Skip to Main Content
Have library access? Log in through your library
People-centred public health

People-centred public health

Jane South
Judy White
Mark Gamsu
  • Cite this Item
  • Book Info
    People-centred public health
    Book Description:

    People-centred public health examines how members of the public can be involved in delivering health improvement, primarily as volunteers or lay health workers. With a foreword by Professor Sir Michael Marmot and Dr Mike Grady, this timely book draws on a major study of lay engagement in public health, using case studies and real life examples to provide a comprehensive and accessible overview of policy, practice and research in this area. In an economic and political climate where there is renewed interest in the role of the citizen, the authors challenge old orthodoxies in public health and build a coherent argument for radical change in the way public agencies support lay action. The book is aimed at readers with an academic or professional interest in public health and/or community involvement, including practitioners and managers within public services and the voluntary sector, and post-graduate and undergraduate students studying public health, health promotion, public sector management, social policy and community work.

    eISBN: 978-1-4473-0532-3
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-ii)
  2. Table of Contents
    (pp. iii-iii)
  3. List of tables, figures and boxes
    (pp. iv-v)
  4. Glossary
    (pp. vi-viii)
  5. Notes on the authors
    (pp. ix-ix)
  6. Acknowledgements
    (pp. x-xi)
  7. Foreword
    (pp. xii-xii)
    Michael Marmot and Mike Grady

    The Commission on the Social Determinants of Health ‘Closing the gap in a generation’ was commissioned by the World Health Organization and reported in 2008. The overarching recommendations included: improving daily living conditions for all people throughout life; tackling the inequitable distribution of power, money and resources; and measuring and understanding the problem and assessing the impact of action to achieve greater health equity in a generation.

    Fair society, healthy lives(The Marmot Review, 2010a, 2010b) brought together the best available evidence and proposed six key policy objectives to address the social determinants of health and reduce the health gap...

  8. Series editors’ preface
    (pp. xiii-xv)
    Stephen Peckham and David Hunter
  9. ONE Introduction
    (pp. 1-14)

    The public health system forms a framework encompassing all the different sectors that contribute to the public’s health (Hunter et al,2010). Despite the undisputed place of communities within that system, the contribution of civil society to meeting health goals receives minimal attention within public health policy and practice in England. Instead, public health effort has tended to focus on gathering evidence and working through organisations primarily in the health sector to deliver interventions supported by specialist practitioners. Communities can end up defined by their problems and therefore become the deserving ‘target’ of public health interventions, rather than being seen as...

  10. TWO The policy context
    (pp. 15-30)

    In response to the fiscal and political challenges facing society, governments have been prompted to re-evaluate the relationship between citizens and the state and, at least within policy documents, to recognise the contribution that the public can make to health and social care. This chapter examines the current policy context, and traces some of the major policy themes concerning citizen involvement in service delivery. It looks at how the rhetoric of some policies is in sharp contrast not just with other policy pronouncements, but also with the actions taken by government.

    The chapter starts by briefly sketching the scale of...

  11. THREE Lay health workers in practice
    (pp. 31-44)

    This chapter explores the recent history of lay people getting involved in health, starting with programmes established top–down by agencies external to the communities they serve — be they government, non–governmental organisations or charitable foundations — with a particular focus on community health workers. It then looks briefly at activities that have grown ‘bottom–up’ as a result of communities initiating action themselves. The aim of the chapter is to provide a context for considering lay health worker programmes designed to improve health in the English public health system and to reflect on learning from the successes and challenges elsewhere....

  12. FOUR Benefits and value
    (pp. 45-60)

    This chapter looks at the main justifications for involving members of the public in delivering public health programmes. It draws on findings from the People in Public Health study to present some core reasons why services might wish to involve members of the public (South et al, 2010b). Indeed, there was remarkable consistency around these reasons in the different elements of the study. Some of the emerging themes discussed here will be explored in more depth in the case studies of public health projects in Chapters Six to Nine, but this chapter provides an overview of the main arguments around...

