Rowena Estwick, Partnerships Manager, Guy's and St Thomas' Charity
Feb 15, 2018
Last week I attended the Health in All Policies (HiAP) 2018 conference which aimed to create a common understanding of health and health inequalities.
Following on from our response to the Mayor of London’s Health Inequality Strategy consultation and our recent announcement to partner with the Mayor of London to develop a London Childhood Obesity Taskforce, this event proved very timely. It reaffirmed the need to be mindful of the drivers of health inequalities and that tackling these issues is not insurmountable if we work together.
The morning plenary session set the tone for the day. It was refreshing to hear the genuine passion and desire to drive the agenda being reciprocated through the room. All the main speakers agreed that, while the need to address public health remains, recognising the increasing health inequality gap should be the top priority. The most salient point consistently echoed was the importance of taking a place-based approach. Given our role as a place-based health foundation it was good to hear the vital role place can play in tackling health inequalities. It seemed that everyone agreed that tackling this issue takes a whole systems approach. Considering that how health is reflected in all policies is how the system as a whole can combat the issue - where do you start? The main points I took from the speakers on the day were: be honest; relinquish power and act.
Martin Reeves, Chief Executive of Coventry Council, was candid about the current state of dislocation, discrimination and disenfranchisement that underlies inequalities in the UK. Sir Michael Marmot, Director at the Institute of Health Equity, argued that the inequalities were increasing as a direct result of public policy. Both speakers were clear that being honest about the context within which we work to address health equity was essential to understand the solutions needed. We were reminded by Dr Ann Marie Connolly, Director of Health Equity and Impact at Public Health England, that as we look to influence policy and share insights we need to remember it’s a complicated, messy process that will take time. Being able to recognise the faults in the system and not being afraid to call it out, is the type of honesty needed to kick start progress.
The way to deliver change is with people and not at them, which is often counterintuitive to the way systems currently work. Speakers strongly advocated the need to know when to let go and let people get out there and deliver their own future, crowdsourcing solutions for change. They argued that people need to be at the centre, not the periphery of change, and this involves stepping away from many of the traditional academic and clinical models.
Solutions to the inequality gap need action. Speakers argued that much health prevention work is too comfortable with failure, continuing to put resources into a system that is evidently not working, as we see from the growing health inequality gap. Some speakers discussed the tendency for the system to be overly reliant on research and academia, and the need to work differently. Rather than accepting the status quo, we need to make it safe to try initiatives that may fail, not just stick to developing fail-safe solutions. Nevertheless, balance is crucial to delivering meaningful results. Other speakers reflected that knowledge, people and inspirational leadership in equal measures are essential to effect change.
For us, a health in all policies approach is vital if we are to reduce the heath inequality gap we see in our boroughs. We are committed to working collaboratively and in partnership with people from across all sectors to maximise our impact. Through our programmes and partnerships, we work with others to use our collective efforts, powers and resources to improve health in some of the UK’s most diverse and deprived areas.
The conference gave us confidence that despite the very real effects that inequalities have on people’s health, reducing the impacts of poor health on our most vulnerable communities is an attainable goal, if everyone focuses on that same goal in a collective and meaningful way.