A way to the better: an account from the 2023 CHEX conference

“The current cost-of-living crisis [is] the latest stage in a continuing crisis of health and health inequalities” – if the title of Professor Chik Collin’s keynote presentation is one of the key take-away messages from the 2023 CHEX conference, then the other would be that decision-makers urgently need to prioritise investing and supporting community-led health approaches - all as part of a broader and fundamental switch of policy direction towards prevention, participation and wellbeing.

Facing up to the facts

The 2023 CHEX conference was held on the 21st March in the centrally located and very well-equipped Studio in Glasgow. The focus of our first face-to-face conference since before the Covid-19 pandemic was on the impact of cost-of-living and ways to address this, but nobody attending the conference was kidding themselves that the pressures on communities were anything new.

Nevertheless, there were audible gasps from conference-goers when Chik, who recently took up the role of Director at Glasgow for Centre Population Health, clearly illustrated that increasing mortality and health inequalities in Scotland since around 2010 are reversing more positive trends in previous decades. The obvious implication, which wasn’t lost on those listening, was that recent and current UK government austerity policy is the main factor behind this, and the question of whether Scotland has been doing enough, at a central government and local level, was also left hanging in the air.

“Opening comments from Chik were powerful and set the tone for the day.” (conference feedback)

Chik’s presentation began with a Thomas Hardy quote: “If way to the Better there be, it exacts a full look at the Worst” (Tenebris II). This really captured something about the day in that it felt like the presentations, workshops and discussions needed an in-depth and honest setting out of the full impact of our unequal and unjust society on individuals and communities, before solutions at a community and policy level could be explored.

This need was evident right from the start of the day, when our excellent Chair Brenda Black from Edinburgh Community Food (ECF) gave a quick introduction to how ECF meets healthy eating and food security needs of people through sustainable and community-led activities which link food, health and well-being and social care. CHEX is really grateful to Brenda for doing such a brilliant job of chairing our conference.

Workshops

After Chik’s input there was time for discussion and a chance to reflect on how the inequality presented by Chik is impacting on communities across Scotland. A quick tea/coffee break was followed by the first set of workshops which, this year, focused on a range of issues and approaches related to health inequality. The full list are as follows:

• Supporting the health and wellbeing of the Gypsy/Traveller Community in Scotland, delivered by Charise Barclay-Daly from MECOPP

• Cost of living and travel, delivered by Caro Kemp from Sustrans

• The power of peer support – “let the group decide” delivered by Leanne McBride and Jenny Fulton from Chance to Change (C2C)

• How many Health Issues in the Community (HIIC) tutors does it take…? delivered by Anita Aggarwal of Port of Leith Housing Association, Theodora Hidalgo of Edinburgh Community Food and Louisa Richardson from YMCA

• “Trauma? What’s that got to do with me?!” delivered by Fiona Douglas from NHS Lanarkshire

Find out about all of workshops here.

If the workshops this blogger attended and helped facilitate were anything to go by (which were the gypsy/traveller and trauma workshops), then this year’s workshops were full of important and relevant information. For instance, both Charise from MECOPP and Fiona from NHS Lanarkshire had a wealth of experience and knowledge to impart about gypsy/traveller communities and trauma respectively. It was easy to tell that workshop participants were learning a huge amount about areas they were unfamiliar with, and there were a lot of hard-hitting and poignant messages in both workshops.

“The workshops were a great balance of informative and interactive” (conference feedback)

There was enough time in all the workshops for participants to come up with key take away messages for decision makers, which were captured on flipcharts and presented in the main room of the conference.

Some common themes across all of the workshops were:

• Listen to communities – support and investment in proper participation and co-production is required in order to move towards a preventative/social model of health. Without the voice of experience inequalities are only entrenched.

• Recognise the value of community-led approaches and resource it effectively - including long term (3 years plus) funding which is consistent and accessible to develop impactful and sustainable projects. Decision makers should also take part in community-based work to learn how it works for themselves.

• Increased and improved training for staff in all organisations – including in trauma and gypsy/traveller communities

• Fairer distribution of resources – Immediate measures include more support for the most vulnerable groups, including support for public transport and sustainable travel. IN the longer terms we need to restructure our society and economy so that resources are distributed more fairly and sustainably.

The second set of workshops (with 3 workshops repeated) ran after a tasty lunch, and then the conference reconvened for final reflections from Brenda, who expertly summed up how community-led approaches offer a way forward to tackle rising inequality and injustice. We’re just one part of what’s needed if a “way to the better” is to be found. All the workshop hosts and delegates were given a much-deserved thanks before the conference ended.

“Workshops and Chik were very useful. I’ve expanded my understanding of HIIC and have a better understanding of what the traveller community are up against” (conference feedback)

What next?

CHEX’s job is now to draw up a series of actions building on the conference messages. In the first instance, we’re going to target our next briefing at policy makers and decision-makers, and this will articulate and refine the key points which came out of the conference. We’ll be doing a lot more as well, including further development of the HIIC tutor network to help ensure this vital resource plays its part in tackling inequality. To stay updated with what CHEX is doing, sign up to our CHEX-point Snippets newsletter and ensure your community organisation is on the CHEX community-led health database.

Read more about the conference here.