RWJBarnabas Health’s Post

WE DON’T HAVE A HEALTH PROBLEM, WE HAVE A VILLAGE PROBLEM Post-industrial societies often lack the social embeddedness that citizens require to fully participate in the civic, environmental, and economic life of their communities. Such erosion of the social fabric represents a social and health hazard. Growing awareness, among clinicians and their health allies, of this social malaise and its correlation with poor health outcomes has led to an increased focus on population health and community approaches. It has also given rise to some new health programmes aimed at demedicalising and relocating the emphasis towards socialisation, such as social prescribing, which is concerned with referring patients into community-based activities. While reversing medical overreach and promoting a social model of public health [1] is to be strongly endorsed, in this paper, however, I contend that social prescribing falls significantly short of challenging the dominant medical model, which is primarily focused on managing sickness [2], not health promotion or the broader agenda of population health. Community building following the principles and practices of Asset-Based Community Development is, I propose, a more comprehensive and compelling alternative. The community building approach advocated here views health as tied to socio-political, economic and environmental conditions, and while not discounting the value of individual agency, it asserts the need for collective agency for health creation and the pursuit of social and economic justice for all. Hence, I argue we do not have a health problem per se, we have a village problem. To read the full paper click here: https://lnkd.in/eS__BC54 . [1,2] Cormac Russell, (2020) Community Medicine, Vol. 1, Chapter 1, pp. 1-12.

Reform is a word that is thrown around when we are considering change. But the term reform implies a very different type of change to what many of us are familiar with. With social prescribing in the UK, this is a worthwhile concept, but when we simply bolt it onto the side of our current health services, this does not embed the concepts of social prescribing. It does not shift our health services towards reform. Social prescribing is often used as an alternative to do ing the work. The underlying power dynamics and poorly designed services remain in place. This approach does not create a new dynamic between the community, third sector, and people. Anyone who is serious about reforming the health sector will learn much from this article by Cormac Russell

I could not agree with John Mortimer and Cormac Russell more. Having attended training on ABCD by Cormac over a decade ago (Exeter Co-Lab), what he speaks of consistently is how we support the development of the assets of community, the strengths of individuals and communities (in relation to each other), to work away from a place of 'doing to' towards supporting and enabling them to fulfil their ambitions. This is a massive psychological step for the public sector that habituates 'doing to' as the experts with the resources. But in the community context the communities are the experts, and the resources lie less with the public sector these days. The public sector role in this is now fundamentally different. We need to develop our skills in listening, understanding, connecting, unlocking and empowering those communities achieve their highest future possibilities. I still don't think we have cracked that in any authentic way. In the early days of Social Prescribing (in fact before it was a thing) we, in Devon, were working through both asset based community development approaches and also working with the vcse (note the VCSE and not necessarily the community) to have representatives embedded in multi-disciplinary teams across Health and Social Care but still based in the community. It might have pre-dated the 'SP' model that health imposed, and it did have similarities but we absolutely knew that this was a non-clinical model driven from the enablement of the VCSE - and this did not come 'free' and those delivering the social prescribing also needed support and resourcing. However the Social Prescribing vibe landed from the NHS along with funding, skewing the playing field and it tended to place the social prescriber in a GP surgery context as part of a medical model, its aims to divert avoidable demand away from the NHS. The resources went to the employment of link-worker in preference than passing it down into the community and those delivering the 'prescription'. Many viewed the VCSE as a 'free/low cost offering' - making it feel like an inferior 'product' to the resources located at the clinical level. In many ways SP is neither social or a prescription it should be called community-driven wellbeing and its resourcing and ownership should be more firmly placed in service of the community and not in the service of the NHS - which is the wrong source. IN many ways 'social prescribing' is the right solution, placed against the wrong 'problem'. To 'solve the NHS' we need to move the genuine locus to supporting community development and prevention/intervention in the community, by the community. Its a mistake to view the NHS as the owners of health. By continuing to focus the bulk of resources into the NHS to fix it just enforces the paradigm that they do.

Absolutely. We can empower individuals but creating empowering social contexts is the key to lasting change.

