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Article ; Online: Associations between residential greenspace exposure and mortality in 4 645 581 adults living in London, UK: a longitudinal study.

Hajna, Samantha / Nafilyan, Vahé / Cummins, Steven

The Lancet. Planetary health

2023 Volume 7, Issue 6, Page(s) e459–e468

Abstract: Background: Urban greenspaces could reduce non-communicable disease (NCD) risk. The links between greenspaces and NCD-related mortality remain unclear. We aimed to estimate associations between residential greenspace quantity and access and all-cause ... ...

Abstract	Background: Urban greenspaces could reduce non-communicable disease (NCD) risk. The links between greenspaces and NCD-related mortality remain unclear. We aimed to estimate associations between residential greenspace quantity and access and all-cause mortality, cardiovascular disease mortality, cancer mortality, respiratory mortality, and type 2 diabetes mortality. Methods: We linked 2011 UK Census data of London-dwelling adults (aged ≥18 years) to data from the UK death registry and the Greenspace Information for Greater London resource. We calculated percentage greenspace area, access point density (access points per km Findings: Data were available for 4 645 581 individuals between March 27, 2011, and Dec 31, 2019. Respondents were followed up for a mean of 8·4 years (SD 1·4). All-cause mortality did not differ with overall greenspace coverage (hazard ratio [HR] 1·0004, 95% CI 0·9996-1·0012), increased with increasing access point density (1·0076, 1·0031-1·0120), and decreased slightly with increasing distance to the nearest access point (HR 0·9993, 0·9987-0·9998). A 1 percentage point (pp) increase in pocket park (areas for rest and recreation under 0·4 hectares) coverage was associated with a decrease in all-cause mortality risk (0·9441, 0·9213-0·9675), and an increase of ten pocket park access points per km Interpretation: Increasing the quantity of, and access to, pocket parks might help mitigate mortality risk. More research is needed to elucidate the mechanisms that could explain these associations. Funding: Health Data Research UK (HDRUK).
MeSH term(s)	Adult ; Humans ; Adolescent ; Longitudinal Studies ; London/epidemiology ; Diabetes Mellitus, Type 2 ; Parks, Recreational ; Noncommunicable Diseases ; Respiratory Tract Diseases
Language	English
Publishing date	2023-06-07
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2542-5196
ISSN (online)	2542-5196
DOI	10.1016/S2542-5196(23)00057-8
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Cohort Profile: The Public Health Data Asset, 2011 cohort.

Nafilyan, Vahé / Bosworth, Matt / Morgan, Jasper / Ayoubkhani, Daniel / Dolby, Ted / Groom, Paul / Mills, Tom / Pooley, Justine / Tinsley, Jonathan

International journal of epidemiology

2024 Volume 53, Issue 1

MeSH term(s)	Humans ; Public Health ; Socioeconomic Factors ; Health Status Disparities
Language	English
Publishing date	2024-01-08
Publishing country	England
Document type	Journal Article
ZDB-ID	187909-1
ISSN	1464-3685 ; 0300-5771
ISSN (online)	1464-3685
ISSN	0300-5771
DOI	10.1093/ije/dyad194
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Article ; Online: Evaluation of Risk Factors for Postbooster Omicron COVID-19 Deaths in England.

Nafilyan, Vahé / Ward, Isobel L / Robertson, Chris / Sheikh, Aziz

JAMA network open

2022 Volume 5, Issue 9, Page(s) e2233446

MeSH term(s)	COVID-19 ; England/epidemiology ; Humans ; Risk Factors
Language	English
Publishing date	2022-09-01
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2022.33446
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Article ; Online: Employment outcomes of people with Long Covid symptoms: community-based cohort study.

Ayoubkhani, Daniel / Zaccardi, Francesco / Pouwels, Koen B / Walker, A Sarah / Houston, Donald / Alwan, Nisreen A / Martin, Josh / Khunti, Kamlesh / Nafilyan, Vahé

European journal of public health

2024

Abstract: Background: Evidence on the long-term employment consequences of SARS-CoV-2 infection is lacking. We used data from a large, community-based sample in the UK to estimate associations between Long Covid and employment outcomes.: Methods: This was an ... ...

