Martha Bicket

Emerging research suggests exposure to high levels of air pollution at critical points in the life-course is detrimental to brain health, including cognitive decline and dementia. Social determinants play a significant role, including socio-economic deprivation, environmental factors and heightened health and social inequalities. Policies have been proposed more generally, but their benefits for brain health have yet to be fully explored. Over the course of two years, we worked as a consortium of 20+ academics in a participatory and consensus method to develop the first policy agenda for mitigating air pollution's impact on brain health and dementia, including an umbrella review and engaging 11 stakeholder organisations. We identified three policy domains and 14 priority areas. Research and Funding included: (1) embracing a complexities of place approach that (2) highlights vulnerable populations; (3) details the impact of ambient PM2.5 on brain health, including current and historical high-resolution exposure models; (4) emphasises the importance of indoor air pollution; (5) catalogues the multiple pathways to disease for brain health and dementia, including those most at risk; (6) embraces a life course perspective; and (7) radically rethinks funding. Education and Awareness included: (8) making this unrecognised public health issue known; (9) developing educational products; (10) attaching air pollution and brain health to existing strategies and campaigns; and (11) providing publicly available monitoring, assessment and screening tools. Policy Evaluation included: (12) conducting complex systems evaluation; (13) engaging in co-production; and (14) evaluating air quality policies for their brain health benefits. Given the pressing issues of brain health, dementia and air pollution, setting a policy agenda is crucial. Policy needs to be matched by scientific evidence and appropriate guidelines, including bespoke strategies to optimise impact and mitigate unintended consequences. The agenda provided here is the first step toward such a plan.

This briefing explains what complexity science and systems thinking means for people developing and delivering policy. It also introduces a common language and set of symbols to help frame thinking, conversations and action on complexity.

The Food Standards Agency (FSA) is a non-ministerial UK Government department whose main objective is to protect public health and consumer interests in relation to food in England, Wales and Northern Ireland. It works with food producers, suppliers and local authorities to ensure that food is safe and what it says it is. This case study focuses on the FSA’s new programme ‘Regulating Our Future’ (ROF), through which the FSA is changing how it regulates the food sector.

Central government guidance seeks to ensure and enhance the quality of practice and decision-making across – and sometimes beyond – government. The Magenta Book, published by HM Treasury, is the key UK Government resource on policy evaluation, setting out central government guidance on how to evaluate policies, projects and programmes. The UK Centre for the Evaluation of Complexity Across the Nexus was invited to contribute its expertise to the UK Government’s 2020 update of the Magenta Book by developing an accompanying guide on policy evaluation and ‘complexity’. A small multidisciplinary team worked together to produce a set of guidance, going through multiple stages of work and drawing on a variety of sources including academic and practitioner literature and experts and stakeholders in the fields of evaluation, policy and complexity. It also drew on Centre for the Evaluation of Complexity Across the Nexus’ own work developing and testing evaluation methods for dealing with complexity in evaluation. The resulting Magenta Book 2020 Supplementary Guide: Handling Complexity in Policy Evaluation explores the implications of complexity for policy and evaluation and how evaluation can help to navigate complexity. This article, designed primarily for practitioners who might be interested in this guidance and how it was developed, describes the processes involved, particularly related to the interdisciplinary dialogue and consultation with other key stakeholders that this involved. It also briefly outlines the content and key messages in the guidance, with reflections on the experiences of the authors in developing the guide – including the challenges and insights that arose during the process, particularly around the challenges of communicating complexity to a broad audience of readers.