A written proposal outlining a project based on community development principles to assess and address health inequalities within a particular community.
Health inequalities are likely to affect different population groups in a variety of ways. Certain groups of people and particular factors are linked to an increased risk of experiencing health problems. Commentators such as McKeown (1979) have made the case that medicine has a small impact as a determinant of health. Others have also argued that aspects of living conditions, associated with varying levels of economic and social development are more significant in determining whether or not people become ill (Curtis, S. 2004) (Check Clark Sociology text book to identify groups that are likely to experience inequalities and list them)
In this piece of work the author will outline a proposal for a project based on community development principles which will assess and address health inequalities within a chosen community. The project will involve working with a community in East London to establish how members of the community can access information on health and well being. Health records in this community (ONS 2001) have identified risk factors associated with Cerebrovascular diseases including smoking, physical inactivity and unhealthy eating behaviours. The essay will explore the five stage community empowerment model by Bracht, Kingsbury and Rissell (1999) and processes that can be utilised to plan, assess, implement and evaluate the community based activity. Community empowerment is a state that communities may attain as a result of collective action that results in a raised level of consciousness. This results in the achievement of some redistribution of resources or decision making sought by a community or subgroup. Empowerment is a central construct of health promotion. For example, the Ottawa Charter (WHO 1986) defines Health Promotion as “the process of enabling people to increase control over, and to improve their health” (P.1). This denotes a consumer ownership of the process.
To develop this essay further, it is important to also define what a community is. Since coming to power in 1997, one of the main policy agendas that has characterised the Labour government in the UK is the commitment to values of community. Tony Blair described community as the governing idea of modern social democracy (Lloyd et al, 2007). The US Government’s 2010 Healthy People report defines community as a specific group of people, often living in a defined geographical area, who share a common culture, values and norms, and who are arranged in a social structure according to relationships where the community has developed over a period of time (World Health Organization, 1998; US Department of Health and Human Services, 2000). Members of a community gain their personal and social identity by sharing common beliefs, values and norms which have been developed by the community in the past and may be modified in the future. They exhibit some awareness of their identity as a group, and share common needs and a commitment to meeting them. Maser (1997) combines the notion of community and empowerment (communal action) which he terms as community development. He defines community development as the capacity of people to work collectively in addressing their common interests. In other words, it can be attributed to seeking to empower individuals and groups of people, with the skills they need to advocate on their own behalf, improve their lives, and provide communities with access to resources. (Jones et al, 2006) A community development approach to health is underpinned by an understanding that economic, social, physical and psychological factors impact on individuals’ and communities’ health. This social determinants model of health recognises that the circumstances within which people live affect their access to health services and their health status. Community development...
References: Bracht, N., Kingsbury, L.,and Rissel, C. (1999). Health Promotion at the Community Level: New Advances. Thousand Oaks, CA; Sage Publications.
Curtis, S. (2004) Health and Inequality. London; Sage Publications
Earle, S. (2007) Theory and Research in Promoting public Health, London; Sage/the Open University
Jones, L., Sidell, M., and Douglas, J., (2006) The Challenge of Promoting Health: Exploration and Action. London; Palgrave
Lloyd, C.E., Handsley, S., Douglas, J., Earle, S., and Spurr, S. (2007) Policy and Practice in Promoting Public Health. Milton Keynes; Sage/The Open University
Maser, C. (1997) Sustainable Community Development: Principles and Concepts. Delray Beach ;
St. Lucie Press,
McKeown, T. (1979) The Role of Medicine: Dream, Mirage or Nemesis. New York; Tavistock
Plant, R. (1998) Social Policy and Social Justice: The IPPR Reader, Cambridge; Polity.
Wanless, D., (2004) Securing Good Health for the Whole Population: Final Report, London; HM Treasury
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