I’m a Senior Research Associate working in the Norwich Medical School at the University of East Anglia in Norwich, England. I'm a geographer, specialising in the field of population health, and my research considers the health implications of human interactions with natural and built environments. I evaluate projects and interventions which are designed to inrease physical activity and active travel, and I use geographic data, geographic information systems (GIS) and global satellite navigation systems (eg GPS) to understand and visualise behaviour. I have worked in collaboration with researchers at the Centre for Diet and Activity Research (CEDAR) based in Cambridge, England. Currently, I am working with Norfolk County Council (Public Health, Communities and Environment, and Highways teams), Active Norfolk and Sustrans. I'm passionate about the use of GIS and GPS to understand human behaviour and inform strategies to improve health and activity, make us happier, and reduce obesity. I also share my enthusiasm for research through teaching, by leading the Research Methods module for the year three medical students here at UEA.

I originally developed my curiosity for understanding the complex interactions between society and the environment during my undergraduate geography (human and physical) degree at the University of Reading. After graduating, I worked as a consultant for Halcrow Group Ltd for five years, where I led mapping projects for the Environment Agency. During this time, I studied for an MSc in Geographical Information Science at Birkbeck College, University of London. My love of research took me to a PhD with the University of the West of England (UWE), Bristol, England, in the field of sustainable urban form and development. I was enticed to East Anglia with the opportunity to push forward my knowledge and skills for examining human behaviour into the realm of population level public health.

Current Projects

Health Data Interpretation Group. This collaborative project between the Health Data Interpretation Group (HDIG) at the UEA and the Public Health team at Norfolk County Council, will analyse and interpret information on people’s health and healthcare in Norfolk. This will be used to aid recovery from the Covid pandemic, inform how to improve the quality of healthcare and reduce harms from larger risks to health, including: smoking, unhealthy diets and obesity, physical inactivity, alcohol and drug use. We are looking at the impact of Covid on emergency health sevices activity and health outcomes, and the increase in referrals to children's mental health services; life expectancy and prevention of poor health. I have spatially mapped calculated life expectancy and healthy life expectancy for MSOAs across Norfolk, as well as associated risk factors.

Active Travel Programme evaluation. Norfolk County Council (NCC) is leading six programmes to encourage walking and cycling for travel within the county, and these lead on from the Pushing Ahead programme. There are around twenty activities and behaviour change interventions, including School Streets (road closures outside schools at drop-off and pick-up times), the development of a county-wide Local Cycling and Walking Infrastructure Plan, an ebike loan scheme, adapted ebike sessions, travel hubs, and Beryl Bikeshare.

Recent Projects

'Pushing Ahead AtoBetter' walking and cycling health evaluation. The 'Pushing Ahead' programme, led by Norfolk County Council (NCC), aims to increase the prevalence of walking and cycling within Norfolk, and is funded by the Department of Transport (DfT). I carried out an evaluation of the activities and interventions that were delivered as part of this programme, including personal travel plans, bicycle provision schemes; bicycle maintenance and training; walking and cycling festivals; cycling events in Norwich and Great Yarmouth; bicycle and walking route mapping; workplace engagement; and casualty reduction schemes. I designed the evaluation framework to ensure that key performance indicators were obtained for reporting by NCC, and that the efficacy of each of the programme components, in terms of both outcomes and process, were captured. Evaluation results suggested that some of the initiatives had good potential to lead to positive outcomes for participants. The evaluation showed that cycle provision schemes have potential to encourage cycling and reduce inequalities (ee forthcoming paper). We found that interventions in workplaces need a combination of bottom-up and top-down approaches, both to enable well-informed design of initiatives, and to get buy-in from those who make decisions. Large-scale cycling events can help raise awareness and publicity of cycling, but are not likely to directly result in behaviour change. Same for walking festivals, which need to be specifically designed and targeted for people who would not usually walk for fun. We developed a good understanding of barriers to cycling, and how these differ according to cycling ability and behaviour. The evaluation showed the importance of context, and how different approaches are necessary according to who the intervention is aimed at, and what the desired outcomes are.

Promoting Physical Activity in Older Age. The Lifelong Health and Wellbeing (LLHW) grant uses data from the Norfolk EPIC (European Prospective Investigation of Cancer) cohort to characterise patterns and changes in physical activity in older people and their determinants and consequences. EPIC-Norfolk has been running since 1993, successfully recruiting over 20,000 people for the first ‘Health Check’; we are currently carrying out Health Check four. My role as health geographer on this project is to analyse activity data and GPS-derived data in GIS software to understand patterns of activity in time and space. I am assessing the role of the environment on health and well-being, recorded objectively and through self-report. I have found that physical activity is not the reason that people living in greener areas are less likely to develop incident diabetes (see paper here), and that greenspace has a protective role over decline in physical activity over time (paper). I am currently looking at the environmental determinants of cardiovascular disease and risk. The project was led by Professor Simon Griffin at the MRC Epidemiology Unit, with the University of Cambridge.

