It’s been a week or 2 since I attended a very useful forum on Promoting healthier communities, the public health forum was held at Keele University on 16th June 2009. I took the notes during the day and have since tidied them up a little, hope you find these notes, especially the questions useful?

Looking at political ideologies, looking at macro and micro approaches, top down and bottom up interventions. Looking at the impact of interventions.

Three initial questions were:

What constitutes a healthy community?

What do we mean by good communities?/ how do we assess that?

How do we recognise good intervention?

A vital point raised early on was:

Does the community exist?

Defining community agreeing on a definition, communities are in a state of flow, therefore evaluations are difficult.

What do we mean by community health?

What macro factors facilitate or inhibit it?

We discussed the limited data and evaluations on the impact of community based interventions. We need more robust data, longer term data is needed, 1000’s of factors also finding meaning for the individual is vital. Instead of focusing purely on problem analysis, we need to develop more appreciative inquiry:

How can we identify what we are doing well and sharing this information?

Data has only started to be collected on interventions and so therefore is scarce.

During the discussions we learned there are difficulties with short term targets,the inherent difficulties in making quick wins, therefore there is a need for longer term studies.

Another interesting question came about:

Does it matter about having little data when you can see the impact on individuals?

Randomised control trials (RCT’s) are not very useful, however there are other methods to get evaluation, such as participatory evaluation, “….the model of evaluation needs to be owned by the community as well as the professionals”

In relation to health determinants, more global approach to focusing on targets, current health promotion messages can be counter productive, people can switch off. Some concerns that targets are divorcing communities, too specific targets i.e smoking and not on community health as a whole.

We need to understand what the community’s issues and not assume, we need to move away from the ideology of “we know what the problems are and we tell the community the solutions” which can lead to blaming the individuals, or local orgainsations when the outcomes are poor.  We also need to wait for things to work. There was debate over the potential to increase inequalities, possibly though language and the way resources are shared out.

A philosophical question focusing on the potential improvements to health was if people  live longer…then what?

There was an agreement that we need to establish relationships and to work with stigma such as “Stoke as a sick city”. Also the issue that resources seem to leak out of stoke.

One of the discussion groups developed a ‘manifesto’ for Stoke- individual health budgets with help, better heath education in schools, cheaper gyms. Create a physical bike riding infrastructure helping communities to identify aspirations and help to achieve them.

Community arts is one way of engaging with the community/groups, this allows a different approach to understanding the issues to the community and explore ways of addressing them, these questions emerged:

Why use arts?

• sense of purpose through the arts projects
• participation with agencies
• broke down barriers
• attracted more resources for future work
• put wider issues on the agenda

How do community artists solve tensions?

How does comm arts help with engagement any ore effective than other models of engagement?