Shaping Places for Healthier Lives A joint grant programme with the Local Government Association for councils to work with partners from their local area to improve health and address health inequalities.

Bristol City Council, North Somerset Council and South Gloucestershire Council are leading councils in an initiative aimed at developing innovative, long-term system changes to improve food security and reduce health inequalities in some of the most disadvantaged communities in the region.

Food insecurity can be defined as ‘the inability to acquire or consume an adequate quality or sufficient quantity of food in socially acceptable ways, or the uncertainty that one will be able to do so’ (Dowler, 2001: Poverty Bites: Food, Health and Poor Families. London: Child Poverty Action Group). It is a symptom of poverty and links to inadequate and/or insecure income, issues with welfare, increased living costs, rising debt, and financial problems for households and has been exacerbated over the last 18-months due to the COVID-19 pandemic.

The three councils are working together, to establish the issues and drivers that lead to food insecurity within five areas of high need and are working towards alleviating them.

Their approach explores the structures and boundaries of the underlying causes food insecurity and their interactions. This will enable them to identify the challenges and barriers, and then design improvements required for positive change and provide added value for organisations already grappling with the challenges of food insecurity.

Their aims include:

• Developing solutions to food insecurity which are pragmatic, manageable, and sustainable.
• Reducing health inequalities.
• Developing solutions that build on the physical and social assets of each community at regional, local and neighbourhood level in a way that creates additional value for their local communities.
• Collaborating, joining up and co-creating solutions to learn from and build on the many successful local food security initiatives and aspirations that have grown during the COVID-19 pandemic and not lose precious social gains made during the pandemic.
• Developing solutions that enhance community resilience and cohesion and gain wider stakeholder support by aligning with the strategies and goals of local public, private and third sectors.
• Understanding which solutions and/or design approaches are transferable to other areas or communities and share this widely.

The long-term vision for Stainforth is a place that will support good mental health for generations to come by building a community where the wider determinants of mental health are enhanced to support local residents.

This will mean it will be a place that will support good mental health for generations to come. This will involve building a community where the wider determinants of mental health are enhanced to support local residents.

Working with the community, Stainforth has allowed Doncaster Council to develop a clear vision of a community that supports good mental health. The agreed way forward builds on the assets that the community have, embeds long-term thinking and is evidenced based to ensure meaningful change to people and place.

Currently, Stainforth residents feel more depressed than the average in Yorkshire and Humber (Y&H) and residents also have a lower life satisfaction and lower sense of self-worth than Y&H comparators (Acorn Data 2020). Doncaster’s vision is focused on improving self-worth and life satisfaction by creating community pride and enhancing residents' capabilities.

The aim is to make the physical place look different, with streets and green spaces that are clean, safe and used by everyone; people will travel actively and will be outdoors and engaging with their community. All ages will be playing and socialising together and enjoying life. Residents will have the right to play without fear of safety. Access to good work will be possible in a thriving local economy and many young people will no longer want to leave the village to seek a better life elsewhere. It will be a just and fair place, where people have a right to the same aspirations as other communities. Our vision will work to create this right for residents by connecting and building relationships that create agency.

Their focus is on intergenerational building, to tie a current disconnect between young people and older people. This disconnect is currently creating a Stainforth that does not enhance good mental health, by leading to an environment of distrust and lack of community cohesion. They will work with young people as a primary focus to build the seeds for local social mobility. Collectively, the community will support generations to grow and this will build the conditions for people to live in a community conducive to good mental health and allow for the building blocks to reduce local health inequalities.

Newham’s long-term vision is to understand and address food insecurity for children and young people so that all families can afford and benefit from a sufficient, nutritious diet.

Over half of Newham’s 60,000 children and young people live in poverty (51.8% after housing costs, 2019) and 17,154 are eligible for free school meals.

Food insecurity is a key driver of poor health outcomes and Newham’s development phase explorations led them to focus on causes by economic hardship.

Newham wants to create a system shift in how the borough’s food insecurity interventions are framed and delivered.  

A systems approach will build on and extend existing strategies and interventions already underway, but also allow more creativity and new connections, identifying new levers for action.  Long-term, they believe this will create a more effective and sustainable approach to children and young people (CYP) food security and ultimately ensure no CYP in Newham go hungry. 

