Author: Sureya

Housing – A Human Bridge to Health Access

Health and housing

Introduction

The intersection of housing and health has garnered significant scholarly attention within public health discourse, particularly in the context of social determinants of health. Housing conditions exert a profound influence on health outcomes, with empirical evidence linking substandard housing to a myriad of health issues, including respiratory diseases, mental health disorders, and overall diminished well-being (Marmot, 2010). This article posits that housing can function as a vital conduit connecting individuals experiencing socio-economic inequalities to the National Health Service (NHS) and social care. By examining various partnerships and initiatives, this article highlights best practices and strategies for enhancing health equity through recognising housing associations as the ability to act as a human bridge, supporting and empowering people to access health pathways.

Health Inequalities in the UK

The World Health Organization (WHO) defines social determinants of health as the conditions in which individuals are born, grow, live, work, and age (WHO, 2019). Housing represents a fundamental social determinant that shapes health outcomes through pathways such as environmental exposures, socio-economic status, and access to healthcare services (Bambra et al., 2010).

Health inequalities in the United Kingdom are pronounced, with significant disparities in health outcomes observable across different socio-economic strata (Office for National Statistics, 2020). These inequalities are exacerbated by factors such as inadequate housing, which disproportionately impacts low-income families and marginalised communities (Baker et al., 2016). Due to the significant under supply of social housing only those in greatest need of social housing support receive it. The ripple effect has resulted in social housing customers living in the most deprived areas of the UK and being significantly overrepresented in all aspects of health inequalities.

The Role of Housing Providers

Housing providers occupy a unique position to identify and support vulnerable populations at risk of health issues due to suboptimal living conditions. By serving as a point of contact, housing services can facilitate access to health services, particularly for those encountering barriers such as language difficulties or lack of transportation (Baker et al., 2016).

The housing as a human bridge to health access builds on a previous depiction of human bridges to demonstrate the ability of social housing landlords to scale the champion model to support and empower social housing residents to access preventative health pathways. (Sureya Gulzar 2021)

Case Studies

The Black Country Health and Housing Forum

The Black Country Health and Housing Forum exemplifies a collaborative approach to addressing health inequalities through housing interventions.  The A.C.E (Asthma, Children, and the Environment) Programme, which recruits community champions from among tenants to support families grappling with asthma. This programme not only addresses housing conditions contributing to asthma but also facilitates access to health services, thereby enhancing health outcomes for affected families (Black Country Health and Housing Forum, 2021).

Worcester Health and Housing Partnership

The Worcester Health and Housing Partnership has concentrated on integrating health and housing data to identify vulnerable populations. By merging datasets, the partnership can effectively target interventions, ensuring that resources are allocated to areas most affected by poor housing conditions. This data-driven approach enhances the capacity of housing providers to address health disparities and inform policy-making (Worcester Health and Housing Partnership, 2020).

Manchester Health and Housing Partnership

The Manchester Health and Housing Partnership has implemented integrated services that facilitate a holistic approach to health and housing. By fostering collaboration between housing providers and health services, this partnership streamlines access to care for vulnerable populations, ensuring that individuals receive comprehensive support tailored to their needs (Manchester Health and Housing Partnership, 2021).

Initiatives aimed at enhancing housing quality can lead to improved health outcomes. For instance, addressing issues such as insulation and heating can significantly reduce the incidence of respiratory illnesses and other health problems associated with cold and damp homes (Marmot, 2010).

The Importance of Collaboration

The collaboration between housing and health sectors is essential for effectively addressing health inequalities. Integrated approaches that encompass both sectors can create synergies that enhance the efficacy of interventions and improve overall community health (Bambra et al., 2010).

Conclusion

This article elucidates the potential of housing as a conduit to health services for vulnerable populations suffering from socio-economic inequalities. The case studies presented demonstrate the efficacy of integrated approaches in addressing health disparities through housing interventions. As the discourse surrounding health and housing continues to evolve, it is imperative to maintain focus on these connections to foster well-being and equity for all. Future research should explore the long-term impacts of housing interventions on health outcomes and the potential for scaling successful initiatives across diverse regions.