Abstract	Background: Evidence on the long-term employment consequences of SARS-CoV-2 infection is lacking. We used data from a large, community-based sample in the UK to estimate associations between Long Covid and employment outcomes. Methods: This was an observational, longitudinal study using a pre-post design. We included survey participants from 3 February 2021 to 30 September 2022 when they were aged 16-64 years and not in education. Using conditional logit modelling, we explored the time-varying relationship between Long Covid status ≥12 weeks after a first test-confirmed SARS-CoV-2 infection (reference: pre-infection) and labour market inactivity (neither working nor looking for work) or workplace absence lasting ≥4 weeks. Results: Of 206 299 participants (mean age 45 years, 54% female, 92% white), 15% were ever labour market inactive and 10% were ever long-term absent during follow-up. Compared with pre-infection, inactivity was higher in participants reporting Long Covid 30 to <40 weeks [adjusted odds ratio (aOR): 1.45; 95% CI: 1.17-1.81] or 40 to <52 weeks (aOR: 1.34; 95% CI: 1.05-1.72) post-infection. Combining with official statistics on Long Covid prevalence, and assuming a correct statistical model, our estimates translate to 27 000 (95% CI: 6000-47 000) working-age adults in the UK being inactive because of Long Covid in July 2022. Conclusions: Long Covid is likely to have contributed to reduced participation in the UK labour market, though it is unlikely to be the sole driver. Further research is required to quantify the contribution of other factors, such as indirect health effects of the pandemic.
Language	English
Publishing date	2024-02-29
Publishing country	England
Document type	Journal Article
ZDB-ID	1129243-x
ISSN	1464-360X ; 1101-1262
ISSN (online)	1464-360X
ISSN	1101-1262
DOI	10.1093/eurpub/ckae034
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Article ; Online: Sociodemographic inequalities of suicide: a population-based cohort study of adults in England and Wales 2011-21.

Ward, Isobel L / Finning, Katie / Ayoubkhani, Daniel / Hendry, Katie / Sharland, Emma / Appleby, Louis / Nafilyan, Vahé

European journal of public health

2024 Volume 34, Issue 2, Page(s) 211–217

Abstract: Background: The risk of suicide is complex and often a result of multiple interacting factors. Understanding which groups of the population are most at risk of suicide is important to inform the development of targeted public health interventions.: ... ...

Abstract	Background: The risk of suicide is complex and often a result of multiple interacting factors. Understanding which groups of the population are most at risk of suicide is important to inform the development of targeted public health interventions. Methods: We used a novel linked dataset that combined the 2011 Census with the population-level mortality data in England and Wales. We fitted generalized linear models with a Poisson link function to estimate the rates of suicide across different sociodemographic groups and to identify which characteristics are independent predictors of suicide. Results: Overall, the highest rates of suicide were among men aged 40-50 years, individuals who reported having a disability or long-term health problem, those who were unemployed long term or never had worked, and those who were single or separated. After adjusting for other characteristics such as employment status, having a disability or long-term health problem, was still found to increase the incidence of suicide relative to those without impairment [incidence rate ratio minimally adjusted (women) = 3.5, 95% confidence interval (CI) = 3.3-3.6; fully adjusted (women) 3.1, 95% CI = 3.0-3.3]. Additionally, while the absolute rate of suicide was lower in women compared with men, the relative risk in people reporting impairments compared with those who do not was higher in women compared with men. Conclusions: The findings of this work provide novel population-level insights into the risk of suicide by sociodemographic characteristics in England and Wales. Our results highlight several sociodemographic groups who may benefit from more targeted suicide prevention policies and practices.
MeSH term(s)	Adult ; Female ; Humans ; Male ; Cohort Studies ; England/epidemiology ; Incidence ; Suicide ; Wales/epidemiology ; Middle Aged
Language	English
Publishing date	2024-02-07
Publishing country	England
Document type	Journal Article
ZDB-ID	1129243-x
ISSN	1464-360X ; 1101-1262
ISSN (online)	1464-360X
ISSN	1101-1262
DOI	10.1093/eurpub/ckad233
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Article ; Online: Socio-demographic differences in access to psychological treatment services: evidence from a national cohort study.