The project aims include:

• Embedding a systems approach to CYP’s food insecurity across the council by creating structures and methods for coordination among partners, making ‘systems thinking’ a default approach for the council and local partners, and sewing a ‘food security in all actions’ ethos into the fabric of the whole council.  
• Identifying and demonstrating success and levers for action - pinpointing where there may be potential for new interventions that bring maximum return, and exploring why some existing interventions may fail.  Where are the gaps, and where is the potential for maximum impact? 
• Investing in partnership working and communication and enhancing community engagement and participation; improving understanding of inequality and diversity
• From this, the team hopes to support a cohesive, system-wide package of sustainable interventions.  The project will be co-delivered with voluntary sector and academic partners, including the Association for Young People’s Health, and the London School of Hygiene and Tropical Medicine. 

The Heart of Blyth project will create the conditions for a safer and stronger community to flourish by means of improving how people relate to each other, how Blyth is seen by others and how Blyth looks in order to reduce fear of crime and improve the wellbeing and health of people living in Blyth.

People living in specified wards in Blyth, experienced poor health outcomes and health inequalities, with significantly worse income deprivation, child poverty, child development, GCSE achievement and limiting long term illnesses than other parts of England. The wards also had the highest levels of crime and antisocial behaviour in Northumberland. 

Research shows that people experiencing greatest income inequalities are more likely to be fearful of crime and experience poorer subjective wellbeing and evidence suggests that interventions incorporating community engagement using asset-based approaches have a positive impact on health and on reducing health inequalities. 

Residents said that opportunities to come together, increase community pride, work together towards a common aim, to be involved creatively in decisions affecting them, would improve their health and wellbeing. These factors would also reduce fear of crime which also has a negative impact on health and wellbeing. 

Over the next three years, the Heart of Blyth project aims to:

• Increase a sense of community pride
• Involve the community in developing the next phase of the HoB project
• Improve the quality of relationships
• Provide opportunities in the form of activities and events to bring the community together
• Providing opportunities for residents and neighbours to come together, build connections, strengthen relationships, exchange knowledge and work towards a shared purpose
• Use creative and co-designed approaches to grow community pride, develop a positive reputation and identity which can be promoted and communicated within the town and to visitors
• Harness the ideas and contributions residents shared. Ensure residents influence local decisions by providing opportunities to get involved with the HoB project and also wider developments in the town

Shropshire’s long term vision: statutory and voluntary services will work together with communities to ensure everyone in Shropshire has access to the help and support they need to prevent food insecurity.

The target beneficiaries are residents of South-West Shropshire however by embedding whole system approaches to address food insecurity, through shared learning, all of Shropshire will benefit.  Within South-West Shropshire action will be prioritised in electoral wards where food insecurity is greatest.     

The county’s rurality poses significant challenges for those on low incomes with the cost of an essential shopping basket in one area of Shropshire costing almost 2.5 times more than in another. Highlighted are eight electoral wards where these communities have higher rates of obesity, hypertension, coronary heart disease, stroke and cancer compared with Shropshire’s average. Childhood obesity is a specific challenge fundamentally associated with food insecurity along with deprivation.
   
Achieving long-term health requires improvement in a broad, complex range of inter-connected factors.

Shropshire’s vision will see:  

• System decision-makers appreciating complexity and more consistently adopting whole system approaches across the determinants of health, having a synergistic impact on health and well-being outcomes. Health in all policies will be evident.  
• All of Shropshire’s system will be contributing to a reduction in poverty and risk of poverty will be identified early with proactive interventions and support provided. There will be easier and increased access to benefits, support schemes and hardship grants by those eligible. As the key driver of food insecurity and of wider ill-health addressing poverty is fundamental to health improvement and reduced health inequalities.  
• A re-framing of the narrative around poverty and food insecurity with reduced stigma and the provision of active mutual support within our communities. This will have a specific impact on mental well-being, reducing stress and anxiety and enabling individuals to access the support available to them.  
• Local communities and system leaders will work together maximising the value of local assets and building on the enthusiasm, skills and resources available. This will build community well-being through strengthening the factors that support good health and that protect against ill-health.   

 
Realising the vision will result in thriving communities, with improved life-chances enjoying improved well-being and reduced ill-health. Residents will be supported by a system that has a granular understanding of the challenges faced and with the skills to co-produce solutions.