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Placing health

Placing health: Neighbourhood renewal, health improvement and complexity

Tim Blackman
Copyright Date: 2006
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  • Book Info
    Placing health
    Book Description:

    Where people live matters to their health. Health improvement strategies often target where people live, but do they work? Placing health tackles this question through an examination of England's Neighbourhood Renewal Strategy and its health targets. It evaluates the evidence base for the strategy, compares experiences from the United States and elsewhere in Europe, and illustrates the relevance of complexity theory to area-based health improvement work. The book brings together these topical issues with a social science analysis of current programmes based on the methods and concepts of complexity thinking. It concludes by setting out how local action based on these ideas offers a new approach to area-based health improvement work. Placing health is aimed at researchers, academics and students in the social and health sciences with an interest in area-based health improvement work, as well as practitioners in health services, local government and voluntary agencies working on neighbourhood renewal and health projects.

    eISBN: 978-1-84742-168-5
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-vi)
  3. List of tables and figures
    (pp. vii-vii)
  4. Acknowledgements
    (pp. viii-viii)
  5. List of abbreviations
    (pp. ix-x)
  6. Preface
    (pp. xi-xiv)
  7. ONE Policy and places
    (pp. 1-30)

    This book is concerned with one of the central questions in social policy: what difference does difference make? My main concern in this respect is the difference that places make to people’s health. The purpose of this chapter is to introduce the book’s framework for exploring this question, set out the policy background, and consider how places matter for health and offer settings for interventions.

    People’s health in the UK has shown a pattern of steady improvement over several decades. Between 1971 and 2003, life expectancy for males increased from 69.1 years to 76.2 years, and for females from 75.3...

  8. TWO Health, neighbourhoods and complexity
    (pp. 31-54)

    This book argues that improving health in neighbourhoods can be informed by using complexity theory. The reason is that neighbourhoods and their ‘states’ are outcomes of complex causation.

    A relationship whereby A causes B in a linear and mechanical fashion is simple (echoing the last chapter’s point about ‘tame’ problems). Many such relationships operating together is complicated.Complexityarises when there isinteractionbetween many elements, such as the relationship between A and B depending on interactions with C, D or E (a ‘wicked issue’ in policy terms). When this happens, emergent and difficult-topredict properties can arise from the interactions....

  9. THREE Emergence and environment press
    (pp. 55-78)

    Qualitative change in a system can arise from internal agency, an external intervention or more typically a mixture of both. At any given time, however, environmental parameters present limits to what is possible in a given phase space. Within these limits a variety of outcomes are possible, with local agency making a difference. The limits can also change with a phase transition. Take the example of a social housing estate in England. This housing tenure is nationally regulated in ways that create a defined space of possibilities, with limits defined by access to the tenure depending on housing need. Within...

  10. FOUR The neighbourhood effect
    (pp. 79-108)

    It is often argued that communities of propinquity, neighbourhood communities, have declined as people’s work and consumption patterns have become wider and more fragmented (Gilleard and Higgs, 2005). This transition has been described in various ways, such as from Fordism to post-Fordism, from ‘organised’ to ‘disorganised’ capitalism, or from modernity to late modernity or post-modernity (Lash and Urry, 1987). In the UK, this new phase space is post-industrial. But although the occupational basis for a neighbourhood identity such as that of a pit village or shipyard community may have largely disappeared, neighbourhoods still often have a material basis in consumption...

  11. FIVE Neighbourhood renewal and health inequalities
    (pp. 109-140)

    Lupton (2003, p 1) comments that, ‘Rarely has the neighbourhood enjoyed as high a profile in public policy as it does today’. She continues with a list of the many area-based initiatives (ABIs) introduced by Labour governments since 1997. In England, the focus on neighbourhoods in strategies to tackle deprivation has mainly been concerned with improving the delivery of public services in deprived areas so as to achieve measurable improvements in key outcomes across health, employment, education, housing and crime. Similar approaches exist in Scotland, Wales and Northern Ireland, but currently with less emphasis on performance assessment and management. While...

  12. SIX Health inequality as a policy priority
    (pp. 141-176)

    The Black report, published in 1980, is often cited as the key reference point for when health inequality was placed on the national policy agenda in the UK (Black et al, 1980). Its recommendations, however, were rejected as too costly by the then Conservative government which the previous year had replaced the Labour administration that had commissioned the report. Health inequality, though, would not go away as an issue, with continuing pressure from public health movements such as the WHO’s ‘Health for All’ campaign and Healthy Cities Project (Ashton and Seymour, 1988). Nevertheless, public health policy under the Conservatives concentrated...

  13. SEVEN Conclusion: neighbourhoods in the wider picture
    (pp. 177-202)

    Layard (2005), in what I believe is an important book, maps out the ‘new science’ of happiness, a state associated with, but not the same as, good health. Ultimately, policies for neighbourhoods should be aiming at happy neighbourhoods as well as healthy ones. Step outside the front door and there are things to be happy about rather than things that are troubling or stressful. These may be a job to go to; a place for children to play and teenagers to hang out; neighbours that we trust and spend some time with; contact with nature and trees; an environment that...

  14. References
    (pp. 203-230)
  15. Index
    (pp. 231-246)
  16. Back Matter
    (pp. 247-250)