In what ways does the concept of community have relevance in understanding welfare and wellbeing?
The earliest and most frequently accepted meaning of ‘community’ denotes people living in an environment who have face–to-face contact with each other. Built on this declaration Tönnies (1955) named community as ‘Gemeinschaft’ to refer to social formation in the pre-industrial period where face–to-face contact was achieved in rural and tribal society. With changes in industrialised society, a new society arose that was more similar to objective contact among its people. People connected with each in strict ways and life was somewhat predetermined.
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The French sociologist Emile Durkheim in 1897 conducted one of the earliest, and now classic, studies on the importance of the role that community social forces play in the health of the individual (Durkheim, 1951). According to Syme & Ritterman (2006)
‘In his work on suicide, Durkheim noted that, in conventional thinking, the causes of suicide must be found within the individual: a person’s personal demons, failures, aspirations, and dashed hopes. Yet Durkheim noted that suicide rates were dramatically higher among certain groups and communities and that these differences persisted over time even as individuals entered and left those communities. ‘ (p1)
In an attempt to rationalise this difference among groups, Durkheim asserted that this phenomenon perhaps had its roots in the social organisation of groups. This would in turn explain the varying rates of suicide, and shed light on why suicides were lower or higher within certain groups. This concept outlined by Durkheim may nowadays be referred to as “social capital.” (Syme & Ritterman, 2006) This essay will begin by outlining the link between community and the health welfare of its members. The next section will draw on current research to outline the link between the concept of community and Elderly wellbeing. The essay will conclude with two examples of community development in action and the associated benefits for the overall health and wellbeing of its members.
Link between community and health welfare
Research on the connection between social class and health. Since the beginning of recorded history, persons deemed to be in a low social-class order appear to have increased rates of poorer health. This opinion appears to have much validity whether one categorises people in terms of income, occupation, residence, or education (Adler et al., 1994). This remark is also understood whether or not one trusts the unbiased or self-reports of social-class position (Singh-Manoux, Adler, & Marmot, 2003; Singh-Manoux, Marmot, & Adler, 2005). There appears to be some consistency to these rates: these variances in health by social class continue over time even as people come and go from the community (Kaplan, 1996). Therefore, the reasons that contribute to worsening health need further exploration. How does a lower social-class position result in poorer health? Is this related to financial status or lower education, lack of nutrition, inaccessible health care and a lack of sanitary housing? Syme & Ritterman (2006) conclude that
‘It is of course impossible to separate these influences since they are inextricably interrelated. The predominant view has been that, short of revolution, social classes will always be with us because nothing can be done to eliminate them; thus, it is more useful to work on topics that are amenable to intervention, such as diet, smoking, and physical activity. ‘ (p 7)
Research carried out by Scuderi (2005) has reflected this phenomenon in the investigation of a group of cardiac rehabilitation patients, who are Italian immigrants. His study verified that the model of rehabilitation focusing on exercise, diet, and medico-education proved to have the most fruitful results. Participants in the study testified that the social contact with people who shared their language and culture were of significant importance. Also, activities both internal and external to their family unit proved of equal significance. Equally, Lee and Cubin (2002) accredited relationships between community factors and cardiovascular health trends in young people. This research tracks a rudimentary principle of community psychology, whereby if a traditional emphasis is placed on individual level interventions and associated outcomes, it is likely to overlook the implication of the framework in which the individual and group are operating.
Importance of the concept of Community in Elderly Wellbeing
According to the Joseph Rowntree report entitled “From welfare to well-being – planning for an ageing society”,
‘Research has shown that, at neighbourhood level, older people have often been marginalised from the regeneration process. This is despite the fact that they are normally the most stable population group because they have lived in a community for longer, move less often, and have more time on their hands.’ (p13)
The Task Group reported nevertheless, that some areas are operating on a neighbourhood basis to bring unify older people, with local agencies working in partnership. The overall aim is to promote a positive view of aging. This is grounded on the acknowledgement that older people tend to identify themselves with the community they reside in. If their home and environment are empowering and supportive, then older people are more likely to retain their independence and have a better quality of life.