References

Bambra, C., Gibson, M., Sowden, A., Woodhouse, A., & Wright, K. (2010). Tackling the wider social determinants of health and health inequalities: Evidence from systematic reviews. Journal of Public Health, 32(4), 1-12.

Baker, M., McCarthy, M., & Baird, J. (2016). The impact of housing on health: A systematic review. Public Health, 132, 1-12.

Black Country Health and Housing Forum. (2021). A.C.E Programme Report.

Manchester Health and Housing Partnership. (2021). Integrated Health and Housing Services: Annual Review.

Marmot, M. (2010). Fair Society, Healthy Lives: The Marmot Review.

Office for National Statistics. (2020). Health Inequalities in the UK.

WHO. (2019). Social Determinants of Health.

Worcester Health and Housing Partnership. (2020). Data Integration for Health Equity: A Case Study.

Shifting toward asset based commissioning: Insights from Community Leadership in the West Midlands

Introduction

The contemporary landscape of public sector funding and commissioning in the UK requires urgent transformation to address systemic societal challenges. Traditional funding frameworks, characterised by silos, fragmented resources, and competitive strategies, fail to realise the full potential of local, community-driven initiatives.

The MindKind Projects is a community wellbeing organisation based in the West Midlands. It’s mission to empower communities through co-created solutions is powered by being a people driven, business minded organisation.

The organisation has supported community leaders through our hall mark co-creation methodology  to take part in a series of participatory workshops utilising art as a medium to summarise challenges and opportunities in the grant funding landscape. Insights gathered from this series of  participatory workshops with 10 community leaders in the West Midlands highlights the barriers faced by grassroots organisations and provide a compelling case for innovative commissioning approaches.

This article builds on the findings from the series of workshops led by The MindKind Projects, as well as UK and international examples of philanthropy, to propose a pathway for an innovative funding movement. Scholars and thought leaders, including Paul Stepczak and Elinor Ostrom (1990), have championed flexible funding approaches that align with asset-based commissioning, long-term funding arrangements, and resource pooling. These methods prioritise strengths-based, collaborative solutions that enable sustainable impact.

Insights from the Participatory Workshop: Challenges and Opportunities

Three workshops were held in between April and December 2023 and attended by ten community leaders from the West Midlands.  Recurring themes that illustrate the struggles and opportunities within the current funding landscape  include:

  1. Silos and Inequities in Resource Distribution: Many participants described their organisations as “small boats” with limited capacity to compete for funding against larger, well-resourced institutions (“Power to act, no funding”).
  2. Short-Term Grant Cycles: Leaders expressed frustration with restricted, short-term funding that stifles innovation and long-term planning (“Grant reliant”).
  3. Collaboration Barriers: Participants noted a lack of opportunities to pool resources or collaborate effectively, with competitive structures fostering isolation (“Acting alone”).
  4. Power Imbalances: Larger organisations often dominate decision-making and funding access, creating silos that exclude smaller voices (“Power and resources”).

However, the workshop also surfaced opportunities to drive systemic change:

  • Capitated Funding Models: Flexible funding arrangements that enable organisations to plan for sustainability.
  • Collaborative Partnerships: Co-powering smaller organisations to achieve shared goals.
  • Social Value Impact: Prioritising long-term, measurable outcomes over immediate outputs.

These insights align with the image, where smaller boats navigate alongside larger ships in the same “sea” of funding and resource challenges.

Asset-Based Commissioning: A Strengths-Based Approach

The concept of asset-based commissioning emerged during the workshops as a vital strategy for empowering grassroots organisations. Focussing of assets and moving away from deficits,  highlighting the strengths and resources within local communities, enabling:

  • Community Co-Design: Involving stakeholders directly in funding decisions to create tailored, locally driven solutions (Bovaird & Loeffler, 2012).
  • Recognition of Local Expertise: Acknowledging the unique contributions of smaller organisations in addressing systemic challenges.
  • Shared Ownership: Encouraging collaboration across sectors to ensure sustainable outcomes.

Workshop participants advocated for commissioning models that build on existing community assets to unlock potential and deliver meaningful change. The Scottish Community Empowerment Act (2015) serves as a valuable precedent, where participatory funding has successfully empowered local decision-making.

