Richard John Shaw

University of Glasgow | UofG · Institute of Health and Wellbeing

Background Following the acute phase of the COVID-19 pandemic, record numbers of people became economically inactive (i.e., neither working nor looking for work, e.g., retired), or non-employed (including unemployed job seekers and economically inactive people). A possible explanation is people leaving the workforce after contracting COVID-19. We a...

Objectives: To examine whether there is an association between people who experienced disrupted access to healthcare during the covid-19 pandemic and risk of an avoidable hospital admission. Design: Observational analysis using evidence from seven linked longitudinal cohort studies for England. Setting: Studies linked to electronic health reco...

Linked administrative data offer a rich source of information that can be harnessed to describe patterns of disease, understand their causes and evaluate interventions. However, administrative data are primarily collected for operational reasons such as recording vital events for legal purposes, and planning, provision and monitoring of services. T...

Background: The association between loneliness and suicide is poorly understood. We investigated how living alone, loneliness and emotional support were related to suicide and self-harm in a longitudinal design. Methods: Between 2006 and 2010 UK Biobank recruited and assessed in detail over 0.5 million people in middle age. Data were linked to pros...

The 'ethnic density hypothesis' is a proposition that members of ethnic minority groups may have better mental health when they live in areas with higher proportions of people of the same ethnicity. Investigations into this hypothesis have resulted in a complex and sometimes disparate literature. To systematically identify relevant studies, summari...

Background Long-term sequelae of COVID-19 (long COVID) include muscle weakness, fatigue, breathing difficulties and sleep disturbance over weeks or months. Using UK longitudinal data, we assessed the relationship between long COVID and financial disruption. Methods We estimated associations between long COVID (derived using self-reported length of...

Background SARS-CoV-2 infection rates vary by occupation, but the association with work-related characteristics (such as home working, key-worker, or furlough) are not fully understood and may depend on ascertainment approach. We assessed infection risks across work-related characteristics and compared findings using different ascertainment approac...

Background Following the acute phase of the COVID-19 pandemic, record numbers of workers, particularly those aged over 50, have become economically inactive in the UK, termed the ‘great resignation’. A possible explanation is people leaving the workforce following contracting COVID-19. We used data held by the UK Longitudinal Linkage Collaboration...

Background People who live alone experience greater levels of mental illness; however, it is unclear whether the COVID-19 pandemic had a disproportionately negative impact on this demographic. Objective To describe the mental health gap between those who live alone and with others in the UK prior to and during the COVID-19 pandemic. Methods Self-...

Background: The COVID-19 pandemic disrupted healthcare and may have impacted ethnic inequalities in healthcare. We aimed to describe the impact of pandemic-related disruption on ethnic differences in clinical monitoring and hospital admissions for non-COVID conditions in England. Methods: In this population-based, observational cohort study we u...

Background: Long-term sequelae of COVID-19 (long COVID) include muscle weakness, fatigue, breathing difficulties and sleep disturbance over weeks or months. Using UK longitudinal data, we assessed the relationship between long COVID and financial disruption. Methods: We estimated associations between long COVID (derived using self-reported length o...

Background: Home working has increased since the Coronavirus Disease 2019 (COVID-19) pandemic's onset with concerns that it may have adverse health implications. We assessed the association between home working and social and mental wellbeing among the employed population aged 16 to 66 through harmonised analyses of 7 UK longitudinal studies. Met...

Objectives: To describe the mental health gap between those who live alone and those who live with others, and to examine whether the COVID-19 pandemic had an impact on this gap. Design: Ten population based prospective cohort studies, and a retrospective descriptive cohort study based on electronic health records (EHRs). Setting: UK Longitudinal p...

Background Health services across the UK struggled to cope during the COVID-19 pandemic. Many treatments were postponed or cancelled, although the impact was mitigated by new models of delivery. While the scale of disruption has been studied, much less is known about if this disruption impacted health outcomes. The aim of our paper is to examine wh...

Multiple studies across global populations have established the primary symptoms characterising Coronavirus Disease 2019 (COVID-19) and long COVID. However, as symptoms may also occur in the absence of COVID-19, a lack of appropriate controls has often meant that specificity of symptoms to acute COVID-19 or long COVID, and the extent and length of...

