Centre for Public Health and Wellbeing

What people missed most during the UK Covid pandemic: A survey in the West of England

Centre for Public Health and Wellbeing | 22 May 202622 May 2026

By Dr Kate Brennan (GP specialist trainee), Dr Isabelle Bray, Prof. Danielle Sinnett, and Dr Yarden Woolf

Background

The Covid‑19 outbreak disrupted daily life across the world. In the UK, lockdowns in 2020 and 2021 led to the closure of shops, venues and workplaces, cancellation of cultural and sporting events, and sharp changes to how people worked, travelled and socialised. These restrictions had a substantial impact on mental health.

Beyond the immediate effects of the virus, physical health was also affected through reduced physical activity, delays in diagnosis and treatment of other conditions, and long Covid. Inequalities widened, and loneliness became a major concern. In March 2022, a third of UK adults reported that their mental health had deteriorated because of the pandemic, particularly young people, disabled people and those living in deprived areas. As the Covid inquiry continues, many of these longer‑term social and mental health effects remain.

The UK Covid‑19 Inquiry recently released a report looking at the impact of the pandemic on healthcare systems. Later modules will report on the impact on the care sector and society more broadly, including population mental health. Using data from adults living in the West of England, we take a closer look at one simple but revealing question: what did people miss most during lockdown?

A quiet urban street, reflecting disruption to everyday routines

What we did

We carried out a cross‑sectional survey between May and July 2020. Alongside questions on green space use, physical activity, mental health and wellbeing, participants were asked: “Please tell us the ONE thing you most miss under lockdown.” A total of 607 people responded.

What we found

The sample was largely white (92%), well‑educated (73% had a degree or higher), and older (68% were aged over 45). Around 30% were retired and 85% owned their home, which should be kept in mind when interpreting the findings.

What respondents reported missing most during the UK Covid‑19 lockdowns (n = 607)

The graph above shows what respondents reported missing most. Over half (53%) said they missed socialising above all else. Mentions of family (28%) and friends (24%) were similar overall, although patterns differed by age. The second most commonly missed thing was holidays or travel (13%), followed by pubs, restaurants and cafés (11%). Thirty‑six respondents (6%) specifically mentioned missing the pub, which was more common among men than women (10% compared with 4%). Those aged 45–54 and non‑retired couples were particularly likely to report missing the pub.

Clear age differences emerged. Young adults aged 18–24 were the most likely to miss socialising (63%), especially with friends. In contrast, those aged 65–74 mentioned family more than friends (37% versus 19%), often referring to grandchildren. People aged 75–84 were the least likely to mention socialising.

Exercise was most commonly reported as the single most‑missed activity among those aged 65–74 (9%). No respondents aged 18–24 or 75–84 identified exercise as the one thing they missed most. Freedom, described as the ability to do things spontaneously, was reported by 14% of those aged 75–84, compared with none of those aged 18–24 or 55–64. Older respondents were also more likely to report missing holidays and travel (20% among those aged 75–84, compared with 6% of 18–24‑year‑olds).

Among those employed before lockdown, 10% said they missed work most. Excluding those of retirement age, young adults aged 18–24 were more likely to miss work or study, while those aged 25–34 were less likely to do so, possibly reflecting competing demands such as childcare or increased work pressures.

Implications

These findings highlight the importance of social contact, shared spaces outside the home, and having things to look forward to. While some people enjoyed aspects of lockdown, young adults (18-24) particularly missed socialising and seeing friends and family. Older adults, especially those aged 75–84, placed greater importance on freedom and the ability to travel.

These insights can help guide responses to any future lockdown. Where older adults missed cafés, adapted or outdoor alternatives could be considered when safe to do so. Among young adults, missing study may reflect the loss of structure, purpose or social interaction, underlining the need to consider how education and training can support wellbeing as well as learning during periods of restriction.

Finally, the lockdown experience highlighted that many homes are not well suited to long‑term working from home, which also has implications for physical activity, social connection and mental health. At the same time, the pandemic showed how technology can support not only work and study, but also social connection within neighbourhoods. These factors should form part of future pandemic preparedness.

