issuesAuthor interviewsCategorySub-categoryArticle typeVolumeKeywordBookmark and ShareArticle metrics: 204 viewshttps://doi.org/10.3332/ecancer.2020.1039Abstract | Full Article | PDFReviewThe impact of armed conflict on cancer among civilian populations in low- and middle-income countries: a systematic reviewMohammed Jawad1, Christopher Millett1, Richard Sullivan2, Fadel Alturki3, Bayard Roberts4 and Eszter P Vamos11Public Health Policy Evaluation Unit, Imperial College London, Hammersmith, London W6 8RP, UK2Institute of Cancer Policy, Cancer Epidemiology, Population and Global Health, King's College London and Guy's & St Thomas' NHS Trust, London, UK3Faculty of Medicine, American University of Beirut, Lebanon4Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UKAbstractBackground: Armed conflicts are increasingly impacting countries with a high burden of cancer. The aim of this study is to systematically review the literature on the impact of armed conflict on cancer in low- and middle-income countries (LMICs).Methods: In November 2019, we searched five medical databases (Embase, Medline, Global Health, PsychINFO and the Web of Science) without date, language or study design restrictions. We included studies assessing the association between armed conflict and any cancer among civilian populations in LMICs. We systematically re-analysed the data from original studies and assessed quality using the Newcastle-Ottawa Scale. Data were analysed descriptively by cancer site.Results: Of 1,543 citations screened, we included 20 studies assessing 8 armed conflicts and 13 site-specific cancers (total study population: 70,172). Two-thirds of the studies were of low methodological quality (score <5) and their findings were often conflicting. However, among outcomes assessed by three or more studies, we found some evi

Journal article

Patterson R, Panter J, Vamos EP, Cummins S, Millett C, Laverty AAet al., 2020, Associations between commute mode and cardiovascular disease, cancer, and all-cause mortality, and cancer incidence, using linked Census data over 25 years in England and Wales: a cohort study, Lancet Planetary Health, Vol: 4, Pages: E186-E194, ISSN: 2542-5196

BackgroundActive travel is increasingly recognised as an important source of physical activity. We aimed to describe associations between commute mode and cardiovascular disease, cancer, and all-cause mortality.MethodsWe analysed data from the Office for National Statistics Longitudinal Study of England and Wales (ONS-LS), which linked data from the Census of England and Wales (henceforth referred to as the Census) for 1991, 2001, and 2011 to mortality and cancer registrations. The cohort included individuals traced in the ONS-LS who were economically active (ie, aged ≥16 years, not retired from work, and not a full-time carer). Commuting by private motorised transport, public transport, walking, and cycling were compared in terms of all-cause mortality, cancer mortality, cardiovascular disease mortality, and cancer incidence, using Cox proportional-hazards models with time-varying covariates. Models were adjusted for age, sex, housing tenure, marital status, ethnicity, university education, car access, population density, socioeconomic classification, Carstairs index quintile, long-term illness, and year entered the study, and were additionally stratified by socioeconomic group.FindingsBetween the 1991 Census and the 2011 Census, 784 677 individuals contributed data for at least one Census, of whom 394 746 were included in the ONS-LS and were considered to be economically active working-age individuals. 13 983 people died, 3172 from cardiovascular disease and 6509 from cancer, and there were 20 980 incident cancer cases. In adjusted models, compared with commuting by private motorised vehicle, bicycle commuting was associated with a 20% reduced rate of all-cause mortality (hazard ratio [HR] 0·80, 95% CI 0·73–0·89), a 24% decreased rate of cardiovascular disease mortality (0·76, 0·61–0·93), a 16% lower rate of cancer mortality (0·84, 0·73–0·98), and an 11% reduced rate of incident ca

Journal article

Chambers T, Millett C, Sassi F, 2020, New Zealand's Public Services Act: a policy opportunity for cross-government action on unhealthy products, PERSPECTIVES IN PUBLIC HEALTH, Vol: 140, Pages: 144-145, ISSN: 1757-9139

Journal article

Rauber F, Steele EM, Louzada MLC, Millett C, Monteiro CA, Levy RBet al., 2020, Ultra-processed food consumption and indicators of obesity in the United Kingdom population (2008-2016), PLOS ONE, Vol: 15, ISSN: 1932-6203

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