Community Engagement for Health Equity: Insights from the Webinar
The third webinar in our series of monthly talks on addressing health inequalities discussed methods of engagement with minoritized communities, with the goal of improving access to healthcare and fostering trust between communities and their local authorities. A range of speakers from the University of Southampton, Southampton City Council, and NHS Solent shared their expertise.
Professor Joanna Sofaer - University of Southampton
“The place where you grow up is the starting point for your life’s pathway”.
Joanna Sofaer, researcher and Co-Director of the Southampton Institute for Arts and Humanities, shared her experiences engaging with young people in Southampton with the Pathways to Health organisation.
Pathways to Health works with young people from disadvantaged areas to find out what culture means to them, how they experience it, and what the cultural assets of the young people in the community are. Finding and supporting hidden cultural assets, that are important to young people but previously unrecognised as such by the city council, provides new pathways to connect with the community in order to promote health and wellbeing.
Click below to learn more about Pathways to Health.
Professor Sofaer shared research showing that the mapped areas of cultural significance for young people varied significantly to those of the adult population. Young people’s healthcare barriers were markedly different, both due to their hyperlocal communities and connection with social media and commercial brands over more traditional cultural avenues, such as the voluntary sector. A key healthcare barrier was their fear of the outdoors due to criminal danger, reducing their use of green spaces.
Pathways to Health uses creative ways to engage with young people in a safe and trusting environment, such as dance workshops. Hosting dance workshops in collaboration with community partners allowed young people to build trust and express their feelings in non-traditional ways, and provided researchers with new insights on the feelings of connectedness and loneliness in young people.
Another method community engagement is the Young Researcher Training Programme (founded in collaboration with LifeLab), empowering young people to research the things they want to know. This creates an avenue for change, with youth-led research feeding directly up to decision-makers, so that young people can forge their own pathways to health.
Professor Sofaer described how youth-led insight and a strength-based approach (focused on what a community has, rather than what is lacks), creates conditions for sustainable outcomes.
“Young researchers are exploring what a healthy Southampton should look like”.
Dr Abdoulie Sanneh - Community Cohesion and Diversity Officer at Southampton City Council
“Health equity is the absence of unfair and avoidable differences in health outcomes among groups of people.”
Dr Sanneh of Southampton City Council shared various examples of council strategies that are driven by community engagement.
He described the processes used in effective community engagement, including needs assessments; community development and active participation; co-productive planning and design alongside community stakeholders; delivery and implementation of evidence-based health interventions; and monitoring and evaluation of its success.
Within a region, there are many groups that rely on community engagement. Local authorities have a statutory obligation to engage with their communities, and other groups like health and wellbeing boards, commissioners and steering committees rely on having strong social capital for their research.
The Southampton City Council Corporate Plan has 4 overlying goals:
1) Creating strong foundations for life in the city
2) Creating a proud and resilient city
3) Creating a prosperous city
4) Successful, sustainable organisation
Dr Sanneh described some of the methods used by the council to engage with the community in achieving these goals. This included a Stronger Communities team of youth outreach and community safety officers, interdepartmental work, collaboration with community partners, scrutiny committees and community asset transfer (shifting management of the council’s assets to the community).
Dr Anastasia Lungu-Mulenga, NHS - Head of community engagement for Solent NHS
Dr Lungu-Mulenga described her work as part of a specialist team dedicated to engaging with the minoritized communities that face barriers to NHS care.
She related an experience of leading a community meeting in St Denys, where the residents described all the negative experiences they had under regional NHS care. Rather than visiting sporadically to give talks encouraging vaccination, regular visits were arranged for her to listen to the residents and build trust.
Many patients do not recognise the branched authorities of NHS services, rather viewing the NHS as a single organisation. Dr Lungu-Mulenga shared how, rather than dismissing a complaint because it wasn’t under the authority of Solent Mind, she was able to listen and pass her findings to other NHS jurisdictions.
This community group worked to identify 4 priorities they asked of NHS Solent.
To come and talk regularly (not only to rollout vaccinations, but to become a core part of the community)
To address health inequalities
To ensure everyone, regardless of background, has a good experience under the care of NHS Solent
To give the community a say in healthcare decisions and allow them a voice.
Another instance of using performative arts as a method of alternative communication is the use of slam poetry to learn from first generation migrant mothers about their experiences. Dr Lungu-Mulenga shared a video on this work, shown below.
Another tool Dr Lungu-Mulenga shared was NHS Solent’s Community Partner Network, consisting of a range of individuals and organisations. When the NHS identify a gap in engagement from a community, this network is used to research why. This is particularly useful in communities where there is a lack of trust with the NHS or local authority, such as the drug addiction community. Organisations within the network are able to engage with these groups on behalf of the NHS, whilst maintaining safe spaces.
NHS Solent also aims to reciprocate support for these organisations by reinvesting in the community. 40% of all grant money that NHS Solent is able to access as a larger organisation is then redistributed to smaller community partners.
Discussion
A discussion was led between speakers on what could be done to strengthen engagement. Some key suggestions were:
The recognition that organisations “don’t know it all”; that they need to respect the strengths of the community, and that their goals will not be achieved without community expertise.
To consider that Southampton is a dynamic community with many recently moved people and communities that aren’t online. It’s important to find and access the physical places (such as faith organisations) where communities lie.
Not to underestimate people’s agency, and to do with communities rather than do to them.
To engage with true community partners, rather than only those who claim to be community leaders.
“Nothing can replace groundwork. You have to spend time!” – Professor Joanna Sofaer
To learn more about work on health inequalities supported by Centre for the South, click below.