THE BLOG

Empowering Communities - A New Look For Public Health?

08/11/2016 11:39

We need to rethink our approach to public health in the UK. Last week, Public Health England announced that one in ten adults in the UK will be at risk of diabetes by 2035. If correct, this means millions more living with diabetes, billions more spent treating the disease and thousands of people dying before their time.

Public Health England's troubling prediction is not the only sign that our current approach isn't working. A child born in the UK today is more likely to become overweight than go to university, the cost of obesity to the UK is estimated at £15.8 billion each year; and one in four people in the UK do less than 30 minutes of exercise each week.

We already understand that many preventable conditions are linked to individual lifestyles and behaviour - arthritis, heart disease, Type 2 Diabetes, dementia and even some cancers are all associated with inactivity. However, to be able to tackle our current health crisis we must look beyond the behaviour of individuals and instead focus on the social and cultural context in which they exist.

Jaywick in Tendring, Essex was once a popular seaside destination for working-class Londoners but today ranks among the most deprived areas in the UK with over a third of 16 to 24 year olds claiming jobseeker's allowance. The consequences of this deprivation are not only economic - life expectancy for men in the most deprived areas of Tendring is almost 9 years shorter than in the least deprived areas.

Any meaningful attempt to tackle health inequality must take into account the broader social, environmental and economic conditions that cause them. We shouldn't be surprised if someone doesn't join a gym or visit a leisure centre when facilities are being closed in their town. Nor can we expect someone to walk to work or school if they don't feel their area is safe.

Health interventions that target the behaviour and lifestyles of individuals will only have a limited impact - to be able to transform the health of millions across the UK we must start looking at how we change communities.

Jaywick, as well as other towns and villages in Tendring, took part in a free, fun initiative called Beat the Street this Summer. Thousands of residents were given cards and fobs and challenged to walk and cycle as far as possible. To track their journeys, they would tap their cards against sensors called Beat Boxes dotted across Tendring which would reward them with points for them and their chosen team - the further they walked or cycled, the more points they would receive.

The game was free and, most importantly, fun to play. Within weeks, more than 10,000 residents were playing Beat the Street - walking, cycling and tapping boxes to receive points. By the end of the game, it had helped change the behaviour of residents with an increase from 23% to 48% of adult players meeting the Chief Medical Officer guidelines of 150 minutes of exercise per week.

However, the power of Beat the Street in Tendring is that it didn't just change the behaviour of individuals, but it also changed the community. The initiative encouraged people to use parks and spaces that they may have never visited before, it helped start conversations and connections between people playing the game, and it strengthened the entire community.

In the months since the game has ended, Beat the Street has continued to guide people into sports sessions, nature walks and other activities that will ensure long-term changes in people's health. But this success is thanks to its focus on targeting the social determinants of health.

The task ahead for health professionals is monumental - it will mean changing the habits and behaviours of millions of people across the UK. But we can be successful if we stop just looking at individuals, and start looking more at communities.

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