Asset based approaches for health and wellbeing

It seems in recent times the terms asset based approach, asset based community development, assets, health assets are almost everywhere I look. Well, when I say everywhere, I mean in terms of my work focus and outside interests.

I’m intrigued on two levels to understand why this is? Is it the latest fad in thinking and practice in health and care sectors or the new wave of understanding and describing what we (need to) do to support people to take more control over their lives and health?

Perhaps these terms and in turn the (implied) approaches involved in doing asset based work chime with core values championed by people in communities of practice, of place etc – “that it feels right, that it reflects my personal values of how I want to be with others”. This is no bad thing and it was certainly a theme often reflected in our recent report. We spent time with people in a range of places and settings where asset based approaches were being used to connect people in neighbourhoods, and where there were attempts to refocus the nature of care support in health sectors.

My intrigue and interest in the presence of asset based approaches as a trend in health and related sectors is also focused on the question of why now? Is it a response to the policy agenda on active and engaged citizens? Is it a natural coming together of communities of interest against the backdrop of austerity and major changes in the public sector – where care and community services are changing beyond recognition in the context of budget constraints? Maybe it’s all of these and more.

What I do know is that currently asset based approaches to health and wellbeing have a firm foot hold in the UK, based on foundations that are rooted in many parts of the community development system. There is a good evidence and knowledge base too for health assets. I sense the opportunity to refocus and bring greater clarity to this paradigm, to focus on the potential of asset based approaches to promote and sustain health and wellbeing, is one we should invest time and energy in.

In so doing there are some fundamental issues that need to be addressed:
1. Moving the balance increasingly to a focus of what “creates health” – at an individual and community level. We need to look more to the value of the social and relational, the environments and circumstances in which people live. This has historically been within the realm of public health and health promotion practice but increasingly evidenced in practice in recovery movements and community based action for health – health champions etc.

2. Understanding the steps in developing “health assets” to include mental, social, material and physical resources that enable people to flourish and have a sense of coherence and control in the everyday.

3. Adopting methods for community development that enable people to improve their resilience, independence, co-dependence and wellbeing. The primary environment for this action is within neighbourhoods. There are a range of community development approaches that are relevant to health assets which need to be considered [1].

In our recent report we set out these principles in some detail and give examples of places and situations where progress is being made.

In proposing these stages, I don’t believe the journey will be easy nor without contention; indeed the areas of asset based working – specifically asset based community development has been subject to some critique in the UK more recently [2/3]. There are a number of established community development methodologies which have asset based approaches, we need to consider these more as we move this agenda forward to achieve a more plural approach that supports the local context.

So, I accept the move toward more community place based action is positive yet complex but that public and related sectors need to recalibrate their practice to create an environment for the growth in asset based approaches, while recognising that some people and places have specific needs that require support and attention and adopting asset based approaches should not be about handing off these issues to local people, but rather as my colleague Jane Foot argues [4] “asset based approaches complement services and other activities that are intended to reduce inequalities on life chances and life circumstances and which meet needs in communities.”

[1] Appreciating Assets – Carnegie UK Trust & The International Association for Community Development 2011.
[2] What we’ve tried hasn’t worked: The politics of asset based public health. Friedli.L Critical Public Health. 2012. 23:2. P131-145
[3] Neoliberalism with a Community Face? A critical analysis of Asset Based Community Development in MacLoed MA, Emejulu. A Scotland. Journal of Community Practice. 2014. 4:22. P430-450
[4] What makes us healthy? The asset approach in practice: evidence, action and evaluation: Jane Foot. 2012.

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