Glasgow Centre for Population Health Podcast

What of healing?

Founded by MOBO award-winner Akala in 2009, The Hip-Hop Shakespeare Company is a musical theatre production social enterprise which offers young people a different view of the arts and ultimately of themselves.

Identifying biologic and behavioural causes of disease has been one of the central concerns of epidemiology for the past half century. This has led to the development of increasingly sophisticated conceptual and analytic approaches focused on the isolation of single causes of disease states. However, the growing recognition that (a) factors at multiple levels, including biologic, behavioural, and group levels may influence health and disease, and (b) that the interrelation among these factors often includes dynamic feedback and changes over time challenges this dominant epidemiologic paradigm. Using examples we will discuss how this deterministic paradigm has led us down a narrow path that challenges our capacity to meaningfully understand the complex causes of health states. Once we begin ‘thinking in systems’ we inevitably arrive at a broader public health conceptualization of the causes of health states. This has important implications both for the science as well as for a public health policy approach that aims to improve the health of populations.

Vorarlberg in Austria has 20 years of experience in experimenting with different ways and methods of promoting a more sustainable society. Out of this experience has emerged the idea of a 'learning institution' embedded in a tight-knit network of co-operating institutions.

We all blame our genes for many of our features, behaviours and illnesses. Recent studies suggest that the environment before birth is also a major influence on the risk of ill-health across the lifespan and perhaps into a further generation.

Very few people argue with the need to address the social determinants of health and much effort has already been made at national and international level to reduce persistent health inequities between and within countries. However, global health inequities continue to widen, as the effectiveness and quality of programmes vary considerably, sometimes resulting in the reverse of expected outcomes. Local political issues and cultural conflicts clearly play a part in these situations. However, the asset model proposed in ‘Health Assets in a Global Context’ suggests that it is the disproportionate emphasis between deficit and asset based approaches that prevent effective and sustained action. The former focuses on assessing health needs, sometimes ignoring the potential strengths of individuals and communities; the latter assesses multiple levels of health-promoting aspects in populations, and promotes joint solutions between communities and outside agencies. The Asset Model sets out a challenge for policy makers, researchers and practitioners to think and act differently to support positive joint solutions for health. It brings together a range of existing ideas to provide a framework for establishing the evidence base required to demonstrate the benefits to be gained from investing in asset based approaches. Antony Morgan is an epidemiologist and the Associate Director, Centre for Public Health Excellence for NICE. He is currently responsible for producing public health guidance across a range of public health topic areas, including inequalities, community engagement, social and emotional wellbeing of children, sexual health, alcohol misuse, quitting smoking during pregnancy, domestic violence and Hepatitis B and C.