The future of improving the nation’s health

Elwell-Sutton, Tim; Finch, David; Jenkins, Deborah; Ranmal, Rita; Marshall, Louise; McNeill, Olivia; Briggs, Adam; Cameron, Genevieve; Malhotra, Mimi

doi:10.37829/hf-2020-hl11

Cited by 7 publications

(10 citation statements)

References 9 publications

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“…When the body of the literature is considered, lay perceptions recognise the complexity of several contributing factors resulting in health inequalities including macrostructural, place-based, psychosocial, material and individual's lifestyle/behavioural components. 5,14,25,26,30,31,36 Furthermore, discussing health inequalities can be emotive, for example, emotions reported in the literature include helplessness, 31 worry, 25 inferiority, shame and concern about being judged particularly when comparison between social groups occurred 30 as well as feeling stigmatised. 25,33,36 In particular, shame has been reported due to concerns of 'being "looked down on"' 36(p. 9) and how other people may have wrong perceptions regarding the reasons for any money difficulties, for example being falsely perceived as lazy, or the shame around 'living in the "wrong" kind of housing'.…”

Section: Discussionmentioning

confidence: 99%

“…However, the research findings around public understanding of health inequalities can be conflicting, likely because of the varying methods used and the way the questions were framed. When the body of the literature is considered, lay perceptions recognise the complexity of several contributing factors resulting in health inequalities including macrostructural, place‐based, psychosocial, material and individual's lifestyle/behavioural components 5,14,25,26,30,31,36 . Furthermore, discussing health inequalities can be emotive, for example, emotions reported in the literature include helplessness, 31 worry, 25 inferiority, shame and concern about being judged particularly when comparison between social groups occurred 30 as well as feeling stigmatised 25,33,36 .…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, knowing how the public view and understand health and health inequalities is important to help frame the conversation and communicate the evidence in the most effective way to the required audience. 5 For example, to aid the UK government's proposed levelling-up agenda, a programme of work aimed to help reduce geographical inequalities, researchers have made policy recommendations which included 'to broaden the public narrative on health outcome disparities from being perceived as a predominantly health service issue (dealing with the impact) to a social/structural issue that everyone needs to invest in'. 6(p. 4) It was suggested that a public conversation could assist this discussion.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Coproduction of a resource sharing public views of health inequalities: An example of inclusive public and patient involvement and engagement

Parbery‐Clark,

Nicholls,

McSweeney

et al. 2023

Health Expectations

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BackgroundUNderstanding Factors that explain Avoidable hospital admission Inequalities—Research study (UNFAIR) addresses how to reduce health inequalities, particularly for avoidable hospital admissions. Our Patient and Public Involvement and Engagement (PPIE) members broached that health inequalities are complex, challenging to understand and communicate. They identified a need to explore diverse views, including people who have a higher risk of health inequalities. With limited public‐facing resources relating to the public's understanding or emotions around health inequalities, this project aimed to fill this gap using co‐leadership and co‐production.MethodsMembers of the public worked with researchers to co‐produce and run PPIE workshops. This project was co‐led by a member of the public and a researcher. One online workshop open to anyone in England accompanied by three face‐to‐face workshops were held. Public contributors, including people living in diverse communities, were invited. Inclusive involvement opportunities were offered including flexible ways of involvement and remuneration. To strengthen the key messages' rigour, transcriptions of the audio‐recordings from each workshop, with facilitator notes, were analysed using thematic analysis. From the key messages, an animation was co‐produced with public contributors with the public's voice being integral throughout.Key MessagesA total of 58 people took part capturing intersecting and multiple dimensions of marginalisation including people with a range of ages, genders, ethnicities, socioeconomic backgrounds, and members of communities who face exclusion (including people with learning difficulties and experiencing ill‐health). The animation highlighted powerful lived experience, for example, some people are dying earlier than expected. Health inequalities conjured up powerful emotions, such as anger and hopelessness. Public views of how to address health inequalities included respecting, accepting and valuing everyone, regardless of, for example, where people live. The animation is publicly available for use by anyone, including decision makers across the health and care system.ConclusionsThrough co‐leadership and co‐production, this project is an example of inclusive PPIE. This project provided a way for the public's voice to influence policy and practice to inform understanding and action to address health inequalities. The animation provides powerful insights into what health inequalities mean to people with examples of lived experience and corroborates the moral argument for action by decision makers.Patient and Public ContributionMembers of the public, including people who were affected or at higher risk of health inequalities, co‐led this project and were involved as co‐creators and developers from the inception of the project to completion. Their involvement was integral and documented in full throughout the project.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Coproduction of a resource sharing public views of health inequalities: An example of inclusive public and patient involvement and engagement

