12 Winter 2019
SDG3: Good health and well-being Susan Paxton, Head of Programmes (Community-led Health and Networking), Scottish Community Development Centre The Community Health Exchange (CHEX) has been part of the Scottish Community Development Centre (SCDC) since 1999, and works to support and promote community development approaches to improve people’s health and well-being. We provide support to a network of community-led health initiatives and their public sector partners who are tackling health inequalities in many communities across Scotland.
needs to be done to speed up implementation to achieve the policy aspirations to reduce health inequalities.
There is increasing recognition that whilst access to health services is important at times when people are ill, good health and well-being goes far beyond the control of the NHS. Health is the business of everyone, and there needs to be a shift towards preventing people getting ill in the first place and helping people to live in good health. This requires a focus on Over recent decades, life expectancy has addressing the wider determinants of health. risen and we have seen improvements in A shift in investment towards preventative, people’s health in Scotland, not only because self-help approaches to tackling health issues of universal health care provision, but also is imperative if we are to gain ground in due to improvements in the things that keep improving Scotland’s health. There is mounting us healthy: access to housing, education, evidence that unless people feel in control of employment, social support, income, and their health and their community support. lives, and unless power However, not everybody imbalances are redressed, has benefited from HEALTH INEQUALITIES SUMMARY GRANT PROGRAMME 2016/17 there will be little room these improvements. SERVICE USERS by PRIORITY OUTCOME for further improvement. Since 2012, the decline 36 health inequalities projects funded across Edinburgh have proven to effectively tackle health eating more healthily: 4105 30,413 in mortality has stalled 83% inequalities across the city. Those living in People increased social capital: 5127 BENEFITED Focusing on prevention and early intervention by across the whole poverty and/or who from activities directly tackling the cause of health inequalities reducing abuse & violence: 144 Of participants felt that whilst also creating resilient communities; they population of Scotland, activities had positively are marginalised will increased activity: 1572 help people stay healthier for longer. impacted their lives 85% and has actually risen increased income: 13189 continue to experience Impact targets ATE MORE increased greenspace usage: 1728 in the most socio“I've doubled the fruit I met or poorer health than other 90% HEALTHY FOOD buy and don’t buy fizzy drinks or EXCEEDED increased community capacity: 2488 sweets. I put the fruit bowl in the economically deprived groups unless there is a sitting room, so instead of going FELT LESS reduced anxiety: 1812 to the kitchen for a snack, we 85% SOCIALLY ISOLATED areas. This can be just grab fruit now” 10 significant effort to reduce reduced drug & alcohol misuse: 75 Priority explained by the existence REDUCED IMPACT OF reducing stigma: 173 the inequalities that OUTCOMES 84% ABUSE & VIOLENCE INCREASED COMMUNITY "The walking group has changed my of health inequalities, 78% persist in Scotland. From life. My fitness improved, I lost weight, CAPACITY INCREASED 36 © Professor Roger Crofts my sleep pattern changed, my skin defined as the “unfair and 82% PHYSICAL ACTIVITY a community development complexion is better; my weary bones Health FELT LESS are no longer. Others have Projects avoidable differences” in ANXIETY & encouraged me on and taken away my FELT MORE 75% perspective, there are FUNDED loneliness" DEPRESSION SEEKING 82% CONFIDENT people’s health across HELP WITH DEBT many examples of local Leverage Volunteer Hours REDUCED For every £1 funded, volunteers added a further 21% social groups and between USED GREENSPACE ALCOHOL & community-led initiatives organisations brought in a of hours to those worked by 73% 81% MORE OFTEN DRUG MISUSE further £1.69 paid staff different population that focus on supporting groups. They result in those most in need to thousands of unnecessary This model shows the collective impact 36 Edinburgh Community Health Forum organisations can improve their health and have on the health of local people. premature deaths every well-being. year. Men in Scotland’s most deprived areas spend nearly Community-led health organisations are typically rooted 24 fewer years in ‘good health’. This is unfair because these in the communities they serve and work to a social model health inequalities do not occur randomly but are socially of health. They provide a range of services to meet local determined by circumstances largely beyond an individual’s people’s needs, help them to identify issues that affect their control. In Edinburgh for example, despite being only two health, and support them to take individual and collective miles apart, the gap in average life expectancy at birth action on these issues. Edinburgh Community Health Forum between those living in the residential neighbourhoods near comprises a range of community health initiatives which to the Bankhead tramline stop compared to those living near deliver services and support to people experiencing the the Balgreen tramline stop is almost 11 years for men and poorest health and social outcomes. eight years for women. This shows, by aggregating data from a range of communitySo whilst the legislative and policy context for health led organisations, that they have a significant impact improvements and for reducing health inequalities in on thousands of individuals, often those who are most Scotland is strong, there is widespread acknowledgement that marginalised and those whom public agencies struggle to progress to implement these policies and strategies is slow, reach. The data suggests that a shift in resources to invest in and that they are not yet achieving the intended impact to community-led health approaches/organisations would have a reduce inequalities and improve health particularly for those greater capacity to achieve policy aspirations than the current who experience the poorest health and social outcomes. This practice of concentrating the vast majority of resources on is exacerbated by many years of austerity and welfare reform the delivery of health and medical services. which has resulted in significant cuts to all public services and a reduction in the workforce that delivers services across sectors, all of which have hit the poorest hardest. In sum, whilst Scottish health policy is strong on principle, more
“Whilst Scottish health policy is strong on principle, more needs to be done to speed up implementation.”
* % calculated from service user figures for each priority outcome
Infograph produced in collaboration with NHS Lothian, City of Edinburgh Council and LCHIF.
Ensure healthy lives and promote well-being for all at all ages.