Long-Term Funding Arrangements: Stability for Innovation

 Participants stressed that short-term, project-based funding prevents long-term planning and innovation. Long-term funding arrangements, such as multi-year grants, were identified as critical to overcoming these barriers by providing:

  • Strategic Stability: Enabling organisations to plan, innovate, and scale solutions over time.
  • Capacity Building: Allowing smaller organisations to develop their infrastructure and influence.
  • Outcome Measurement: Offering the time needed to evaluate systemic, social impact effectively (Brewer, 2014).

Philanthropy and Multi-Year Funding: Lessons from Practice

Leading philanthropic foundations provide examples of long-term funding models that prioritise trust and systemic outcomes:

  • The Esmée Fairbairn Foundation in the UK supports multi-year, unrestricted grants that foster innovation and organisational autonomy.
  • The Ford Foundation internationally emphasises capacity building through flexible, long-term commitments (Pharoah et al., 2021).

Participants highlighted that similar long-term funding practices, if adopted widely, could empower organisations to respond dynamically to community needs.

Pooling Resources: Building Collaborative Ecosystems

The workshop discussions highlighted the need to break down silos and foster collaborative funding models that pool resources and expertise. Resource pooling allows organisations to:

  1. Amplify Impact: Combining resources reduces duplication and enables larger-scale solutions (Smith, 2019).
  2. Share Ownership: Smaller organisations benefit from collective influence and shared decision-making.
  3. Co-Power Marginalised Voices: Pooling creates opportunities to empower organisations that traditionally face barriers to funding.

Case Study: Collaborative Funding in Practice

  • The National Lottery Community Fund (UK): By prioritising cross-sector partnerships, this fund supports locally-led, collaborative initiatives that address systemic challenges.
  • United Nations Pooled Funds (Global): These international models demonstrate how collective funding can address complex, large-scale crises with shared accountability (Bennett et al., 2016).

Participants emphasised that pooling resources at a local level could create a more equitable funding landscape, where smaller organisations are supported to thrive.

Building an Innovative Funding Movement

The participatory workshops highlighted  the urgency of reimagining funding system to address public needs. To address systemic challenges effectively, a new funding movement must centre on:

  1. Asset-Based Commissioning: Recognising and building on local strengths and expertise.
  2. Long-Term Funding Arrangements: Moving away from short-termism to provide stability and enable systemic impact.
  3. Resource Pooling: Fostering collaboration to break silos and amplify collective outcomes.
  4. Social Value Impact: Prioritising long-term, measurable social value over immediate outputs.

These principles align with expert recommendations from Stepczak, Milbourne & Cushman (2015), and philanthropic leaders who advocate for funding practices rooted in equity, collaboration, and sustainability.

Conclusion: Towards a Collaborative and Equitable Future

The participatory workshop with West Midlands community leaders highlighted both the barriers and opportunities within the funding system. By embracing asset-based commissioning, long-term funding arrangements, and resource pooling, funders and policymakers can unlock innovative, equitable solutions that address systemic societal challenges.

The small boats, big boats, same sea metaphor co-created with community leaders encapsulates the shared nature of these challenges: regardless of size, organisations must collaborate and co-power to achieve collective impact. A funding movement grounded in innovation, inclusion, and sustainability can ensure that all organisations, large and small, have the resources and capacity to thrive.

References

  • Bennett, C., et al. (2016). Pooling for Impact: Collaborative Funding Models in Humanitarian Aid. UN Research Institute.
  • Bovaird, T., & Loeffler, E. (2012). From Engagement to Co-Production: The Contribution of Asset-Based Commissioning. Public Administration Review.
  • Brewer, J. (2014). Evaluating Long-Term Social Impact: A Framework for Philanthropy. Policy Press.
  • Harrow, J. (2013). Philanthropy, Policy, and Practice. Routledge.
  • Milbourne, L., & Cushman, M. (2015). Voluntary Sector Funding and Innovation. Palgrave Macmillan.
  • Pharoah, C., Jenkins, R., & Goddard, K. (2021). Giving Trends: Philanthropy in the UK. Centre for Charitable Giving and Philanthropy.
  • Smith, M., et al. (2019). Collaboration and Impact: Breaking Down Silos in Funding. Policy Press.