community development and community immunity dr bh fisher mbe ppi lead for the nhs alliance lead for...
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COMMUNITY DEVELOPMENT and COMMUNITY IMMUNITY
Dr BH Fisher MBE
PPI Lead for the NHS Alliance
Lead for the HELP Project
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www.healthempowermentgroup.org.uk
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THE HELP PROJECT
• A business case for investment in CD in health
• Small team supporting work in 3 estates in 3 areas - Devon, Wandsworth, Solihull
• Builds on 12 years experience
• Evidence-based, replicable
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THE HELP APPROACH We start from issues
raised by local people
We bring people and services together
We develop sustainable partnerships
We work with other local projects
We do this in ‘7 steps’
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HELP – THE 7 STEPS
1. establish a residents & service providers learning set
2. joint workshops and learning to develop skills
3. organise ‘listening events’ - residents and services
4. create formal partnership - links with community & service
5. establish monthly public partnership meetings
6. evidence of change, social capital, organisational, key indicators
7. embedding sustainability - coordination, facilitation, communications
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HELP OUTCOMES
• Post-natal depression reduced
• Breast feeding increased
• Impact on crime
• Improved educational attainment
• Increase in community resources
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WHAT COMMUNITY DEVELOPMENT CAN DO, ALL AT THE SAME TIME
• Statutory services become more responsive
• Promotes health protection and community resilience
• Helps tackle health inequalities
• Has an impact on behaviour change
• Saves money
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SOCIAL RETURN ON INVESTMENT
• CD creates £2.16 of social and economic value for every £1 invested
• For £233,655 invested across four authorities the social return was £3.5 million.
• For every £1 a local authority invests, £15 of value is created.
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OUTCOMES - RESPONSIVE SERVICES
• Services begin to change within 6 months
• Affects many sectors simultaneously (health, police, education)
• Communities gain confidence and leaders emerge
• Staff enjoy their jobs more
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OUTCOMES - TACKLING HEALTH INEQUALITIES
• Strong communities are key
• Health Inequalities are mediated through feelings of lack of control
• Unequal communities have few SNs and lack a sense of control
• More confidence breeds more SNs, stronger more vibrant communities
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OUTCOMES - BEHAVIOUR CHANGE –
• safer cycling• improved housing• reducing alcohol-related crashes, • improving alcohol-related behaviours • helping prevent injuries to children, • promoting a healthy diet in children. • effective promotion of physical activity
through walking.
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A BIT OF THEORY
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CDStronger and deeper SocialNetworks
RESILIENCE
Health protectionResilience to economic adversityBetter mental health
ENHANCED CONTROL
Can negotiate with servicesMore strength for self-careHealth inequalities reduce
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6-Month Survival after Heart Attack, by Level of Emotional Support
0
10
20
30
40
50
60
70
Men Women
Per
cent
die
d 0
1
2 or more
Sources of support
OUTCOMES – HEALTH
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WanlessAnd the engaged population
Place-based budgets
Health with roots in thecommunity
Engaged primary care
Agencies working together, with residents