How to create productive and progressive partnerships with health

On 3 March we launched our Healthy Neighbourhoods report. This event was the culmination of an eight-month research and events programme which aimed to develop clear and practical recommendations for the creation of more productive and progressive partnerships between the health and built environment sectors.

In addition to outlining the report findings, this event featured two speakers. Here we highlight their useful reflections on how to implement the report recommendations and have an impact on health inequalities.

Our speakers were:

  • Dan Barret, Director, Thrive London, who outlined the implications of the report for London’s mental health
  • Merron Simpson, Chief Executive, The Health Creation Alliance, who reflected on the recommendations related to community engagement.

From Dan’s perspective, the report’s focus on broadening the case for health is of key importance in the wake of Covid. The pandemic has heightened mental health inequalities whilst creating new ones. Although our mental health is influenced by a whole range of factors, many still see health as a sector or a service, not an attribute that is heavily affected by our environment. To encourage those beyond health to take more of an active role requires effort from lots of different sectors. One practical action Thrive LDN are taking is to train councillors on how they can use their power and influence to create mentally healthier environments. They’ve trained over 200 councillors across 20 London boroughs and are keen to do more.

Cross-sector collaboration

Merron explained that with her background in housing and her work in health she often acts as a ‘sector bridger’. She reflected that “Bringing insight together across many different sectors, although it’s immensely difficult, it’s also immensely powerful”. The Healthy Neighbourhoods report calls for better cross-sector collaboration and more meaningful engagement with community groups. Merron agreed that now is a really good time to be doing this.

Dan reinforced the opportunity (as put forward in the report) offered by the roll-out of Integrated Care Systems (ICSs) for the built environment and health to work together more effectively. These place-based partnerships will provide scope for a broader range of groups to work together to improve health at a population level. He suggested drawing on the Centre for Mental Health’s model for mentally healthier ICSs and the Office of Health Improvement and Disparities’ set of resources for better mental health for further guidance on how we can make healthy environments more of a reality.

The importance of community control

How can we go about activating the reports’ recommendations around increasing the power of communities, so that they can define and influence their own health priorities? Merron suggested the Health Creation approach.

“Health creation is the process through which individuals and communities gain a sense of purpose, hope, mastery and control over their own lives and immediate environment. When this happens, their health and wellbeing is enhanced.”

Health creation can often be overridden by political and economic forces, but where it is working, its because of progressive partnerships like the ones showcased in the report. Dan highlighted a good example – South London Listens (as part of Thrive LDNS’s Right to Thrive programme) where conversations and community meetings were held with over 6000 people to develop a shared action plan for mental health.

Health creation as a tool

The principles of heath creation are contact, confidence and control. Building meaningful and constructive contact between people and within communities increases confidence, which leads to greater control over their lives and their health. In short, and as reflected in our report, communities taking control improves health. But how can we, as built environment professionals, create the conditions for this to happen? Merron outlined the health creation framework which has huge relevance to citymakers considering how to work better with communities on place-based projects. The features below were derived from talking to communities whose health has improved and asking what has made a difference to them. The key conditions are as follows:

  • Listening and responding
  • Trust-telling – the foundation of trust
  • Strengths-focus – drawing on the asset of the community, rather than seeing them as a problem
  • Self-organising – or connecting people, developing collective agency
  • Power-shifting
  • Reciprocity – people are willing to give a lot, but they need to get something back.

Beyond this framework, the Health Creation Alliance have ‘dug deeper’ into what people need to be able to create health in their communities.

Slide showing diagram of a framework for creating health in communities. People need to be connected, have space, to employ/enjoy skills and passions and to take control

The Health Creation Alliance have found that where community partnerships adopt these principles, it genuinely makes a difference, improving health and reducing A&E attendance and GP appointments. Merron warned that if we don’t engage with health in an active way, we will see inequalities widen further. And she challenged us to see working meaningfully with communities as a shared ambition or opportunity, rather than a barrier. It’s up to us as citymakers to embed this kind of approach to make sure that health improvement and creation is a routine part of our projects.

The Healthy Neighbourhoods programme was possible thanks to our sponsors Montagu Evans, Mount Anvil and Pollard Thomas Edwards. Take a look at the report for more practical ideas of how you can improve health outcomes through your work. Some of the themes raised in the launch will be picked up by our Knowledge programme in 2022 , including a focus on community engagement. Keep an eye on our website for more information, or get in touch with Anna Odedun, Head of Knowledge, if you’d like to be involved.