To understand the association between population mental health and economic prosperity at the small area level in England and explore regional differences.

A longitudinal small area-level analysis exploring the association between a proxy for population mental health and economic prosperity across 6789 small areas in England from 2011 to 2019 (NxT=61 101). We apply linear regression models with fixed effects at the area level. Mental health in each area is proxied by a standardised index constructed from administrative data on the use of services related to mental health.

National study of geographical areas in England.

Small areas of England.

Economic prosperity is measured by gross disposable household income (GDHI) per capita at the small area level.

A one SD increase in the index is linked to a 1.9% (95% CI 1.4% to 2.5%) rise in GDHI. The association varies depending on the region, with the strongest association in the North East.

There is evidence of a positive association between proxies for better population mental health and subsequent household income per capita, varying by region. While we cannot infer causality, these findings are consistent with the view that improving mental health may support local economic prosperity.

Atrial fibrillation (AF) is the most common sustained arrhythmia worldwide, associated with significant morbidity, mortality and healthcare utilisation. AF rhythm control strategies demonstrate attrition with time. A number of modifiable AF risk factors contribute to an atrial cardiomyopathy culminating in incident AF but importantly also recurrence. We propose that a novel multidisciplinary lifestyle intervention (Super Rehab, SR) may improve symptoms and AF burden.

This is a single-centre, randomised controlled study. Patients aged ≥18 years with a body mass index ≥27 kg/m² with paroxysmal or persistent AF will be randomised 1:1 to National Health Service (NHS) usual care (UC) or to SR (together with NHS UC). SR incorporates high-intensity exercise, personalised dietary advice and AF risk factor modification. SR will be undertaken over 12 months. In addition to baseline assessments, follow-up assessments will occur at the 6, 12 and 15-month time points. The primary outcome will be the difference in AF symptom burden at 12 months between groups. Secondary outcomes include AF burden (assessed by an implantable cardiac monitor), changes to cardiac structure and function and computed tomography-based assessment of epicardial adipose tissue.

Ethics approval was granted by London-Chelsea Research Ethics Committee (reference: 22/LO/0479 22/08/2022). All participants will provide written informed consent prior to enrolment. Study findings will be disseminated via presentations to relevant stakeholders, national and international conferences and open-access peer-reviewed research publications. A summary will also be communicated to the participants.

ClinicalTrials.gov ID NCT05596175.