USING CULTURE TO CREATE HEALTHY FUTURES

The place where you grow up can determine your health throughout your life: those born and living in disadvantaged areas are at higher risk of poor health and reduced life opportunities.

Southampton is a young and vibrant city – almost 20% of the population is aged between 0-16. But, despite being in the so-called ‘affluent south’, it is a place of great inequality. One in five children under the age of 16 live in low-income families. A similar proportion of young people come from neighbourhoods considered to be in the 10% most deprived nationally. The number of looked after children in Southampton is almost a third higher than the average in England.

The effects of deprivation on young people in the city can lead to health challenges around alcohol, mental health and obesity, which worsen into adulthood. Previous efforts to tackle this have had limited success.

The ‘Pathways to Health Through Cultures of Neighbourhoods’ project set out to change that, creating a network of academics, civic leaders, health professionals, charities and cultural organisations working together with young people aged 11 to 16. Co-Director of the Southampton Institute for Arts and Humanities and Professor of Archaeology, Professor Joanna Sofaer, led the project. She explained:

“Although we know that early intervention can prevent adult health inequality there is a gap in the provision and understanding of adolescent needs within Integrated Care Systems (the partnership of local organisations, including the NHS, councils, voluntary sector, social care providers and others which come together to develop plans and services to meet local needs).

“Pathways to Health aimed to address that gap. Rather than simply taking a medical perspective, we looked beyond traditional ways of thinking to recognise the power of engaging with culture to promote health and wellbeing,” she continued.

“But what does ‘culture’ mean to young people and where do they experience it?”

The project, which began in 2022, has created a city-wide consortium of 30 organisations. The multidisciplinary research team included University of Southampton academics from Arts and Humanities, Social Sciences, and Medicine, as well as the leaders of Southampton City Council’s Public Health and Stronger Communities teams, and charities Artswork and No Limits.

Hearing from young people

Consultation carried out as part of Southampton’s bid to be UK City of Culture 2025 revealed that access to ‘official’ arts and culture opportunities for young people varies enormously across the city.

“For us to understand the needs of young people, shape the development of provision and reduce future health challenges,” said Joanna, “the first step had to be hearing from the young people themselves.”

The project worked with more than 200 young people from disadvantaged communities across the city. It aimed to understand what culture means to them, how they use placebased cultural assets, how they feel about the places where they live, and to empower them to shape their own pathways to health.

Workshops delivered by the consortium’s creative partners, including photography, drama, dance and creative writing, enabled young people to express their thoughts and experiences. Young participants emoji-mapped their neighbourhoods, took part in focus groups and ‘plausible futures’ exercises. The project also asked adults in those communities about community cultural assets.

The University’s LifeLab, which works with young people to co-create and deliver health education interventions, trained a cohort of 19 young people aged 14 to 16 as peer researchers and advocates.

“The best people to talk to young people are young people themselves,” said Joanna. “Our ‘Young Researcher’ training programme recruited young people to become the voice of their communities.

“They are telling us what the issues are that matter to young people, how these impact their health and wellbeing, and potential ways to address them,” said Joanna.

The project found that despite living in the same places as adults, young people experience them differently. Their understandings of place-based strengths and opportunities are different to those of adults in their communities and to ‘official’ assets documented by the City of Culture project and Southampton City Council.

“Young people have not only told us about ‘hidden’ cultural and community assets but also about ‘hidden’ barriers to accessing them. Young people challenge existing approaches to health improvement and point to ways of doing things differently. These have significant implications for service provision, including its form, location and uptake,” explained Joanna.

Lines of communication

A series of development days and a young researcher conference during 2023 gave the young people the opportunity to speak directly to the city’s decision-makers, including the Director of Public Health, school head teachers, and the leaders of charities and cultural organisations.

By bringing together different services and providers to learn from young people and involve them in decision-making, Pathways to Health has facilitated joined-up thinking and created a new youth-led vision for the city. It has helped the consortium better understand the central role of culture in young people’s lives and how co-creating opportunities with young people can be used to support their health and wellbeing. This will enable the development of best practice and tools for using cultural engagement to improve young people’s health outcomes and life chances.

“The project has created a knowledge exchange forum with the young people at its centre and culture as a way of understanding young people’s lives,” said Joanna. “We have created, not just new research, but also a community of practice, and lines of communication throughout the city that did not previously exist.”

“Participation in the Young Researcher Training Programme has transformational effects on young people. Teachers tell us that their students are more confident and motivated, and the young people say they feel more confident and empowered.”

Pathways to Health finished at the end of 2023, but consortium members, including Southampton City Council, are committed to continuing to work together with young people. The consortium and Young Researcher Training Programme have secured additional funding, enabling development and evaluation of the programme, as well as sharing good practice in working with young people. Their goal: to improve the health outcomes of young people now and as future adults.

Pathways to Health and the Young Researcher Training Programme are funded and supported by the AHRC/UKRI through the Mobilising Community Assets Programme, University of Southampton, NIHR Public Health Research Support Service, NIHR Southampton Biomedical Research Centre, Southampton Institute for Arts and Humanities (SIAH), LifeLab, and Young Person’s Professional Advisory Group (YPAG).

Read more about Pathways to Health: www.pathways-to-health.org

Professor Joanna Sofaer