In his seminal report Fair Society, Healthy Lives, Michael Marmot tells us that ‘people with stronger networks are healthier and happier’. We are all interconnected and our health and wellbeing is influenced by these interactions. So, how can we support stronger, positive relationships with family, friends and our local communities as part of the foundations for healthy lives?
Resilience: within, between and beyond
At the Glasgow Centre for Population Health (GCPH), we are interested in the idea of resilience and its application in practice to support the population’s health. Back in 2014, when resilience was an emerging concept in a public health context, we published a report on how we might better understand it. Our short animation explains the concept of resilience and summarises key findings.
We found that resilience is not simply a quality that is ‘within us’, enabling us to cope with life’s difficulties or recover from adversity by being tough. Resilience is also ‘between us’ – in our connections to other people, including those like us and those with different interests, opportunities and networks. Resilience is also ‘beyond us’ – whether we feel we can communicate with, and are heard by, those people and organisations that make decisions affecting our lives. These connections are often referred to collectively as our ‘social capital’.
What is needed for resilience to flourish? When we looked across policy areas, the unifying principle appeared to be allowing people and communities to realise their strengths and aspirations – we investigated this further in our work on asset-based approaches. Policies should serve people, not the other way around. So, taking economic policy as an example, rather than considering what makes our economy resilient, we might ask how the economy and forms of work can contribute to the resilience of communities and individuals.
Creating the conditions
As we know, the circumstances in which people are able to create and maintain health and wellbeing are far from equal, and the impacts far from fair. The wider context in which we live exerts a vast range of pressures – too numerous to mention here – and our social and economic situations may mean that these pressures are keenly felt. The experience of living in chronically stressful circumstances (in poverty, for example) makes successive hard times more difficult to endure and adapt to. Resilient people and communities require conditions that support them to develop and maintain social connections and networks, including the networks where decisions are made and are empowered to draw on these in order to flourish.
Not only is it the case that stronger networks lead to health and happiness, but also that health and happiness facilitate stronger networks in return.
Of course, improving health and addressing inequalities is complex, with action and interventions required across the range of influences on health. We do already know a lot about the appropriate actions to take, however. Two of the six priority areas for action in Fair Society, Healthy Lives, for example, are focused on the early years: ’give every child the best start in life’; and ‘enable all children, young people and adults to maximise their capabilities and have control over their lives’.
The early years
Drawing together learning from across GCPH’s work, Sara Dodds recently produced a synthesis paper on health and the early years, children and young people. This work identifies five key factors that are important for a child to have the best opportunity to become a healthy, happy, well-connected and resilient adult. Firstly, strong emotional attachments and positive relationships in the early years of a child’s life are fundamental. Secondly, the need to feel safe – at home, at school and in the local neighbourhood – is critical to avoid damaging, long-lasting impacts for children into adulthood. Thirdly, there is significant capacity for healing from lack of attachment and stressful early experiences if children’s circumstances change and they are exposed to nurturing approaches, with resilience supported through family connections, nurseries and schools, communities and services. Fourthly, services need to be capable of understanding and responding to differences in personal circumstances. Finally, children and young people should be meaningfully involved in decisions affecting their lives.
We all, as human beings, need social support and protection from social isolation to flourish. In practice, bringing more of ourselves to our professional roles may help us to feel better connected to each other. And we know what that can lead to.
Val McNeice is a Senior Public Health Research Specialist at the Glasgow Centre for Population Health
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