Parbery‐Clark,

Nicholls,

McSweeney

et al. 2023

Health Expectations

View full text Add to dashboard Cite

show abstract

“…In such circumstances, culturally shared 'frames' (e.g. in the form of simplified narratives, myths, analogies or generalisations) provide simplifying structures that allow people to make sense of complex and ambiguous information (Elwell-Sutton et al, 2019;Frameworks Institute, 2018). Frames have their own internal logic and, by emphasising certain aspects over others, encourage particular understandings of social problems.…”

Section: Conceptual Frameworkmentioning

confidence: 99%

The sociocultural framing of public attitudes to sharing the costs of social care for older people in England

Dixon

Exley²,

Wistow

et al. 2022

Health Social Care Comm

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Twelve synchronous online focus groups were conducted, each involving four to six members of the general public who had expressed in-principle support for sharing the costs of social care for older people between service users and government.These explored participants' reasons for preferring a shared approach and their views on how costs should be shared, with particular attention given to the sociocultural frames employed. Four main sociocultural frames were identified, reflecting dominant discourses concerning (i) the financial burden of meeting social care need ('scarcity' frame) (ii) the core purpose of social care ('medicalised conception of care' frame) (iii) the role and perceived limitations of the private market ('consumer' frame), and (iv) fundamental concerns about safety, security and belonging ('loss and abandonment' frame). Of these four frames, the 'scarcity' frame was dominant, with views about how costs should be shared overwhelmingly formulated upon assumptions of insufficient resources. This was reflected in concerns about affordability and the consequent need for the financial burden to be shared between individuals and government, and resulted in a residual vision for care and anxieties about care quality, cliff-edge costs and abandonment. The concept of shared funding was also employed rhetorically to suggest an equitable approach to managing financial burden, reflected in phrases such as 'splitting the difference'. Whilst out-of-pocket payments were sometimes seen as useful or necessary in the context of scarce public resources, the idea of shared funding was sometimes interpreted more flexibly to include individual contributions made in a range of ways, including tax, social insurance payments and wider social and economic contributions to society. Despite the dominance of the 'scarcity' frame, participants favoured greater government contribution than currently. These four frames and their associated discourses provide insight into how the public 'hear' and make sense of the debate about social care funding and, specifically, how apparent support for shared public-private funding is structured. Government and those hoping to influence the future of social care funding need to promote a vision of funding reform and win support for it by actively engaging with the sociocultural framesThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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“…It was announced in August 2020 that Public Health England was to be dismantled and replaced by the National Institute for Health Protection (Elwell-Sutton et al 2020). This new organisation's priority focus will be the ongoing management of the pandemic.…”

Section: Building Back Fairer: Investment Is Needed For the Long Termmentioning

confidence: 99%

Building Back Fairer: investment is needed for the long term

Cheater

2021

International Journal of Health Promotion and Education

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The future of improving the nation’s health

Cited by 7 publications

References 9 publications

Coproduction of a resource sharing public views of health inequalities: An example of inclusive public and patient involvement and engagement

Coproduction of a resource sharing public views of health inequalities: An example of inclusive public and patient involvement and engagement

The sociocultural framing of public attitudes to sharing the costs of social care for older people in England

Building Back Fairer: investment is needed for the long term

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