Where you can live can affect your health and well being. Using examples from block 3 discuss this statement in relation to both the negative and positive impact that neighbourhoods can have for people who live there.

Katherine Jones K101 An Introduction to Health and Social Care PI: B7902913 TMA04

Many reports have shown how a person’s geographical location can effect their health, not only because of the so called ‘postcode lottery’ of healthcare provision, but also because of their social and economic circumstances. The World Health Organisation’s definition of health is that it is “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” (W.H.O. 1946) Similarly, Ronald Labonte puts forward that three elements are needed to experience health and well-being – physical capability, mental health and a social connection to family and others in the community (k101 Unit 9, p.12-13). It is important, therefore, to realise that just as circumstances in individual homes can impact on occupants health, conditions in local communities can also have major effects on health and well-being.

In this essay it will show that a healthy neighbourhood can provide a focus for improving the health and well-being of the community by discussing both the negative and positive impacts on its residents. In this essay will also discuss the ‘Thornhill Plus You’ project which was set up to address neighbourhood concerns in poor health indices, low educational attainment, low skills and anti-social behaviour.

The concept of neighbourhood based health initiatives, such as the project in Thornhill, was introduced in a Government green paper ‘Our Healthier Nation’ (D.O.H. 1998) which led to a public health seminar and subsequent report ‘Healthy Neighbourhoods’ (Gowman 1999), commissioned by the King’s Fund. This report suggested that people should feel safe and included in their neighbourhood, feel confident about expressing their health needs and encouraged new, creative ideas linked to opportunities offered by the wider community (k101 Unit 9, p.20). It also suggested that the Government, national organisations and local people should work together to provide resources, such as amenities, local knowledge and accessible services to achieve a healthier neighbourhood (k101 Unit 9, p.20 - 21).

Donald Acheson went further in his report and identified ‘poverty, low wages and occupational stress, unemployment, poor housing, environmental pollution, poor education, limited access to transport and shops, crime and disorder, and a lack of recreational facilities’ (Acheson 1998) as things which had an impact on health. The most important of these being poverty as it can directly affect the others. Unfortunately, since 1970 rates of poverty have changed significantly with the overall number of households living below the poverty line increasing, peaking at 27% in 2001 (JRF 2005). Research into poverty has shown that two-fifths of adults, aged 45-64, on below-average incomes have a limiting long-standing illness or disability, more than twice the rate for those on above-average incomes. Also, adults in the poorest fifth of the income distribution are much more likely to be at risk of developing a mental illness as those on average incomes. (Data retrieved from: on January 27th 2012)

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Living at, or below, the poverty line will obviously affect the choices and resources available to individuals and their families. Availability of affordable nutritious food, accessible playgrounds and after school activity programmes for young people as well as local health care facilities and convenient transportation would encourage and promote healthy living. For example, access to affordable supermarkets selling fresh produce can help to promote healthy eating and reduce obesity rates compared to purchasing fast food from local convenience stores. Similarly, individuals are more likely to become physically active when they live in neighbourhoods with safe places to exercise such as parks and where activity programmes are run. Further, individuals are more likely to seek and receive professional health care when facilities are either located nearby or affordable, convenient transport is available. Similarly, good transportation links would allow access to employment and training opportunities and other public resources which could also influence the health of an individual.

The social environment of a neighbourhood can also impact on the health of residents. For example, people who have developed a mutual trust and feeling of ‘togetherness’ are more likely to work together to achieve common aims such as ensuring public areas are safe and/or ensuring social controls are in place to discourage crime and littering as well as smoking and alcohol abuse. This is important as neighbourhoods with a high degree of social disorder have been shown to have residents with higher levels of anxiety and depression. Similarly residents are more likely to pass on information regarding education and employment opportunities, childcare, health provision and other services. Also, young people are more likely to come into contact with role models and receive guidance to prevent them from engaging in unhealthy behaviours relating to drug and alcohol abuse or unwanted pregnancies or from becoming involved in gang activity. This is particularly important as young people are more susceptible to unhealthy conditions with implications for them in later life.

Another neighbourhood factor which can impact on the health of its residents is the availability of local services and opportunities. The quality of education provision, transportation and employment opportunities can influence health indirectly by providing the means to gain an acceptable standard of living in later years while the provision of local health care services can directly influence the health of both the younger and older generations.

In response to Acheson’s report the Government produced two papers - Reducing Health Inequalities: An Action Report (DoH 1999a) and Saving Lives: Our Healthier Nation (DoH 1999b) – setting out a commitment to ‘improving the health of the worst off in society’. They stressed the importance of evaluating what needed to be done at a local, rather than national, level as well as recommending specific initiatives to tackle health and educational inequalities such as ‘Healthy Living Centres’, ‘Sure Start’ and ‘New Deal for Communities’.

