Inequalities in older people: A plan for action

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Health inequalities result in poor accessibility to primary, secondary, community and preventative care as well as food sources and other health practices such as exercise and physical activity, across the lifespan1,2. However, globally, we have increasingly ageing population, and the importance of addressing issues related to deprivation in this vulnerable group is crucial. Older people living in deprived communities have reduced access to a range of services, which compromises their health and social-care1. This is often further exacerbated in areas of conflict, political and social unrest.
Public Health and Primary Care often adopt top-down approaches, identifying behaviours or individuals as ‘problems’ and developing programmes to target the behaviours or individuals. This can result in programmes that widen rather than reduce inequalities. Our sandpit was designed to explore an evidence-based, bottom-up, community engagement approach3, that enables communities to identify barriers to their health and wellbeing and design sustainable and contextually specific solutions.
Our expertise, the urban-rural disparity across GW4 and our global partners uniquely placed us to address the ‘Health, demographic change and wellbeing’ grand challenge and contribute to the GW4 priority areas ‘Inclusive innovative and reflective societies, and ‘Social Justice, Inequality, local and global.’ We worked with research partners in Colombia and Namibia to develop transferable adaptive processes and approaches for these developing countries and the welfare of their older populations.
From the outset we identified several key outcomes and benefits from this research sandpit:
• To be in a position to inform responses to local, national and international grand challenges to create inclusive communities and promote social justice.
• To be in a position to inform government programmes for improving health inequalities of older people.
• To develop a, network of researchers, community members and service providers, who can cogenerate ‘community engagement’ approaches, that are underutilised.
The focus of our application was to identify new approaches and ways of addressing inequalities in health among older people living in low income / economically disadvantaged communities. In particular we wanted to maximise a community-development, bottom-up approach that is evidenced to have positive effects on health behaviours, health consequences and self-efficacy2. This also aligns with the Healthy Living theme proposed in the GW4, 5-year strategy3.
To identify new approaches, based on bottom-up approaches, to address inequalities in health among older people, living in low income and economically disadvantaged communities.
- Design and deliver a 2-day, international, residential sandpit
- Create a network and data base of expertise, including academic, professional and local community members, with expertise in inequalities in older people, from across the GW4 locality and from the two DAC countries of Colombia and Namibia
- Form a platform to develop community lead public health education health initiatives, identified by the local communities.
- Develop one-two potential research projects in readiness for any future, related calls.
How the funds were used ?
Funding supported a 2-day, residential sandpit called: ‘Health inequalities in older people: a plan for action’. This was facilitated by a professional facilitator to enable us to achieve our aim and outcomes and ensured that we maximised our productivity. Attendees included stakeholders from relevant service providers and community members as well as academics with expertise in health inequalities in older people. This combined expertise and experience ensured that collective ideas and approaches were focused on grounding any project within the lived experience of economically disadvantaged communities.
To advertise the event we designed a poster promoting the two-day, international, residential sandpit titled ‘Inequalities in older people: A plan for action’ (appendix 1). We emailed this to selected, potential delegates from stakeholder organisations, including service providers, community members and academics with expertise in health inequalities in older people, throughout the GW4 locality. We included a link on the poster taking interested applicants to an on-line registration page that we created using the Bristol on-line Survey system (BOS). The application form also asked potential delegates to provide details about their areas of expertise and to state whether they were happy for these to be placed on our database. In addition, we included a draft programme for the event.
Approximately three-weeks before the event we circulated a document providing pen portraits from each of the GW4 leads involved in the original application (appendix 2). In the final two weeks prior to the event communication was maintained between organisers and potential delegates and important information, such as the programme for the sandpit was provided (figure 1).
The residential 2-day sandpit took place at the Novotel, Victoria Street, Bristol. This was a central location in Bristol. It was a 5-minute walk from the main railway station and on major bus routes. Parking was provided for all delegates, by the hotel, if required.
Original languageEnglish
Number of pages33
Publication statusPublished - 11 May 2018


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