Heath Inequalities Atlas
HDRC Aberdeen has developed an online, interactive Health Inequalities Atlas. The portal is freely available, see below, and presents a range of data relating to health, health inequalities, and the wider determinants of health. The broader North East of Scotland area is covered, with plans to extend coverage to other local authority areas across Scotland. Available data includes census data, datasets such as the Scottish Indices of Multiple Deprivation and research data on wages, food prioritisation and access to health assets and hazards. Each element is visually mapped to the lowest geographical level available. The Atlas is fully interactive and data can be exported to various file formats.
We are continuing to develop the Atlas and there are plans to add additional datasets as well as links to data analysis and interpretation.
Poverty
Poverty is the common issue which impacts many of the determinants of health. Effective prevention and intervention depend on a sound understanding of how it impacts communities, families and individuals.
HDRC Aberdeen are engaging with a range of colleagues and partners to help understand the prevalence, causes and impact of poverty, and to support joint working to reduce and mitigate poverty. The extent of the work reflects the significance of poverty across almost all areas of the Council's work. Specific examples of current work include:
- Our partnership with Public Health Scotland and the University College of London Institute of Health Equity to advance Aberdeen as a 'Marmot Place' and position Aberdeen as one of three local authorities in Scotland taking part in the 'Collaboration for Health Equity in Scotland'.
- Leading a successful funding bid to the Scottish Government Child Poverty Accelerator Fund and developing a local 'Low Income Family Tracker' (LIFT) which integrates Council data with Department of Work and Pensions data to pinpoint financial vulnerability at a household level.
- Undertaking work on debt cancellation, including producing a scoping review and supporting Council Officers to use the evidence produced. We have also facilitated meetings between the Council and a debt cancellation project in the Netherlands to learn from their experience of building an evidence base for this type of intervention in a political environment.
- Working to inform the Council’s response to the needs of asylum seekers and those with no recourse to public funds.
This work is informing the Council and its partners in multiple ways and impacting on formal strategies and plans. For example, our work through CHES and the development of LIFT are being used to inform the 'Fairer Futures Pathfinder' programme. This is a fundamental organisation-wide change to tackle child poverty.
Asylum Seekers’ Needs
Informed by discussions with ACC Officers from Education, Housing and Children's Social Work, our Research Fellow, Dr. Leo Ho, and others, have completed an overview review on asylum seekers’ care needs and experiences in high-income countries to help us inform future policymaking. We identified issues commonly reported by asylum seekers, including communication barriers, attitudes of healthcare workers, mental health issues, access to healthcare, and housing difficulties. The findings have been submitted to a peer-reviewed journal for academic dissemination and shared to our colleagues from NHS Grampian to lay the foundation for their asylum seekers’ need assessment. In addition, a dedicated workshop session was hosted at our Conference in November 2024 to share our findings to the attendees. The outputs of this workshop will be compiled in our Conference Report in due course.
https://youtu.be/6DOkkl2XEjcView video (2m 36s)
Asylum Seekers' Needs Video transcript:
Around the world, 6.1 million people are seeking asylum due to persecution, conflicts, and human rights abuses. People seeking asylum often present with complex health and social care needs due to their circumstances and traumatic experiences. Those who go through the health and social care pathways in the host countries may also encounter numerous obstacles before being able to receive appropriate care services.
In this work, the sources of evidence are systematic reviews. Systematic reviews identify, appraise, and synthesise all the evidence generated from original studies. This results in an overview of evidence which allows for a summary of existing evidence and helps to identify gaps in our knowledge. The focus was on adult asylum seekers’ care needs and experiences in countries where each person is earning US$13,845 or more per year on average. These are considered by the World Bank to be “high-income” countries. This makes the overview more applicable to our own City of Aberdeen.
The overview identifies common issues encountered by asylum seekers in their day-to-day lives. These included language barriers, mental health issues, limited access to healthcare, and difficulties around housing. Many asylum seekers faced negative and unfriendly attitudes from healthcare workers. A lack of social and financial support made it hard for individuals to get the care and housing they needed. Trust issues and fear of deportation affected their sense of security. Poor housing conditions and challenges in finding rental properties impacted their daily lives and ability to settle into society.
Given the problems these individuals already have there are implications for service delivery. Services ought to be and should be nudged toward a more warming Scottish welcome, a more compassionate response considering the ’trauma’ these individuals and families are already experiencing.
Early Learning & Childcare
Early Learning and Childcare (ELC) services, which provide care and learning for children before they start school, are a policy priority for the Scottish Government. In August 2021, publicly funded support was provided to increase the provision of ELC from 600 to 1,140 funded hours for eligible two-year-olds, as well as for all three-, four-, and five-year-olds who had not yet started primary school. Aberdeen City Council (ACC) are responsible for implementing the policy across the city and are required to consult with parents every two years and publish plans reflecting the consultation.
