The oft-quoted Marmot review stated that 80% of causes of ill health are due to factors other than access to healthcare.
These broader determinants of health include income and social status, social support networks, education, physical environment, genetics and gender.
The majority of these can lead to preventable demand on healthcare services and, crucially, are very much rooted in place.
It is from this acknowledged truth that the New Local Government Network and Collaborate’s major new commission, Reimagining Place-Based Health, builds.
We start with place and its citizens rather than any one institution or sector and seek to build a vision beyond the usual five-year horizon.
Picture the future: communities of individuals who can take responsibility for their own health supported, where necessary, by a network of organisations operating collaboratively; home-based care is the norm; acute care is reserved for acute circumstances; promoting health rather than responding to illness is incentivised by government, and; demand for healthy goods (park runs, good gyms, fruit and vegetables) far outstrips demand for preventable healthcare interventions.
A healthy place is created by something much broader than its institutions and services.
Everything that makes up a locality – its local businesses, voluntary and community sector organisations, the councils, parks, arts and leisure facilities, community groups, friends and neighbours – all contribute to a person’s physical and mental health and wellbeing.
Utilising these assets, facilitating cross-sector collaboration and mobilising communities (virtually, as well as physically) should be at the heart of creating healthy places and healthy people.
Through our commission, we want to inspire and help broker a transformation in place-based health.
Excellence is happening in pockets currently – we will examine these through our evidence sessions in Sunderland, Suffolk, Sutton and the West Midlands.
We ask what it would take for these to be the norm – not the exception – and what is the role for local institutions in enabling this: insight building?
Catalysing social action?
Creating new behavioural and financial incentives?
Reconfiguring resources in new models of community based integrated care?
Certainly thinking beyond the boundaries of individual organisations and beyond just pooling resources (which is hard enough currently).
We are also looking to discover the best from around the country in our survey so we can help to build up a picture of what the future could look like, and then use this to understand the barriers to systemic change in the interests of citizens rather than organisations, politicians or regulators.
Our commission brings together leading experts from health, local government, housing, private and charity sectors to understand new local collaborative models, and explore the implications for our current services in order to reimagine place-based health.
Sarah Stopforth is an assistant researcher at NLGN and Sarah Billiald is managing director of Collaborate