Background Evidence on associations between COVID-19 illness and mental health is mixed. We aimed to examine whether COVID-19 is associated with deterioration in mental health while considering pre-pandemic mental health, time since infection, subgroup differences, and confirmation of infection via self-reported test and serology data. Methods We...

Background: Home working rates have increased since the COVID-19 pandemic's onset, but the health implications of this transformation are unclear. We assessed the association between home working and social and mental wellbeing through harmonised analyses of seven UK longitudinal studies. Methods: We estimated associations between home working and...

Background: Cardiovascular disease (CVD) has a disproportionate effect on mortality among the poorest people. We assessed the impact on CVD and all-cause mortality of the world's largest conditional cash transfer, Brazil's Bolsa Família Programme (BFP). Methods: We linked administrative data from the 100 Million Brazilian Cohort with BFP receipt...

Objectives Administrative data are primarily collected for operational processes and these processes can lead to sources of bias that may not be adequately considered by researchers. We provide a framework to help understand how biases might arise from using linked administrative data, and hopefully aid future study designs. ApproachWe developed th...

Background The COVID-19 pandemic has led to major economic disruptions. In March 2020, the UK implemented the Coronavirus Job Retention Scheme – known as furlough – to minimize the impact of job losses. We investigate associations between change in employment status and mental and social wellbeing during the early stages of the pandemic. Methods D...

Ethnic inequities in COVID-19 vaccine hesitancy have been reported in the United Kingdom (UK), and elsewhere. Explanations have mainly focused on differences in the level of concern about side effects, and in lack of trust in the development and efficacy of vaccines. Here we propose that racism is the fundamental cause of ethnic inequities in vacci...

Multiple studies across global populations have established the primary symptoms characterising COVID-19 (Coronavirus Disease 2019) and long COVID. However, as symptoms may also occur in the absence of COVID-19, a lack of appropriate controls has often meant that specificity of symptoms to acute COVID-19 or long COVID, and the extent and length of...

Background Evidence on associations between COVID-19 illness and mental health is mixed. We examined longitudinal associations between COVID-19 and mental health while considering: 1) pre-pandemic mental health, 2) time since infection; 3) subgroup differences; and 4) confirmation of infection via self-reported test, and serology data. Methods Usi...

Background: The COVID-19 pandemic has led to major economic disruptions. In March 2020, the UK implemented the Coronavirus Job Retention Scheme, known as furlough, to minimize the impact of job losses. We investigate associations between change in employment status and mental and social wellbeing during the early stages of the pandemic. Methods: Da...

Today’s most troublesome population health challenges are often driven by social and environmental determinants, which are difficult to model using traditional epidemiological methods. We agree with those who have argued for the wider adoption of agent-based modelling (ABM) in taking on these challenges. However, while ABM has been used occasionall...

Background Social contact, including remote contact (by telephone, email, letter or text), could help reduce social inequalities in depressive symptoms and loneliness among older adults. Methods Data were from the 8th wave of the English Longitudinal Study of Aging (2016/17), stratified by age (n=1,578 aged <65; n=4,026 aged 65+). Inverse probabil...

Background: Recent theory suggests that antihypertensive medications may be useful as repurposed treatments for mood disorders, however, empirical evidence is inconsistent Objective: We aimed to assess the risk of depression incidence as indicated by first-ever prescription of antidepressant in patients newly exposed to antihypertensive monotherapy...

Background: Social contact, including remote contact (by telephone, email, letter or text), could help reduce social inequalities in depression and loneliness among older adults. Design: Cross-sectional survey. Participants: 8th wave of the English Longitudinal Study of Aging (2016/17), stratified by age (n=1,635 aged <65; n=4,123 aged 65+). Method...

Today's most troublesome population health challenges are often driven by social and environmental determinants, which are difficult to model using traditional epidemiological methods. We agree with those who have argued for the wider adoption of agent-based modelling (ABM) in taking on these challenges. However, while ABM has been used occasionall...

Background Recent work suggests that antihypertensive medications may be useful as repurposed treatments for mood disorders. Using large-scale linked healthcare data we investigated whether certain classes of antihypertensive, such as angiotensin antagonists (AAs) and calcium channel blockers, were associated with reduced risk of new-onset major de...