HDRC Aberdeen has helped design the latest public consultation and are developing a longitudinal research study to assess the long-term impact of the expanded ELC services. The study is being done in collaboration with the ACC Integrated Children and Family Services team. The research will follow up a cohort of participants over three years and aims to measure the ongoing impacts of ELC on family and mental well-being, as well as parents’ and carers’ working, training, and studying opportunities.
Food insecurity
The HDRC Aberdeen research team have participated in research into the causes of infant food insecurity. A review of research findings has been completed in order to gather a fuller understanding of the issues and to help to identify potential ways of tackling infant food insecurity in the local context of Aberdeen. The team is in the process of creating an interactive map of foodbank locations to make it easier for anyone in need to locate the nearest suitable food bank. Additionally, they are finishing an analysis of the Scottish Government’s policy landscape on food insecurity and poverty, which will identify opportunities for improvement. This work was presented in a poster at the Annual Scientific Meeting for the Society for Social Medicine and Population Health in September 2024. HDRC Aberdeen has been working with Food Poverty Action Aberdeen and with Community Planning Aberdeen’s Anti-Poverty Outcome Improvement Group on this work. In addition, a dedicated workshop session was hosted at our Conference in November 2024 to share our findings to the attendees. The outputs of this workshop will be compiled in our Conference Report in due course.
Financial Exclusion
We anticipate that the Child Poverty Accelerator Fund project will begin to provide new intelligence during Summer 2024. This has followed the significant development of agreement with the Department of Work and Pensions for reuse of data and the procurement of an analytics tool. Once this new intelligence is available this can underpin numerous single and multi-agency interventions e.g. debt alleviation, warm homes, food insecurity, employability support, etc.
Population
A paper has been submitted to Community Planning Aberdeen and Aberdeen City Council's governance groups on the City’s population data, showing low birth rate, low net migration, growing numbers of people unfit to work and discussing the potential impacts of this. Further work is ongoing as the 2022 Census results are released to update this and a Population workshop event was held at the end of August (including population heath issues).
Read the report:
Adult Literacy
While at an early stage, HDRC Aberdeen has begun work with Council colleagues to support an evidence-based review of adult literacy in the context of the city’s libraries provision.
Child Mental Health and “At Risk”
HDRC Aberdeen supported the creation of a new data set matching Aberdeen City Council child protection and NHS Grampian CAMHS records. We also contributed to and reviewed the analysis which this allowed. The resultant paper has been accepted for academic publication. In addition, a dedicated workshop session was hosted at our Conference in November 2024 to share our findings to the attendees. The outputs of this workshop will be compiled in our Conference Report in due course.
Family Support Model
HDRC Aberdeen are involved in discussions with colleagues on the development of more integrated family support. Scottish Government funding has been secured by the Council to test a new model and this potentially includes investment in temporary posts either within, or adjacent to, HDRC Aberdeen. The scope of this is currently being prepared.
Place
HDRC Aberdeen are central to bringing together a multi-agency research group, which is currently mapping existing council strategic interventions which relate to climate change and health. This work is tying into the ongoing focus of the North East Place and Wellbeing Network, which is being led by an HDRC Aberdeen co-applicant. Other members of the HDRC Aberdeen team are attending and providing support, including most recently, our Social Prescribing PhD student and academic supervisor. As well as working with the Council’s Strategic Place Planning cluster on the public consultation for the Local Transport Strategy, the HDRC Aberdeen has also delivered a cluster training session on the social determinants of health. The research team hosted a workshop at the HDRC Aberdeen conference in November 2024, which delved into the critical role of "place" in shaping health and wellbeing, introducing participants to the concept of place and exploring its definition and its link to health outcomes. The outputs of this workshop will be compiled in our Conference Report in due course.
Relational Place Lived Experience
We’re working with the Council and Community Planning Aberdeen on two projects to understand people's lived experiences; Community Justice and Relational Placemaking. The Relation Placemaking project will test a community-based approach in one area of Aberdeen City. It will explore what it’s like to live in that community, including any challenges residents face. This project will use different methods to understand how place affects health and wellbeing, with potential insights for public engagement, environmental sustainability, and urban planning. Because the HDRC Aberdeen is all about culture and capacity building, both projects will involve training staff and community members, creating processes for managing and sharing stories, and recognising public participation in research.
Ethnically Inclusive Research Practices
The PhD project, ‘The Missing Voices in Health Research: An ethnographic exploration of inclusive public involvement in research, with and for, global ethnic majority women’, funded by Robert Gordon University, supports the HDRC Aberdeen by addressing the underrepresentation of Global Ethnic Majority (GEM) women in health research through an ethnographic exploration of inclusive public involvement. It focuses on identifying both the challenges faced by stakeholders in implementing inclusive practices and the successful cultural frameworks that facilitate engagement with marginalised groups. A Public Advisory Group, representing all major ethnic communities in Aberdeen, alongside a Reference Group of local policymakers and third-sector professionals, has been established and will guide the research to ensure both community and professional involvement at every stage from initial scoping review through to dissemination of findings. The expected impact includes enhanced representation of GEM women in research, informed policy recommendations, and strengthened public involvement practices, contributing to systemic change in health determinants research inclusion. In addition, a dedicated workshop session was hosted at our Conference in November 2024 to share findings to the attendees. The outputs of this workshop will be compiled in our Conference Report in due course.
