Phil Veasey, Public Health, Community Engagement, Sports Development Consultant
Jul 26, 2017
Urban inner city settings, home to some of our most disadvantaged communities, present real challenges around keeping active and eating well. On exiting Whitechapel tube station in London’s East End for example - it becomes apparent that for many families, the prospect of living a healthy life is daunting.
The combination of:
All contribute to the perfect storm of an obesogenic environment.
The public health response is often lots of short term initiatives, sprinkled like confetti on a windy day from the roof of the Town Hall - initiatives which the community don’t want, never find out about, or don’t think are for them. To top it all a series of external providers with funding for the latest ‘childhood obesity silver bullet’ solutions breeze in and out of the community. Their shiny websites and leaflets completely by-passing the target audience, when most disadvantaged communities are driven by word of mouth.
The National Child Measurement Programme continues to collect chilling data indicating upward trends in childhood obesity, whilst preventative health approaches and solutions are placed firmly in the laps of the over-busy GP and primary care system. I sometimes wonder who it is that needs to change behavior? The providers of health resources, or the consumers of health resources? However, when you explore communities such as Whitechapel, and spend quality time listening to local families and stakeholders, there is good news. Even the toughest communities have a range of physical and human assets, and partners, who can really engage and motivate residents to live healthy lives. Quite simply, it’s that rich tapestry of residents, partners, and physical assets which, if aligned well, can empower communities to shift from consumers of scarce health resources to becoming co-producers of healthy lives.
Organisations such as Guy's and St Thomas' Charity are exploring ways to co-produce long-term, sustainable approaches to childhood obesity in the London boroughs of Lambeth and Southwark. So, what are some of the factors that anyone working on this issue should consider when taking a community engagement approach? The key factor is to empower communities. The days of ‘doing to’ are over. Co-production will give you a decent shot at the cost effective and sustainable solutions you will be seeking.
Firstly, to understand how to help solve the challenges that residents face on a day to day basis, you will need to deploy a range of processes from participatory appraisal, to focus groups, to stakeholder interviews. There are no shortcuts to understanding the community, earning its trust, and co-producing solutions. And be sure to move at a pace the community can cope with.
Secondly, disadvantaged communities sometimes lead tight geographical lives. The distance residents are willing and able to travel to take part regularly in a positive activity such as a sport, or learning cooking skills - may be as little as 300m from home. Interventions encouraging play, for example, will need to take place quite literally on the doorsteps of the community.
Thirdly, there will be a lot more health promoting activity taking place in the community than locals know. Co-producing and delivering a communications plan may be the most important part of the entire process. Piggy-backing on existing local structures, processes and social networks – may be the best way to do this!
Finally, the asset base of a community is its people, and its places. As well as corralling a range of partners and places, be sure to identify residents who can become your co-planners and producers, local sign-posters to activities, physical activity coordinators and coaches, healthy eating advisors, and cooking skills mentors. Incentivise these champions by honouring them and supporting them to fulfill their own life goals, for example, by providing skills development opportunities to increase their employability.