Academic Spotlight: Dr Issy Bray

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In this Academic Spotlight we asked Dr Issy Bray, Associate Professor in Public Health (Epidemiology) at UWE Bristol.

Tell us about your background and how you became interested in your research area?

My background is originally in statistics. A final year module in medical statistics was a light-bulb experience for me – I’d found what I wanted to do – so I went on to do a masters in medical statistics. That was nearly 30 years ago, and since then my work has become gradually more applied and I have moved into Public Health. One of the things that motivated me to do this was the first time I heard Sir Michael Marmot speak about social capital and inequalities. Although my early research was in cancer epidemiology, much of my work since then has focused on mental health and wellbeing. My interest in studying both cancer and mental health problems stems from the fact that they are common, they can affect anyone, and the risk factors are complex and difficult to untangle – in that sense they both represent a huge challenge to the science of epidemiology. Research into mental health is fascinating on so many levels, and I have had the opportunity to be involved in studies analysing risk factors for suicide and self-harm through to general wellbeing at the population level. One of the other things I find really interesting about mental health is the bi-directional relationship with physical health. Most recently my work has centred around the benefits of exposure to green and natural environments in terms of our mental health, particularly for young people and those living in urban environments. These issues were brought to the fore by the Covid pandemic and are not going away.

Tell us more about your research and research projects, are there any particular projects you want to highlight?

My research sits within the Centre for Public Health and Wellbeing, an inter-disciplinary research centre, but I also collaborate with other research centres at UWE. I have worked closely with psychology colleagues in the Centre for Appearance Research to study the relationships between body dissatisfaction, disordered eating, mental health outcomes (depression and anxiety) and other health-related behaviours (e.g. drinking and smoking) amongst adolescents. For me, the most important outcome of this collaboration was the realisation that health psychology and public health send out very different messages to the public about body size, which is counter-productive, and we worked together to call for a more unified approach to the dual problems of overweight/obesity and body dissatisfaction.

In 2020 I led a multi-disciplinary team to review the evidence on the potential benefits of exposure to green and natural environments in reducing anxiety and depression amongst young people living in urban areas. This was both challenging and exciting. Challenging because the topic is vast, time was limited, and as a multi-disciplinary team we all had different viewpoints. Exciting because the funder (The Wellcome Trust) clearly wanted something other than a standard systematic review of the literature, so we had free rein to take an unconventional approach. We combined evidence from many different disciplines and study designs but focused specifically on young people (as opposed to children or adults) to generate a conceptual model explaining the pathways linking exposure to green and natural environments with mental health outcomes for this age group.

Early analyses of Covid data highlighted important risk factors (e.g. age, ethnicity, co-morbidities, occupation) but considered each factor in isolation. So it was not possible to separate out the effects of deprivation and ethnicity, for example. This was a big problem, but it took some time for the data to become available for this level of analysis. In the mean time, Public Health England (as was) published rates of Covid mortality by Local Authority. This would allow a multivariate analysis of risk factors at a Local Authority level, so I set to work gathering data on age, ethnicity, pollution levels, over-crowding, obesity and deprivation for each Local Authority. This analysis, published in 2021 with Public Health colleagues, was the first evidence that was able to take deprivation and age into account when estimating the effects of pollution, or ethnicity, on Covid mortality rates.

Finally I am working closely with a PhD student and other colleagues using experiments to determine whether viewing green, blue and historic environments (on a flat screen television monitor or using virtual reality) can benefit mental health, which we are assessing through self-reported questionnaires and physiological measures in the psychology lab. A similar experiment with colleagues in ecology has examined different soundscapes (traffic versus birdsong) to estimate the effects of different levels of biodiversity on our mental wellbeing. The aim is not to replace real-life exposure with virtual reality, but to use it as a tool for researching the benefits of different environments on human health, and to bring those benefits to people who are not able to access them.

To connect with Dr Issy Bray, contact her through her LinkedIn profile.

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