Health effects of low‑level air pollution: implications for public health

Centre for Public Health and Wellbeing | 22 April 2026

Image credit: Photo “Friends of the Earth 24” by Friends of the Earth Scotland, Flickr, is licensed under CC by 2.0.

By Brodie Walker

Introduction

In 2022, the Scottish Government commissioned a review to examine whether current levels of ambient air pollution, relatively low by international standards, continue to pose measurable risks to population health. The work was undertaken to inform the Cleaner Air for Scotland 2 (CAFS2) Strategy and support alignment with the World Health Organization’s 2021 Air Quality Guidelines. The review was conducted by an interdisciplinary team from UWE Bristol affiliated with the Air Quality Management Resource Centre and the Centre for Public Health and Wellbeing, and the final report was published in October 2023.

An aim of the review was to assess health impacts in countries with ambient air pollution levels comparable to Scotland. This focus arose from earlier CAFS2 work, which identified an apparent absence of association between air pollution exposure and cardiovascular disease in Scottish studies compared with the wider international evidence. To explore this, we undertook a robust, rapid review examining health effects at low concentrations and potential methodological and contextual explanations for these differences.

Health impacts observed at low levels

The review identified strong and consistent associations between low‑level exposures and a wide range of health outcomes:

Cardiovascular disease: Evidence from countries with ambient pollution levels comparable to Scotland indicates increased risks of cardiovascular outcomes, including stroke and ischaemic heart disease, at PM₂.₅ concentrations well below current guideline values. The absence of these findings in the Scottish studies is likely an artefact of study design and data.
Respiratory outcomes: Low‑level exposures are associated with worsening asthma, impaired lung development in children, and increased exacerbations of chronic respiratory conditions, even where average concentrations are relatively low.
All‑cause mortality: Multiple cohort studies report elevated all‑cause mortality risks across the exposure range, including at the lowest observed concentrations of PM₂.₅.
Birth outcomes: Associations with adverse birth outcomes, including preterm birth and low birth weight, have been detected at low NO₂ and PM₂.₅ concentrations, suggesting sensitivity during early life.
Neurological and mental health outcomes: Emerging evidence points to associations between long‑term exposure to low‑level air pollution and outcomes such as cognitive decline, dementia, and poorer mental health and well‑being, although causal mechanisms remain an active area of research.
Other outcomes: Evidence for outcomes such as diabetes and cancer at low pollution levels is more limited and variable, though observed associations may still be important at a population level.

No evidence of a “safe” threshold

A central finding is the lack of any reliably identifiable threshold at which the harmful effects of air pollution cease. For PM₂.₅, large cohort studies demonstrate linear or near‑linear concentration‑response relationships extending to very low exposure levels. The slope of these associations often remains steep at the lower end of the distribution, indicating that marginal reductions in exposure can still produce public health benefits.

Bus in Edinburgh city centre
“Activists gather to demand clean air as Edinburgh Air Pollution Zone to be expanded.” by Friends of the Earth Scotland is licensed under CC BY 2.0

Low levels of pollution does not mean low inequality

Although national average levels of air pollution in Scotland are relatively low, the review highlights the importance of spatial variability in exposure and the methodological challenges this presents in low‑pollution settings. Limited exposure contrasts and greater potential for exposure misclassification, particularly for traffic‑related pollutants such as PM₂.₅ and NO₂, may reduce the ability of studies to detect associations when analysing population‑level averages. While the review does not explicitly focus on social inequalities, these considerations are consistent with a wider evidence base suggesting that uneven exposure patterns and population vulnerability may contribute to under‑estimation of health effects.

Implications for public health policy

One of the review’s most important implications is that air quality policy remains highly relevant in low‑pollution contexts. Achieving compliance with existing standards should be viewed as a baseline rather than an endpoint.

