Designing for Health Equity: Insights from British Red Cross services

Key findings 

In producing this report, we have mapped our activities to the six domains recommended in the 2010 Marmot Review, Fair Society, Healthy Lives. An additional area, ‘who we support’, looked at the scale and reach of our services.

Who we support 

• While all of our UK services reach people likely to be experiencing inequalities in their health outcomes, targeted programmes and services have a higher reach than universal services. 
• Our services reach disproportionately more people living in areas of England and Wales where there is inequality in health outcomes. 

Give every child the best start in life 

• Our support in this area is focussed around refugees and asylum seekers. We provide essential items for babies and children to help meet their short term needs and help people to access financial help to make a longer term impact too.

Enable all children, young people, and adults to maximise their capabilities and have control over their lives. 

• All British Red Cross services are designed to help people feel more in control of their lives. Evidence shows the significant value that this support brings to people.

Create fair employment and good work for all 

• Our support for this determinant of health is concentrated in our services for refugees and asylum seekers. Evidence on the value of this support is limited. 

Ensure a health standard of living for all 

• There is a large amount of work across all British Red Cross services to address this determinant of health. There is emerging evidence of increased activity where it is most likely to be needed.

Create and develop healthy and sustainable places and communities 

• We took action almost 64,000 times around housing and helping people to connect with their local communities. The majority of this work focussed on providing sustainable value and growing evidence shows the positive results this support has for people.

Strengthen the role and impact of ill health prevention 

• The combined support across all of our UK services means we are helping people to access other support for their health and access health and wellbeing support themselves. This work is highly valued and impactful in services targeted at those most at risk of inequalities in health outcomes. 
  

Recommendations 

This research shows our commitment to being present where we are needed the most. It supports the continuous improvement of our services as we increase our impact and helps us to show how our services are making a difference.

We offer the following recommendations for health and social care leaders on how person-centred care can help achieve health equity:

1. Understand that people can face multiple and compounding inequalities and require support to address these to mitigate the impact on their health and wellbeing. Short term support can reduce immediate risks but longer-term support is needed to resolve need where there are complex and compounding inequalities. 
    
2. To give people the best chance to live a healthy life, design accessible wrap around care that addresses social as well as clinical need e.g. personal care. Support individuals to maximise their own capabilities through information and education and further enable sustainable change. 
    
3. Ensure an ecosystem of community support that spans the breadth of the Marmot Principles is commissioned. This could help provide early intervention found to be more cost-effective and avoid unnecessary deterioration. 

Acknowledgements

Thank you to Professor Geeta Nargund for funding this research and development and for her focus on health inequalities across our operations in the UK. 

We are grateful to the advice and guidance provided by the Institute of Health Equity, University College London and our colleagues at the British Red Cross. Without their commitment, collaboration and guidance, this work would not have been possible.