How can we create a social movement in health? In this 5 minute video, the RSA asked health and community leaders to help explain.
Not exactly sure what people mean by the phrase “Health as a Social Movement”? As part of our work with NHS England, nef and Nesta, the RSA asked health and community leaders to help explain the term and the ideas behind it. This five-minute video is the distillation of several hours of footage from two events hosted by NHS England that brought together health practitioners, patients, and community leaders. The RSA was keen to understand what it would mean to create a social movement in health and why it is an important endeavour. While there is no exact definition, some clear trends – and tensions - emerge.
Within this group, it was taken as given that ‘health’ is more than just treatment as a response to an acute illness, it is also living well to prevent illness or to manage a chronic condition.
We asked the event participants ‘how would you describe the idea of health as a social movement to a friend or family member?’ A common theme that emerges is around empowering people to engage in health-creating or health-maintaining activities outside of (or alongside) the formal health care system. Creating a social movement in health requires energy from within communities to support and respond to their particular needs. Communities may be place-based, tied together by a mutual geographic location, or condition-based, linked through mutual health conditions or interests.
Another trend among the respondents was to highlight how much good practice already exists. Some noted that the formal health care system should support the informal initiatives. But can social movements be engineered? Or must they grow organically? Can and should we create the conditions for social movements to take shape? In some cases, the view was that the way to do this was for the formal health care system to remove the barriers to getting involved with healthy initiatives, and simply get out of the way of what is already working. The logic here is that if existing initiatives can be supported and scaled, there’s potential for them to grow into larger movements beyond the formal healthcare system to promote healthy living for us all.
Part of the RSA and the other national learning partners’ work will be to explore the questions above about the nature of social movements and how they could play out in relation to health. Nesta will be publishing a primer document which reviews the theory and history of social movements in health and beyond, and highlights some of the some of the opportunities in this area. This is due to be published in September. Nef is working closely with six vanguard models of health and care around how they create change. And the RSA will be supporting the wider group of vanguards to develop a network to share their learning about how to facilitate healthy living practices.
Together, the national learning partners are asking how can good practice be adopted and spread? Indeed, one of the tensions that emerged when we asked respondents about how to encourage wide-scale take up of a given behaviour or activity, was around the role of facts and figures versus personal stories. While not explored in this initial short video, we will be thinking about these two different approaches as we try to learn more about how individual-level behaviour change can be scaled up to group-, population-, and system-level change.
Look out for updates on this project as it progresses. Autumn highlights include a public event hosted at the RSA and the upcoming publication of Nesta’s primer on social movements. In the meanwhile, we hope you enjoy the video and that it helps to introduce the major underlying themes of health as a social movement.
Find out more about the Health as a Social Movement project
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There's no doubt that good health, particularly mental health, is influenced by societal behaviour. Healthy communities of people who treat each other with respect and recognise difference will always be healthier than those riddled with competitive pressure and worse, pressure to conform to what become societal norms.
I watched the video and was none the wiser at the end of it. The contributors seemed unable to articulate what is meant by "the idea of health as a social movement". They all said in a variety of ways that we cannot carry on as we are and that we have to do things differently but noone offered concrete ideas about what that might mean in practice.
Quite right. Watching/reading this material was interesting - but there is no longer a _national_ health service in England. The service is being fragmented, underfunded, part-privatised and any potentially profitable parts are being eyed-up by (mainly) US insurance companies. Accountancy firms and consultancies have been planning all this for years. What's left of the NHS as we knew it in England is being set up to fail so that the privateers can move in. I'm not sure how a social movement turns this around. Perhaps we can have an explanation.
Unfortunately a very true comment. Current services stretched and difficult to see how integration of services will improve the situation, rather than just spreading resources thinner. Interested to the solution that vanguards propose for this
Thanks Nathalie for sharing. This is an incredibly important area of work, and I look forward to hearing more as the project progresses. I will keep an eye out for the Autumn event!
Our experience of evaluating community based interventions resonates with Anna's comments - in particular the cultural and behavioural factors that often act as barriers (or facilitators) to the shifts we need to empower people and communities (within and outside organisations). See our work on Spice Time Credits here: http://www.apteligen.co.uk/what-we-do/#case707. Spice have also recently published a report on how Time Credits can play a role in system level change, see: http://www.justaddspice.org/our-work/scale-impact, which might provide important learning for your work in health.
