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Role of healthy places and sustainable communities in reducing health inequalities

Role of healthy places and sustainable communities in reducing health inequalities. Peter Goldblatt. Social justice Material, psychosocial, political empowerment Creating the conditions for people to have control of their lives. Key principles. www.who.int/social_determinants.

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Role of healthy places and sustainable communities in reducing health inequalities

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  1. Role of healthy places and sustainable communities in reducing health inequalities Peter Goldblatt

  2. Social justice Material, psychosocial, political empowerment Creating the conditions for people to have control of their lives Key principles www.who.int/social_determinants

  3. Life expectancy and disability-free life expectancy at birth by neighbourhood income deprivation, 1999-2003

  4. Fair Society: Healthy Lives: 6 Policy Objectives • Give every child the best start in life • Enable all children, young people and adults to maximise their capabilities and have control over their lives • Create fair employment and good work for all • Ensure healthy standard of living for all • Create and develop healthy and sustainable places and communities • Strengthen the role and impact of ill health prevention

  5. Healthy and sustainable places and communities - policy recommendations • Prioritise policies and interventions that both reduce health inequalities and mitigate climate change • Fully integrate systems to address the social determinants of health in each locality • Support locally developed and evidence-based community regeneration programmes that remove barriers to • community participation and action • social isolation

  6. Reduce health inequalities and mitigate climate changeAcross the social gradient: • Active travel • Access to safe, good quality open space • Improved food environment locally • Improved energy efficiency of housing

  7. Principles in reducing health inequalities • Health inequalities result from social inequalities - ‘causes of the causes’ – the social determinants • Address the social gradient in health through ‘proportionate universalism’ • Life course approach • Intergenerational focus • Address processes of exclusion • Develop strategies based on assets, resilience, capabilities and strengths. • Human Rights framework

  8. Fully integrated approach to health inequalities MACROLEVEL CONTEXT WIDER SOCIETY SYSTEMS • LIFE COURSE STAGES Accumulation of positive and negative effects on health and wellbeing Prenatal Early Years Working Age Older Ages Family building Perpetuation of inequities

  9. People and PlacesCritical linkage of health, wellbeing and resilience.Evidence of linkage of low level stress, depression and exclusion are barriers to participation: “ You can see the deprivation, all you have to do is look outside. Its in your face every day, litter everywhere, rats and rubbish. It’s a dump……it feels like people around you have no meaning to life. I keep my curtains closed at times….It doesn’t give you a purpose to do anything” (Focus group participant) Many communities are characterised by lack of mutual trust, isolation and under developed social cohesion. “It is a deprived area ,there are no jobs , people are stressed out family and partner relationships and all things like that are going wrong” (June)

  10. What is detrimental to my wellbeing and health What enhances my wellbeing and health Lack of interesting activities in winter Recycling facilities Green spaces that I can use Poor local job prospects Affordable healthy food Poor street lighting and uneven pathways Affordable transport Spending time with my neighbours Soaring fuel bills and poor insulation

  11. Partnership with individuals and communities- an asset based approach. I&DeA A Glass half-full:how an asset approach can improve community health and wellbeing.

  12. Health, wellbeing and resilience • Evidence participation and improving life skills ameliorates impact of health inequalities through developing social support networks. (Bynner and Parsons 2006) • Learning and skill development impact positively and fosters community action. “I have learned ..I use my counselling skills with my family. I listen more and I know my daughter will say I am really proud of what you are doing ,Mum “ (Jane) • Social networks create the conditions in which people thrive “I would say that people in the group have more confidence. At one poInt they would have been sat at home doing nothing ,now they are out and are involved. Once you get there it ‘s amazing to see how far you can go.” (Joyce)

  13. Coventry City Council Deficit Asset Start with assets of communities Identify opportunities and strengths Invest in people as citizens Emphasise civil society Focus on neighbourhoods and common good Citizens as co producers People take control People are the answer • Start with deficiencies and need externally defined • Respond to problems • Provide services for users • Focus on individuals • Clients as consumers • Passive recipients • Fix people with programmes as the answer

  14. Creating conditions in which individuals and communities have control over their health and lives and participate fully in society

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