”We all have a piece of the jigsaw but are seeing the picture differently,” Hilda Campbell of COPE Scotland said of efforts to tackle health inequalities at Voluntary Health Scotland’s annual conference last week.
“Now, we need to move from looking at our piece of the jigsaw and starting to put it together with other people so that we have a common vision.”
However, it is a puzzle that we don’t have the luxury of dawdling over. We have already taken far, far too long and each further delay is another life fractured or lost.
Former Chief Nursing Officer, Anne Jarvie, who recently served on the Commission on Housing and Wellbeing, shared the stark fact that nearly 5,000 children across Scotland will spend this Christmas homeless. The value of housing is often underplayed, she said, and yet ‘home’ is the key place in which wellbeing is created or lost. Our homes provide shelter, security and a space for family activities and individual development. They are essential to health and wellbeing and quality of life. For these children, the clock is ticking.
“We should act as though time has run out,” Voluntary Health Scotland’s Claire Stevens’ said, “because it has for those living in the gap.”
Ending health inequalities should not be “Mission Impossible”, she added. But we must move from describing health inequalities to taking action.
Professor Carol Tannahill of the Glasgow Centre for Population Health’s, helpfully set out the core principles that should apply to all our efforts.
- Level up, not down. We need to close the gap by improving the outcomes amongst those whose outcomes are currently worse, she said. This means recognising that we will need to deliver services differently and more intensively for those with the greatest need.
- Focus on causes not consequences of inequality. We need to remove barriers to access and make positive outcomes and behaviours easier.
- Start young. A good start in life doesn’t guarantee good outcomes, but it does make it more likely that some of the problems we see in adulthood are less likely to happen.
- Target, tailor and positively discriminate. We will not reduce health inequalities in Scotland if we do the same things in every part of the country and population. Universal doesn’t mean uniform.
- Build resilience. This will help reduce inequalities in the next wave of challenge. But it will require networks, personal skills and conducive environments to express these.
While ending health inequalities is everyone’s business, Tannahill noted that the voluntary health sector has a “crucial” role to play as it has both the knowledge and know-how to make a difference.
“It is about being flexible and sensitive to needs and individual circumstances and being able to tailor your intervention to recognise those things that really makes a difference. It is not about taking off-the-shelf solutions.”
There is real strength and sustainability in being close to the ground, which Tannahill said the voluntary health sector demonstrates “fantastically” in its work to reduce health inequalities in Scotland and the way it brings the authentic voice of people’s experience.
However, if we are all to learn, improve and, ultimately, succeed in ending health inequalities then the sector must also share its own experiences and the lessons it learns along the way. So as Tannahill urged, “When you do help, don’t forget to tell the story.”
You can join in the conversation online using the conference hashtag #ClosingtheGap2015 and share how you are making tackling health inequalities your business.
You can also ready the Storify of all the top tweets from there conference, here: sfy.co/r10LX