It is also crucial for the NHS to engage more effectively with community organisations - they are often already well connected within existing communities, and can play a vital role in building leadership and role models in relation to healthy living. There is some great work going on in Wales in this area: http://www.apteligen.co.uk/what-we-do/#case723. I'd be keen to know how the vanguards are tackling this.
Hope thats helpful. Measuring impact in complex systems is a particular specialism of my organisation, so please do get in touch, happy to share more learning. Contact details are on my RSA profile page.
Thanks for your response. As it happens David Russell's blog on Time Credits and the 'new social entrepreneurs' has just been published on our project page: https://www.thersa.org/discover/publications-and-articles/rsa-blogs/2016/07/no-more-throw-away-people-welcome-the-new-social-entrepreneurs. Also please see Jenny Brumble's blog on Millom Health Action Group, great case study highlighting the potential for these approaches: https://www.thersa.org/discover/publications-and-articles/rsa-blogs/2016/07/voluntary-service-born-out-of-crisis
Thanks for the heads up on Wales - will have a read!
A movement itself cannot be created by anyone. Suitable leaders naturally emerge from within a community as they express what is in peoples hearts and minds. They can only help to awaken the collective potential from within people and communities.
There are already so many projects that model a shift in power and control from topdown hierarchies to more distributed power that include communities as equal partners with professionals. Once they become more visible to each other and connect in their visions and actions they can grow the new nervous system that will enliven a whole new movement.
Many of these projects model an integrative approach that includes complementary approaches to health and wellbeing and make everyone feel as if their humanity and wholeness really matter. Furthermore they are creating enabling structures that unleash the latent potential of patients and professionals working together for the benefit of both as well as society at large.
To make a real shift in culture and prevent becoming absorbed by the still dominant hierarchical system both staff and patients need emotional support to maintain long-term motivation and commitment. We need to accept that it is not only external institutional structures that need changing to become more enabling to human creativity and innovation but also our internalised conditioned thinking and behavior that has become accustomed to top down power hierarchies and an assumption of scarcity. During times of crisis the human tendency is to drift back into old familiar habits unless we have a deeper understanding of the forces that motivate us, a trust in our ability to find new ways to create the life our hearts tell us is possible and the commitment to remain true to our values despite serious challenges.
To enable the radical change we need in health and social care, we need safe spaces where we can enter into open conversations with each other and discover and practice new ways of being together that enable us to see each other more deeply and behave as whole human beings.
What we can do and must do urgently is to create the conditions that enable a movement to emerge by connecting what is already happening yet disconnected. Seed these connections and nurture them rather than attempt to control them.
Margaret Wheatley has done a lot of useful research in this field. However there are many others like Jamie Harvey who work with communities to develop capacity building http://www.margaretwheatley.com/articles/irresistiblefuture.html
Quote from M.Wheatley: Self-organizing systems have what all leaders crave: the capacity to respond continuously to change. In these systems, change is the organizing force, not a problematic intrusion. Structures and solutions are temporary. Resources and people come together to create new initiatives, to respond to new regulations, to shift the organization's processes. Leaders emerge from the needs of the moment. There are far fewer levels of management. Experimentation is the norm. Local solutions predominate but are kept local, not elevated to models for the whole organization. Involvement and participation constantly deepen. These organizations are experts at the process of change. They understand their organization as a process of continuous organizing.
Taking social innovation to scale: http://healthcommonshub.net/article/lifecycle-emergence-using-emergence-take-social-innovations-scale
Jamey Harvey: Communities creating Health http://healthcommonshub.net/article/building-new-operation-systems-health-creation-and-healthy-communities
My own view is expressed in this article: The Future of our NHS and the Power of Communities. http://healthcommonshub.net/article/future-our-nhs-and-power-community-relational-approach
feel free to get in touch [email protected]
Thanks so much for reading, and for your comments and email address. It is clear that you have a lot of experience in this area, and we'd love to hear more from you. One of us from the team will get in touch with you via your email address very soon. Thanks again!