Asset-based approaches are the best form of prevention argues the ALLIANCE's Lorne Berkley.
Health outcomes in Scotland are starkly unequal, with those from the most disadvantaged backgrounds continuing to die disproportionately younger than those who are more affluent. What’s more – the Glasgow Centre for Population Health (GCPH) reports health inequalities are increasing, particularly for conditions that are largely preventable, and the Health Inequalities Policy Review claims that “around 40 per cent of spending is currently accounted for by interventions that could have been avoided by prioritising a preventative approach”.
These difficulties are exacerbated by the fact that service delivery continues to be largely concerned with reacting to problems rather than preventing them. A huge amount of public money is spent on dealing with health and social problems after they arise rather than on prevention and early intervention.
Recently, however, there has been growing recognition of the need to find better ways of working guided by the Christie Commission which recommended that “public services are built around people and communities, their needs, aspirations, capacities and skills, and work to build up their autonomy and resilience”.
This has helped shift the political focus towards prevention; co-production of services; integration of services driven by partnership working; and legislation which enables people to exercise choice and exert greater control over the types of support they wish.
Within this context, there has been increased interest in assets-based approaches which the ALLIANCE believes offer huge potential to improve health and reduce inequalities. Assets-based approaches promote and strengthen the resources individuals, families and communities possess that help protect against poor health and which support the development and maintenance of good health and quality of life. Asset-based approaches work with people to make their skills visible and give them confidence that they are valued. As confidence and self-esteem grow in individuals and neighbours, trust and community cohesion are built.
Assessing assets alongside needs allows a better understanding of the health and care requirements of individuals and helps to build resilience, increases individual and community resources, and enables a shift towards more empowering, sustainable and holistic approaches to delivering services and improving health. By working with people rather than doing things to them, asset-based working has the potential to transform the way public services are delivered so that they are better positioned to assist people in addressing their problems in effective and sustainable ways.
Asset-based approaches, however, are not about overlooking structural and material issues or asking people to overcome difficulties themselves. Addressing poverty, deprivation and material inequality must continue to be the focus of concentrated effort as key social determinants of health and wellbeing. With this in mind, asset-based approaches offer real opportunities to reduce health inequalities in 21st Century Scotland.