For the UK Government public health is a top priority, but how can the government really help citizens lead healthier lives?
We recently finished a piece of work with Shropshire Council, helping them build a richer picture of the experiences and barriers of people engaging in physical activity in the local area. The project was commissioned to give some real stories from the people beneath the statistics. What stood out for me was that for many local people the barriers to being physically active were entirely self-imposed. It was about confidence, self-esteem, perception of self, habit, structure of life, and aspirations. The factors influencing their behavior were not always something that public health services were addressing. One lady, for example, stopped going swimming shortly after the pool built a large observation window between the pool and the pool cafe.
Perhaps the most important lesson learned from this project was that improving the health of a population is not purely about providing more services and facilities – if these are made available without considering the complex nature of people’s lives, their fears, and aspirations, then we will find the same sub-population using them and the same sub-population not.
In a ‘big society’ based around encouraging greater personal and family responsibility, my concern is that without involving people and creating more citizen-centred support systems, many people who are less inclined to engage will find themselves being increasingly alienated.
Is it possible to design health services that don’t just provide, but services that inspire and enable?