Co-designing healthy bodies and places requires a lifecourse approach

Dr Scott K Phillips FRSA responds to the RSA ANZ blogging challenge, hosted in collaboration with 92Y as part of the Seven Days of Genius Festival - a global festival celebrating the power of new ideas. Scott advocates for taking a lifecourse approach to co-designing healthy bodies, services, places and spaces that support people’s healthy development and transitions.

What are new ways to achieve a more equitable environment and fairness for all people? Research has demonstrated a compelling need, in the context of accelerating climate change and social complexity, for a new approach to securing healthy and productive outcomes for individuals, families and communities. Central to this is a focus on improving people’s early life conditions and supports as the foundation for everyone’s long term health, productivity and development (Prescott 2015)[1].

This involves adopting a lifecourse perspective. Such a focus necessarily involves considering the social, economic, environmental and cultural determinants of people’s health and wellbeing. It requires shifting away from sectoral ‘silos’ and taking a more integrated and collaborative approach to planning:

The many global challenges across so many domains cannot be solved in isolation, and will ultimately require a more coordinated, collaborative, cross-sectoral approach. This needs a broad vision, and a long vision, with a deep understanding that the solutions of tomorrow must begin today. (ibid)

There is an extensive research literature, especially since the 1980s, on supporting lifecourse health development. It draws together research across biology, medicine, maternal and child health, psychology, sociology and health policy (Halfon et al 2014)[2].

Researchers show how optimising lifelong health is not solely the responsibility of the medical or health sector. They call for enhanced horizontal integration of health, education and community support services to promote health in all policies, places and activities. For example, instead of addressing childhood obesity primarily in the office of a paediatrician, a lifecourse perspective shifts the nexus of prevention and intervention to local schools, day care settings, parks, recreation sites and community-based nutrition programs (Halfon et al 2014: 360). These ‘require more collaborative, networked models of care that not only integrate physical and behavioural health, but coordinate with social, community and education assets and resources (op cit: 365).’

Local governments are using this approach in working with community partners to foster health and wellbeing. Perhaps the most notable example in Australia is the Melbourne for All People Strategy 2014 – 2017:

Melbourne for All People 2014–17 takes a life course approach which recognises the importance of family, community, culture and place for all people from birth to 100 years+. It supports people’s rights and aspirations to live safe, healthy and connected lives within cohesive, vibrant communities, and recognises that public spaces, infrastructure and service delivery should cater for everyone’s needs (p3).

Melbourne City Council describes this as ‘an important shift’ which enables it ‘to develop more resilient, healthier and better connected individuals and communities.’ This has been done ‘by improving opportunities for inclusion and accessibility; better integrating City of Melbourne services, programs and activities; and encouraging different generations to support each other.’ (ibid)

Melbourne City Council has specified ‘important considerations that a robust life course approach acknowledges.’ These are:

• people at different stages of life and ability are already interconnected by family, community and interests
• people of different ages and abilities can relate to and support each other
• providing timely and appropriate services at transition points in life can improve health, employment, education, culture and social inclusion
• there are a number of contributors to a sense of wellbeing, some personal, some community based and some government influenced
• early intervention and primary prevention can have significant and long lasting positive outcomes
• locally based and community driven services strengthen communities and build social inclusion (p. 13)

Local Councils elsewhere in Australia – from Adelaide to Whittlesea, from Wyndham to Mitchell – are using a lifecourse lens when planning for the integrated and holistic supports needed by people of all ages, backgrounds and abilities as they transition through their life stages and social roles. The author of this article has worked with some of these Councils to develop their integrated lifecourse frameworks for social planning.

What is becoming clear is that, increasingly, people are working with local Councils to ‘co-design’ integrated services, places and spaces that meet their various life stage needs. Terms like ‘co-design’ are changing the language of planning beyond standard ideas like ‘partnership’ which ‘have been used without real engagement of people experiencing exclusion.’ (Burkitt 2016)[3]. ‘Co-design’, on the other hand, is part of a new policy discourse and ‘can form a foundation for exploring a meaningful re-engagement of citizens.’ (Burkitt 2016) 

We are, then, on the brink of ensuring planners (social, economic, environmental) work together- alongside community, business and government stakeholders – to co-design public places, housing stock, community centres, education and health services and transport connections that will support diverse people of all abilities, genders and backgrounds.

One of the new ways to achieve a more equitable environment and fairness for all people, therefore, is a lifecourse approach to co-designing services, places and spaces that support people’s healthy development and transitions.

We have the opportunity to advocate for this long term approach to early intervention and ongoing integrated community supports. We can contribute to the implementation, evaluation and continuous improvement of these new ways for improving the life prospects and contributions of all people everywhere.