Riding the Rollercoaster of Health Improvement
In 2009 I moved out of my comfortable role as a Health Practitioner, to a newly formed Health Improvement Service. Anecdotally, I was aware that the area I would be working in was renowned for its health inequalities and social problems. On my third day in post, a Community Councillor likened the task to being handed a “poison chalice”.
Unlike my previous role, there was no intervention to deliver, no PowerPoint handout to aid my delivery, and no firm way of defining success that was measurable. How would I know if I was capable of making a difference? A new team, placed in the epicentre of complex, inter-generational challenge, accompanied by my feeling that the residents had chosen to abandon the value of good health and wellbeing.
I paused and reflected on the task ahead, exploring strategies that would enable me to break down the barriers that I was feeling about the unknown. I drafted some short and long-term goals and this helped to ground me and accept that change would take time.
I realised that my ability to rise to the challenge was based on the collective strength of my colleagues. Together, we set out by literally walking the walk… we wanted to have a physical presence and be more than the previous team that delivered public health improvement from an office. We took the communities’ lead and paused the paraphrasing from the NICE guidance, and instead began building a relationship with the residents. Whether we were dressed up as giant head lice with nit combs in the schoolyard, or standing outside a dilapidated pub, handing out recipe cards we lived and breathed our new normal.
Yet I still struggled to understand how our team would demonstrate success. Yes, we could provide data on numbers through the door, how many freebies we gave away at a consultation event, but so what? What difference was made? To this day, I’m still not sure how you can succinctly articulate where our team was most effective, but such is the challenge and privilege of working in a community engagement role. From my perspective, that moment came whilst working with a group of teenagers. Bravado, body odour, and bad language was always a component of a ‘cook and eat’ session, but on this particular occasion, it was also accompanied, for the first time, by snippets of engagement and a sense of inclusion. Tentative steps away from floundering and belief towards a brighter future.
The realisation? This WAS public health in action and it was making a small, significant difference. I stayed in the role for five years and observed pockets of growth, cohesion and developed my own fresh approach to actively listening to and working with ideas — rather than being led by biases or stereotypes. I learned that deprivation within a community does not define the individual, rather my work with individuals can support shaping a community.
The role gave me the foundation into public health improvement that I didn’t know I needed and an experience that no textbook could provide. It ignited a passion inside me to empower others and be an advocate for change. The next step? Deepen my understanding and theory and apply it better, and enable others to do similar. Returning to academic study has been an easy choice and I’m learning how best to combine study with a full-time job, but this time around, I have hindsight and the power of reflection to help me along the way.
Have I handed myself a ‘poison chalice’ or a golden ticket? Only time will tell.