In Scotland, annual CAFS2 progress reports published in June 2024 and June 2025 confirm continued nationwide compliance with statutory air quality objectives, while recognising that meeting these limits does not imply the absence of health risk (Scottish Government, 2024; Scottish Government, 2025a). Full enforcement of Low Emission Zones (LEZs) has now been extended across all four major Scottish cities, with early evaluations demonstrating substantial improvements in air quality. Monitoring data indicate a 34% reduction in nitrogen dioxide concentrations within Glasgow city centre following full LEZ enforcement between 2023 and 2024 (Glasgow City Council, 2025).

At a strategic level, the Scottish Government has initiated preparatory work towards a new Air Quality Delivery Framework for Scotland, planned to replace CAFS2 after 2026. In the UK, the Environment Act (2021) continues to drive legally binding commitments, including new, more ambitious PM₂.₅ targets for England.

Conclusion

The review, together with the wider international evidence base, demonstrates that low‑level air pollution continues to produce detectable adverse health effects and that further reductions in concentrations are likely to deliver measurable population health benefits. For policymakers and stakeholders, this reinforces the need to view air quality not simply as a matter of regulatory compliance, but as a continuing public health challenge, even in low‑pollution contexts.

References

Scottish Government (2023a) Health impacts of low‑level air pollution: review and assessment of the evidence. Edinburgh: Scottish Government. Available from:
https://www.gov.scot/publications/review-assessment-evidence-health-impacts-low-level-pollution-countries-levels-ambient-air-pollution-comparable-scotland/
[Last accessed 9 April 2026].

Scottish Government (2023b) Summary report: review and assessment of the evidence on health impacts of low‑level air pollution in countries with ambient concentrations comparable to Scotland. Edinburgh: Scottish Government. Available from: https://www.gov.scot/publications/summary-report-review-assessment-evidence-health-impacts-lowlevel-pollution-countries-levels-ambient-air-pollution-comparable-scotland/documents/
[Last accessed 9 April 2026].

Scottish Government (2024) Cleaner Air for Scotland 2 strategy: progress report. Edinburgh: Scottish Government. Available from:
https://www.gov.scot/publications/cleaner-air-scotland-2-strategy-progress-report/
[Last accessed 9 April 2026].

Scottish Government (2025a) Cleaner Air for Scotland 2 strategy: progress report. Edinburgh: Scottish Government. Available from:
https://www.gov.scot/publications/cleaner-air-scotland-2-strategy-progress-report-2/
[Last accessed 9 April 2026].

Scottish Government (2025b) Air quality policy update: Scottish Air Quality Annual Seminar 2025. Edinburgh: Scottish Government. Available from:
https://www.scottishairquality.scot/sites/default/files/publications/2025-04/Air_Quality_Policy_Update_Andrew_Taylor.pdf
[Last accessed 9 April 2026].

Glasgow City Council (2025) City centre air pollution drops by a third following LEZ enforcement. Available from:
https://www.glasgow.gov.uk/13535
[Last accessed 9 April 2026].

HM Government (2021) Environment Act 2021. London: The Stationery Office. Available from:
https://www.legislation.gov.uk/ukpga/2021/30/contents/enacted
[Last accessed 9 April 2026].

Department for Environment, Food & Rural Affairs (Defra) (2025a) Air pollution in the UK 2024: compliance assessment summary. London: Defra. Available from:
https://www.gov.uk/government/publications/air-pollution-in-the-uk-2024/air-pollution-in-the-uk-2024-compliance-assessment-summary
[Last accessed 9 April 2026].

Department for Environment, Food & Rural Affairs (Defra) (2025b) Air pollution in the UK 2024. London: Defra. Available from:
https://assets.publishing.service.gov.uk/media/68da4202c487360cc70c9e4f/air_pollution_uk_2024_issue_1.pdf
[Last accessed 9 April 2026].

World Health Organization (2021) WHO global air quality guidelines: particulate matter (PM₂.₅ and PM₁₀), ozone, nitrogen dioxide, sulphur dioxide and carbon monoxide. Geneva: World Health Organization. Available from:
https://www.who.int/publications/i/item/9789240034228
[Last accessed 9 April 2026].

