Time to harness the renewable energy of people and communities to reduce health inequalities | Dr Sally Hayes

Dr Sally Hayes

It is no secret that health and social care organisations are facing a major challenge – how to deliver better health and wellbeing outcomes for less cost while also ‘addressing’ health inequalities.

At Leeds Beckett University, we are working with people, patients, communities and stakeholder organisations to build the evidence base to address that very challenge. After all, we can redesign all the services and buildings we like but “without citizen participation and community engagement fostered by public service organisations, it will be difficult to improve penetration of interventions and to impact on health inequalities.”1

For us, this work is founded on a belief that asset-based approaches are key (see Hopkins et al 2015). Instead of asking ‘what is the matter’ or ‘what is wrong’ and designing services to address these deficits, we believe the most impactful questions to ask include ‘what matters to us’ – rather than what is the matter with us – and ‘what makes us healthy and happy’. 

By promoting and strengthening the factors that support good health and wellbeing, we can protect against poor health and foster communities and networks that sustain health. Indeed, in Simon Stevens’ Five Year Forward View, community assets are called the ‘renewable energy’ of the NHS.

This assertion is, of course, founded on a growing evidence base that such asset-based approaches are not only effective but economically good policy – see, for example, the work of Professor Martin Knapp from the London School of Economics. 

One example of assets in Leeds is our volunteers. With around 4,000 third sector organisations, and estimates of 1 in 4 people (200,000) volunteering at least five hours a month, accurately quantifying the impact of this on health and wellbeing is complex. Research undertaken by Leeds Beckett, however, demonstrated that volunteers themselves gain a range of benefits from taking part, leading to increased wellbeing. And they are able to ‘reach people not in touch with services and connect with them in meaningful ways’. There can also be a positive ripple effect beyond the projects when volunteers use their informal networks to cascade information to their friends, neighbours and others in their community. 

So how can we as public sector organisations work more closely with communities to promote health and wellbeing though an asset-based approach? 

The Institute for Health and Wellbeing at Leeds Beckett has, for a number of years, been building an evidence base and framework for community engagement, led by the work of Professor Jane South. Working with Public Health England, she recently led the development of A guide to community-centred approaches to health and wellbeing. This guide outlines a ‘family of approaches’ for evidence-based community-centred approaches for health and wellbeing.

In research terms, these approaches are characterised by crucial tenets like participation, co-construction, empowerment and enablement – it’s about doing research ‘with’ people and communities, not ‘on’ communities. Working with ‘lay’ individuals as research partners provides rich and detailed data about lived experience – as researchers, we must constantly ask ourselves if we can really empathise with individuals in social contexts so distant often from our own.

Secondly, training lay individuals in research skills is empowering for those involved and can provide opportunities for confidence building, raising self-esteem and acquiring skills that can be transferred to other contexts (like applying for employment etc.). 

But at Leeds Beckett, we go far beyond the traditional research role to work in collaboration with third sector partners. Both our CommUNIty initiative and LeedsACTS work to build sustainable partnerships between voluntary/community organisations and Leeds Beckett University. The overarching goal is to find new, more effective ways to improve health and reduce health inequalities in communities. This can be working collaboratively with organisations to tender for research funding, knowledge exchange events, or mobilising our own assets as a University, i.e. our estate, our students as volunteers, or students undertaking evaluative projects for partners as part of their dissertation research. 

Through our Health Together project, we then work with organisations to develop approaches to commission for and deliver effective engagement to improve health and wellbeing. It is key to combine practical experience of policy-making and programme delivery with academic rigour and in-depth knowledge of the evidence base.

My challenge? How could your organisation work differently with both PEOPLE and COMMUNITIES to build on our assets together?

1 Marmot (2010) Fair Society, Healthy Lives, p151

Dr Sally Hayes is head of school at Leeds Beckett University. Follow her on Twitter @DrSallyHayes and email her at s.hayes@leedsbeckett.ac.uk for further information.

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