How do we shift the dial on health inequalities?

Grapevine’s work is about strengthening people, sparking community around them and then shifting power in their lives and the systems that serve them.

We do that for two reasons.

  1. A lot of what an individual life needs to make a long lasting move forward – things like love, hope, optimism, intimacy – can really only be found in relationships with others.
  2. But also because what lives diminished by inequity also need is a shift in power.
Volts shown on a gauge
Image by Thomas Kelley on Unsplash.

Our CEO Clare Wightman writes…

Health inequalities like other inequalities are mainly decided by how resources and opportunities are distributed. That’s about who has power and who doesn’t.

The first round of central government driven austerity landed hard in Coventry. There was a neighbourhood here with five times the city rate of lone parent families with children under 18. And yet that data was available when the decision was made to close the children’s centre, close the youth service and locate the replacement family hub somewhere else. Resources were taken away from those families with little or no protest and certainly no organised response.

In order to create better, healthier places, Grapevine works on the agency and capacity of people who live in the city so they can form and lead their own solutions and hold others to account when they need to. Without that work I believe we won’t shift the dial on health inequalities.

But it’s going to take a robust understanding of what community power is and what it really takes to build it or untap it. It’s not as simple as – “there is community action happening in the ‘wider determinants’ space and the public sector needs to get better connected to it.”

Here’s a couple of stories to show you what I mean.

Dorothy is a Cameroonian refugee who set up an exercise class in Willenhall – a Coventry area with stubborn health inequalities.

A black woman wearing a red tracksuit, bumbag and a big smile makes two peace signs with her hands on top of a hill in the Peak District on a sunny day with other walkers behind her. She is Dorothy from Waka Waka Fitness.
Dorothy and 50 people in her community challenged themselves with the Dovedale and Thorpe Cloud circuit through the Peak District in September.

Dorothy knows about war, she knows about our depressing immigration process, about being moved with a new baby into an empty building in a place where she knew no-one. There were health struggles for Dorothy as an older mother, followed later by mental health struggles for her daughter brought on by school bullies which affected the whole household.

Next came the Covid-19 pandemic which became the reason for Dorothy and her family to get outside and walk together. “It united the family, revitalised our emotional health and uplifted us”, says Dorothy. In spite of many deep challenges Dorothy now leads an exercise group of 50 mainly migrant women.

When we asked her what was important about what she is doing in her community, she said: “One of our members had been facing deportation to Cameroon after finishing her studies. Another one is facing eviction from her home and she’s got children. Others are here from Ukraine.

“Who cares about what the scale says when you have such weight on your shoulders? We are taking the weight off people’s bodies and their shoulders. Willenhall is an area with lots of people carrying both weights. No one else is dealing with these issues the way that we do.”

But there was no ‘hey presto’ to this story.

We only found Dorothy with all her rich vision and leadership potential

  • because our community organiser immersed himself in her neighbourhood and starting attending the same church services as her
  • because he talked to her many times in order to uncover what she’d like to change
  • because he walked with her on that journey of change – coaching, planning, refusing to give up, attending the class himself.

Only now two years on might she and her team stand a chance of being powerful enough in their vision and agenda for change to partner with say the NHS or the local council in anything like an equal and influential way.

More about Dorothy here.

Another quick story.

‘Willenhall Coalition’. The Coalition team – people living in and caring for the neighbourhood – have identified priorities it needs to tackle first. Members decided that by focusing on the unused park they could help people improve their health, socialise, and support local children and their families. Their campaign is well underway and its first goal is improving the existing play area. The team has applied for their first batch of funding. Some developing ideas include better pre-school provision, an outdoor gym for older children and adults and a multipurpose court.

Two women, one white and one black, are turned away from the camera as they examine an information board with development plans and photos on it at a local Coventry park.
The ‘Friends of Brookstray Park’ community group recently held a recruitment drive at the park in Willenhall where they are campaigning for improved park and play facilities.

This coalition started out as a pretty stormy public meeting. It took carefully handled meetings, door knocking, surveys, hundreds of one-to-one conversations with people interested in making change to draw out passions, strengths and motivation. Following that it required individual coaching, regular ‘house meetings’, and thrown in along the way there were still setbacks that called for skill and resilience, belief in people and that behind every door lay some wisdom and some insight.

The sheer skill and persistence needed to create what you see on the surface is the untold story of community power.

These stories are not to say this work is too hard.

They’re to say – look at the beautiful, staggering, agency and leadership that is there potentially even amongst people and neighbourhoods experiencing the toughest of times.

They’re to say – uncovering and growing community power requires method, infrastructure as well as committed and long term investment, if you really want dials to move.

There is much talk now that to create the conditions for everyone to thrive we need a new way of governing, one that combines the power of Westminster with the power of communities.

But it is an agenda that would be well served by a robust understanding of what community power is, how it can be developed, what is needed for it, what value it can create and what might limit it.

In October, Clare supported Turning Point’s first webinar in its 60th anniversary series alongside Sir Michael Marmot and Amy Stephenson: how do we shift the dial on health inequalities?

Watch the recording of this webinar by following this link.