King's College London

To inform our priorities for research, and identify how best to partner with local organisations, the Social Science & Urban Public Health Institute (SUPHI) and CLAHRC Public Health Theme consulted with community groups in the local south London boroughs of Lambeth, Lewisham, and Southwark.

Who did we speak with?

We did an initial consultation with people who came to the launch of SUPHI, which was reported on our website. Participants here focused on issues of transport and environment as priorities. We then spoke to a number of groups, to get a range of different ages and populations. They included:

The Young Citizens Panel, Lewisham

• December 2018, and January 2019: 20 Young Advisers aged between 11 and 18, and 12 Young Citizens aged between 11 and 15.

The Streatham Patient Network, Lambeth

• January 2019: this group coordinates and represents patient associations in Lambeth, and included 11 members.

Bells Gardens Tenants & Residences Association (TRA), Southwark

• March 2019: with 2 TRA members and 4 members of Southwark council.

Tulse Hill Forum, Lambeth

• March 2019: this is one of the 12 that belong to the Lambeth Forum Network. Nine members attended, 2 of whom worked for Lambeth council at the time of the consultation.

A Southwark Tenants & Residences Association

• July 2019: with 1 representative from the TRA.

What were their key priorities?

A key issue was identifying what was meant by ‘public health’. For some groups, the term was synonymous with ‘health services’ (primarily the NHS); others noted ‘hygiene and sanitation’ to be key issues. A challenge for consulting on public health is that knowledge from experience is primarily derived from what happens to the individual and their immediate family and community: a ‘public health’ view of the whole population (on issues such as inequalities in health, for instance) can be difficult to relate to lived experience. The groups all discussed the issues that affected their communities, and what they felt the responsibilities of public health research would be.

 

The topics that were of most concern included:

• The confusing nature of much ‘expert’ information on healthy lifestyles. Participants believed that it was their responsibility to maintain their own health, but in the context of a health care system that provided good services.
• Funding cuts to the NHS, and the implications of this for health service staffing (from experience of locum doctors and lack of nurses, for instance).
• Maintaining care for vulnerable people: key concerns were around more community outreach programmes targeted at those with poor mental wellbeing, and improving counselling and wellbeing programmes offered at schools.
• Hygiene and sanitation: three groups identified this as a priority, mainly citing greater responsibility onto individuals to avoid littering and to better dispose waste. Some also called for a ban on plastic water bottles.
• Obesity: every group cited lowering obesity levels as a priority. In addition to wanting better education about how to eat well and keep fit, many groups noted that there are too many cheap fast food options (on high streets and in schools) competing with more expensive and healthier alternatives, and that school food was not healthy.
• Crime: two groups explicitly noted incidences of crime in their area, with one group arguing that some did not feel safe leaving their house.
• Lack of recreational spaces: three groups noted that there is a lack of recreational and safe spaces for people to spend time without having to pay any money or being disturbed by people engaging in unsociable behaviour; some noted the need for outdoor gyms in their area, arguing that having a free and local outlet for exercise can promote healthy activities.

 

What were the key implications for public health researchers?

On research priorities: These consultations provided insights into some of SUPHI’s overarching research questions, namely, ‘how does the city ‘get under the skin’ of those who live in it?’ and ‘how are local neighbourhoods experienced in a globalised world?’. The data collected feeds into our primary research themes of urban health and mobility, and urban mental health, and are supportive of general research agenda, centred currently on air pollution, the effects of the Daily Mile in primary schools, and older people and mobility within the city. The key issues discussed are also aligned with local public health priorities, such as fostering sustainable community cohesion (e.g. Future Lambeth 2016/2021), addressing obesity (e.g. Joint Strategic Needs Assessment, Picture of Lewisham 2019), and maximising opportunities for wellbeing and development (e.g. the Southwark Health and Wellbeing Strategy 2015-2020).

 

On our responsibilities: Those participants who had been consulted in the past expressed interest in wanting to know how their contribution affected the research they were involved with, with the participant from a Southwark TRA explicitly stating that some form of follow-up from researchers would be beneficial. Many participants expressed limited opportunities to voice their view, and a lack of evidence that their views will lead to change.

 

On the challenges of communication: Public health can be a challenging concept to share with the public, and the inherent uncertainties of its evidence can be difficult to communicate without seeming confusing. Our goal is to develop more appropriate knowledge exchange methods which can help us communicate with publics about public health research, drawing on participants’ experiential knowledge, but also links to wide upstream determinants of health. Linked to this is who is trusted to provide information: participants welcomed advice from individual health care providers such as GPs, but were often less trusting of other sources.

 

Next steps: The upcoming King’s Health Partners Applied Health Research funding will be a unique opportunity to build on citizen collaborations to take forward work that is relevant to the public.

 

Contact: Shayda Kashef; Judith Green; Peter Littlejohns (suphi@kcl.ac.uk)