Sharland, Emma / Rzepnicka, Klaudia / Schneider, Dorothee / Finning, Katie / Pawelek, Piotr / Saunders, Rob / Nafilyan, Vahé

Psychological medicine

2023 Volume 53, Issue 15, Page(s) 7395–7406

Abstract: Background: Since 2008, the Improving Access to Psychological Therapies (IAPT) programme has offered adults in England evidence-based psychological treatments for common mental disorders (CMDs) such as depression and anxiety disorders. However, ... ...

Abstract	Background: Since 2008, the Improving Access to Psychological Therapies (IAPT) programme has offered adults in England evidence-based psychological treatments for common mental disorders (CMDs) such as depression and anxiety disorders. However, inequalities in access have not been explored at the national level. Methods: Using a unique individual patient dataset that linked 2011 Census information of English residents to national IAPT data collected between April 2017 and March 2018, we estimated the rate of access by a wide range of socio-demographic characteristics that are not routinely available. A large household survey was used to estimate the prevalence of probable CMDs by these socio-demographic characteristics. We estimated the probability of access to IAPT amongst people with CMDs by comparing the rates of access from IAPT data and the estimates of prevalence of CMDs from the household survey. Both unadjusted and adjusted (for important patient characteristics) access rates were estimated in logistic regression models. Results: As a proportion of those with a probable CMD, access to IAPT varied markedly by socio-demographic characteristics. Older adults, males, people born outside of the UK, people with religious beliefs, people from Asian ethnic backgrounds, people reporting a disability and those without any academic or professional qualifications were underrepresented in IAPT services nationally, in adjusted models. Conclusions: The identification of patients who may be underrepresented in IAPT provides an opportunity for services to target outreach and engagement with these groups. Further understanding of barriers to access should help increase equity in access.
MeSH term(s)	Male ; Humans ; Aged ; Cohort Studies ; Anxiety Disorders/therapy ; England/epidemiology ; Demography ; Health Services Accessibility
Language	English
Publishing date	2023-05-17
Publishing country	England
Document type	Journal Article
ZDB-ID	217420-0
ISSN	1469-8978 ; 0033-2917
ISSN (online)	1469-8978
ISSN	0033-2917
DOI	10.1017/S0033291723001010
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Article ; Online: Estimating the effectiveness of COVID-19 vaccination against COVID-19 hospitalisation and death: a cohort study based on the 2021 Census, England

Bermingham, Charlotte / Nafilyan, Vahe / Andrews, Nick / Gethings, Owen

medRxiv

Abstract: Objective: To estimate the effectiveness of COVID-19 vaccination against hospitalisation for COVID-19 and death involving COVID-19 in England using linked population level data sources including the 2021 Census. Design: Retrospective cohort study. ... ...