When focus is placed at a community level, the potential exists to link in with established neighbourhood initiatives, as this ties in with community support networks most often found in rural areas. For example, some Community Councils, when drafting their yearly parish plan, examine the needs of its early and try to organise a variety of local initiatives with the aim of tackling social isolation and providing key services. (Joseph Rowntree Report, 2004). The Report also outlines that Slaley Parish Community Group in Northumberland, following the drafting of their parish plan, has begun working alongside Age Action to deliver a shopping service, run by their staff and a team of local volunteers. When older people are actively engaged in such initiatives, it can be a source of increased self-esteem and worth. By using a community approach, staff from the various agencies can focus in on how they can support in elderly in their service delivery. The approach encourages collaboration and focuses on providing practical solutions to promote wellbeing, rather than following the traditional healthcare led approach. In keeping with a community approach, the elderly have greater accesses to services and the concept of reciprocity comes into play as people are now assuming the role of giver as well as taker. Local agencies also have made professional links which facilitates an easier sharing of information, thus cultivating a collaborative effort.
Examples of Community Well-being initiatives
According to the NHS England report entitled ‘A guide to community-centred approaches for health and wellbeing’ (2015), ‘Community hubs are community centres or community anchor organisations focused on health and wellbeing that can be either locality based or work as a network.’ (p. 28) These typically develop and provide activities which are aimed at addressing health issues in a particular community. Some hubs are linked in with current community resources such as community centres and public libraries. The NHS report outlines one such example. ‘ HealthWORKS’ community hub in Newcastle and Bromley-by-Bow provide a range of local community services in partnership with various local community groups. Services provided include community cafés, employment training, a community gym, financial advice group, and social support group. (NHS England Report, 2015) This model which promotes health living and general wellbeing allows access to local services by facilitating affordable and easy to join activities, thus breaking down barriers for disadvantaged groups.
A report by the Joseph Rowntree Foundation, in partnership with Sheffield Hallam University, entitled ‘Community-led approaches to reducing poverty in neighbourhoods: A review of evidence and practice’ (2016), states that ‘There is case study evidence that community-led housing can play a valuable role in regenerating low income communities (…) The Helmsdale and District Community Owned Housing Project illustrates how community-led housing can address a number of aspects of poverty.’ (p. 41) This housing project began working in partnership with the local Housing Association to support the construction of energy efficient housing, under an affordable rent scheme. The project had the overall aim of tackling population decline in the Scottish Highlands. The Rowntree Foundation Report further stipulates that
‘Benefits identified included a renewed sense of community purpose, the attraction of young families, and a positive impact on fuel poverty. Equally significantly, the housing also generates a sustainable income from rentals and solar energy panels of more than £20k per annum, much of which is earmarked for investment in future community-driven projects.’ (p. 41)
Therefore, this purpose led project highlights how community developed housing projects can bring about poverty-related improvements for low-income households in a disadvantaged rural setting.
In terms of wellbeing and welfare, people on the margins of society seldom have considerable power over key decisions affecting their lives. These include power over where they chose to reside, how their children will access the best education, and how they can achieve parity in accessing health services. Power over these issues depends on outside sources and it is therefore outside of the capacity of many to influence change single handily. Manifestly, as a consequence, community development work must strive to influence itself in issues relating to power and decision making. Effective community development seeks to be the voice of the marginalised. This can be described as empowerment, a fundamental tenet of successful community development initiatives.
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- Scuderi, C. S. (2005). The experience of cardiac illness: Illness perceptions and the meaning of good health in Italian-speaking cardiac patients. Paper presented at the Australian Society for Behavioural Health and Medicine Annual Conference, Melbourne, February Available at: http://vuir.vu.edu.au/16154/ (Accessed 09.01.19)
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