Health Champions – “unlocking the power of communities”

Health Cubes_iStock_000022075266Large

By Heather Cameron

“On the societal level, we must understand that health is not an individual outcome, but arises from social cohesion, community ties, and mutual support.” Dr Gabor Maté

Health inequalities have long been an issue in the UK and despite continuous government commitment to tackling them, they continue to persist.

It is estimated that avoidable illness costs around £60 billion and that 1 in 4 deaths are preventable with the adoption of healthier lifestyles. Calls have therefore been made for radical changes in the approach to public health by improving health and wellbeing outside of the core public health workforce.

This is just the approach of the Community Health Champion model, developed by Altogether Better, which has demonstrated not only the positive impact on health but the social value of such an approach.

What are health champions?

Health Champions are volunteers from all walks of life who are provided with accredited training and support so they can undertake health promotion activities within their communities to reduce health inequalities and improve the health of the local population.

The Community Health Champion role began as a five year Big Lottery Funded programme (Wellbeing 1) in 2008. Over 18,000 Health Champions were recruited, trained and supported between 2008 and 2012, reaching over 105,000 people.

Through a combination of their training and own personal experiences, these volunteers empower and encourage people within their families, communities and workplaces to take up healthy activities, create groups to meet local needs and can signpost people to relevant support and services.

Challenges

While Wellbeing 1 succeeded in reaching many people in need, the programme also raised two specific challenges: in almost all cases, the work being done was invisible to the NHS; and securing ongoing funding to continue the support was difficult.

Peer support was later identified as the most appropriate way of trying to connect communities with health services.

Following this recognition and the success of the original model, further lottery funding was awarded to develop the Champion model and use it to engage champions, communities and health services (Wellbeing 2).

Co-production of health and wellbeing outcomes

The model was applied to health services specifically with the aim of addressing the apparent disconnect between the NHS and community-based services. It helps connect both patients with support in their communities and professional practices with those communities.

Many citizens have volunteered in different ways and in different settings. These include:

  • Practice Health Champions working closely with their General Practice to create new ways for patients to access non-clinical support
  • Youth Health Champions where children and young people are recruited, trained and supported to help young people more actively engage with and influence their own and their community’s health
  • Pregnancy and early years Health Champions who are interested in giving children a better start
  • Health Champions working within a specialist, hospital-based NHS service
  • Senior Health Champions who engage with older people, offering a complimentary approach to more formal programmes

Community-based health improvement initiatives such as this could help to strengthen community-professional partnerships and cross-collaboration among health, social and other services. And this in turn could lead to a reduction in health inequalities.

Positive outcomes

According to a recent evaluation of the Health Champions programme, Wellbeing 2 has resulted in a range of benefits:

  • 86% of champions and 94% of participants in the programme reported increased levels of confidence and well-being;
  • 87% of champions and 94% of participants in the programme acquired significant new knowledge related to health and well-being;
  • 98% of champions and 99% of participants in the programme reported increased involvement in social activities and social groups;
  • 95% of practice staff involved with the programme would recommend it and wish to continue.

Other benefits included reduced social isolation, increased levels of exercise/healthy eating and feeling physically better. One champion reported “this has helped me more than any medication might.”

Success stories  include the work of a cycle champion who has improved her own health and wellbeing, encouraged over 70 other people to improve theirs through taking up cycling, provided cycle training to over 50 people in 6 community groups and provided specific detailed help to 5 people.

Other successes have involved volunteers setting up football training, providing support to women with mental health issues, providing advice and support to ethnic minorities and providing advice on healthy eating.

In terms of monetary value, an  analysis of the social return on investment (SROI) of a series of Altogether Better project beneficiaries found a positive SROI of between £0.79 and £112.42 for every pound invested, highlighting the potential value of these initiatives to funders.

Final thoughts

At a time of increasing demands on health services and with the relentless squeeze on public sector resources, perhaps the move towards greater community empowerment and collaboration across sectors is the right one. After all, as I’m sure we’d all agree, prevention is better than cure.