An inspiring read - makes me think about how we can support more of these sorts of place-based discussions across Western Australia. With community *leading* the discussions, supported by services and systems. And where I live, we have the added benefit of strong Indigenous ways of being in community that we can learn from, thanks to the careful and tenacious stewardship of Aboriginal and Torres Strait Islander peoples across what we now call Australia. In my work in the health system, I see an increasingly urgent need for place-based solutions, but we've organised ourselves into very centralised governance structures - understandably so as we seek economies of scale. I'm left thinking: what's the community's tolerance for a potential decrease in public sector "efficiency" - my assumption being there would be some increase in costs to transition to a more place-based approach - to deliver a potential increase in community wellbeing? Some words that stood out for me: * "Community is the smallest unit of health, not isolated individuals." * "[Asset based community development] is based on anthropological accounts from residents with regards to what they use to become collectively productive and powerful as citizens. ABCD, therefore, involves paying attention to what is in a local place, *not what outside actors think should be there, or what they believe to be absent.*" * "If upward of 20 per cent of people attending their doctors are not doing so for biomedical reasons but due primarily to social isolation... then caring societies ought to seek to get to the root of those issues, and not just to provide one-sided ameliorative relief-based interventions that solely address the *symptoms*." * "We cannot expect to engage with and refer socially isolated people to communities via social prescribing or any other method of referral unless in tandem we support citizens to collectivise their efforts to build their communities from the inside out and we shift practices away from transactional referrals toward more authentic reciprocal connections." Jane Harwood Emily Hull Luke van der Beeke Dean Cracknell Nick Maisey Dan Minchin Gloria Jacob Meredith Waters Gabriella Jerrat Jessica Clements Helen Mitchell, GAICD Alison Dalziel, ACEcD Dr Sheralee Tamaliunas Avril Fahey Jody Niven Frances Downey Karina Moore Mark Fallows Pip Brennan Iqbal Samnakay Yvonne Parnell GAICD, MCHSM Ben Horgan Richard Newman Darren Munday Mad Magladry Debbie Childs Tarun Weeramanthri AM Annie Scanlon I know many of you are working towards this already - this article may be of interest if you haven't seen it yet

HEALTH CREATION ON-LINE FORUM: A rights-based approach to health and wellbeing Tuesday 25 June @ 12:30-13:30 Led and facilitated by David Aynsley, Founder and Trustee of Tr14ers, a rights-based Community Dance Charity, and a THCA Associate Join Zoom meeting: https://lnkd.in/dXDHYqeC My human rights and your human rights are the same because they are universal. They are our human rights. This is about equity. What may not be universal is our access to our human rights or the state’s legal and moral responsibility to enable the causes of good health as well as remove the causes of ill health. This is about inequality. We must make ourselves familiar with our human social rights because they are one of the foundations on which a whole-system, nationwide, health creating approach can be achieved. Knowing our rights gives us permission to be inventive in redesigning services and pathways and take novel actions that enable more people to achieve their right to the best standard of health attainable. This theme runs through our recently launched manifesto like a golden thread and is included in the eight personal actions we can take to deliver change. Join us next Tuesday to hear more about how access to human social rights creates health and how Health Creation gives us access to our human social rights. This is reciprocity in action.

At People Helping People, we tackle social challenges in the broader community through a multi-faceted approach aimed at creating sustainable and meaningful impact. Our initiatives are designed to address key issues and contribute to the overall well-being of society: Community Needs Assessment: We begin by conducting comprehensive needs assessments to understand the unique challenges faced by different communities. This data-driven approach ensures that our efforts are targeted and aligned with the specific needs of the people we serve. Education and Skill Development: Recognizing the transformative power of education, we run programs and initiatives that promote learning opportunities, scholarships, and skill development. By empowering individuals with knowledge and skills, we aim to break the cycle of poverty and contribute to the community's overall growth. Healthcare Access: Access to healthcare is a fundamental right. We collaborate with healthcare providers, organize medical camps, and facilitate awareness campaigns to improve healthcare access in underserved areas. Our goal is to enhance the overall health and well-being of the community. Food Security Initiatives: Hunger and malnutrition remain pressing issues. Through food drives, community kitchens, and partnerships with local businesses, we work to ensure that no one in our community goes to bed hungry. Our food security initiatives are designed to provide sustenance and support to those in need. Advocacy and Community Building: Beyond direct interventions, we engage in advocacy efforts to raise awareness about social issues. By fostering a sense of community and encouraging collaboration, we aim to create a network of support that goes beyond immediate challenges. Partnerships and Collaborations: Collaboration is at the heart of our approach. We actively seek partnerships with other NGOs, businesses, and government agencies to amplify our impact. By working together, we can address social challenges more comprehensively and effectively. By combining these strategies, People Helping People strives to be a catalyst for positive change in the broader community, fostering resilience, empowerment, and a brighter future for all.

