The contextual development of healthy living centres services: an examination of food-related initiatives.

The Healthy Living Centre (HLC) programme was designed to address the wider determinants of health, in particular social exclusion and socio-economic disadvantage, through targeting services at the most deprived local communities. This paper draws on data collected during an in-depth process evaluation of six Scottish HLC case study sites. Food-related services, which were found to cross-cut all the sites, were used to address social exclusion and to promote health. Three types of service, each linked to a social model of health, were found to be in operation: those which enhance skills; those which promote social inclusion; and those which influence food accessibility. The paper illustrates how food-related services have developed in the case study HLCs to take account of the differing needs of the communities and neighbourhoods that have been targeted. Consideration is then given to how HLCs adapt to meet the practicalities of improving health while addressing social exclusion through targeting health inequalities.

[1]  D Acheson,et al.  Independent inquiry into inequalities in health , 2005 .

[2]  E. Brunner,et al.  Socio-economic differentials in health: The role of nutrition , 1997, Proceedings of the Nutrition Society.

[3]  G. Riches.  Hunger, food security and welfare policies: Issues and debates in First World societies , 1997, Proceedings of the Nutrition Society.

[4]  M. Caraher,et al.  Local food projects: The new philanthropy? , 2003 .

[5]  Gillian Smith,et al.  Area-Based Initiatives: The Rationale and Options for Area Targeting , 1999 .

[6]  M. Gillman.  Enjoy your fruits and vegetables , 1996, BMJ.

[7]  T. Key,et al.  Dietary habits and mortality in 11 000 vegetarians and health conscious people: results of a 17 year follow up , 1996, BMJ.

[8]  Alan Bryman,et al.  Developments in qualitative data analysis: an introduction , 2002 .

[9]  Alan Bryman,et al.  Analyzing Qualitative Data , 1994 .

[10]  S. Skerratt.  Food availability and choice in rural Scotland: the impact of “place” , 1999 .

[11]  W. James,et al.  A life course approach to diet, nutrition and the prevention of chronic diseases , 2004, Public Health Nutrition.

[12]  E. Dowler.  Food and Poverty in Britain: Rights and Responsibilities , 2002 .

[13]  L. Spencer,et al.  Qualitative data analysis for applied policy research , 2002 .

[14]  Anne Murcott,et al.  The Sociology of food and eating : essays on the sociological significance of food , 1983 .

[15]  M. Wiseman,et al.  The dietary and nutritional survey of British adults. , 1990 .

[16]  L. Hart,et al.  The Impact of Context on Data , 1999 .

[17]  Sally Robinson,et al.  National diet and nutrition survey: young people aged 4 to 18 years , 2001 .

[18]  S. Cummins,et al.  A Systematic Study of an Urban Foodscape: The Price and Availability of Food in Greater Glasgow , 2002 .

[19]  M. Caraher,et al.  A survey of food projects in the English NHS regions and Health Action Zones in 2001 , 2004 .

[20]  A. Robertson,et al.  Food is a Political Issue , 2005 .

[21]  Raymond Asomani-Boateng,et al.  Closing the Loop , 2007 .

[22]  J. Gregory,et al.  Report of the diet and nutrition survey , 2000 .

[23]  M. Nelson,et al.  Socioeconomic determinants of health: The contribution of nutrition to inequalities in health , 1997 .

[24]  H. Graham.  Tackling Inequalities in Health in England: Remedying Health Disadvantages, Narrowing Health Gaps or Reducing Health Gradients? , 2004, Journal of Social Policy.

[25]  J. Ashton.  The Peckham Pioneer Health Centre: a reappraisal. , 1977, Community health.