We focus on four complex health issues more prevalent in urban areas
With the Social Progress Imperative, we've developed the first neighbourhood level, health-focused social progress index of its kind.
With Wellcome Trust
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Urban health
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Our response to the Mayor of London's office
Note: Impact on Urban Health is part of Guy’s and St Thomas’ Charity.
Our consultation response refers to the following sections:
The Mayor should be congratulated on a comprehensive and determined approach to tackling London’s pressing health inequalities. We would particularly support the ambition to spread best practice across boroughs; and to build energetic partnerships between communities, business and the statutory sector.
There are areas the strategy could go further across children, place and communities.
Emphasise should be placed on the fact that childhood obesity is primarily not a problem of individual knowledge, motivation or self-discipline. Rather, childhood obesity is often ‘a normal response to an abnormal environment’.
The spaces in which many of London’s children and young people spend their time have more barriers to healthy eating and activity than they do opportunities. This is especially true for those living in disadvantaged circumstances. Unless we start from this assumption, we are unlikely to make significant impact, and risk exacerbating existing inequalities.
Our works supports the proposed approach to tackle children’s health in the three environments where children spend most of their time: with their parents/carers (home), education settings (schools/nursery) and play/community settings (streets). We would go further and say that they should not be viewed in isolation as a behaviour or formed habit, but should be integrated with other initiatives that support promoting healthy children.
In addition to this we feel the strategy should:
Further work is needed to understand the cumulative effect of urban environment, deprivation and high levels of diversity on people’s health. The Mayor could put London at the forefront of this work.
As one of the UK’s largest place-based funders, we partner with London local authorities, central government and the Greater London Authority to jointly act, develop knowledge and share learning. Currently we are focusing on children’s health and food, early intervention on multiple Long – Term Conditions and understand the driving factors of Urban Health disparities and solutions.
Childhood obesity is a global problem, with 70 million young people predicted to be obese by 2025. We know that the impact of place is as important as individual choice. Both affect the strongest drivers of obesity – eating behaviour and physical activity. For us, the combined lens of urban living and deprivation is critical. These are key ingredients of ‘obesogenic environments’ – those that encourage people to eat unhealthily and not to do enough exercise. We believe that improving these environments is crucial if we want to create a long-term sustainable impact.
We plan to tackle childhood obesity by taking a whole system, cross sector approach that focuses on creating environments that support and encourage nutritious eating and physical activity in places that children of all ages spend their time: Home, School and Neighbourhoods.
Over the next 10 years, we plan to:
In our work, we are particularly interested in how urban environment, high levels of diversity and deprivation affects people’s health. We know that a person’s socio-economic status and ethnicity links to the known drivers of multiple long term conditions. Research has shown that people from deprived areas are more likely to develop multiple long-term conditions earlier than those from wealthier ones. There is also emerging evidence of an association between ethnicity and multiple long-term conditions. A person’s social context, their education and ability to cope with life events such as bereavement, influences the likelihood and severity of long-term conditions
We plan to improve the lives of people with multiple long-term conditions in urban, diverse and deprived areas. This will involve working both with the formal statutory sector, and with many other actors –businesses, academics, civic organisations, community groups and residents themselves. Over the next 10 years, we plan to:
Our programmatic focus helps us to understand and develop our learning of the drivers and contributors of Urban Health, that often see the most vulnerable of our society have the worse health outcomes. We aim to share the insights we gain into urban health from our programmes in Lambeth and Southwark across London and further afield with comparable cities that face the same urban health challenges. Our focus is on the intersections of the urban environment, diversity and deprivation:
As an independent foundation, we can take risks on new approaches, co-produce with a range of partners and use our assets to leverage further resources. We are open to partnering with anyone who shares our aims of improving the health of urban diverse and deprived communities, to develop solutions, gain insights and share knowledge that can be used to effect change in our boroughs and urban communities like ours.
The Mayor should make clear, throughout, that a whole system and cross sector approach is needed to tackle health inequalities in London. The Mayor should aim to ensure that reducing health inequalities is an integral factor in all polices and directives which the Mayor has influence over.
We support the Mayor’s ambitions to give children in London the best start in life. We recommend that the strategy:
We support the Mayor’s ambitions of creating a healthy environment, society and economy. We recommend that the strategy:
We support the Mayor’s ambitions to ensure that London’s diverse communities become healthy and thriving. We recommend that the strategy:•Create SMART targets to address the factors that underlay the health inequalities of urban health. This might helpfully focus on:
We have commissioned research that may be of interest to you that examine this in more detail:
Insights on the assets and risks of urban environment, diversity and deprivation
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