How do accessible communities prioritize the health and well-being of their residents? Accessible communities prioritize the health and well-being of their residents by implementing various strategies and initiatives. Here are some ways in which accessible communities address health and well-being: 1. Access to Healthcare: Accessible communities ensure that residents have convenient access to healthcare facilities, including hospitals, clinics, and medical professionals. They prioritize the availability of quality healthcare services and work to eliminate barriers that may prevent individuals from receiving necessary medical care. 2. Active Transportation: Accessible communities promote active transportation options, such as walking and cycling. They prioritize the development of sidewalks, bike lanes, and pedestrian-friendly infrastructure to encourage physical activity and reduce reliance on motor vehicles. This not only improves physical health but also reduces air pollution and traffic congestion. 3. Parks and Green Spaces: Accessible communities provide ample parks, green spaces, and recreational facilities. These areas offer opportunities for residents to engage in outdoor activities, exercise, and connect with nature. Accessible design principles are applied to ensure that parks and green spaces are inclusive and can be enjoyed by people of all abilities. 4. Healthy Food Access: Accessible communities prioritize access to healthy and affordable food options. They support the establishment of grocery stores, farmers markets, and community gardens in underserved areas. This ensures that residents have access to fresh, nutritious food, reducing food insecurity and promoting healthier eating habits. 5. Mental Health Support: Accessible communities prioritize mental health support services. They work to reduce the stigma around mental health and provide resources such as counseling services, support groups, and mental health awareness programs. These initiatives help residents maintain positive mental well-being and access the support they need. 6. Age-Friendly Design: Accessible communities design their infrastructure and public spaces to be age-friendly. This includes features such as well-maintained sidewalks, benches, ramps, and accessible public transportation. These design elements make it easier for older adults to navigate the community independently and safely, promoting their overall well-being. 7. Inclusive Recreation and Social Activities: Accessible communities offer a range of recreational and social activities that are inclusive and cater to diverse needs. This may include adaptive sports programs, inclusive community events, and spaces that accommodate people with disabilities. These activities foster social connections, reduce isolation, and promote overall well-being.

🌟 "The best way to find creative solutions to your real-world problems is to listen to the wisdom of those who have already found them!" 🌟 In health and social care, it’s time to shift the narrative from a top-down approach to one that values grassroots innovation and real-world wisdom. The change-makers on the ground, especially in the social prescribing sector, hold the key to transforming healthcare into a sustainable wellness model. I recently had an enlightening conversation with a founder of a social prescribing organization struggling to remain viable despite their invaluable work. From dog walking to gardening and wellbeing groups, their initiatives deeply connect with community needs but remain underfunded and undigitized. These creative interventions are more than activities; they are lifelines that prevent hospital admissions and promote wellness, yet they are often overlooked by Integrated Care Boards (ICBs). 📢 We need to amplify the voices of these groups—not only during pandemics but always. Many such organizations rely on the sheer determination of their founders and often struggle to scale or sustain operations due to financial and systemic constraints. It's high time our health commissioners, ICBs, and governmental bodies recognise and integrate these grassroots solutions into our healthcare framework. Let's decentralise power, engage with those who have firsthand experience, and revalue the contributions of voluntary, community interest groups and social prescribing services. To all in the charity sector, social prescribing, and community organisations: Your efforts are seen, your impact immense. Keep pushing forward. 💪 #HealthcareHeroes #SocialPrescribing #CommunityCare #WellnessNotIllness #GrassrootsChange #HealthInnovation #Cic #communityinterestgroups #digitaltransformation #nhs #procurement #entrepreneur

Hello Friends We are building a Optimally Healthy Community. Key characteristics of an optimally healthy community include: 1. Access to Quality Healthcare: Availability of affordable and comprehensive healthcare services that cater to the needs of all community members. 2. Healthy Environment: Clean air, water, and safe spaces that promote physical activity and reduce exposure to pollutants and hazards. 3. Education and Awareness: High levels of health literacy and education, empowering individuals to make informed decisions about their health and wellness. 4. Economic Stability: Opportunities for employment and financial stability, reducing stress and enabling access to health-promoting resources. 5. Social Support Networks: Strong community ties and support systems that provide emotional and practical assistance, fostering a sense of belonging and mutual aid. 6. Nutrition and Food Security: Availability of nutritious and affordable food options that support healthy eating habits. 7. Physical Activity: Accessible recreational facilities and programs that encourage regular physical activity for all age groups. 8. Mental Health Resources: Comprehensive mental health services and support systems to address the psychological well-being of community members. 9. Inclusive and Equitable Policies: Policies that promote equity and inclusion, ensuring that all community members have equal opportunities to thrive. 10. Community Engagement: Active participation of community members in decision-making processes and initiatives that affect their health and well-being. 11. Emergency Preparedness: Robust systems in place to effectively respond to emergencies and disasters, minimizing their impact on community health. 12. An optimally healthy community aims to create an environment where all individuals can achieve their full potential and enjoy a high quality of life. 13. This involves collaboration between various sectors, including healthcare, education, government, and community organizations, to address the diverse needs of the population. We have an ongoing Optimally Healthy Community. 09 Jun 24 we had a sharing and learning session. Recording of the same are attached. Any one wish to be part of this wonderful forward looking community you are welcome to contact me on my 9880032903. Look forward to your point of view on this for improvemnet