Objective: Atherosclerosis is the underlying cause of most cardiovascular disease, but mechanisms underlying atherosclerosis are incompletely understood. Ultrasound measurement of the carotid intima-media thickness (cIMT) can be used to measure vascular remodeling, which is indicative of atherosclerosis. Genome-wide association studies have identi...

Background Poor physical health in severe mental illness (SMI) remains a major issue for clinical practice. Aims To use electronic health records of routinely collected clinical data to determine levels of screening for cardiometabolic disease and adverse health outcomes in a large sample ( n = 7718) of patients with SMI, predominantly schizophren...

Background: The association between loneliness and suicide is complex, poorly understood, and there are no prior longitudinal studies. We aimed to investigate the relationship between living alone, loneliness and emotional support as predictors of death by suicide and self-harm. Methods: Between 2006 and 2010 UK Biobank recruited over 0.5m people a...

Introduction: Being bullied is a threat to children’s mental wellbeing and there is some evidence that emotional support may buffer children against bullying victimisation. However, technology has changed the way children interact, not only do children face traditional bullying but also cyberbullying. Our study aims to investigate whether bullying...

This study investigates if cyberbullying is associated with wellbeing independently of traditional bullying and if social support and eating family meals together promotes resilience by buffering adolescents against the consequences of both types of bullying. Data for 5286 eleven, thirteen and fifteen year olds participating in the cross-sectional...

Objectives: Atherosclerosis is the underlying cause of most cardiovascular disease, but mechanisms underlying atherosclerosis are incompletely understood. Ultra-sound measurement of the carotid artery intima-media thickness (cIMT) can be used to measure vascular remodelling, which is indicative of atherosclerosis. Genome-wide association studies ha...

Background: Recent work suggests that antihypertensive medications may be useful as repurposed treatments for mood disorders. Using large-scale linked healthcare data we investigated whether certain classes of antihypertensive, such as angiotensin antagonists and calcium channel blockers, may have potential as repurposed treatments for Major Depres...

Manhattan plot of GWAS of ordinal suicidality in UK Biobank (N = 100,234), adjusted for age, sex, genotyping chip, population structure, psychiatric disorders and childhood sexual abuse. Dashed red line = genome wide significance threshold (p < 5 × 10−5). Inset: QQ plot for genome-wide association with DSH. Red line = theoretical distribution under...

Manhattan plot of gene-based GWAS of ordinal suicide in UK Biobank (N = 122,935). Dashed red line = genome wide significance threshold (p < 5 × 10−5). Inset: QQ plot for genome-wide association with suicidality in UK Biobank. Red line = theoretical distribution under the null hypothesis of no association.

Regional plots for GWAS significant loci identified in the gene-based analyses. Highlighted genes for suicidality A) ADCK3/COQ8A on Chromosome 1, B) CEP57-FAM76B-MTMR2 on Chromosome 11, C) DCC on Chromosome 18, For DSH D) SENP3 on Chromosome 17 and for SIA E) CDKAL1 on Chromosome 6. SNPs (each point) are aligned according to position (X axis) and s...

Functions of genes in novel suicidality loci eQTLs in brain of predicted functional SNPs in the CEP57-FAM76B locus

Flow chart of UK Biobank participants available for primary analyses (Ordinal GWAS and PRS analysis)

Manhattan plot of gene-based GWAS of ordinal DSH in UK Biobank (N = 100,234). Dashed red line = genome wide significance threshold (p < 5 × 10−5). Inset: QQ plot for genome-wide association with suicidality in UK Biobank. Red line = theoretical distribution under the null hypothesis of no association.

Genotype-specific gene expression of the Chromosome 9 lead SNP, rs62535711 on transcripts of FRMPD1, MELK, TRMT10B, ZCCHC7 and GRHPR, (Supplementary Fig. 3 E–H) in cerebellar cortex (CRBL), frontal cortex (FCTX), hippocampus (HIPP), medulla (specifically inferior olivary nucleus, MEDU), occipital cortex (specifically primary visual cortex, OCTX), p...

All SNPs associated with ordinal suicidality at GWAS significance

Allele frequencies of lead SNPs by suicidality category

Effect of genetic loading for suicidal behaviour on psychiatric disorders and related traits.

