Improving health and reducing health inequalities through a systems resilience approach

Popay, J.; Simpson, Glenn; Ring, Adele; Porroche-Escudero, Ana; Barr, Ben; Holt, Vivien; Mosedale, Sarah; Sadler, Gill; Wheeler, Paula

doi:10.48037/mbmj.v7i12.74

Cited by 4 publications

(8 citation statements)

References 2 publications

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“…This finding reflects wider debates in relation to the extent to which public, media and professional discourses may undervalue the strengths and contributions of older adults or at‐risk groups during crisis periods 43 . Finally, diarists' situations also showed vastly different experiences of the pandemic, highlighting that crisis responses also need to address underlying social determinants of mental health, 34 rather than focusing only on building resilience of individuals and communities 44 …”

Section: Discussionmentioning

confidence: 84%

“…43 Finally, diarists' situations also showed vastly different experiences of the pandemic, highlighting that crisis responses also need to address underlying social determinants of mental health, 34 rather than focusing only on building resilience of individuals and communities. 44 A key limitation relates to the small participant sample, which largely reflected a female and older demographic who were retired or not in paid employment. This meant that the study did not address the implications of juggling work and family responsibilities, which has gender-related implications for mental health.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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‘A lot of small things make a difference’. Mental health and strategies of coping during the COVID‐19 pandemic

Halliday

Holt

Khan

et al. 2021

Health Expectations

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Introduction The social and economic consequences of COVID‐19 have the potential to affect individuals and populations through different pathways (e.g., bereavement, loss of social interaction). Objective This study adopted a solicited diary method to understand how mental health was affected during England's first lockdown. We also considered the experiences of diary keeping during a pandemic from the perspective of public participants. Methods Fifteen adults older than 18 years of age were recruited from northwest England. Diarists completed semistructured online diaries for 8 weeks, which was combined with weekly calls. A focus group captured participants' experiences of diary keeping. Findings Four key factors influenced mental health, which fluctuated over time and in relation to diarists' situations. These concerned navigating virus risk, loss of social connections and control and constrictions of the domestic space. Diarists also enacted a range of strategies to cope with the pandemic. This included support from social networks, engagement with natural environments, establishing normality, finding meaning and taking affirmative action. Conclusion Use of diary methods provided insights into the lived experiences of the early months of a global pandemic. As well as contributing evidence on its mental health effects, diarists' accounts illuminated considerable resourcefulness and strategies of coping with positive effects for well‐being. While diary keeping can also have therapeutic benefits during adversity, ethical and practical issues need to be considered, which include the emotional nature of diary keeping. Public Contribution Members of the public were involved in interpretation of data as well as critiquing the overall diary method used in the study.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

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‘A lot of small things make a difference’. Mental health and strategies of coping during the COVID‐19 pandemic

Halliday

Holt

Khan

et al. 2021

Health Expectations

Self Cite

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“…The NRP sought to operationalise the concept of neighbourhood system resilience and evaluate the impacts. [37][38][39] The NRP was developed by partners in the Collaboration for Leadership in Applied Health Research and Care in the North West Coast region of England (CLAHRC NWC) between 2014 and 2019. It was funded by the English National Institute for Health Research and CLAHRC NWC partners and implemented in nine Neighbourhoods For Learning (NFLs).…”

Section: The Neighbourhood Resilience Programmementioning

confidence: 99%

System resilience and neighbourhood action on social determinants of health inequalities: an English Case Study