Food Sustainability
A review is underway as part of an MSc with the University of Aberdeen to identify, describe, and compare interventions of UK ‘Sustainable Food Places’ to promote food choices that increase the uptake of sustainable diets in response to the climate emergency, using a behavioural framework and compare to interventions proposed or conducted by Aberdeen City Council.
Warm Home Prescribing
We worked with Energy Systems Catapult, an independent research and technology organisation that supports Net Zero energy innovation, to implement 'warm home prescriptions' in Aberdeen City and Aberdeenshire. The Grampian/Aberdeen University Data Safe Haven selected eligible residents for the prescriptions, which were delivered by SCARF, a third sector energy partner. Working alongside researchers from the University of Aberdeen, we recently published a paper that explores how effective different types of financial support are for households in fuel poverty. We are now working with Council staff on the use of Council funding to prevent and fight against poverty, and are exploring specific options and further funding opportunities.
NDL Housing & Health
The HDRC Aberdeen team have worked closely with NHS colleagues funded through the Network Data Lab (NDL). The 3rd phase of the NDL has been agreed as “Housing and Health”. HDRC Aberdeen are currently in discussions around the scoping and planning of this work.
Criminal Justice
HDRC Aberdeen are working with colleagues in Criminal Justice Social Work to develop and test approaches to gathering the lived experiences of criminal justice service users.
Community Planning Aberdeen has identified that there are 'hard to reach' populations not being reached by existing public consultations. This pilot project is using qualitative methods to capture the lived experiences of criminal justice social work clients. Existing justice social work staff, who already have relationships with service users, are conducting one-to-one interviews after receiving training from qualitative research experts. The aim is to gain an understanding of an individual's journey through the justice system and how this has impacted on their experiences with Council services and in their community. The project will also build the capacity of social work staff to participate in research.
Social Prescribing
Our University of Aberdeen HDRC focussed PhD student working on social prescribing has started; her work will look to build the evidence base around longer term impacts of social prescribing on those using the Link Workers service in Aberdeen city; combining both qualitative and quantitative methods, this PhD is being supervised by a mixed team of academics and practitioners, with representation from Aberdeen City Council, Aberdeen City Health and Social Care Partnership and SAMH, supported by the HDRC Aberdeen. Our student is carrying out a review of existing studies to establish the background and context for her study now and we will support her to share her preliminary findings as widely as possible towards the end of the year. This project will also involve data matching across partner datasets and the HDRC are providing support with successfully navigating multi-agency data governance processes.
Whole Systems Approach to Healthy Weight
Obesity, including childhood obesity, has been identified as a priority issue for Aberdeen City Council (ACC).
A 'whole systems approach' to obesity and health inequalities was initiated by Aberdeen City Health and Social Care Partnership in 2024. The whole systems approach has been termed 'Healthy Weight Aberdeen' and is being co-developed by communities and stakeholders across the City, including the HDRC Aberdeen. A whole systems approach is required as the causes of obesity can be complex and are often related to the conditions in which individual people are born and live. A whole systems approach shifts the focus away from individuals and seeks to understand and address the social determinants of health.
We are working in partnership with Aberdeen City Council and Community Planning Aberdeen to support an evidence-based approach to the 'Healthy Weight Aberdeen' initiative. By embedding researchers from the University of Aberdeen, Robert Gordon University and the HDRC Aberdeen into Community Planning Aberdeen we will ensure that a social determinants lens is employed throughout the implementation, evaluation and adaptation of the 'Healthy Weight Aberdeen' initiative.
Hip Fractures
We have recently appointed a Robert Gordon University PhD student who will be researching cause, prevention and mitigation of hip fractures. This project will be co-supervised by academics from Robert Gordon University and Officers from Aberdeen City Council/ Aberdeen City Health and Social Care Partnership to ensure a sustained focus throughout two way knowledge sharing and organisational priorities.
Severe and Multiple Disadvantage
HDRC Aberdeen is an investigator in a randomised control trial led by the University of Edinburgh, testing approaches to outreach for people who are experiencing severe and multiple disadvantage. Testing is due to start early 2025. HDRC Aberdeen are linking this with local work to develop a Family Support Model.
Network Data Labs Intermediate Care
The HDRC Aberdeen team are liaising with NHS colleagues funded through the Network Data Lab (NDL). The 2nd Phase of the NDL is bringing together data on intermediate care. HDRCA’s current input is around data linkage.
Cost of Living Crisis
This briefing is aimed at policy makers dedicated to maintaining and improving the health of the population in the face of the cost-of-living crisis. It includes a rapid review of evidence on what could be done to mitigate the adverse health effects of rising cost-of-living in the UK.
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