Abstract	Objective: To estimate the effectiveness of COVID-19 vaccination against hospitalisation for COVID-19 and death involving COVID-19 in England using linked population level data sources including the 2021 Census. Design: Retrospective cohort study. Setting: England, 21 March 2021 to 20 March 2022. Participants: Individuals alive and aged 16+ on 21 March 2021, resident in England, enumerated in the 2021 Census as a usual resident, and able to link to an NHS number. A sample of 583,840 individuals was used for the analysis. Exposures: COVID-19 vaccination: first dose, second dose and third dose/first booster dose, with categories for time since each dose. Main outcome measures: Hospitalisation for COVID-19 or death involving COVID-19. An adjusted Cox proportional hazard model was used to estimate the hazard ratio for the outcomes for vaccinated participants for different doses and time since dose compared to unvaccinated individuals. Vaccine effectiveness was estimated as (1 minus hazard ratio)x 100%. A control outcome of non-COVID-19 death was also assessed. Results: Vaccine effectiveness against hospitalisation for COVID-19 was 52.1% (95% confidence interval 51.3% to 52.8%) for a first dose, 55.6% (55.2% to 56.1%) for a second dose and 77.6% (77.3% to 78.0%) for a third dose, with a decrease in vaccine effectiveness 3+ months after the third dose. Vaccine effectiveness against COVID-19 mortality was 58.7% (52.7% to 63.9%) for a first dose, 88.5% (87.5% to 89.5%) for a second dose and 93.2% (92.9% to 93.5%) for a third dose, with evidence of waning 3+ months after the second and third doses. For the second dose, which is the most comparable across the different time-periods, vaccine effectiveness was higher against COVID-19 hospitalisation but slightly lower against COVID-19 mortality in the Omicron dominant period than the period before the Omicron variant became dominant. Vaccine effectiveness against both COVID-19 hospitalisation and mortality was higher in general for mRNA vaccines than non mRNA vaccines, however this could be influenced by the different populations given each vaccine vector. Non-zero VE against non-COVID-19 mortality indicates that residual confounding may impact the results, despite the inclusion of up-to-date socio-demographic adjustments and various sources of health data, with possible frailty bias, confounding by indication and a healthy vaccinee effect observed. Conclusions: The vaccine effectiveness estimates show increased protection with number of doses and a high level of protection against both COVID-19 hospitalisation and mortality for the third/booster dose, as would be expected from previous research. However, despite the various sources of health data used to adjust the models, the estimates for different breakdowns and for non-COVID-19 mortality expose residual confounding by health status, which should be considered when interpreting estimates of vaccine effectiveness.
Keywords	covid19
Language	English
Publishing date	2023-06-07
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2023.06.06.23290982
Database	COVID19

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Article ; Online: A comparison of excess deaths by UK country and region during the first year of the COVID-19 pandemic.

Hopper, Neil A / Campbell, Annie / Roberts, Cath / Ramsay, Julie / IJpelaar, Jos / Glickman, Myer / Nafilyan, Vahé / Islam, Nazrul

European journal of public health

2023 Volume 34, Issue 2, Page(s) 411–414

Abstract: We compare the impact of the first two waves of the COVID-19 pandemic on risk of age-standardized mortality by sex, UK country, and English region. Each wave is defined as lasting 26 weeks and are consecutive beginning in 2020 week 11. The expected rate ... ...

Abstract	We compare the impact of the first two waves of the COVID-19 pandemic on risk of age-standardized mortality by sex, UK country, and English region. Each wave is defined as lasting 26 weeks and are consecutive beginning in 2020 week 11. The expected rate is estimated from 2015 to 2019 mean and the projected mortality trend from the same period are used to estimate excess mortality. By both measures, excess mortality was highest and lowest in regions of England, London and the South-West, respectively. Excess mortality was consistently higher for males than females.
MeSH term(s)	Male ; Female ; Humans ; COVID-19 ; Pandemics ; England/epidemiology ; Mortality
Language	English
Publishing date	2023-10-19
Publishing country	England
Document type	Journal Article
ZDB-ID	1129243-x
ISSN	1464-360X ; 1101-1262
ISSN (online)	1464-360X
ISSN	1101-1262
DOI	10.1093/eurpub/ckad144
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Article ; Online: Risk of death following COVID-19 vaccination or positive SARS-CoV-2 test in young people in England.

Nafilyan, Vahé / Bermingham, Charlotte R / Ward, Isobel L / Morgan, Jasper / Zaccardi, Francesco / Khunti, Kamlesh / Stanborough, Julie / Banerjee, Amitava / Doidge, James C

Nature communications

2023 Volume 14, Issue 1, Page(s) 1541

Abstract: Several studies have reported associations between COVID-19 vaccination and risk of cardiac diseases, especially in young people; the impact on mortality, however, remains unclear. We use national, linked electronic health data in England to assess the ... ...

