Tackling health disparities through social innovation: a multi-stakeholder coalition for inclusive health in Brent, London
Lead Research Organisation:
University College London
Department Name: Epidemiology and Public Health
Abstract
People living in the London Borough of Brent face a number of challenges, including poverty - with one in three households in Brent being classed as poor. However, this poverty is not distributed evenly across the borough, with two wards in particular - Stonebridge and Harlesden - having the highest rates of unemployment and low household incomes, as well as crime. These two wards also have the highest black population in the borough. There is also historical mistrust of police and government services in the borough, particularly in these two wards. Similarly, health patterns across the borough reflect the divisions between the more deprived areas, where life expectancy is almost 12 years less for men and 9 years lower for women compared to the least deprived. Rates of childhood obesity are higher in the most deprived areas, and a quarter of children in Year 6 in Brent are considered obese. More than half of Brent households have limited access to green spaces. There are also high rates of heart disease and diabetes, particularly among people from black and other ethnic backgrounds. Brent also experienced some of the highest Covid-19 death rates in England but has one of the lowest vaccination rates. Residents themselves have highlighted a number of issues around health and wellbeing including inadequate housing; poor nutrition and lack of healthy food options in cafes and restaurants; a lack of safe green spaces for fitness, and few other areas for socialisation such as youth clubs; high crime rates and anti-social behaviour; domestic violence; lack of support for mental health issues; difficulties in accessing health (in particular GPs) and other services, and, digital exclusion particularly for older age groups.
Brent Council was awarded central government funding to address these challenges and set up 'Brent Health Matters' (BHM), who work along with NHS partners and community groups. Their initial focus was on increasing vaccine uptake, but this has shifted to addressing wider health inequalities in the borough (including diabetes and mental health issues). Our proposed research will build on initial work between the partners to explore an innovative community-based intervention to tackle health disparities in Brent. In this phase, we want to examine how physical, knowledge and institutional assets in a community can be harnessed and deployed to address health disparities. These disparities can be described as 'syndemic', which refers to biological and social interactions which increase a person's susceptibility to harm or worsen their health outcomes.
Our consortium will use the London borough of Brent as a case study for place-based learning, examining the BHM programme as an instance of social innovation in response to health disparities. Fostering collaboration among multiple agencies - a key feature in social innovations - BHM is at the forefront of developing and deploying solutions to systemic health challenges in Brent. Among others, this research will examine whether and how this innovation is resulting in the inclusion and agency of different actors in responding to health disparities and broader societal challenges in the borough. Policies, spaces and interactions will be key in our analyses.
We will undertake participatory action research (PAR) to identify community assets in Brent and map their potential to improve health. We will then work with partners to produce a framework for co-designing inclusive community-led interventions that will utilise these assets to improve health and wellbeing. This will give us the opportunity to explore different collaborative models and policy levers for integrating knowledge co-production, before forming a consortium to deliver and measure co-designed social innovation interventions to address identified health disparities using the syndemic approach.
Brent Council was awarded central government funding to address these challenges and set up 'Brent Health Matters' (BHM), who work along with NHS partners and community groups. Their initial focus was on increasing vaccine uptake, but this has shifted to addressing wider health inequalities in the borough (including diabetes and mental health issues). Our proposed research will build on initial work between the partners to explore an innovative community-based intervention to tackle health disparities in Brent. In this phase, we want to examine how physical, knowledge and institutional assets in a community can be harnessed and deployed to address health disparities. These disparities can be described as 'syndemic', which refers to biological and social interactions which increase a person's susceptibility to harm or worsen their health outcomes.
Our consortium will use the London borough of Brent as a case study for place-based learning, examining the BHM programme as an instance of social innovation in response to health disparities. Fostering collaboration among multiple agencies - a key feature in social innovations - BHM is at the forefront of developing and deploying solutions to systemic health challenges in Brent. Among others, this research will examine whether and how this innovation is resulting in the inclusion and agency of different actors in responding to health disparities and broader societal challenges in the borough. Policies, spaces and interactions will be key in our analyses.
We will undertake participatory action research (PAR) to identify community assets in Brent and map their potential to improve health. We will then work with partners to produce a framework for co-designing inclusive community-led interventions that will utilise these assets to improve health and wellbeing. This will give us the opportunity to explore different collaborative models and policy levers for integrating knowledge co-production, before forming a consortium to deliver and measure co-designed social innovation interventions to address identified health disparities using the syndemic approach.