Effect of genetic loading for suicidal behaviour on traits of relevance to psychiatric disorders

Novel Suicidal behaviour loci and previous associations in the GWAS catalogue

Previously reported suicidal behaviour-associated SNPs

Manhattan plot of gene-based GWAS of ordinal SIA in UK Biobank (N = 108,090). Dashed red line = genome wide significance threshold (p < 5 × 10−5). Inset: QQ plot for genome-wide association with suicidality in UK Biobank. Red line = theoretical distribution under the null hypothesis of no association.

Cohort demographics of individuals included in the Ordinal suicidality GWAS and the completed suicide PRS analysis

Flow chart of UK Biobank participants available for secondary analyses. The flow chart of participants is the same as Supplementary Fig. 1 up to the highlighted box. Relatedness exclusions were applied for A) the DSH GWAS considering the categories Controls, Contemplated self-harm and Actual self-ham and B) the SIA GWAS considering the categories C...

Manhattan plot of GWAS of ordinal DSH in UK Biobank (N = 100,234). Dashed red line = genome wide significance threshold (p < 5 × 10−5). Inset: QQ plot for genome-wide association with DSH. Red line = theoretical distribution under the null hypothesis of no association.

Manhattan plot of GWAS of ordinal SIA in UK Biobank (N = 108,090). Dashed red line = genome wide significance threshold (p < 5 × 10−5). Inset: QQ plot for genome-wide association with SIA. Red line = theoretical distribution under the null hypothesis of no association.

Background Suicide is a major issue for global public health. Suicidality describes a broad spectrum of thoughts and behaviours, some of which are common in the general population. Although suicide results from a complex interaction of multiple social and psychological factors, predisposition to suicidality is at least partly genetic. Methods Ordi...

Background Sedentary behaviour is related to poorer health independently of time spent in moderate to vigorous physical activity. The aim of this study was to investigate whether wellbeing or symptoms of anxiety or depression predict sedentary behaviour in older adults. Method Participants were drawn from the Lothian Birth Cohort 1936 (LBC1936) (n...

Background: Suicide is a major issue for global public health. ‘Suicidality’ describes a broad clinical spectrum of thoughts and behaviours, some of which are common in the general population. Methods: UK Biobank recruited ∼0·5 million middle age individuals from the UK, of whom 157,000 completed an assessment of suicidality. Mutually exclusive gro...

Background Between 1997 and 2017 the number of middle-aged people living alone in the UK increased by 53% and loneliness is now recognised as an important policy area. We aimed to understand the interrelationships between loneliness, living arrangements and emotional support in predicting suicidal thoughts and behaviours. Methods Between 2006 and...

The Seniors USP study measured sedentary behaviour (activPAL3, 9 day wear) in older adults. The measurement protocol had three key characteristics: enabling 24-hour wear (monitor location, waterproofing); minimising data loss (reducing monitor failure, staff training, communication); and quality assurance (removal by researcher, confidence about we...

Higher cognitive ability is associated with being more physically active. Much less is known about the associations between cognitive ability and sedentary behavior. Ours is the first study to examine whether historic and contemporaneous cognitive ability predicts objectively measured sedentary behavior in older age. Participants were drawn from 3...

Background: Sedentary behaviour is a public health concern that requires surveillance and epidemiological research. For such large scale studies, self-report tools are a pragmatic measurement solution. A large number of self-report tools are currently in use, but few have been validated against an objective measure of sedentary time and there is n...

Objectives: To investigate whether sedentary behaviour in older adults is associated with a systematic and comprehensive range of socioeconomic position(SEP) measures across the life course. SEP measures included prospective measures of social class, income, educational qualifications and parental social class and contemporaneous measures of area d...

Sedentary behaviour is an emerging risk factor for poor health. This study aimed to identify ecological determinants of sedentary behaviour, for which evidence is currently scarce. The study participants were community dwelling adults from, respectively, the Lothian Birth Cohort 1936 (n = 271, mean age 79) and the 1930s (n = 119, mean age 83) and 1...