If you liked this blog post, you might also want to read Heather’s earlier post on social prescribing

Follow us on Twitter to see what developments in policy and practice are interesting our research team.

 

 

Fighting the cold: working to reduce excess winter deaths

Image from Flickr user FranTaylor under Creative Commons License

Image from Flickr user FranTaylor under Creative Commons License

We may have all breathed a sigh of relief when last week’s cold snap finally eased, but for those working in public health the consequences of the cold weather are still playing out.

Cold weather poses a significant risk to health. There is a notable rise in deaths, and also illnesses and injuries, during the winter period. Indeed, in England and Wales there were 11.6% (18,200) more deaths in 2013/14 during the winter period (December to March) compared with the non-winter period (known as “excess winter deaths”).

Older people, particularly those aged over 75 years old, are most vulnerable to cold weather-related illness. The majority of excess winter deaths occur within this age group and those living on their own or who are socially isolated are most at risk. Other groups at risk include those experiencing chronic or severe illnesses, particularly heart conditions or circulatory disease, children under the age of five, and homeless people /street sleepers.

The reasons why cold weather has such a negative impact on health are complex and interlinked with fuel poverty, poor housing and health inequalities. There can be an increase in circulating infectious diseases, particularly flu and norovirus, and snow and ice can cause falls. Cold weather has also been linked to increased cases of hypothermia, carbon monoxide poisoning (from faulty heating appliances), and mental health problems such as depression and anxiety.

However, there is evidence to suggest that many of these ill effects are preventable. In some northern European countries, such as Finland, the rate of winter deaths is far lower than that in England, despite experiencing much lower temperatures.

To help address this, the Government has published an annual ‘Cold Weather Plan’ (CWP) since 2011 aimed at local authorities, health and social care staff and any professionals working with vulnerable people. The plan operates a system of cold weather alerts, comprising five levels (Levels 0-4), from year-round planning for cold weather, through winter and severe cold weather action, to a major national emergency. Each alert level aims to trigger a series of appropriate actions, which are detailed in the plan. The latest CWP was published in October 2014.

It stresses the importance of year round planning and all-winter action for reducing excess winter deaths and relieving the additional pressures on the NHS and social care which occur during the winter months. Recommended all-year actions include:

  • addressing fuel poverty
  • improving housing and energy efficiency measures
  • raising awareness of preventative actions among staff.

All-winter actions (November to March) include:

  • communicating with the public about what they can do to reduce the risk of cold weather to their health
  • identifying vulnerable clients
  • supporting vulnerable clients to seek appropriate help.

There are also key public health messages which should be communicated with residents/patients, relating to flu vaccinations, keeping homes adequately heated and ventilated, available financial support, and looking after vulnerable older neighbours and relatives.

A guide to communicating effectively with the public during periods of extreme weather was published recently by the Local Government Association (LGA). The LGA have also provided guidance for local authorities on how they can help to reduce the negative effect of cold weather on health. It highlights examples of innovative schemes, including the installation of free temperature sensors and a volunteer ‘winter squad’ to care for vulnerable residents.

Investing in cold weather planning is important – although the media focuses on travel disruption during cold weather, for many of the most vulnerable in our society it can be a death sentence.


Further reading

The Information Service has a number of resources on cold weather planning – a selection are listed below.

Cold weather plan for England 2014: making the case – why long-term strategic planning for cold weather is essential to health and wellbeing

A turn for the better (Liverpool’s Healthy Homes Programme), IN Property Journal, Jul/Aug 2014, pp42-44 (Ref No. A51407)

Staying in touch (social media), IN Local Government News, Vol 36 No 2 Mar/Apr 2014, pp44-45 (Ref No. A49753)

Behind cold doors: the chilling reality for children in poverty

Reducing harm from cold weather: local government’s new public health role

N.B. Abstracts and access to journal articles are only available to members.