Popay

Kaloudis

Heaton

et al. 2022

Perspect Public Health

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Aims: This article seeks to make the case for a new approach to understanding and nurturing resilience as a foundation for effective place-based co-produced local action on social and health inequalities. Methods: A narrative review of literature on community resilience from a public health perspective was conducted and a new concept of neighbourhood system resilience was developed. This then shaped the development of a practical programme of action research implemented in nine socio-economically disadvantaged neighbourhoods in North West England between 2014 and 2019. This Neighbourhood Resilience Programme (NRP) was evaluated using a mixed-method design comprising: (1) a longitudinal household survey, conducted in each of the Neighbourhoods For Learning (NFLs) and in nine comparator areas in two waves (2015/2016 and 2018/2019) and completed in each phase by approximately 3000 households; (2) reflexive journals kept by the academic team; and (3) semi-structured interviews on perceptions about the impacts of the programme with 41 participants in 2019. Results: A difference-in-difference analysis of household survey data showed a statistically significant increase of 7.5% (95% confidence interval (CI), 1.6 to 13.5) in the percentage of residents reporting that they felt able to influence local decision-making in the NFLs relative to the residents in comparator areas, but no effect attributable to the NRP in other evaluative measures. The analysis of participant interviews identified beneficial impacts of the NRP in five resilience domains: social connectivity, cultural coherence, local decision-making, economic activity, and the local environment. Conclusion: Our findings support the need for a shift away from interventions that seek solely to enhance the resilience of lay communities to interventions that recognise resilience as a whole systems phenomenon. Systemic approaches to resilience can provide the underpinning foundation for effective co-produced local action on social and health inequalities, but they require intensive relational work by all participating system players.

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“…The principles of a whole-system approach outlined by Stansfield et al 12 are used in this study to explore ways in which community and organisational connectivity is being (re)built with communities facing significant challenges as a result of living in one of the 10% most deprived wards of England ( https://www.localhealth.org.uk/%23c=report&chapter=c01&report=r01&selgeo1=ward_2020.E05001087 ). Community connectivity is defined as the process of connecting people with each other, with organisations and power to influence decisions about how resources are used that affect the conditions in which people live, work and play (adapted from Popay et al 19 ). The insights gained are relevant to community-centred COVID-19 recovery efforts, using localised, place-based approaches.…”

Section: Introductionmentioning

confidence: 99%

“I think people have been in survival mode”: a qualitative study of community connectivity in a neighbourhood of North East England before and during COVID-19

et al. 2022

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ObjectivesThe aim of the study was to examine whether and how community-centred approaches facilitate community connectivity by exploring changes that matter to communities.DesignQualitative study comprising ethnographic methods, participant observation and interviews.Setting Economically deprived neighbourhood of North East England.ParticipantsInterviews with community members (n=14) and staff and stakeholders (n=14) involved in a National Lottery Community-funded initiative and 567 hours of participatory observation were undertaken between September 2019 and July 2020. Data were thematically analysed using a community-centred public health framework.ResultsCommunities experiencing disadvantage approached the pandemic adversely affected by stigma, austerity and reductions in public sector funding. Community members’ priorities centred on the environment, housing, activities for children and young people, crime, community safety and area reputation. Multiagency efforts to promote connectivity, led by voluntary and community sector organisations, were prerequisites in community-centred approaches to public health. Stakeholders reported that these approaches can help alleviate some of the health, social and financial burdens facing communities that are marginalised. Findings suggest community-centred responses were facilitated by trusting relationships, visionary leadership and lived experience of adversity among staff. Issues which appeared to hamper progress included interorganisational power dynamics and attempts to impose solutions. The strength of stakeholders’ connections to the area and to people living there contributed to laying the foundations for local responses to the COVID-19 pandemic. Relational, values-informed work with communities provided a platform to mobilise recovery assets.ConclusionsWhole-system approaches, codesigned with communities most affected, can help address the long-term consequences of COVID-19 and its negative effects on health and social inequalities. Further comparative implementation research is needed to examine the partnerships, values and principles that drive success and inclusion.

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Improving health and reducing health inequalities through a systems resilience approach

Abstract:

Cited by 4 publications

References 2 publications

‘A lot of small things make a difference’. Mental health and strategies of coping during the COVID‐19 pandemic

‘A lot of small things make a difference’. Mental health and strategies of coping during the COVID‐19 pandemic

System resilience and neighbourhood action on social determinants of health inequalities: an English Case Study

“I think people have been in survival mode”: a qualitative study of community connectivity in a neighbourhood of North East England before and during COVID-19

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