Shrinking            the state    +      AusterityThreat to                                        Increasingcommunity    ...
Communities, power   and health    Brian Fisher MBEChair of the Socialist health        Association
RESILIENCE UNDER PRESSURE• Hollowed out  communities• Threat to mental  health• Attenuation of social  networks• Weakening...
PARTICIPATORYACCOUNTABILITY     DEMOCRATIC
ASSET-BASED WORKING
ASSET-BASED      COMMUNITY DEVELOPMENT• Statutory services become more responsive• Promotes health protection and communit...
Stronger and CD                       deeper Social                          NetworksRESILIENCE                  ENHANCED ...
OUTCOMES – HEALTH                      6-Month Survival after Heart Attack,                         by Level of Emotional ...
SOCIAL NETWORKS         REDUCE MORTALITY RISK• 50 % increased likelihood of survival for people with  stronger social rela...
A RESIDENT-LEDPARTNERSHIP  LED BY RESIDENTS  THEIR EXPERIENCE DRIVES CHANGE  FORMAL STRUCTURES MAY BE NEEDED  A CORE REACH...
OUTCOMES - RESPONSIVE         SERVICES• Services begin to change within 6  months• Affects many sectors simultaneously  (h...
RESPONSIVE SERVICES• A new dental service established• Funding of £95k to transform a derelict area into a  playpark award...
Operation Goodnight
CRIME – A CASE STUDY• “This downward trend is more than likely due to the  introduction of a permanent PCSO for Townstal a...
SOCIAL RETURN ON             INVESTMENT• With modest gains on the eight indicators, the model  posits a saving of £559,000...
NOT BIG SOCIETY• No intention to substitute statutory services with  private or voluntary.• Does not cut across work on:  ...
AN OPPORTUNITY• A new approach to improving population  health• Wraps around primary care• Links LAs and primary care• Cha...
It has transformed the way we practice medicine. It hasstopped us seeing our patients as if we were just serviceproviders ...
www.healthempowerment.co.uk
Community Development and Health
Community Development and Health
Community Development and Health
Community Development and Health
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Community Development and Health

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  • Welcome to HELP presentation will explain ¥ what HELP is ¥ who we are ¥ how we work ¥ our impact
  • Community Development and Health

    1. 1. Shrinking the state + AusterityThreat to Increasingcommunity inequalitylife A crisis in democratic accountability
    2. 2. Communities, power and health Brian Fisher MBEChair of the Socialist health Association
    3. 3. RESILIENCE UNDER PRESSURE• Hollowed out communities• Threat to mental health• Attenuation of social networks• Weakening of associational life• Deterioration in health
    4. 4. PARTICIPATORYACCOUNTABILITY DEMOCRATIC
    5. 5. ASSET-BASED WORKING
    6. 6. ASSET-BASED COMMUNITY DEVELOPMENT• Statutory services become more responsive• Promotes health protection and community resilience• Helps tackle health inequalities• Has an impact on behaviour change• Saves money
    7. 7. Stronger and CD deeper Social NetworksRESILIENCE ENHANCED CONTROL Health protection Can negotiate with services Resilience to economic More strength for self-care adversity Health inequalities reduce Better mental health
    8. 8. OUTCOMES – HEALTH 6-Month Survival after Heart Attack, by Level of Emotional Support 70 Sources of support 60 50 0Percent died 40 1 30 2 or more 20 10 0 Men Women
    9. 9. SOCIAL NETWORKS REDUCE MORTALITY RISK• 50 % increased likelihood of survival for people with stronger social relationships• Comparable with risks such as smoking, alcohol, BMI and physical activity.• Consistent across age, sex, cause of death.• 2010 meta-analysis of data [1] across 308,849 individuals, followed for an average of 7.5 years 1] Social relationships and mortality risk: a meta-analytic review. Holt-Lunstadt, Smith, Bradley Layton.Plos Medicine July 2010, Vol 7, Issue 7. www.plosmedicine.org doi:10.1371/journal.pmed.1000316
    10. 10. A RESIDENT-LEDPARTNERSHIP LED BY RESIDENTS THEIR EXPERIENCE DRIVES CHANGE FORMAL STRUCTURES MAY BE NEEDED A CORE REACHES OUT
    11. 11. OUTCOMES - RESPONSIVE SERVICES• Services begin to change within 6 months• Affects many sectors simultaneously (health, police, education)• Communities gain confidence and leaders emerge• Staff enjoy their jobs more
    12. 12. RESPONSIVE SERVICES• A new dental service established• Funding of £95k to transform a derelict area into a playpark awarded• A new GP surgery planned• Well attended social events and football sessions• Relations with the housing department improved and tenants more satisfied.• Summer holiday activities for all ages• A cooperative plan for social renewal agreed between the community and public agencies
    13. 13. Operation Goodnight
    14. 14. CRIME – A CASE STUDY• “This downward trend is more than likely due to the introduction of a permanent PCSO for Townstal and a more regular link with the Dartmouth Community College and the school.”• “The community involvement of the Townstal Community Partnership giving the residents ownership and a ‘say’ in what they want for Townstal has brought the community together and must be considered as a factor in this reduction of crime.” • Townstal Beat Police sergeant
    15. 15. SOCIAL RETURN ON INVESTMENT• With modest gains on the eight indicators, the model posits a saving of £559,000 over three years in a neighbourhood of 5,000 people, for an investment of £145,000: a return of 1:3.8• For £233,655 invested across four authorities the social return was £3.5 million.• For every £1 a local authority invests, £15 of value is created.
    16. 16. NOT BIG SOCIETY• No intention to substitute statutory services with private or voluntary.• Does not cut across work on: – Income inequality – A just tax system – A living wage• This is about responsiveness and effectiveness
    17. 17. AN OPPORTUNITY• A new approach to improving population health• Wraps around primary care• Links LAs and primary care• Challenges the balance of power• A number of models to choose from – HELP – Altogether Better – Turning Point
    18. 18. It has transformed the way we practice medicine. It hasstopped us seeing our patients as if we were just serviceproviders to people who are ‘needy’.We now recognise that they can contribute, and when yousee people light up when you ask them to do so, it changesyour relationship with them.The culture has changed. The relationships are different,deeper and more therapeutic than they are in the usualdoctor’s office.Dr Abby Letcher
    19. 19. www.healthempowerment.co.uk

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