Across the world, systems tend to see health as something ‘provided’ for and through people rather than one where it is ‘created’ with and alongside.
For over 500 years, Guy’s and St Thomas’ Charity has worked to improve people’s health. Our resources were left to us with the instruction to treat “the incurable” health challenges of people living in the London boroughs of Lambeth and Southwark.
The nature of these challenges has changed over time. They are today as complex as they have ever been. They relate not only to people’s physical and mental health, but also to what people perceive a healthy life to be; not only to the individual in isolation, but also to the context in which they live; and not only to the absence of illness, but also to the ability to thrive.
And this suggests to us two important points. Put simply, that people and place matter.
Like many others, we believe that progress on complex health challenges starts from a simple perspective - that of the person.
But while at one level this is incredibly obvious (who wouldn't design something around the people for whom it’s intended?) experience tells us that it’s surprisingly difficult to do well in practice. Across the world, systems tend to see health as something ‘provided’ for and through people rather than one where it is ‘created’ with and alongside.
And so we’re delighted this year to be partnering with Nesta Health Lab in hosting a conference on The Future of People Powered Health. Together we aim to showcase the very best examples of how people are creating health and wellbeing themselves, and explore how these solutions can be sustained.
We recently commissioned Uscreates to carry out ethnographic research in Lambeth and Southwark to inform our own thinking on the effect of urban, diverse and deprived environments on people’s health.
The impact, we’re learning, is highly complex. It varies from individual to individual – in some cases, the risk factors of urban living are amplified by diversity and deprivation. In others, they cancel each other out. For example, faith and community ties provide protection for some against the health risks of the high cost of living or poor housing.
All of which is to say: focusing on people alone might not be enough. We also need to focus on the worlds in which they live.
So our contribution to this debate is that of place.
We believe health improvements have a better chance of succeeding when rooted in a richer understanding of people’s context – from the streets they avoid, to the shops they buy from, to the local services they use or ignore because who ‘they feel they are for’.
Our work looks at these sorts of issues, alongside variations in outcomes across our boroughs, and uses both as a starting point to identify where to focus our resources. Our hypothesis then is that to tackle complex health challenges you to need do many things at once. Put simply, that’s our new strategy: with partners, to take a coordinated approach on a small number of issues.
Our first programmes are on childhood obesity and people living with multiple long-term conditions. On these, we want to see how social movement, community-led change, and data and design-driven approaches can combine to be more than the sum of their parts.
The growing practice of putting people at the centre of health is exciting. For both us and Nesta, the next step is working with a much greater understanding of precisely how people’s place impacts on their attitudes, behaviours and ability to keep well. We think that can make a huge difference on health.
And if you’re drawn to the same opportunities, do please start a conversation with us.
Guy’s and St Thomas’ Charity is an independent, place-based foundation. Find out more about its work in health in urban, diverse and deprived areas at www.gsttcharity.org.uk. The Charity’s new report Personal perspectives on urban health and wellbeing: Insights on the assets and risks of urban environment, diversity and deprivation is out now.
Nesta Health Lab held the second annual 'The Future of People Powered Health’ event in central London on May 9 in partnership with Guy’s and St Thomas’ Charity. Find out more and replay the event live stream here.