Good relations and health

Definitions

'Fostering good relations’ is specified in the Equality Act (2010) General Equality Duty as requiring public authorities to have due regard, in particular, to the need to tackle prejudice and promote understanding between people who share protected characteristics and those who do not. In practice this could mean fostering good relations between, for example, people with and without a visual impairment or between people from different religious/ethnic backgrounds.

The Equality and Human Rights Commission (EHRC) promotes the following four areas as a way to explain the concept of good relations:

  • Attitudes - promote positive attitudes between or towards different people or groups

  • Personal security - improve individuals' sense of personal security

  • Interactions with others - support positive and diverse interactions between different individuals/groups

  • Participation and influence - encourage wide participation of different individuals and groups so that people can get their voices heard and can influence relevant decisions.

These domains have been incorporated into the Good Relations Measurement Framework (2010) which was used to analyse four case studies to provide support and practical examples of good practice to public authorities. These case studies were gathered to help improve understanding of good relations in Scotland. The researchers concluded that levels of understanding around good relations vary widely and that there are opportunities for good relations to be built into areas such as community regeneration and population health improvement. The report also recognised that measuring progress of good relations work is challenging for public bodies.

The EHRC has produced a short briefing: Good Relations in Scotland (2012), which describes the historical development of this duty, the role of public policy and the challenges of defining the concept.

Policy

The Christie Commission Report is a key driver for policy and budget allocation. It recommends that public services are built around people and communities, their needs, aspirations, capacities, skills and work to build up their autonomy and resilience (p.72). It encourages community participation in the design and delivery of services. Participating and influencing outcomes affecting people’s lives is one the key elements of ‘good relations’ and also underpins the public sector equality duty and a human rights based approach.

Health boards have to publish a set of equality outcomes to demonstrate how they will meet the public sector equality duty (PSED), which includes outcomes linked to ‘fostering good relations’, and they must report on progress.

However, the most sustainable and effective way to deliver good relations activity is to embed it in what organisations do as a norm rather than being part of a separate initiative. The EHRC case study report (p.17) identifies that good relations work relates directly to a public authority’s core organisational activity by contributing to the attainment of several of the National Outcomes including to: 

  • ‘Achieve a strong, fair and inclusive national identify’
  • ‘Have strong, resilient and supportive communities where people take responsibility for their own actions and how they affect others’
  • ‘Take pride in a strong, fair and inclusive national identify’
  • ‘Live our lives safe from crime, disorder or danger.’

Links to health

Strong social networks and social capital are key to reducing actual and perceived crime levels and these are also indicators of good community relations. The damage done to an individual's wellbeing by experiencing crime and fearing crime is comparable. It is therefore important to prioritise tackling perceptions of crime and social disorder alongside measures to reduce actual crime levels (Bacon et al, 2010 p.79) and enhance a sense of security in the community which fosters good relations.

Fair Society Healthy Lives (The Marmot Review) argues that the evidence about the relationship between social and community capital and health is growing stronger. Communities living with multiple deprivations can often have higher than average levels of stress, isolation and depression. Social isolation can lead to increased risk of premature death, while re-connection through social networks and participation can improve mental health. Some area-based initiatives have demonstrated limited success and they argue that including communities and individuals in designing interventions that draw on community strengths and through co-production to address social isolation would help improve their effectiveness.

NHS Health Scotland’s outcomes framework for Scotland’s mental health improvement strategy is informed by evidence which indicates that when people feel connected to their local communities and participate in social networks, their general state of wellbeing improves and the impacts upon health services are likely to be reduced.

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