Recovery through community: overcoming barriers to engagement in addiction services

Centre for Public Health and Wellbeing | 31 March 202621 April 2026

By Dr Amy Beardmore and Leila Powell

Introduction

Over the past 3 months, Dr Amy Beardmore, a Senior Lecturer in Public Health, and Leila Powell, a Research Associate, have had the opportunity to work on an Accelerated Knowledge Transfer project. This is a rapid, 3-way collaboration between a university, a business partner, and a research associate, to bridge research and current practice. This was made possible through a partnership between the Centre for Public Health and Wellbeing at UWE Bristol and Via, a national drug and alcohol support charity, supported by Innovate UK and NIHR.

We found this project to be an exciting opportunity to combine academic and business perspectives, learn from each other, and co-create a meaningful toolkit with the people who use and deliver services at Via. This blog will outline the project, its objectives, outcomes and next steps.

Project objectives

We set out to explore what helps and hinders Via’s service users from accessing community assets that can support their recovery and wellbeing. The core goal was to apply asset-based community engagement (ABCE) theory into a practical, easy-to-use tool that Community Connectors, Via Staff and service users themselves can use to understand what assets would better support their recovery process. Through co-design, we wanted this tool to feel grounded in current needs and be genuinely helpful for building connection to the community. Alongside this, we worked to develop a set of outputs that would influence future design of Via’s Digital Community Asset Platform, and to support asset access.

Project phases

The project unfolded in three key phases. We began with a rapid evidence review, which helped to anchor the project in current evidence and literature. The second phase, and arguably the core of the project, involved two planning meetings and two participatory workshops at Via’s services in Redbridge. This involved service users, peer workers and Via staff. These sessions were full of rich conversations, co-designed workshop activities, and insights drawn directly from the lived experiences of people accessing Via’s services. In the final phase, we moved on to refining the toolkit and report, bringing together everything we’d learned. Each phase naturally built on the last, and the structure of the project was truly shaped by the experiences of the participants.

Key actions

While the rapid review provided a strong starting point and anchored the research, the workshops really grounded the project in the realities of those recovering from dependency. In the first workshop, participants mapped the assets they currently access as well as the ones they aspire to use, while discussing real-world challenges that inhibit participation. This laid the groundwork for the conceptual supportive tool. Working together in the second workshop, we began to scope what elements would work in an ABCE toolkit to support access. Towards the end, we began thinking through the practicalities and what future recommendations may facilitate the use of the digital platform. One of the biggest takeaways for us was the value of co-production, and how bringing together academic knowledge, professional expertise and lived experience leads to richer, more grounded solutions.

Deliverables

Together, we produced an adaptation of the Stages of Change to form the Stages of Access; this helps to map the process from not being interested in accessing local assets in the community to maintaining regular access, through building confidence, regular support, and assertive linkage processes with a Community Connector.

Additionally, we adapted Stage 3 of the ABCE theory and Maslow’s Hierarchy of Needs into a provisional questionnaire for Via, whereby anyone may use this to better understand what skills and passions a person possesses, what matters to them most, and what their urgent needs are. By combining these tools together, Via can develop a rooted understanding of an individual’s priorities and needs concurrently with their current stance on accessing assets, leading to tailored advice and the introduction of the digital platform at the correct time for the service user.

Reflections & insights

Across the workshops, several themes stood out strongly. Participants spoke about the importance of confidence and connection when engaging with community resources. They also highlighted how seemingly small barriers, like transport challenges, can have major impacts on people’s willingness to take part. Hearing these insights first-hand reinforced a shared belief that lived experience must sit at the centre of the tool development. We also found that grounding the project in evidence-based practise helped keep the work focused and aligned with public health values. Working together across various backgrounds has been deeply enriching. It strengthened our partnership, helped us see issues from different angles, and reminded us of the power of collaborative design.

What’s next?

We’re both excited to see how the ABCE toolkit performs during piloting, and how it evolves with real-world use. From our perspectives, this project has shaped the way we think about collaboration, co-production and the integration of research into practise. We hope to continue building on this momentum, securing further funding and exploring how the tool can support recovery across different services and contexts. Most importantly, we are optimistic to continue a partnership with Via and UWE, while keeping lived experience at the centre of everything that comes next.