Walking for Health evaluation. Using eight case studies, this research evaluated a nationwide walking scheme, to provide evidence of the programme’s impact and draw out key lessons learned to support on-going development and improvement. I focused on the case studies of Brighton & Hove and Milton Keynes, and spoke to walk leaders/volunteers, walkers, referral agencies and coordinators at the councils. Walking was found to be an accessible (and fun) way for people, from different backgrounds and with different interests, to be physically active. Walkers and volunteers reported a wide variety of health and social benefits of the walking schemes, including confidence, empowerment, social interaction, reduced depression and improved fitness. Early evidence suggested that patients recovering from breast cancer and cardiac arrest could benefit from quicker recovery times. Best practice examples were found of integration between walking schemes and GP surgeries. Walking for Health could be a suitable alternative to the (potentially more onerous and less successful) method of referral of patients to more traditional exercise programmes and facilities, such as the gym. UEA have also been involved with a pedomter research and survey as part of the nationwide evaluation. The Walking for Health evaluation ran between August 2013 and January 2015 with research consultants Ecorys, and was funded by Macmillan and the Ramblers.

The environment and risk factors for type 2 diabetes. Working with the Leicester Diabetes Centre, we investigated the relationship between the environment and diabetes. We had a wide range of objectively measured health variables from up to 16,000 people recruited for six studies into diabetes in Leicestershire. Using GIS software, we found that access to green space was inversely associated with type 2 diabetes.

iConnect: An Evaluation of Sustrans ‘Connect2′ Progamme. TheiConnect study is an evaluation of the Sustrans Connect2 programme which has aimed to improve the network of walking and cycle routes across the UK. As part of this study, I used participant GPS-derived data and activity data from accelerometers to predict mode of travel and to validate self-reported physical activity. Existing techniques, such as the Personal Activity and Location Measurement System (PALMS) program, are not yet fully able to match activity and location data to derive route and mode information without some manual analysis. We found that using data on both speed of travel from GPS and level of activity from accelerometers allowed us to accurately predict mode of travel. Automating the process of extracting individual trips was not possible – we found that manual extraction was the only way to guarantee that these trips were accurately identified. We are currently investigating methods of automation using computer algorithms.

Analysis of Commuting and Health in Cambridge. This project involves the study of a ‘natural experiment’ in the provision of new transport infrastructure: a new guided bus route into Cambridge, UK. The aim of the research is to address the following research question: is investment in new high-quality transport infrastructure associated with an increase in the use of active modes of travel (walking and cycling)? A quasi-experimental cohort study of adults who travel to work in Cambridge is being conducted, combined with nested in-depth quantitative and qualitative studies. The project is led by Dr David Ogilvie at the MRC Epidemiology Unit in Cambridge and I am working with Professor Andy Jones of the Norwich Medical School at the University of East Anglia.

I carried out spatial analyses in geographic information systems (GIS) software using data collected from participants of the study, including questionnaires and household travel diaries, as well as objective measures of activity collected using GPS receivers and accelerometer devices. The first piece of research looked into the influence of accessibility and location on modal choice and active travel. This found that limiting workplace car parking as well as improving street connectivity and access to public transport could help to encourage active commuting (published in PLOS ONE June 2013). The second area of research compared modelled (using GIS) versus actual (using GPS) commuting routes to and from work, concluding that although both methods have advantages, the use of GPS over modelled data is recommended. The mode of travel used may influence how predictable their commuting behaviour may be and therefore the type of research necessary to draw accurate conclusions. Findings from this study were presented at the GIS Research UK (GISRUK) conference in Liverpool on 4th April 2013.

The study is a collaboration between the Medical Research Council (MRC) Epidemiology Unit, Cambridge, the University of East Anglia and University College London under the auspices of the Centre for Diet and Activity Research (CEDAR), one of five new centres of excellence in public health research funded by the UK Clinical Research Collaboration (UKCRC). Phase I of the study (2009) was funded by the MRC, the Phase II and beyond (2010-2014) will be funded by the National Institute for Health Research Public Health Research programme.

Evaluation of the Healthy Towns Programme. Nine local areas (‘Healthy Towns’) in England received funding from 2009-11 to provide innovative, community-driven interventions to encourage physical activity, active travel and healthy living (eating and lifestyle). The areas responded by planning and implementing (building, improving or mapping) various pieces of physical infrastructure to modify the built environment and provide facilities to encourage behaviour change. We assessed whether this infrastructure was best located in relation to areas of need, according to the socio-demographic characteristics of neighbourhoods, using GIS techniques. Our findings suggest that the infrastructure was generally well-delivered in terms of spatial equity (published in the International Journal of Equity in Health June 2013). I also wrote a blog about the article, following an invitation by the U.S. Department for Health and Human Services. This research formed part of a national evaluation commissioned by the Department for Health, led by Professor Steven Cummins at the London School of Hygiene and Tropical Medicine. Research conducted with stakeholders has, however, revealed that although the programme aimed to offer opportunities for innovative thinking, the emphasis on following evidence-base policy may have restricted its success.

Valuing Nature Network (VNN). Valuing nature is about putting a value – monetary or not – on nature and the benefits we get from it, making sure that the value of nature is included in decision-making even when there is no obvious ‘price’ for that service. The mission of the network was to support interdisciplinary partnerships to scope, develop and promote research capacity in the valuation of biodiversity, ecosystem services and natural resources and facilitate the integration of such approaches in policy and practice in the public and private sectors. I worked as a coordinator on the development of this network, led by Professor Ian Bateman at The Centre for Social and Economic Research on the Global Environment (CSERGE) at UEA. We collating the reports from ten different projects which set out to assess 1, how to incorporating the complexity of socio-ecological systems within ecosystem service valuation; 2, how to incorporate stocks, flows and sustainability into this and 3, how to value nature for better decision-making. The findings of this were presented at a conference in March 2013.