Title | Community researchers blogs |
Description | Each community researcher wrote a blog, one produced their own illustrated 'zine' |
Type Of Art | Creative Writing |
Year Produced | 2023 |
Impact | Increased awareness by BHM about their work, and the potential dividends from community research in terms of capacity building and engagement. |
URL | https://www.ucl.ac.uk/epidemiology-health-care/sites/epidemiology_health_care/files/zine_of_a_commun... |
Title | Community researchers blogs |
Description | Each of the two community researchers wrote a blog about their experiences of the project. |
Type Of Art | Creative Writing |
Year Produced | 2023 |
Impact | Increased awareness by BHM about their work, and the potential dividends from community research in terms of capacity building and engagement. |
URL | https://blogs.ucl.ac.uk/iehc/2023/10/04/working-as-a-community-researcher-on-the-brent-integrated-ca... |
Description | This was a short research grant with an overall aim of building a research consortium in Brent. We worked with Brent Council, specifically Brent Health Matters, to explore how community-based public health interventions (such as Brent Health Matters) could better utilise local assets to reduce health inequalities, focusing on two wards in the Borough. In addition to building up a strong research consortium, the researchers undertook a range of activities, including focus group discussions, interviews, community walks and photography to understand the challenges and opportunities in these approaches, using a framework called Political Economic Analysis (PEA). We found 17 themes, which highlighted the complex dynamics and challenges emerging in the context of community-based public health interventions harnessing local assets. The themes reflected both particular local individual concerns and challenges as well as the systemic issues faced by all interviewed stakeholders. These findings indicate challenges which are routinely seen as emerging in asset-based health projects. We also suggested some ways these might be overcome, including further resources for use by councils and communities. |
Exploitation Route | The team already collaborated with another research team funded under the same grant on a Phase 3 call. Though unsuccessful, this led to cross-council collaboration between Brent and Ealing councils, as well as researcher at UCL, IDS and other community researchers. BHM were also given a suite of policy-focused and impact tools they that could use to measure impact. |
Sectors | Communities and Social Services/Policy Healthcare Government Democracy and Justice |
URL | https://www.ucl.ac.uk/epidemiology-health-care/research/epidemiology-and-public-health/research/ucl-centre-humanitarianism-and-social-inclusion-6 |
Description | Findings from out work have been shared with the Brent Public Health (PH) team as well as BHM, including tools to help improve collection of impact data (e.g. ripple mapping). The PH team indicated they were keen to be involved in further research as opportunities arose (which has and is happening). We have maintained contact with colleagues in the council, including through engagement with students on the REACH programme (https://reachalliance.org/), who are undertaking research on digital access for people in Brent. This is led by co-investigator Julius Mugwagwa. We have also began discussions about developing this research to look more specifically at the health impacts of Brent's Climate Policy, with a view to submitting an NIHR grant in April 2024. We have also produced a number of community-focused materials, which are available online, as well as in hard copy, which is being distributed by BHM at community events. Anecdotally, this project has been referenced informally in shaping other research by Brent Public Health team, for example an application to the PHIRST (https://phirst.nihr.ac.uk/) around health and well-being in spatial planning project. |
First Year Of Impact | 2023 |
Sector | Communities and Social Services/Policy,Healthcare,Government, Democracy and Justice |
Impact Types | Policy & public services |
Description | Influence within Brent Council |
Geographic Reach | Local/Municipal/Regional |
Policy Influence Type | Influenced training of practitioners or researchers |
Description | AHRC phase 3 grant application - EBC |
Organisation | Ealing London Borough Council |
Country | United Kingdom |
Sector | Public |
PI Contribution | This collaboration led to the development of a phase 3 funding application, building on the two separate awards under phase 2. Contact was initiated by IDS to work together to develop a phase 3 proposal, with Ealing Council and other partners, which was sadly unsuccessful. MK was Co-PI on the application. All teams members contributed to drafting of the proposal. |
Collaborator Contribution | All partners contributed to the co-development of the proposal |
Impact | Grant application to phase 3 (https://www.ukri.org/opportunity/collaborative-community-research-to-tackle-health-inequalities/) Multidisciplinary team, including local authority public health teams (Brent and Ealing) and community groups (Brent and Ealing). Academics from technology and innovation, anthropology and public health. |
Start Year | 2023 |
Description | AHRC phase 3 grant application - IDS |
Organisation | Institute of Development Studies |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | This collaboration led to the development of a phase 3 funding application, building on the two separate awards under phase 2. Contact was initiated by IDS to work together to develop a phase 3 proposal, with Ealing Council and other partners, which was sadly unsuccessful. MK was Co-PI on the application, along with MSS (IDS). All teams members contributed to drafting of the proposal. |
Collaborator Contribution | Collaborative research design and co-production of grant application |
Impact | Grant application to phase 3 (https://www.ukri.org/opportunity/collaborative-community-research-to-tackle-health-inequalities/) Multidisciplinary team, including local authority public health teams (Brent and Ealing) and community groups (Brent and Ealing). Academics from technology and innovation, anthropology and public health. |
Start Year | 2023 |
Description | Brent Public Health Team Meeting |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Professional Practitioners |
Results and Impact | Formal presentation of findings to Brent Public Health team (an agenda item as part of their regular scheduled team meetings) |
Year(s) Of Engagement Activity | 2023 |
Description | Feedback to Brent Public Health team |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Public/other audiences |
Results and Impact | presentation of research finding to Brent Public Health team |
Year(s) Of Engagement Activity | 2023 |
Description | Focus Group Discussion about research with community groups |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Third sector organisations |
Results and Impact | Series of FGDs with community members in two wards in Brent. Engaged with issues and contributed to research discussions. |
Year(s) Of Engagement Activity | 2023 |
Description | Health Inequalities and Vaccination Executive Group |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Professional Practitioners |
Results and Impact | Formal presentation on research findings to the group (who are part of the North West London Integrated Care System). This was an agenda item on a regular scheduled meeting (online) |
Year(s) Of Engagement Activity | 2023 |
Description | Presentation to NWL ICB Executive board |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Professional Practitioners |
Results and Impact | Presentation about ongoing research to North West London Integrated Care Board Executive board |
Year(s) Of Engagement Activity | 2023 |