Using faith to generate theory, population data to test it, and both to design inclusive dementia prevention

Centre for Public Health and Wellbeing | 27 February 2026

By Dr Sanda Ismail

Dementia is often framed as a biomedical problem, but my research starts from a different place. It begins with a simple observation: people do not live, age, or make sense of health in isolation. They do so within communities, cultures, belief systems, and social structures that shape behaviour, meaning, and wellbeing across the life course.

Over the past few years, my work has focused on faith and community environments, not simply as settings for intervention, but as sources of insight. These contexts help generate theory about how social participation, meaning, and identity shape brain health. I then use large population datasets to test these mechanisms at scale. Finally, I bring both strands together to design more inclusive approaches to dementia prevention and support.

Brain health is shaped not only by biology, but by the social and psychological environments in which people live

Faith communities as engines of theory, not just delivery sites

Faith communities are often treated instrumentally in public health: useful channels for disseminating messages or recruiting participants. My research takes a different view. Faith settings are rich social systems where people gather regularly, form identities, share values, build trust, and engage in meaningful routines. These features offer clues about how social environments might protect brain health.

In many faith contexts, including mosques and Muslim community organisations, older adults are embedded in dense social networks. They take on roles, maintain routines, and participate in practices that provide structure, purpose, and belonging. These are not just spiritual activities; they are social and psychological exposures with potential implications for dementia risk.

Rather than asking whether religion itself is “protective”, my work asks a more precise question: what features of faith-based participation might shape exposure to modifiable dementia risk factors and could those features be relevant beyond faith settings?

Community participation, shared identity, and belonging are powerful social exposures that may influence dementia risk

Testing mechanisms using population data

To move beyond description, I turn to large-scale epidemiological data. Using the English Longitudinal Study of Ageing (ELSA), my analyses examine how modifiable dementia risk factors, such as depression, loneliness, physical inactivity, and cardiovascular conditions, are distributed across faith and non-faith groups.

What emerges is not a simple story of advantage or disadvantage, but a patterned one. Faith communities are heterogeneous, yet many exhibit social cohesion, routine participation, and collective identity that are associated with lower exposure to certain psychosocial risks. These patterns suggest that dementia prevention is shaped not only by individual choices but by the social environments in which those choices are made.

This is where large cohorts matter. They allow us to test whether ideas generated in community contexts about belonging, meaning, and participation hold when examined longitudinally, across populations, and over time.

Meaning in life as a pathway to cognitive health

A closely related strand of my work focuses on meaning in life as a psychosocial pathway to healthy cognitive ageing. Using longitudinal ELSA data, I found that higher meaning in life is associated with a lower risk of developing cognitive frailty, an early and potentially reversible state combining physical frailty and mild cognitive impairment.

Importantly, this relationship appears to operate through mechanisms such as reduced depression and loneliness, and possibly through enhanced cognitive reserve. While meaning in life is deeply personal, it is often cultivated through social roles, moral frameworks, spirituality, and contribution to others, elements that are especially salient in faith and community settings.

These findings reinforce a central insight: dementia prevention may depend as much on purpose and belonging as on physical health behaviours.

Understanding “what works, for whom, and why”

To integrate these strands, I am undertaking a realist synthesis examining how faith-based settings influence dementia risk awareness and management. Rather than asking simply “what works”, realist methods ask: what works, for whom, in what contexts, and through which mechanisms? This evidence base will help explain why faith contexts can be powerful and where their limits lie.

Designing inclusive prevention: the Muslim Dementia Recovery College

The most applied expression of my work is the Muslim Dementia Recovery College (M-DROC). Co-designed with people living with dementia, carers, imams, clinicians, and community organisations, the project translates theory and evidence into practice.

The aim is not to “add culture” to existing models, but to build learning and support grounded in Islamic values such as compassion, dignity, family responsibility, and collective care. By doing so, the project seeks to reduce stigma, improve dementia literacy, and create culturally safe spaces for support and prevention.

