The Role of Community Organisations in Tackling Inequalities
In our communities today, inequalities manifest in various forms, impacting health, opportunity, and wellbeing across different demographics. The NHS Long Term Plan and the pervasive effects of the COVID-19 pandemic have further highlighted the need to address these disparities. As the CEO of Communities 1st, I have witnessed firsthand how community organisations are pivotal in bridging these gaps and fostering a society where everyone can thrive.
Health inequalities in Hertfordshire reveal stark realities: individuals in the most deprived areas live in good health for 18.5 years less than those in the least deprived areas. Moreover, the life expectancy for people with learning disabilities is 15 years lower compared to the general population. These statistics are not just numbers; they represent real people, families, and communities grappling with systemic barriers that limit their access to health and wellbeing. Addressing these inequalities requires a multifaceted approach that integrates community insight and action, focusing on improving living conditions, healthcare access, and social support across all sectors (Office for National Statistics) (The Health Foundation).
Community organisations at the forefront
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Reaching the Unreachable: It is often said that it is services that are hard to reach, not people. Community organisations bridge the gap, creating accessible touchpoints for individuals who otherwise might resort to emergency services due to barriers such as language, awareness, or accessibility. By providing local, familiar, and trusted services, these organisations help individuals navigate the healthcare system more effectively and avoid the need for emergency interventions.
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Addressing Wider Determinants of Health: Health is influenced by a variety of factors including housing, education, and social connections. Community organisations understand these intersections and work holistically to address them. For example, they might support youth facing crime-related stress by providing safe spaces and mentorship programmes, or assist families navigating economic hardships through food banks and financial counselling. Additionally, they aid older people experiencing social isolation by offering companionship services, community activities, and transportation to medical appointments. Unpaid carers are supported with respite care services, support groups, and practical help with day-to-day tasks.
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Building Trust and Cultural Competence: For many marginalised communities, distrust in traditional health services is a significant barrier. Community organisations, embedded within these communities and reflective of their diversity, build trust through consistent, culturally competent engagement and advocacy. This trust is crucial for encouraging individuals to seek preventive care and adhere to treatment plans, ultimately improving health outcomes.
The key to sustainable impact lies in collaboration. Integrated care systems involving voluntary, community, and social enterprise (VCSE) sectors, public health officials, and healthcare providers can harness collective strengths. For instance, community conversations and partnerships can significantly contribute to shared understanding and trust, shaping services that truly reflect community needs.
Community organisations can help integrate health and social care services, making them more accessible and seamless for users. This might involve coordinating between different service providers to offer a comprehensive care package that addresses both medical and social needs. Such integration helps ensure that individuals receive holistic care that supports their overall physical and mental wellbeing.
Successful partnerships however require mutual respect, shared goals, and clear communication. Community organisations often act as intermediaries, facilitating dialogue between healthcare providers and community members. This ensures that the services provided are relevant and responsive to the actual needs of the community. By working together, these partners can design and implement interventions that are more likely to be effective and sustainable.
Transforming how services are designed and delivered requires long-term commitment and shared accountability. Community organisations advocate for system-wide changes that include diverse voices in service design, ensuring that interventions are not only effective but also equitable.
Achieving long-term change involves sustained engagement with policymakers, healthcare providers, and the communities themselves. Community organisations play a critical role in this process by continuously advocating for the needs of the communities they serve, giving people a voice, empowering control of their lives and situations and therefore ensuring that these needs are reflected in policy and practice.
Effective change also requires mechanisms for measuring impact and holding all stakeholders accountable. While community organisations can be supported in analysing data on health outcomes, service utilisation, and community needs, it is essential for broader systems to assist in these efforts. This data is crucial for evaluating the effectiveness of interventions and making necessary adjustments.
Taking Action
Real change comes from action. Engaging community voices in the planning process is crucial, but it must be followed by tangible action. This could mean selecting specific health and wellbeing challenges identified by communities for focused interventions or adopting a 'test and learn' approach to continuously improve service delivery.
The COVID-19 pandemic has thrown into stark relief the health inequalities that exist in our society. From higher mortality rates in deprived areas to the devastating toll on black, Asian and minority ethnic communities, the crisis has underscored the urgent need to address the non-medical factors that shape people's health outcomes.
Community organisations can act as vital bridges, building trust with marginalised groups and helping to make services more accessible and responsive to local needs. Their deep understanding of communities' lived experiences is invaluable in addressing the wider determinants of health, from crime and isolation to mental health challenges.
Effective collaboration also means recognising and empowering community-led, informal solutions. Friends, family, and trusted local networks often play a far more significant role in people's health and wellbeing than formal services. By working hand-in-hand with VCSE organisations, the public sector can build on these community assets and expand the reach of support.
Ultimately, tackling health inequalities requires shared ownership and accountability across all local partners. It's not solely the responsibility of healthcare providers. Community organisations, residents, and public sector bodies must come together to identify the respective actions they can each take. This means creating more opportunities for ongoing, accessible community conversations that feed directly into service design and delivery. It means investing in longer-term VCSE partnerships and equipping professionals with the skills to collaborate effectively with people and communities.
At the heart of any effort to reduce inequalities must be trust-building between commissioners, providers, community organisations and communities. This means going beyond traditional consultation to truly listen to diverse voices and lived experiences. As one local resident shared, they are willing to engage in their own wellbeing, but face obstacles in accessing services. By tapping into the expertise of community groups, the NHS and local authorities can co-design solutions that resonate with all populations.
The COVID-19 response showed what's possible
During the pandemic response, we saw the immense value community organisations brought. From staffing testing sites and distributing food parcels, to sharing public health messaging in multiple languages, their roles were vital. Now, as we look to the future, it's time to solidify and properly resource these partnerships on a longer-term basis. These groups should have a permanent seat at the table.
The role of community organisations in tackling health inequalities is irrefutable. They bring insights, accessibility, and trust to the healthcare equation—elements that are indispensable in addressing the root causes of health disparities. As we look to the future, the integration of these organisations into the wider health system is not just beneficial but essential for creating equitable health outcomes for all. By investing in community-driven solutions and authentic partnership working, we can emerge from this crisis more united and resilient. It won't be easy, but drawing upon the assets within our communities is an essential piece of the puzzle. Together, we can build a more inclusive and healthier society for all.
Only through the concerted efforts of healthcare providers, community organisations, and the individuals they serve can we hope to address the systemic barriers that perpetuate health inequalities. By fostering trust, ensuring accessibility, and promoting holistic wellbeing, community organisations can lead the way in creating a society where everyone has the opportunity to thrive. As we continue this journey, the commitment to equity and collaboration must remain at the forefront of our efforts.
Stephen Craker,
Chief Executive, Communities 1st.
