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Title: How will the 2014 Commonwealth Games impact on Glasgow's health, and how will we know?
Author: McCartney, Gerry
Awarding Body: University of Glasgow
Current Institution: University of Glasgow
Date of Award: 2010
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The project effects arise from specific projects or programmes that are undertaken in the context of the Games, but which could be implemented in the absence of such an event. The evaluation of these could be improved if either a prospective cohort study (where the participants in the projects can be predicted in advance) or retrospective cohort study (where the participants will only be known after they have taken part) is arranged. This will require to be undertaken in combination with qualitative studies and the creation of a theory of change to understand why any such project effects are (or are not) seen. The direct impacts of the Games, that is the impacts that occur as a direct result of playing host (such as the impact on tourism), require a different approach to achieve a quality evaluation. First, a theory of change to identify the critical pathways in generating impacts should be elucidated. Next, a combination of a cohort study and an ecological study (using routine data and a series of comparison areas identified in advance), should be used to identify the attributable impacts of the Games. Qualitative work alongside these studies will be required to understand why the impacts occur (or not). For the economic impacts specifically, an ecological design or economic modelling should be performed using routine statistical data (rather than estimates) and taking account of the opportunity costs. The catalytic impacts are particularly difficult to evaluate as it is not yet clear what these impacts might be. These potential impacts will require being identified using regular qualitative work with key individuals within the public and private sector in Glasgow, and this information will then need to be used to design quantitative studies to test these hypotheses. The synthesis discussed whether or not the Games could legitimately be described as a health improvement intervention. It found that some of the critical steps in the intervention were very similar to the tried and tested mechanisms used over many decades in the West of Scotland in attempt to improve the health and social conditions (economic growth and improved environment), without success. The ability of the Games to impact on the other critical steps (sports participation, increased volunteering and increased pride) is not supported by the evidence from previous events, and it is difficult to see what is different about the plans for the 2014 Games that might generate a different result. It was therefore concluded that the 2014 Games are unlikely to be an effective health improvement, and are unlikely to generate the plethora of social and economic benefits that pepper the bid document and legacy plans. Discussion: There are high expectations from Government that the 2014 Games will deliver a plethora of health and social benefits. The evidence from previous events is of poor quality, and there is an absence of evidence of positive impacts occurring. Given that a publication bias towards positive impacts is expected, it is unlikely that large positive health or socioeconomic benefits have occurred from major multi-sport events in the last 30 years. Health impact assessment can be used as an effective method of engaging the public and can be used to inform policy-making with evidence. Although the HIA did not predict the net overall impact of the Games, it is possible to make evidence-informed recommendations that are likely to maximise the potential for positive impacts and minimise the potential for negative impacts. The quality of evidence on the impacts of major sports events could be improved if a theory of change evaluation framework was applied to the event and if this was used to design a series of qualitative, cohort and ecological studies with appropriate comparison groups. However, it is unlikely that the 2014 Games will have a large positive impact on the health of Glaswegians or on socioeconomic outcomes because there is little evidence that the likely critical pathways have been successfully used in generating positive impacts despite similar attempts in the past. Some critics of major sports events have also made a plausible case for their being important negative consequences from playing host. The strengths of the thesis include the use of robust methodologies for the systematic review and health impact assessment, and the innovative use of a critical pathways approach for estimating whether or not the net impact of the Games will be positive. The weaknesses of the thesis include the reliance on the Government’s published work to discern the theory of change; the 34 studies that could not be obtained for possible inclusion in the systematic review; the limited evidence base upon which to make recommendations in the HIA; and the reliance on an accurate theory of change to predict the net impact of the Games, including the absence of emergent impacts from the complex Glaswegian context. Conclusions: The 2014 Games are unlikely to generate a large positive impact for health or the socioeconomic determinants of health. There is potential for unintended negative consequences to occur. The impacts of the Games are most likely to be optimised if the HIA recommendations are acted upon by decision-makers, and these impacts will only be accurately known if there is work to improve the quality of the evaluation. It is possible that the marketing of the Games as an intervention for health and social improvement might deflect attention from more important determinants of health in the city. In that vein, it may be more reasonable to make few other claims for the Games than that it will provide public entertainment and a festival for the population, and to minimise the opportunity costs that the Games will generate.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: RA0421 Public health. Hygiene. Preventive Medicine ; H Social Sciences (General)