A broader lesson for dementia prevention

Faith communities have helped generate theory, population data have tested mechanisms, and co-design has translated evidence into inclusive prevention. As societies become more diverse, dementia research and public health must move beyond one-size-fits-all models and recognise cultural identity as a resource rather than a barrier. Dementia prevention begins long before old age, and it starts where people already live: in communities that provide meaning, structure, and connection.

Meet the CPWHB leadership team – introducing the Centre Director and Theme Leads

Centre for Public Health and Wellbeing | 6 January 20266 January 2026

By Dr. Issy Bray and Yarden Woolf

The Centre for Public Health and Wellbeing aims to impact directly on population health and wellbeing, to reduce health inequalities and enable ethical and reflexive contributions to public health policy and practice. Our approach is multidisciplinary and spans physical, health and social sciences.

Dr. Issy Bray is the Director of the Centre for Public Health and Wellbeing and Associate Professor in Public Health (Epidemiology). She has been with UWE Bristol for over 12 years and currently teaches on the Quantitative Health Research module and the Epidemiology of Non-Communicable Disease modules (MSc Public Health) as well as supervising PhD and MSc students.

The Global Public Health theme brings together innovative social science, health, and implementation research to address pressing population health challenges around the world. Current work includes research funded through the NIHR Global Health Research Programme in collaboration with the Nepal Injury Research Centre at Kathmandu Medical College, with projects exploring interdisciplinary approaches to road danger reduction and the cultural and sociological factors that influence injury risk and prevention in Nepal. The theme also includes research on migration and migrant integration, generating evidence that informs policy and supports progress toward global health equity.

Ageing Well is a brand-new theme for the Centre for Public Health and Wellbeing at UWE Bristol. The vision for this theme is to carry out and support inclusive, interdisciplinary and world-leading public health research that promotes healthy ageing including dementia across the life course underpinned by a socioecological approach to health and wellbeing. Emily has recently completed a qualitative study working closely with voluntary agencies in West Somerset and Cornwall to better understand the particular experiences and challenges of people living with dementia and their families living in rural and coastal communities.

Our research explores how the design of places can shape everyday behaviours, reduce risks, and improve health and wellbeing for communities. This includes looking at strategies for safer streets, stronger community safety, and better integration of health into planning decisions, while also seeking to reduce environmental impacts and improve population health and wellbeing. Emma is currently leading on a project tasked with creating guidance to help local planning authorities in England create healthier places for everyone through better integration of health into local planning policies.

This theme is essentially about creating communities where people can thrive. It brings together community groups, organisations, and networks with public, private, and non-governmental partners to drive social action and meaningful change. Building healthy communities demands a multidisciplinary lens spanning diverse topics such as urban planning, healthy ageing, and digital inclusion, while applying robust methodologies and evaluation design to generate high-quality evidence. Amy is currently working on a project which tackles the complex challenge of drug and alcohol dependency by exploring how individuals engage with community-based resources and what supports or hinders that connection.

Our work within this theme explores different approaches to and methodologies for public involvement and co-production, and what impact these can have. We have a particular focus on how the voice of those experiencing health inequalities can be meaningfully included in research prioritization, design and implementation, and what power-sharing can mean in practice. Jo recently led a project which co-produced resources for Black people living with stroke, following the ‘Experience-Based Co-design’ (EBCD) methodology. The project included the public as co-applicants and core team members, community researchers and co-design facilitators

The Public Health Economics and Evaluation theme focuses on generating robust, policy-relevant economic evidence to inform decision-making across public health, prevention, and integrated care. The theme leads the centre’s work on economic evaluation, return-on-investment modelling, realist economic evaluation, and capacity-building with local authorities and ICS partners, ensuring that our research translates into practical, scalable improvements in population health. A key project Hamad is involved in is the NIHR-funded realist evaluation and economic appraisal of how mosque-based health screening, education and prevention activities influence health and wellbeing in Muslim communities.