MAC-UK were pleased to see the Department for Health and Social Care turn its attention to prevention as prevention is at the heart of what we do. The department outlined their ideas in the Prevention Vision and opened a prevention consultation in July 2019: Advancing our health: Prevention in the 2020s. Today this consultation closed and in response MAC-UK joined forces with Khulisa, StreetDoctors and Redthread to create and submit a position statement which can be found here. As organisations who all work to improve the lives of excluded young people and to tackle youth violence, we are positioned on the frontline at the intersection of health inequalities and violence and this position informed our response.

The approach to prevention outlined in the consultation document attempts to map out strategies for foundations of better health, including a good start in life, valuing health across all policies and environmental risks. However, within this focus the wider social determinants of health and health inequalities have been misunderstood and unaddressed. The prevention paper is over reliant on narratives of individual responsibility and lifestyle factors, clinical outcomes and although it attempts to be cross-governmental, solely focuses on the NHS and omits crime, air quality, work, sustainability and growth. 

Our position statement describes five areas in which the government could do more to create the necessary healthy environments and accessible services for socially excluded young people. This is essential to preventing the psychological distress and poor health outcomes of young people and to creating health equity:

 

  1. Implement a public health approach

A public health approach which tackles violence and mental health problems addresses all causes and promotes protective measures at the personal, familial community and national level.

 

  1. Address the social causes of ill-health by drawing on a ‘health in all policies’ approach

The prevention vision and green paper reference the impact of environment on health but only mentioned individualistic solutions, it fails to elaborate on potential societal approaches. A ‘health in all policies approach’ must be scaled beyond the small number of local authorities currently using it and given further funding so that local governments are able to proactively  address social factors that influence health.

 

  1. Ensure all new social, economic and public policies include a health inequalities impact assessment

Despite acknowledging the growing health inequalities across the country, the green paper doesn’t offer any credible solutions to change these large scale issues.  A health inequalities impact assessment should be carried out across all new and revised policies to understand and prevent how they might contribute to health inequalities. This is already being implemented in Scotland.

 

  1. Co-produce services and interventions with young people to ensure they are relevant, accessible and take into account the lived experience of those directly affected by health inequalities

Collaboration through co-production is key to preventative solutions for communities. Reducing top-down interventions and giving ownership to communities reduces feelings of helplessness and promotes a community’s self determination, which is essential to psychological well-being and good health.

 

  1. Ensure existing services are safe and appropriate for socially excluded young people

The positive impact of some school-based interventions is not sustainable unless supported by highly trained staff and ongoing community projects. Frontline staff  require appropriate psychologically-informed training, support and supervision to enable best practice.

Today MAC-UK have also responded to the online consultation using examples of best practice taken from our innovative INTEGRATE approach as well as our past and current projects. You can read the full Prevention Position Statement here.