Public health

  • Tom Lloyd Goodwin

    Deputy Chief Executive

    • Combined recipe for healthy communities

    How can mayoral combined authorities use their powers and resources to keep us well? In a new programme of joint working launched last month, CLES, The King’s Fund and the Health Foundation have come together to answer this key question. This project builds on a £1.3m Health Foundation award to the West Midlands Combined Authority, who will be working in partnership with eight other combined authorities over three years to drive action on health within the regions.

    English mayoral combined authorities have been established with a remit to boost sub-regional economic growth, enhance local democratic engagement and accountability and address knotty policy problems. Through their distinct powers, responsibilities and resources, they are also able to affect the wider determinants of health, such as people’s access to good quality work, transport and housing.

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    Does it work?

    Measuring impact for community wealth building

    This blog originally appeared on the MJ.

    Does it work? As the UK’s lead organisation for community wealth building, that’s the question we’re asked most frequently as the approach continues its advance into the mainstream of economic development.

    Determining the effectiveness of real-world interventions like community wealth building is notoriously hard. Unlike testing new drugs, where randomised control trials can be used to attribute cause and effect, determining the impact of community wealth building on a local population has to be attempted in the context of the world around us – with all the messiness that entails.
    “a positive impact on [the] health and wellbeing”
    But, while this is challenging, it’s not impossible. A new paper published in the Lancet Public Health last week by the University of Liverpool, University of Central Lancashire, Lancaster University and us here at CLES, shows that community wealth building in the city of Preston is having a positive impact on the health and wellbeing of its residents.
    “3% decline in antidepressant prescribing”
    Our research found that during the period in which Preston’s community wealth building programme was introduced, there were fewer mental health problems than would have been expected compared to other similar areas, as life satisfaction and economic measures improved. The introduction of the programme was associated with a 3% decline in antidepressant prescribing, and a 2% decline in the prevalence of depression, along with a 9% improvement in life satisfaction, and an 11% increase in wages, compared to expected trends.

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    How can health care organisations maximise their resources to improve population health? 

    The Five Year Forward View and evolution towards integrated care systems have placed greater expectations on the NHS to work across a geographical area and maximise its resources to improve the health of a local population. And while this focus on place-based systems of care has spurred developments in the way services are designed and delivered to help prevent ill health and promote wellbeing, limited attention has been given to how the NHS can influence the economic conditions that help create health in the first place.

    The impact the NHS has on people’s health extends well beyond its role as a provider of treatment and care. As large employers, purchasers, and capital asset holders, health care organisations are well positioned to use their spending power and resources to address the adverse social, economic and environmental factors that widen inequalities and contribute to poor health.

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