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System resilience and neighbourhood action on social determinants of health inequalities: an English Case Study

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System resilience and neighbourhood action on social determinants of health inequalities : an English Case Study. / Popay, J; Kaloudis, H; Heaton, L et al.

In: Perspectives in public health, Vol. 142, No. 4, 31.07.2022, p. 213-223.

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Popay J, Kaloudis H, Heaton L, Barr B, Halliday E, Holt V et al. System resilience and neighbourhood action on social determinants of health inequalities: an English Case Study. Perspectives in public health. 2022 Jul 31;142(4):213-223. Epub 2022 Jul 8. doi: 10.1177/17579139221106899

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@article{518a6e01120d4a4c91916fb6279a60d8,
title = "System resilience and neighbourhood action on social determinants of health inequalities: an English Case Study",
abstract = "AIMS: This article seeks to make the case for a new approach to understanding and nurturing resilience as a foundation for effective place-based co-produced local action on social and health inequalities.METHODS: A narrative review of literature on community resilience from a public health perspective was conducted and a new concept of neighbourhood system resilience was developed. This then shaped the development of a practical programme of action research implemented in nine socio-economically disadvantaged neighbourhoods in North West England between 2014 and 2019. This Neighbourhood Resilience Programme (NRP) was evaluated using a mixed-method design comprising: (1) a longitudinal household survey, conducted in each of the Neighbourhoods For Learning (NFLs) and in nine comparator areas in two waves (2015/2016 and 2018/2019) and completed in each phase by approximately 3000 households; (2) reflexive journals kept by the academic team; and (3) semi-structured interviews on perceptions about the impacts of the programme with 41 participants in 2019. RESULTS: A difference-in-difference analysis of household survey data showed a statistically significant increase of 7.5% (95% confidence interval (CI), 1.6 to 13.5) in the percentage of residents reporting that they felt able to influence local decision-making in the NFLs relative to the residents in comparator areas, but no effect attributable to the NRP in other evaluative measures. The analysis of participant interviews identified beneficial impacts of the NRP in five resilience domains: social connectivity, cultural coherence, local decision-making, economic activity, and the local environment.CONCLUSION: Our findings support the need for a shift away from interventions that seek solely to enhance the resilience of lay communities to interventions that recognise resilience as a whole systems phenomenon. Systemic approaches to resilience can provide the underpinning foundation for effective co-produced local action on social and health inequalities, but they require intensive relational work by all participating system players.",
keywords = "neighbourhood resilience, social determinants of health inequalities, Humans, Residence Characteristics, Public Health, Socioeconomic Factors, collective action, place-based public health, Vulnerable Populations, community control, Social Determinants of Health",
author = "J Popay and H Kaloudis and L Heaton and B Barr and E Halliday and V Holt and K Khan and A Porroche-Escudero and A Ring and G Sadler and G Simpson and F Ward and P Wheeler",
year = "2022",
month = jul,
day = "31",
doi = "10.1177/17579139221106899",
language = "English",
volume = "142",
pages = "213--223",
journal = "Perspectives in public health",
issn = "1757-9147",
publisher = "SAGE Publications Ltd",
number = "4",

}

RIS

TY - JOUR

T1 - System resilience and neighbourhood action on social determinants of health inequalities

T2 - an English Case Study

AU - Popay, J

AU - Kaloudis, H

AU - Heaton, L

AU - Barr, B

AU - Halliday, E

AU - Holt, V

AU - Khan, K

AU - Porroche-Escudero, A

AU - Ring, A

AU - Sadler, G

AU - Simpson, G

AU - Ward, F

AU - Wheeler, P

PY - 2022/7/31

Y1 - 2022/7/31

N2 - AIMS: This article seeks to make the case for a new approach to understanding and nurturing resilience as a foundation for effective place-based co-produced local action on social and health inequalities.METHODS: A narrative review of literature on community resilience from a public health perspective was conducted and a new concept of neighbourhood system resilience was developed. This then shaped the development of a practical programme of action research implemented in nine socio-economically disadvantaged neighbourhoods in North West England between 2014 and 2019. This Neighbourhood Resilience Programme (NRP) was evaluated using a mixed-method design comprising: (1) a longitudinal household survey, conducted in each of the Neighbourhoods For Learning (NFLs) and in nine comparator areas in two waves (2015/2016 and 2018/2019) and completed in each phase by approximately 3000 households; (2) reflexive journals kept by the academic team; and (3) semi-structured interviews on perceptions about the impacts of the programme with 41 participants in 2019. RESULTS: A difference-in-difference analysis of household survey data showed a statistically significant increase of 7.5% (95% confidence interval (CI), 1.6 to 13.5) in the percentage of residents reporting that they felt able to influence local decision-making in the NFLs relative to the residents in comparator areas, but no effect attributable to the NRP in other evaluative measures. The analysis of participant interviews identified beneficial impacts of the NRP in five resilience domains: social connectivity, cultural coherence, local decision-making, economic activity, and the local environment.CONCLUSION: Our findings support the need for a shift away from interventions that seek solely to enhance the resilience of lay communities to interventions that recognise resilience as a whole systems phenomenon. Systemic approaches to resilience can provide the underpinning foundation for effective co-produced local action on social and health inequalities, but they require intensive relational work by all participating system players.

AB - AIMS: This article seeks to make the case for a new approach to understanding and nurturing resilience as a foundation for effective place-based co-produced local action on social and health inequalities.METHODS: A narrative review of literature on community resilience from a public health perspective was conducted and a new concept of neighbourhood system resilience was developed. This then shaped the development of a practical programme of action research implemented in nine socio-economically disadvantaged neighbourhoods in North West England between 2014 and 2019. This Neighbourhood Resilience Programme (NRP) was evaluated using a mixed-method design comprising: (1) a longitudinal household survey, conducted in each of the Neighbourhoods For Learning (NFLs) and in nine comparator areas in two waves (2015/2016 and 2018/2019) and completed in each phase by approximately 3000 households; (2) reflexive journals kept by the academic team; and (3) semi-structured interviews on perceptions about the impacts of the programme with 41 participants in 2019. RESULTS: A difference-in-difference analysis of household survey data showed a statistically significant increase of 7.5% (95% confidence interval (CI), 1.6 to 13.5) in the percentage of residents reporting that they felt able to influence local decision-making in the NFLs relative to the residents in comparator areas, but no effect attributable to the NRP in other evaluative measures. The analysis of participant interviews identified beneficial impacts of the NRP in five resilience domains: social connectivity, cultural coherence, local decision-making, economic activity, and the local environment.CONCLUSION: Our findings support the need for a shift away from interventions that seek solely to enhance the resilience of lay communities to interventions that recognise resilience as a whole systems phenomenon. Systemic approaches to resilience can provide the underpinning foundation for effective co-produced local action on social and health inequalities, but they require intensive relational work by all participating system players.

KW - neighbourhood resilience

KW - social determinants of health inequalities

KW - Humans

KW - Residence Characteristics

KW - Public Health

KW - Socioeconomic Factors

KW - collective action

KW - place-based public health

KW - Vulnerable Populations

KW - community control

KW - Social Determinants of Health

U2 - 10.1177/17579139221106899

DO - 10.1177/17579139221106899

M3 - Journal article

C2 - 35801904

VL - 142

SP - 213

EP - 223

JO - Perspectives in public health

JF - Perspectives in public health

SN - 1757-9147

IS - 4

ER -