Power – a health issue!

In our latest blog Elinor Dickie and Emma Doyle of NHS Health Scotland explore how power, and how it is shared between individuals, communities and statutory bodies, can affect health inequalities. 

Unequal distributions of power, income and wealth are the fundamental causes (or the main causes) of health inequalities. At NHS Health Scotland, we know a lot about how having, or not having, income and wealth impacts on our health, but we are just starting to explore the relationship between power and health. Unlike money or wealth, power does not belong to any one person, but exists in the relationships between people and groups of people. We know that those who have power over their lives and the environments in which they live are likely to have better physical, mental, and social well-being. So power is protective of health.

We’ve defined power as the ability to act in a particular way, as a capacity, shared resource or relation. It is a complex concept which includes the ability or capacity to do (or not to do) something and to exercise influence or control in a variety of different ways. People may have power in some situations, such as at home, but less power in others, such as at work or in their community.

If you have power, you are more able to make or influence the decisions that affect aspects of your life, such as where you live and where your children go to school. You are more likely to understand choices available to you and have some confidence that you can make your voice heard in decisions that relate to you and to the community in which you live. When you are able to do this, it seems normal. You might not even recognise it as power.

 However, if you don’t have power, you are likely to feel this lack of control in many parts of your life. You may feel that your voice goes unheard, or is not valued or respected, or that others know better and you will have little sense of control, even over the things that are important to you. People who do not have power may have limited choices, may not be able to make informed decisions and may not get the services that they need.

This means that empowering people at the individual, community and national level is necessary to improve health and wellbeing and to tackle disadvantage and inequality. So how do we do this?

One way is to think about power as a fluid resource, not a limited one. There are many different sources of power, positions of power, and spaces or levels where power is exercised. Understanding this helps us to identify where there may be opportunities to tackle inequalities in how power is distributed. For example, where can power be shared, where can it be ceded and where can it be claimed? We can start by understanding human relationships – who holds power over a certain matter? What influences them? Who or what do they listen to – research evidence? Public opinion? Corporate interests? We are all part of a complex social and political system in which power is exercised to advantage some groups over others.

We need to work with individuals and groups, as well as with the processes and structures that determine the interaction between communities and the state. It’s for us to think about our role in the system and how we can use our power to bring about change.

The Community Empowerment Act is an important new piece of Scottish legislation with opportunities to reduce health inequalities, giving communities greater control through the redistribution of power –  but that depends on us really understanding what power is and where power lies. In partnership with Glasgow Centre for Population Health, we have produced a new animation which explores these issues further.

It’s time for all of us to be part of creating a fairer, healthier Scotland.

#RightToHealth – Jennifer Glinski

The majority of us do not think about our health until something is wrong. It is therefore fair to assume that even fewer of us think about our ‘right to health’ or know that a concept such as the ‘right to health’ even exists. But what if your day to day life was uncertain and unsettled thus directly impacting not only your health but also your treatment options? What does your health or the right to health mean when who you are or what you are experiencing determines the access and quality of care you receive?

In a groundbreaking piece of participatory action research funded by NHS Health Scotland, the Centre for Health Policy at the University of Strathclyde in partnership with the Health and Social Care Alliance Scotland, the Health and Social Care Academy, SNAP, Glasgow Homelessness Network, and the Mental Health Foundation, sought to answer those questions by conducting research alongside members of some of the most vulnerable populations in Glasgow. Peer researchers from the Mental Health Foundation and the Glasgow Homelessness Network met with over 80 research participants who were either refugees or asylum seekers, or persons who had experienced homelessness in Glasgow. The results of the focus groups and personal interviews by the peer researchers give a unique insight into the lives of persons who experience hardships and discrimination in their quest to maintaining their health and well-being.

This Friday, 26th August 2016, the University of Strathclyde warmly welcomes you to join us at the launch of the What do you mean, I have a right to health? research project. The launch will feature a presentation of the key findings and the opportunity for the peer researchers, who themselves have either experienced homelessness or the asylum seeking process, to share their experiences of health and the research process. The session will include the premiere of a new film by Kate Burton, ‘A Right to Health: the view from here’.

The launch will be followed by a talk by Professor Alicia Ely Yamin of Georgetown University on the elements of a human rights-based approach to health.

This event will be of interest to anyone with an interest in health and human rights, including those with personal experience of human rights issues, policy makers and practitioners.

To book your free place on this event visit the Eventbrite page.


Imagining our Future

The Health and Social Care Alliance Scotland (the ALLIANCE), along with many of our 1200 members, have long argued for transformative change in health and social care. Recent years have seen growing consensus on the need for radical change. What is less clear is how we are going to quicken the scale and pace of progress towards models of health and social care that are truly fit for the future.

Attempts to alleviate stubborn health inequalities and find better responses to an ageing population and rising social need are set against a backdrop of mounting financial pressures and reductions in public spending. Disabled people, those living with long term conditions and unpaid carers are feeling the impact of rising living costs (with wages failing to keep pace), welfare reforms and cuts to – or increased charges for – many of the supports that enable them to enjoy their basic rights to health, independent living and work. Read More “Imagining our Future”