Background: Scotland has higher mortality rates than the rest of Western Europe (rWE), with more cardiovascular disease and cancer among older adults; and alcohol-related and drug-related deaths, suicide and violence among younger adults. Methods: We obtained sex, age-specific and year-specific all-cause mortality rates for Scotland and other po...

Background There is increasing recognition that sedentary behaviour (defined as any waking activity with an energy expenditure <1.5 METs in a seated or reclining posture) is a risk factor for poor health. However, neighbourhood influences on sedentary behaviour are poorly understood. Methods Participants were drawn from 1930s and 1950s birth c...

Demographic change and policy changes in social care provision can affect the type of social care support received by older people, whether through informal, formal state or formal paid-for sources. This paper analyses the English Longitudinal Study of Ageing data (wave 4) in order to examine the relationship between demographic and socio-economic...

Introduction Nordic countries do not have the smallest health inequalities despite egalitarian social policies. A possible explanation for this is that drivers of class differences in health such as financial strain and labour force status remain socially patterned in Nordic countries. Methods Our analyses used data for working age (25–59) men (n...

Introduction One challenge in public health is to understand why Nordic countries do not have the smallest health inequalities despite having relatively egalitarian social policies. Our aim is to investigate whether important drivers of class differences in health such as financial strain and labour force status account for the health inequalitie...

Background A major puzzle is why Nordic countries do not have the smallest health inequalities despite having relatively egalitarian social policies. The aim of this paper is to investigate whether important drivers of class differences in health such as financial strain and labour force status account for the social patterning of health in Nordic...

Since the 1930s, the environment has become increasingly obesogenic, leading to rising rates of adiposity and socioeconomic inequalities in adiposity. Building on studies comparing body mass index (BMI) for cohorts born over a period of 20 years, we examine the social patterning of BMI and central adiposity for three cohorts born over a 40-year per...

Background Over the last 80 years the association between social class and obesity has changed. In the 1930s obesity rates were low and wealthy people tended to have a higher risk of obesity than poor people. However, rising affluence and industrialisation has lead to both rising rates of obesity and an obesogenic environment in which socioeconomic...

Objectives: In the United States, Hispanic mothers have birth outcomes comparable to those of White mothers despite lower socioeconomic status. The contextual effects of Hispanic neighborhoods may partially explain this "Hispanic paradox." We investigated whether this benefit extends to other ethnic groups. Methods: We used multilevel logistic r...

The conceptual model developed by Verbrugge and Jette (1994) has identified an individual’s health and the environment in which they live, as key determinants of their process of disablement. However, beyond health and environmental risk factors, and focusing on the latter part of the life course, there has been less emphasis in the literature on t...

This paper describes a system dynamics model for social care, developed in collaboration with a local authority in England, as part of the UK Engineering and Physical Sciences Research Council Care Life Cycle project based at the University of Southampton. The model was populated with data from a wide range of sources, local and national. We presen...

In the current economic circumstances and political climate, older people may be increasingly dependent on their own social and financial resources in order to obtain care and assistance with daily activities. However, the support received in later life may consist of a mixture between formal paid, formal state and informal support, and understandi...

Recent spending cuts in the area of adult social care raise policy concerns about the proportion of older people whose need for social care is not met. Such concerns are emphasised in the context of population ageing and other demographic changes, for example in the living arrangements of older people, which can place greater pressure on formal and...

It has been suggested that people in racial/ethnic minority groups are healthier when they live in areas with a higher concentration of people from their own ethnic group, a so-called ethnic density effect. Ethnic density effects are still contested, and the pathways by which ethnic density operates are poorly understood. The aim of this study was...

This paper introduces a major new cross-disciplinary research project that looks at the UK health and social care system, as part of an ambitious, broader initiative to apply methods from complexity science to a range of key global challenges. This particular project aims to develop new, integrated models for the supply and demand of both health an...

Recent spending cuts in the area of adult social care raise policy concerns about the proportion of older people whose need for social care is not being met. Such concerns are emphasised in the context of population ageing and other demographic changes. For example, the increasing proportion of the population aged 75 and over places greater pressur...

Recent spending cuts in the area of adult social care raise policy concerns about the proportion of older people whose need for social care is not being met. Such concerns are emphasised in the context of population ageing and other demographic changes. For example, the increasing proportion of the population aged 75 and over places greater pressur...