Approaches to Health and Wellbeing

Abstract

Health and wellbeing interventions tend to be described, organised, combined and delivered in different ways across the country, but several main approaches can be identified. Lifestyle programmes aim to address the major behaviour-linked factors that are responsible for ill health: smoking cessation, reducing obesity (through physical activity and healthy eating), and reducing the misuse of alcohol. Local areas generally have strategic plans to support people to adopt healthier lifestyles by addressing the wider determinants of health; for instance physical activity strategies would cover improving access to green space for walking, sport and play. Targeted health and wellbeing programmes are focused on people's health and wellbeing at particular stages of the lifecourse such as children and young people, people of working age and older people, as identified in the Marmot Review 1 . They may also relate to particular health needs such as mental health and long-term conditions. Targeted programmes are integrated with wider preventative strategies for particular groups, such as promoting independence in older people to reduce the need for hospital admission. Neighbourhood or community development is generally focused around areas of deprivation where there are health inequalities and populations at risk of poor health. A variety of types of intervention take place on a neighbourhood basis, with most based on principles of building capacity, co-production and community engagement – to hear and act on the views of people who may otherwise not have a voice. Activity includes encouraging social networks, identifying champions for change, health promotion and skills-building. Examples include supporting Asian women to take exercise or helping communities to set up walking groups or food co-ops with the aim of these going on to operate independently. Doncaster has a strong tradition of working in neighbourhoods, with an enhanced public health programme in local areas. Their Joint Strategic Needs Assessment (JSNA) now include community profiles overlaid by thematic information about local assets such as profiles based on children's centre areas and the voluntary sector perspective on mental health. This work will be fed into a review of the well programmes' delivery model to consider how they can best meet the priorities of their Joint Health and Wellbeing Strategy (JHWS). This will be aligned with work undertaken by the local authority to reshape its neighbourhood management teams and with GP practices.