One area which benefited under the New Deal for Communities initiative was the Thornhill housing estate on the outskirts of Southampton. Developed in the 1950’s to relocate people due to overcrowding in the city centre, it became victim to the decline in manufacturing and the use of the docks and emerged with high levels of social, economic and environmental deprivation. There are currently over 10,000 people living in 4,200 homes with a higher than average proportion of these being young people – 22%. (Mori 2008)The majority of residents are white British with a small community of travellers, mainly Irish gypsies, who choose to live at Thornhill for six months each year (Unit 9, Audio 9.1). Approximately 21% of residents have a life-limiting illness, 18% have no formal qualifications and the unemployment rate stands at 4.3%. (Mori 2008) A high percentage of young people are not in education, employment or training which, in turn, has had an impact on the level of teenage pregnancies. Other health issues affecting the area are high alcohol dependency rates, smoking, lack of exercise and poor diet (Unit 9, Audio 9.2).

The ‘Thornhill Plus You’ project was set up using grant funding with the aim of achieving a ‘Healthy Neighbourhood’. One of its major achievements has been the opening of a Centre for Healthy Living which has provided locally based health provision such as drop in sessions with midwives and mental health workers and increased access to a range of quality health services for residents such as ‘Quitters’ and ‘Weightbusters’ for those who want to quit smoking and lose weight. Another was the setting up of a community based health promotion project, the Thornhill Health and Wellbeing Project (THAWP) which has supported the delivery of basic health advice and services. As a result of these, health outcomes have improved with resident’s satisfaction with access to health services increasing by 13%.

A joined up approach was used to address other issues. For example, the Employment Gateway, in conjunction with Working Links, has increased the number of residents being supported to access employment while the funding of a skills centre has delivered accredited vocational courses for young people. The Sure Start Children’s Centre, built with joint funding, has provided a range of services for children, young people and families. One programme has delivered engagement and support services including work on preventing youth exclusion and helping young people to achieve healthier and safer lifestyles.

Thornhill Plus You project has proved to be a huge success and has shown that, by working in conjunction with outside agencies, community-based projects can aid in the development of healthier communities. Not only that, the residents, having played a vital part in the decision making and planning since its inception in 2005, has shown that by following ‘an incremental process ….. Individuals, families and communities gain the power, insight and resources to make decisions and take action regarding their well-being.’ (SDHCDT and Labonte, 1999)

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REFERENCES:

ACHESON, D. (1998). Independent Inquiry into Inequalities in Health. London: Stationery Office.

DEPARTMENT of HEALTH (D.O.H) 1998 ‘Our Healthier Nation – A Contract for Health’ available online at: (Accessed January 28th 2012)

DEPARTMENT of HEALTH (DoH) (1999a). Reducing Health Inequalities: An Action Report. Available online at: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4006054

DEPARTMENT of HEALTH (DoH) (1999b). Saving Lives: Our Healthier Nation. Available online at: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4008701

GOWMAN, N. (1999) Healthy Neighbourhoods. London: King’s Fund Available online at: (Accessed January 28th 2012)

JOSEPH ROWNTREE FOUNDATION (JRF) (2007) Poverty and Wealth Across Britain1968-2005 Available online at:

(Accessed January 26th 2012)

MARKET and OPINION RESEARCH INTERNATIONAL (MORI) (2008) Population estimates for 2007

SASKATOON DISTRICT HEALTH COMMUNITY DEVELOPMENT TEAM (SDHCDT) and LABONTE, R. (1999). Working Upstream: Discovering Effective Practice Strategies For Community Development In Health. Saskatoon: Prairie Region Health Promotion Research Center & Community Development Team Saskatoon District Health.

THE OPEN UNIVERSITY (2011) Unit 3, K101 An Introduction to Health and Social Care. Milton Keynes: The Open University

WORLD HEALTH ORGANISATION (W.H.O) (1946) ‘Definition of Health’ available online at: (Accessed January 26th 2012)

THE UNIVERSITY (2010) K101 An introduction to health social care, unit 9 healthy neighbourhood’s Milton Keynes, The Open University.

Part b skills.

Supporting people to use community resource.

1 to help mina if the activity she would benefit from I would take in to account her language which is Bengal I would try to translate anything to her for her to understand it what was in the area for her.

2 The practical issues would be weather the activity would consider her cultural need and family’s would they be able to get there and afford to get there she said she is shy asked if she would like someone to go with her to group also need to considered if group dietary suited to her cultural needs.

3 gave mina support to the group have someone to go with her till she feels more confident enough to go on her own if she don’t like the group look for another asking what she like doing hobbies she likes find a group to suite her

4 in supporting mina listening to her if she has and feeling or concerns or worries getting to know her building on a relationship with her

5 supporting mina looking for the right groups for her and options available to mina in the area seek another locations or things happening in other area for people in same culture let her choose a group to suite her and family.

Part c

Self-reflective notes

1 I feel it been really slow for me to understand it all

2finding time to study round with around my family and essay writing with spelling etc.

3 after k101 am not sure yet but was looking at health care practice wanted to see how I get on with this one first