Health is about much more than avoiding disease and living long lives – it’s about feeling well in mind and body, feeling safe, being part of a community and having things to look forward to.
The homes we live in, the design of our roads and high streets, the availability and quality of parks and green spaces and of recreational opportunities – these all have a bearing on our health and wellbeing. As do the types of shops and businesses that we’re exposed to, pollution levels and opportunities to mix with others.
For children living in deprived areas, a whole raft of environmental, economic and social factors combine to stack the odds of a long, healthy life against them. Sadly, prevention research has so far only helped to make the already healthy much healthier, while struggling to reach the less advantaged.
Improving the odds
Attempts to change individual behaviours, such as unhealthy eating, drinking, smoking and lack of exercise, have met with important but limited success. For example, increased awareness of links between childhood obesity and ill health – and the importance of exercise and healthy diet – will only have limited success if we don’t tackle broader issues.
These broader issues might include the many fast food outlets that children may walk past, the lack of access to high quality play and recreational facilities, streets that are not safe for children to walk or cycle to school, poor quality of school food, and, for some, insufficient income to buy healthy food.
Thanks to the UK Prevention Research Partnership £6.6m investment, we’ll look to draw focus towards the life chances of children in two predominantly deprived UK areas: Bradford in Yorkshire and London’s Tower Hamlets.
We’ll be using insights from the Born in Bradford study – one of the largest studies of its kind in the world – which tracks the lives of over 30,000 Bradfordians to find out what influences health and wellbeing. It’s thanks to the people taking part in this study, including 13,500 children born between 2007-2010, that we’ll have a much clearer picture of what action can be taken to make sure our communities, health systems and services can support a healthy childhood.
Focus on childhood
We believe the prevention of physical and mental ill-health will come from the cumulative effect of multiple, system-wide interventions. And we want to test this with a focus on early life, as it is such a critical period. Effective interventions at this stage can have a huge impact on people’s lives and health as they grow older.
We’ve brought together experts local community and authority representatives to establish priority areas of research for improving child health across three key themes: Healthy Places, Healthy Learning and Healthy Livelihoods.
For the Healthy Places work programme, we’ll map local community assets, such as community centres, after-school groups and specific local government policies and initiatives, to help us understand how best to improve them. We also want to improve the quality of green spaces.
For the Healthy Learning theme, we’ll be working to develop local ‘Evidence Active Networks’ of preschool, school and community learning venues. These networks will help develop and evaluate a wide range of approaches to improve child health.
And for the Healthy Livelihoods theme, we’ll be looking at issues such as improving access to welfare advice services, ensuring a minimum basic income for school leavers, and helping local communities to become better involved in decisions about the best ways of spending local authority budgets.
A key to our project is that we’ll be developing a strong data ‘tapestry’ that will bring together existing information with the results of our work. This will help us to better measure, and understand, the success of our initiatives.
We’ve called this emphasis on early life interventions, together with our highly collaborative approach, the “ActEarly City Collaboratory”. Our life course approach will allow us to measure outcomes not just after five years, but in 10 and 20 years.
At the start of the 22nd century, our ActEarly children will be in their seventies and eighties. We hope that what we do in our UKPRP programme will shape their lives, their health and the fairness of the cities in which they live.
This post was originally posted on the MRC Insight blog on 9 May 2019.
Professor John Wright, of Bradford Institute of Health Research, is one of eight UK Prevention Research Partnership (UKPRP) grant winners investigating wider factors, beyond the control of the individual, that impact our health.