Abstract	Several studies have reported associations between COVID-19 vaccination and risk of cardiac diseases, especially in young people; the impact on mortality, however, remains unclear. We use national, linked electronic health data in England to assess the impact of COVID-19 vaccination and positive SARS-CoV-2 tests on the risk of cardiac and all-cause mortality in young people (12 to 29 years) using a self-controlled case series design. Here, we show there is no significant increase in cardiac or all-cause mortality in the 12 weeks following COVID-19 vaccination compared to more than 12 weeks after any dose. However, we find an increase in cardiac death in women after a first dose of non mRNA vaccines. A positive SARS-CoV-2 test is associated with increased cardiac and all-cause mortality among people vaccinated or unvaccinated at time of testing.
MeSH term(s)	Adolescent ; Adult ; Female ; Humans ; Male ; Young Adult ; Age Factors ; Cause of Death ; COVID-19/diagnosis ; COVID-19/epidemiology ; COVID-19/mortality ; COVID-19/virology ; COVID-19 Testing ; COVID-19 Vaccines/administration & dosage ; COVID-19 Vaccines/adverse effects ; Electronic Health Records ; England/epidemiology ; Heart Diseases/epidemiology ; Heart Diseases/mortality ; Incidence ; mRNA Vaccines/administration & dosage ; mRNA Vaccines/adverse effects ; Risk Assessment ; SARS-CoV-2/isolation & purification ; Sex Factors ; Time Factors ; Vaccination/adverse effects ; Child ; Hospitalization
Chemical Substances	COVID-19 Vaccines ; mRNA Vaccines
Language	English
Publishing date	2023-03-27
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2553671-0
ISSN	2041-1723 ; 2041-1723
ISSN (online)	2041-1723
ISSN	2041-1723
DOI	10.1038/s41467-023-36494-0
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Risk of New-Onset Long COVID Following Reinfection With Severe Acute Respiratory Syndrome Coronavirus 2: A Community-Based Cohort Study.

Bosworth, Matthew L / Shenhuy, Boran / Walker, A Sarah / Nafilyan, Vahé / Alwan, Nisreen A / O'Hara, Margaret E / Ayoubkhani, Daniel

Open forum infectious diseases

2023 Volume 10, Issue 11, Page(s) ofad493

Abstract: Background: Little is known about the risk of long COVID following reinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We estimated the likelihood of new-onset, self-reported long COVID after a second SARS-CoV-2 infection, ... ...

Abstract	Background: Little is known about the risk of long COVID following reinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We estimated the likelihood of new-onset, self-reported long COVID after a second SARS-CoV-2 infection, compared to a first infection. Methods: We included UK COVID-19 Infection Survey participants who tested positive for SARS-CoV-2 between 1 November 2021 and 8 October 2022. The primary outcome was self-reported long COVID 12-20 weeks after each infection. Separate analyses were performed for those <16 years and ≥16 years. We estimated adjusted odds ratios (aORs) for new-onset long COVID using logistic regression, comparing second to first infections, controlling for sociodemographic characteristics and calendar date of infection, plus vaccination status in participants ≥16 years of age. Results: Overall, long COVID was reported by those ≥16 years after 4.0% and 2.4% of first and second infections, respectively; the corresponding estimates among those aged <16 years were 1.0% and 0.6%. The aOR for long COVID after second compared to first infections was 0.72 (95% confidence interval [CI], .63-.81) for those ≥16 years and 0.93 (95% CI, .57-1.53) for those <16 years. Conclusions: The risk of new-onset long COVID after a second SARS-CoV-2 infection is lower than that after a first infection for persons aged ≥16 years, though there is no evidence of a difference in risk for those <16 years. However, there remains some risk of new-onset long COVID after a second infection, with around 1 in 40 of those aged ≥16 years and 1 in 165 of those <16 years reporting long COVID after a second infection.
Language	English
Publishing date	2023-10-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	2757767-3
ISSN	2328-8957
ISSN	2328-8957
DOI	10.1093/ofid/ofad493
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