Enabling children and young people’s involvement in whole system action to reduce inequalities in the social determinants of health
Research Team: Mary Crowder, Caroline Dodds-Reynolds, Matt Egan, Vanessa Er, Hannah Fairbrother, Liddy Goyder, Naomi Griffin, Eleanor Holding, Nicky Knights, Pip Kyle, Karen Lock, Carolyn Summerbell, Steph Scott and Nick Woodrow.
Who's involved: LSHTM, Fuse & the University of Sheffield. We also worked with the Association for Young People’s Health (AYPH), Chilypep, the Health Foundation, the Office for Health Improvement and Disparities (OHID) and colleagues in local authority public health to help shape our project. 
September 2020 - March 2022
Project aim:
This project aimed to enable young people to be involved in action to reduce inequalities in the social determinants of health (SDH).
Our objectives were to:
- Explore young people’s views of health and what makes people healthy and makes it harder for them to be healthy within local places
- Explore young people’s understandings of inequalities in health
- Work with young people to identify key priorities for children and young people in addressing the impact of social determinants on their current and future health, and the messages that they would like to convey to people with a role in addressing health inequalities at a ‘place’ level
- Work young people and other key collaborators to plan, design and produce a toolkit of resources aimed at equipping children and young people with:
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- an understanding of health and wellbeing as a human right
- an understanding of the social determinants of health ways
- the tools to enable active involvement in action to reduce inequalities in the social determinants of health
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What we did
We carried out a series of three interlinked qualitative focus group discussions with six groups of young people (n=42) aged 13-21, resulting in 18 focus groups in total. We recruited young people from six youth groups across three geographical locations in England: South Yorkshire, the North East and London. All three locations fell within the most deprived quintile based on the 2019 English Indices of Multiple Deprivation (IMD).
Focus groups took place between February and June 2021, during the Covid-19 pandemic. Due to the UK’s lockdown and social distancing restrictions the majority of focus groups were conducted online. However, focus group discussions with one youth group in the North East were conducted face-to-face, once social distancing restrictions permitted, since the youth group did not have facilities to support online data generation in their building and not all the young people had the technologies to participate from home.
The focus groups involved participatory concept mapping activities, the discussion of relevant news articles, and a participant-led discussion around key priorities for change.
In the news
Publications
Eleanor Holding, Mary Crowder, Nicholas Woodrow, Naomi Griffin, Nicky Knights, Elizabeth Goyder, Rachael McKeown, Hannah Fairbrother (2022). Exploring young people’s perspectives on mental health support: A qualitative study across three geographical areas in England, UK. Health and Social Care in the community. https://doi.org/10.1111/hsc.14078
Fairbrother, H., Woodrow, N., Crowder, M. et al. (2022). ‘It All Kind of Links Really’: Young People’s Perspectives on the Relationship between Socioeconomic Circumstances and Health. International Journal of Environmental Research and Public Health, 19(6), 3679. https://doi.org/10.3390/ijerph19063679
Woodrow N, Fairbrother H, Crowder M, Goyder E, Griffin N, Holding E & Quirk H (2021) Exploring inequalities in health with young people through online focus groups : navigating the methodological and ethical challenges. Qualitative Research Journal https://www.emerald.com/insight/content/doi/10.1108/QRJ-06-2021-0064/full/html
Resources
Research briefing October 2022: Exploring young people’s perspectives on mental health support in areas of high deprivation: the importance of community support
Improving young people’s mental health and wellbeing is a global public health priority. However, despite continued commitment within the UK policy agenda to improve the mental health and wellbeing of young people, the incidence of mental health issues continues to rise.
Young People’s Toolkit: A Fair and Equal Opportunity to be healthy
Mobilising our findings from the research, the Association for Young People’s Health led workshops with our researchers and a group of young people to co-produce a multimedia toolkit. The toolkit aims to equip young people with an understanding of health and wellbeing as a human right, an understanding of the social determinants of health and ways to enable their active involvement in action to reduce inequalities in the social determinants of health.
Personal, social, health and economic (PSHE) health inequalities lesson resources for KS3, 4 and 5
We worked with the PSHE Association to develop a series of lesson resources about health inequalities, informed by our research findings. The aim of the lesson resources is to reduce stigma around health inequalities as well as support young people in engaging with communities and decision-makers to reduce inequalities in the building blocks of health.
Young people’s priorities for change: an animation
Some of the young people involved in the research worked with visual storytelling company, Nifty Fox, to create an animation highlighting their priorities for change to reduce health inequalities.
Young People and Health Inequalities_v2 from Nifty Fox Creative on Vimeo.
Infographic – Young People and Health Inequalities
Strategy for engaging and working with children and young people – June 2021
We created a document outlining our shared principles for working with and engaging with CYP within the project. We created the document by bringing together the principles of our partner organisations; Chilypep and the Association for Young People’s Health, alongside guidelines from INVOLVE.
Webinar – Engaging and working with young people – December 2021
The NIHR Schools for Public Health Research, Primary Care Research and Social Care Research hosted a webinar to explore engaging and working with young people. The webinar included reflections from our project team about the experiences and challenges of carrying out research with young people. Chilypep and the Association for Young People’s Health also shared their insights from the voluntary sector on working both with young people and participating in research.
Discussing ‘Tricky Topics’ with Young People at a Distance: the Challenges of Exploring Sensitive Subjects in Virtual Focus Groups
We wrote a blog post for the Covid Realities blog series. Our blog details and shares our learning from conducting online focus groups with young people around ‘sensitive’ topics of health and inequalities.
Can you hear me? Festival of the Mind Project
We’re also working with community arts organisation, Ignite Imaginations, to produce an art installation based on our project. A professional visual artist or creative writer from Ignite Imaginations will carry out workshops with young people to explore their take on the research project and to explore if young people feel heard when it comes to health inequalities. Young people will capture their thoughts and frustrations through creating their own and joint artworks/ written pieces. The artist (s) will take this as inspiration to create a large scale art installation. This will represent the voices of the young people and be displayed as part of the Festival of the Mind, where we will invite the general public to comment, interact and add to the installation. This creative project aims to:
i) Afford participating young people the opportunity to gain insight into the research process and give their take on a recent project that relates to their health and wellbeing
ii) Showcase contemporary research with real-world resonance carried out by members of TUOS
iii) Stimulate thinking and conversation about health inequalities in the wake of the pandemic and the Levelling Up agenda among the general public.