We’re really proud to have been commissioned by Guy’s and St Thomas’ Charity over the last four months to produce fresh research – Personal perspectives on urban health and wellbeing published today – into the impact of living in an urban, diverse and deprived area on people’s health.
Guy’s & St Thomas’ Charity wanted to understand how the characteristics of Lambeth and Southwark – densely populated, diverse and transient; with pockets of deprivation and affluence living side by side impacted on people’s health. This insight will not only help them design their own funding programmes, but be relevant to other similar areas in the UK and around the world. There is much research about the impact on one or two of the urban, diverse and deprived characteristics on people’s health, but rarely all three.
We combined data and design in a two-phase approach. First, we compared data about health and social determinants of health in Lambeth and Southwark and other areas with similar urban, diverse and deprived characteristics. Data variances allowed us to see where specific place plays a role in health outcomes and where the underlying ‘structural factors’ of urban, diverse and deprived neighbourhoods play a more fundamental role.
Secondly, we created fresh ethnographic insight with people in Lambeth and Southwark, to build on the existing research in this area. Looking at the lived experience of people shows how these characteristics interact with each other.
We found that urban, diverse and deprived characteristics provide both protective and risk factors that can support people and prevent people from managing their health. These can interact with each other in complex ways, amplifying each other sometimes, cancelling each other out other times. For example, living in a city means that you are likely to live close by to a health service, but if English is not your first language, you might not know that they exist. If you’re from a close-knit ethnic group, they might provide informal support and advice. It’s a good thing when you’re actively managing your health and accessing services. But not when it’s based on more passive health management cultures and that you leave it until it’s too late. And access to housing often means moving about often, which might mean losing these social groups. These films of four of our participants show how these factors differ from person to person.
This means that there is an important role for place-based charities, like Guys’ and St Thomas’ to act as connectors at a systemic, organisational and individual level:
- between health and non-health services in the local area to work together to tackle the root causes of people’s health;
- between health services and communities, ensuring that services can understand the needs of their different population groups, and that communities know how to navigate services;
- between community members themselves, building more resilience so people can make the best use of the protective factors, and avoid the risk factors of urban, diverse and deprived areas.
Design can play an important role here. As well as being able to provide a deep human understanding of people’s experiences and motivations – which can help shape relevant health interventions. Its participatory nature can help co-design solutions with communities, and engage people in problem-solving and becoming more resilient. Our recent work with Healthy London Partnership co-designed and incubated three social ventures to tackle childhood obesity, one of which – Make Kit – has demonstrated impact on behaviour change, and has gone on to secure further funding from Hackney Council.
We’re also working with Islington Council and Southwark Council to change their organisational culture into a problem-solving, preventative one. This work is furthering our expertise in leading transformation projects that builds on people’s assets and strengths, and involves a diverse range of players. We’d like to convene some of these diverse voices, share our work and invite a debate. We’re organising a place-based health event on 20 June, so do register here if you would like to find out more.