  13. FIVE The lay perspective
    (pp. 61-72)

    This chapter explores the perspectives of lay health workers and service users regarding members of the public taking on health improvement roles. There is a paucity of literature elucidating lay perspectives (Farquhar et al,2008), particularly reporting the experiences of programme recipients. One of the primary aims of the People in Public Health study was to investigate consumer perspectives on these roles, thereby building knowledge in this area, and this chapter presents findings from interviews, expert hearings and workshops conducted as part of the study (South et al,2009,2010b). The chapter also draws on material from recent evaluative studies conducted by the...

  14. SIX Walking for Health – a case study
    (pp. 73-86)

    Walking for Health is a national initiative promoting community-based health walks, coordinated until recently through Natural England (Natural England, 2011b), and endorsed by the NHS (Department of Health, 2009). As a public health intervention, Walking for Health has achieved considerable success in terms of the scale of volunteer involvement to support wider participation in health (The Countryside Agency, 2005). The case study presented in this chapter focuses on the organisation and delivery of a local scheme operating across one Primary Care Trust, and the experience of being part of Walking for Health is explored through interviews with practitioners, volunteer walk...

  15. SEVEN Sexual health outreach – a case study
    (pp. 87-100)

    There is a long tradition of using peer–based interventions in sexual health promotion, particularly in relation to HIV/AIDS prevention (Janz et al, 1996; Medley et al,2009). This chapter presents findings from a case study of a sexual health outreach project that worked within the gay community to promote uptake of sexual health screening services. Volunteers were involved in supporting a community–based screening service for men who have sex with men and undertook peer education in gay bars and clubs. This small sexual health outreach project is of interest not only because it illustrates lay involvement within a community...

  16. EIGHT Community Health Educators – a case study
    (pp. 101-114)

    One of the primary motivations for involving lay people in delivering health promotion activities is the potential to engage underserved or marginalised populations who experience poor health. This chapter presents findings from a case study of a Community Health Educators programme, where the lay health workers performed a bridging role within disadvantaged urban neighbourhoods, taking out health messages to local communities and supporting people to participate in healthy activities. The Community Health Educators were recruited from the communities they worked with and the programme focused on their personal development and empowerment. The case study is of interest because the programme...

  17. NINE Citizen involvement in neighbourhood health – a case study
    (pp. 115-126)

    Community health projects come in all shapes and sizes; some work with a particular community of interest or a specific health theme, others are more generic, delivering a range of health promotion activities often in a neighbourhood setting or based within a community centre. Such projects have been part of the landscape of health promotion in the UK since the 1970s (Tones and Tilford, 2001; Amos,2002); nonetheless, projects are often small–scale, overly reliant on funding from short–term grants and rarely incorporated into mainstream health provision. The case study presented in this chapter provides a critical examination of volunteering...

  18. TEN Commissioning and delivery
    (pp. 127-148)

    This chapter discusses the key challenges in commissioning and implementing health improvement programmes that engage volunteers and members of the public in lay health worker roles. It builds on the previous chapters, in particular, the case studies and what can be learned from them about how to develop best practice. The effective engagement of lay people in improving the health of their communities needs a whole–system approach that is holistic in nature (Hunter et al,2010). A whole–system approach makes it possible to see the interactions between different elements of the system and avoids reducing complex issues to component...

  19. ELEVEN Dispelling the myths
    (pp. 149-168)

    Throughout this book, evidence has been presented of ways in which lay people are improving community health and what needs to be in place to enable them to do this effectively. This chapter takes a step back to consider whether citizen involvement is necessarily a ‘good thing’ and to explore and challenge some of the counter–arguments about lay health workers and active citizenship in health. These counter–arguments can be broadly categorised into four:

    1. ‘It’s a diversion, as only addressing structural inequalities will improve health and address inequalities.’

    2. ‘Involving lay people is too risky – professionals are needed.’...

  20. TWELVE Future directions
    (pp. 169-180)

    If there is to be success in addressing the major health challenges of today, in tackling the social gradient of health and in promoting well–being in all sectors of the population, then public health needs to be done differently. The current public health system, the way the workforce is organised and the downstream focus on lifestyle interventions is evidently not up to the task in hand. Debate about public health capacity continues to focus almost exclusively on the capabilities and resources of professionals, rather than recognising the capacity of citizens and communities to make a significant contribution. Despite all...

  21. References
    (pp. 181-204)
  22. Appendix: The People in Public Health study
    (pp. 205-206)
  23. Index
    (pp. 207-217)