Tackling Health Inequalities: Doing it better

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Tackling Health InequalitiesDoing it better

• Lessons for the voluntary sector and grant makers

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Tackling Health Inequalities

• What do we mean by health inequalities?
• The big health problems what are they?
• What is the role for the voluntary sector and why
  is it important?
• What should grant makers do?

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Tackling Health Inequalities

• The role of the NGO Forum
• The Forum was established to help improve public
  health and reduce health inequalities across the
  UK.
• It does this by bringing together public health
  experts from non-governmental organisations
  (NGOs) and government policy makers.

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Tackling Health Inequalities

• The Royal Society for Public Health
• Created September 2009 following the merger of
  the Royal Institute of Public Health and Royal
  Society for the Promotion of Health
• Members
• Education
• Vision, Voice and Practice

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Tackling Health Inequalities

• Inequalities are between social classes with
  life expectancy in the wealthiest areas seven to
  eight years longer than that in the poorest
  areas.
• Inequalities between geographical
  areasNorth/South, within neighbourhoods
• Inequalities between different ethnic groups
• Gender men not accessing services, increasing
  number of women immigrants

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Tackling Health Inequalities

• Global WHO Commission on Social Determinants of
  Health
• National Post-2010 strategic review of health
  inequalities (the Marmot Review) 
• London Mayor on his Health Inequalities Strategy
  (due to be published very soon).
• The London population is more mobile than
  anywhere else in the country, younger, more
  ethnically diverse and includes some of the
  wealthiest and some of the most deprived areas of
  the UK.

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Tackling Health Inequalities
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Tackling Health Inequalities

• Obesity/overweight
• Ageing population
• Heart disease
• Long term conditions e.g. diabetes
• Sexual health
• Mental health

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Tackling Health Inequalities

• Voluntary sector
• All sizes and all shapes
• Many focus on health issues
• Even more address well-being and health
  inequalities without even thinking about it

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Tackling Health Inequalities

• Betterdays - African Caribbean Breast Cancer
  Support
• By providing, accurate, easy to understand
  information, as well as practical and emotional
  support. Betterdays Cancer Care has been working
  for 7 years to make a difference in the lives of
  African Caribbean women affected by breast Cancer.

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Tackling Health Inequalities

• Furniture on Street
• Set up by Old Ford Housing Association
• Social enterprise model
• Provides sustainable street and garden furniture
• Works with young people
• Local labour, locally made products

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Tackling Health Inqualities

• Mobile Repair Service
• Covers North East London
• Does those jobs no one else will
• Used to be family and neighbours but people are
  more isolated
• Does the extra bits that need doing without the
  person having to worry about the cost.

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Tackling Health Inequalities

• One-to-One Enfield
• runs an Living a Healthy Life course annually,
  includes information on exercise, and to raise
  the awareness to the detection and prevention of
  cancer, diabetes and heart disease.
• The users lead this organisation and when their
  lost friends from heart disease and undiagnosed
  cancer they decided to something

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Tackling Health Inequalities

• Derman Health Advocacy Service
• Their research proves that Turkish Kurdish
  patients to get better access to appropriate
  health services, helps professionals deliver a
  better service, and makes a significant
  contribution to the bringing about improvements
  in the health of Turkish and Kurdish patients.

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Tackling Health Inequalities
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Tackling Health Inequalities

• The people with money and stability, they say, oh
  yeah we know how you feel - they really don't.
  They are looking from the outside in - you can't
  do that. If you want to help someone or you want
  to be a so-called council for the borough, you've
  got to look from the inside out.

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Tackling Health Inequalities

• You have people that are homeless, addicts and
  alcoholics that have suffered trauma, and the
  statutory agencies are like - we're going to put
  them here, into gainful employment, right? But
  they forget that there's an un-housed state of
  mind - it's just like somebody being in a battle
  zone for five years - you can't expect that guy
  to come out and get a job in a month. I think
  that's what a lot of these service providers fail
  to understand. They just want to tick the boxes.

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Tackling Health Inequalities

• What works?
• Engage people in places where they naturally come
  together
• Dont impose solutions
• Community led so they help find the problem and
  find the solution

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Tackling Health Inequalities

• Grassroots or genuinely organic community
  associations are often treated with suspicion, or
  channelled by the imposition of third party
  intervention, often aimed at changing or
  directing peoples behaviour.
• Ref The Future of the Community, edited D
  Clements, A Donald, M Earnshaw and A Williams.

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Tackling Health Inequalities

• Funding for voluntary projects too short
• Scarce resources tied up in making new
  applications
• Second (and first) applications must be new / a
  fresh project with its own rationale
• Fear of failing and ability to take risks limited
• Adapted from an article by Dr Rowan Williams in
  Engage magazine, May/June 2009 issue

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Tackling Health Inequalities

• Grant makers
• Go out and see the work
• Dont always ask for innovation if its working
  and making a difference why not let it carry on?
• Support the unpopular and the smaller
  organisations
• Give money to build resources within the
  organisation