Growing the evidence base on place-based health
Place can be a complicated word.
Take Guy’s and St Thomas’ Charity, for example. We’re a place-based foundation. But what does that mean? Doesn’t everything take place somewhere?
For us, place has three precise meanings:
- an actual place — for us that’s two boroughs in South London
- a type of place — we focus our energies on areas that are urban, diverse and deprived
- the specifics of place — namely, how the environments people live in create both assets and risks for their health
And we think all three can help us play an important role in addressing complex health issues of our time.
A new science
Of course, place-based health is far from new. Interventions rooted in a particular geography have been earmarked as crucial to addressing health inequity for some time.
Yet, last year, the American Journal of Public Health announced it was “at the beginning of building a new science base” to guide approaches that go beyond the individual to looking at their environments.
We recognise that need. Because while we know a lot about what works on complex health issues — multi-layered approaches; partnerships that straddle public and private spheres; an instinct to look beyond healthcare — we also know that there are no easy taxonomies or solutions.
Indeed, this seems to chime with the very nature of place-based approaches. Their beauty, and intrinsic challenge, is in tailoring responses to the unique needs of a geography and population.
As a foundation focused on health we have an incredible opportunity to contribute to this body of evidence. That is, for our work not only to be evidence-led but also evidence creating.
Working in the London boroughs of Lambeth and Southwark (two prime examples of inner-cities) we are trying to build the evidence base on the complex nature of urban health. We have started to look at the effect of our local environment on health, and something far less explored: how an inner-city setting combines with deprivation and diversity to create different kinds of impact.
Our place focus allows us to explore solutions at the neighbourhood level, investing in the long game for greater gains, and working with others to layer up activities that address different sides of the same challenge simultaneously. And we’ve chosen to learn on complex health issues that are relevant in nearly every major city — tackling childhood obesity and improving the lives of people with multiple long-term conditions.
Our theory of change
We’re at the very start of this programme of work. Our theory of change outlines how far we want to travel, how we aim to get there and, perhaps more importantly, how we plan to share what we find along the way. Our belief is that there is a vibrant local, national and international community fascinated by this question.
So, if place-based approaches are your thing, and you have methods, skills or resources that can help deliver change, do please get in touch.