A collaboration for better and more equitable health

2 years ago, the Health Foundation set out on a journey to develop the Collaboration for Wellbeing and Health [update: now named Health Equals]. Our ambition was to design an initiative that brought together organisations from across sectors to turn the tide on stalling life expectancy and widening health inequalities in the UK (read more about the start of this journey).

At the heart of what we were trying to do was to develop an initiative that would move the conversation and action on health from one that focuses on the role of the individual, or the health care service, to one that also encompasses the wider determinants of health. That is, the social, economic, commercial and environmental conditions that create or restrict people’s opportunities to be healthy.

Our focus on the wider determinants of health was because they were – and are – often missing from proposed policy solutions and discourse when it comes to improving health. To make real progress, they need to figure more prominently in the UK’s policy responses.

The pandemic revealed fault lines in our nation’s health and presented an opportunity for collective action

Fast forward to early 2020, and the onset of the COVID-19 pandemic brought into sharp relief the impact that people’s circumstances could have on their ability to protect themselves and their families. As the Health Foundation’s COVID-19 impact inquiry highlighted, poor health and existing inequalities left people in many parts of the UK more vulnerable to both the virus itself and the restrictions designed to stop its spread. Among the working age population in England, deaths were almost four times higher for people living in the poorest 10% of local areas compared with those in the wealthiest areas.

Experiences of the pandemic have shown with brutal clarity how people’s circumstances can impact on their health and wellbeing in ways often beyond their control (think of the single parent living in a tiny flat unable to access green space during lockdown). And while the pandemic has had cruel and deeply damaging impacts on the health and wellbeing of people from across all parts of society, some have been in a better position to weather this more easily than others.

At the heart of the Collaboration’s vision is a society where people have the opportunities for good health wherever they are born, work and live. We’ve now secured funding for 5 years, and our mission seems more important than ever. It also feels like there is now an opportunity for lasting change that wasn’t there 2 years ago. We must make the most of this increased public consciousness of health inequalities, the wider determinants of health and the need to address them if everyone is to have an opportunity for a healthy life.

Creating a new national conversation on health

The Collaboration for Wellbeing and Health will build the political and public buy-in, and the cross-sector action, necessary to translate existing evidence on the wider determinants into targeted national policy action.

Over the next 5 years we plan to work with a growing and diverse membership of new and existing voices from across different sectors, including employment, housing, education, transport and the environment. Through powerful and joined-up campaigning we want to shape a new public conversation about how health and wellbeing are created, and influence national policy change to prioritise health.

Our approach will be built around five key features:

1. Bold communications

We need to create a significant shift in public understanding of the factors that shape health, to move the narrative away from simply individual behaviour change and treating illness. To do this we will need to work with allies both within and beyond the health sector. We will run public campaigns and equip our allies with communications resources to help make the case for change.

2. A broad membership

Taking action on the wider determinants of health is a complex challenge, which cannot be achieved by one sector or organisation alone. Building on our existing membership, we will bring together a diverse membership from across the public, private and third sectors. This will help us reach new audiences, build pressure for change and develop a rich understanding of the issues and possible solutions.

3. A concrete policy agenda

The breadth of the wider determinants of health can be overwhelming and hold back incremental changes that could have a significant collective impact. Alongside broader campaigning to drive an increase in healthy life expectancy, we will work with our members to call for established policy change and develop new solutions on specific determinants of health.

4. Local experience

Our work to develop the Collaboration has uncovered an opportunity to influence national policy. However, our research and engagement highlighted a common disconnect between central policymaking and local realities. We will work to redress this balance by bringing the insights of local networks into our policy advocacy and development. This will help create more informed, persuasive and effective national policy calls.

5. A long-term remit

We want to build support for tackling the root causes of poor health and wellbeing rather than short-term fixes that address the symptoms. By taking a 5-year view, we plan to shift the fundamental foundations of the debate, and seize opportunities to make short-term progress on specific determinants of health along the way.

What’s next and how can I get involved?

We’re excited about getting started on these plans and we’ll be building our core team over the coming months. We will also be sharing the research that has informed the development of this initiative. Most importantly, this will be a collective endeavour and we would love to hear from you if you are interested in our work or would like to get involved. 

Cathy Irving (@CathyIrvingTHF) is Director of Communications at the Health Foundation.