REALITIES in Health Disparities: Researching Evidence-based Alternatives in Living, Imaginative, Traumatised, Integrated, Embodied Systems

REALITIES (Researching Evidence-based Alternatives in Living, Imaginative, Traumatised, Integrated, Embodied Systems) is a collective of lived and felt experience community researchers already embedded within three localities in Scotland (Clackmannanshire; Easter Ross in the Highland; and North Lanarkshire); local council representatives; third sector organisations; artists; environmentalists; Scottish national dance, theatre and singing bodies; an executive non-departmental public body of the Scottish Government; and academics from diverse disciplines including health policy; health economics; mental health nursing; counselling, psychotherapy and applied social sciences; new public management; human geography; environmental sociology; design innovation and participatory design; and the arts.

Our life experiences, work in communities and research has made us accept that we're part of a fragmented, traumatised system. Guided by Karen Treisman's thinking on organisational trauma, we're seeing the system as the 'client' or 'vulnerable participant' or 'deprived person' with 'lived experience'. Burnt out and suffering from compassion fatigue, the traumatised system polarises people, places and processes. It's crisis driven; avoidant or detached emotionally to cope with insurmountable global inequities. It's chaotic; dysregulated; disconnected.

Our multi-site collaboration will co-design and test the scalable REALITIES model - to piece together the fragmented parts of the system to bring about integrated systemic change through conscious and co-ordinated engagement in hyper-local communities - using a multi-faceted approach that connects people, places, processes and power. We'll think differently and creatively about divergent perceptions of reality (ontology); different types of knowledge and evidence (epistemology) in the system (for example, how dance movement can sit alongside a statistical analysis); and we'll explore the ethics of vulnerability (who decides who is and isn't vulnerable and what does this label mean for the so-called vulnerable?). We're also uniting academics from multiple disciplines, who use diverse methodological approaches to analyse health disparities, and bringing them into deep, critical conversations about data, methods, theories and analysis. The REALITIES model will take us towards methodological convergence (or help us find ways to integrate methodological divergence) that situates participatory, arts-informed, creative-relational, (post)-qualitative approaches alongside positivist, scientific approaches in the evidence-base. In summary, our team will:

i) facilitate cross-partner collaborations in three localities - Clackmannanshire; Easter Ross; and North Lanarkshire (NL) - to establish multiple, clearly defined asset hubs in these neighbourhoods. The hubs have focus on creatively connecting employability, health and social care (particularly mental health), transport accessibility, community learning and development, and the environment.

ii) map and investigate how Integrated Joint Boards in these localities work with non-statutory community groups to connect cultural, natural, social and creative-relational assets to address health disparities;

iii) explore how excluded communities in the system - 'The Outliers' - namely prisoners, ex-offenders, refugees and those experiencing homelessness are integrated within statutory and non-statutory services and partnerships in these localities;

iv) co-design and explore the new scalable REALITIES model across emergent asset hubs in the three localities to understand how we can collaboratively create healthier communities across Scotland.