Looking back over January, it struck me that as predictable as the over indulgence that can come with the festive season, is the ensuing new year flurry of marketing, advertising and features, trying to persuade us all to become healthier and happier in one way or another.
Whether through drinking less (‘Dry January’), eating more healthily (‘Veganuary’), or exercising (cut-price gym membership), there is no shortage of imperatives designed to get us all on the way to a healthier version of ourselves. And this year the new secretary of state for health Matt Hancock has joined in, stressing, as the new plan for the NHS launched, that ‘we all have a responsibility to the NHS to look after ourselves’.
On the face of it, this all seems harmless enough, doesn’t it? Surely encouraging healthier lifestyles is something to be welcomed. As a society we are becoming unhealthier, with increasing levels of obesity and multiple long-term conditions, and stalling life expectancy for the first time in a generation. And these trends impact more on those living in disadvantaged circumstances.
But a more troubling take on this preoccupation with what we can do as individuals to keep ourselves healthy, is that it crowds out space for public debate about the many factors (known as the social determinants of health) often outside our own personal control, that can impact on our health. Factors such as air quality, our social circumstances, access to nutritious food, transport, housing, education and employment. And, importantly, about how these factors can broaden or narrow the available actions we can take as individuals to be healthy.
This means there is no such thing as an equal playing field for health. Nor equal opportunities for making healthy choices. But this gets little mention among the many column inches devoted to reducing our waist inches.
At the Health Foundation, we have been working in partnership over the last year and a half with nine other organisations to set up a collaboration to raise awareness in the UK of the evidence on the social determinants of health and what can be done to address them. In November 2018, the Health Foundation’s board agreed to invest up to £15m in the collaboration over the next seven years to help deliver the ambition we had co-created over those 18 months.
The Collaboration for Wellbeing and Health is part of our wider work to promote healthy lives for all, a core part of the Foundation’s new strategy for 2019 to 2021. The Collaboration aims to build on the existing work and evidence to create the conditions for people to live healthier lives by addressing the social determinants of health. It brings together a range of organisations from different sectors based on the premise that a complex issue such as creating a healthier society, with multiple, interrelated moving parts, requires joined up action. It is informed by Collective Impact, which is an established cross-sector approach to addressing large-scale, complex social issues.
Participating organisations are contributing a mixture of knowledge, networks, funding and expertise to help bring about cross sector action. One initial area of focus is to support people, communities and organisations at a local level to reduce health inequalities. The collaboration is also aiming to inform policy and action at a national level through raising awareness and understanding of the social determinants of health and what can be done to address them.
The issues that the collaboration is hoping to help make a difference to are not new. Nor is the evidence that taking a social determinants approach can have a lasting and positive impact on people’s health and reduce health inequalities. But what this new initiative hopes to add is the power to bring about evidence-based change through aligning action across the different sectors that can have an impact on our health.
The societal challenge of creating the conditions for healthy lives for all is a long term one. And one that has proved difficult to make progress on so far, demonstrated by the unjust gaps in health between the best and worst off. The collaboration will play just one part in wider ongoing efforts by many to improve health. But it is the collaboration’s ambition that through harnessing the power of shared purpose and cross sector action the organisations involved can be greater than the sum of their parts, and begin to help bring about a shift in the way that society thinks and responds to the challenge of keeping us healthy. It is only the beginning of this journey, and we will need others to join us along the way.
I hope that in 10 years’ time when the January headlines and features begin to bombard us, urging us to do things differently to be healthier and happier, they also reflect a wider understanding of what it would truly take to achieve this for everyone.
The Collaboration for Wellbeing and Health is made up of:
- Local Government Association (LGA)
- The National Lottery Community Fund
- Joseph Rowntree Foundation
- Institute for Health Equity
- New Philanthropy Capital (NPC)
- What Works Wellbeing
- People’s Health Trust
- Race Equality Foundation
- The Health Foundation
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