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10.11.17

A new paradigm for public health

Heather Henry RN MBA, Queens nurse and chair of the New NHS Alliance looks into the issue of health inequality in the NHS.

Health inequality is like the many-headed hydra of Greek mythology: no matter how many heads you cut off, the beast of rising illness is still coming to get you.

It’s time to reconsider the weapons we use to slay the hydra. It´s time to think about whether we need new ones.

Both academics and national leaders have opened a dialogue about the future of public health. Arguably, there have been four distinct ‘waves’ to advances in public health: sanitation, germ warfare driven by health technology breakthroughs such as antibiotics and vaccination, welfare reform and more latterly, lifestyle approaches – nudging behaviour change around things like alcohol consumption and exercise. Do we now need next-generation versions of these weapons, or do we need a fifth wave of public health?

Put simply, current public health approaches consist of the ‘3Ps’: health promotion, prevention and protection. Each is predicated on the idea of understanding the causes of illness.

But what if we focus on better understanding the causes of wellness? This is where we need the paradigm shift. Here, the emphasis is on social change not just service change.

Duncan Selbie, the chief executive of Public Health England eloquently sums up what it is to be well as: “having someone to love, somewhere to live and something meaningful to do.” New NHS Alliance goes further in terms of explaining how to achieve these things.

We call it the ‘3Cs’: control over the circumstances of your life, meaningful social contact and confidence to live the life you want to. These are complementary to the 3Ps, not competing. But, a purely biomedical approach is reductionist – people are not their kidneys or their anxiety. What impacts people experiencing disadvantage is past traumatic events and a life of chronic stress. You can’t vaccinate against these. And, isn´t it any wonder that the incidence of smoking and alcohol misuse is more prevalent in these communities.

So, on Wednesday 6 December at the Royal College of General Practitioners, New NHS Alliance will be holding our annual summit to discuss the economics of what we call ‘Health Creation’. Can a social model of health save money or even help the local economy, while addressing health inequalities? We will be discussing and debating innovative Health Creation approaches and ideas. For example, people who have experienced severe disadvantage starting their own businesses and improving their wellbeing by giving meaning and purpose back to them, as well as a small income. We will explore how really listening and working alongside communities, such as Gypsy Travellers, can help them feel valued and in control, as well as saving the system serious money. We will consider how different sectors, such as high street pharmacies and housing providers can be health creating by putting ‘what matters to me’ on an equal footing with ‘what’s the matter with me’.

If you are seriously interested in innovative approaches to addressing the scandal of health inequalities, please join us on the 6 December. Don´t forget to come along with an open mind.

To find out more about whether our 2017 Action Summit is right for you and your colleagues, please click here.  

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