Upstream issues for downstream folk

I have been mulling over various social and health inequality issues recently, mostly prompted by a literature review I wrote on a range of youth issues.

What struck me was how similar the risk and protective factors were across a wide sweep of issues – homelessness, drug and alcohol use, self-harming, depression, living in care – the list goes on. As does the list of risk factors.

It really stood out to me that all these issues are so very interconnect, or intersectional as posh researchers like to say – as the web of risk and protective factors are so similar.

No wonder then, I wondered, that services often fail, We are trying to tackle one or a few risk factors at once rather than dealing with them all at once. Despite the best efforts of holistic, child-centred and integrated care, services usually pick and choose what to deal with and have practice thresholds preventing them from addressing it all.

A further issue is that these are all downstream issues, for the downstream and insignificant people. What matters and what will make a difference is tackling the upstream issue that only important people get to deal with. And by that I mean poverty. Most, if not all, social and health inequalities are worsened by income and wealth inequality. And yet no one does anything about it. No one even talks about it much these days. We seem to have become completely blind and immured to poverty.

My next challenge is to work out what I might do to play my part in highlighting and tackling this prime issue, the single issue that really can transform a wide range of risk factors and inequitable outcomes later downstream.

Perhaps this is the major social issue that the rich can pay their way out of? If only they were willing to.

I’d welcome any ideas anyone else has too…..??


shopping business money pay
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Barnardo’s ‘Child in Cumbria’ Summit 17 – you said we did meet.

Barnardos Summit 17 – After the ‘Being in Child in Cumbria’ – You Said we Did


The Being a Child in Cumbria research designed, conducted and analysed by Barnardos was a significant piece of research. Over 6000 children and young people responded to the survey providing Cumbria with a comprehensive overview of the thoughts and feelings of Cumbrian children about living in Cumbria. The findings were also analysed through the lens of deprivation giving insight into the differences wealth and poverty can make to a child’s experience of living in the same county. If you have not seen the research then check out these you tube films about them:


So one year on, had anyone done anything differently as a result of this research – yes they have.


The conference kicked off with the theme of Giants – as this had been a giant survey. The lyrics of the Take That song ‘We are Giant’s set the tone for the day, as the children and young people involved, practitioners, leaders and managers all trying to make a difference are giants among us.


The issues that face children and young people were represented as boulders that the BFG’s (big friendly giants) among us would need to destroy or navigate. The aspirations of the children and young people were captured as dream jars – something we need to navigate towards single-mindedly.


The day celebrated a range of amazing achievements.


Copeland started the programme and really set the tone for the day. They have created a range of initiatives as a result of this research. One of these is setting up a food bank service that between 70 and 90people access each month – giving away a total of 3 tonnes of food per month.

The Connected Communities team from UCLAN got involved with Copeland and worked with 24 super heros from Mirehouse, aged 10-11 years old and 14 ‘Girls Gang’ community volunteers from Woodhouse, aged 11-12 years old. These young people conducted a range of research projects using creative methods and developed and delivered community development projects.


As a result of this work, Copeland now have a Children’s Charter that ensures that Copeland:

HearChildren’s Voices

Work with School Councils

Keep Children Safe

Change People’s Attitudes about Children

Support Children’s Health


A new project is about to start, connecting young people to older generations in the Youth Connectors scheme.

Copeland are really showing how to listen to what children and young people say, and how to work with children and young people in every strategic decision – taking the seeds from the research and growing great practice from it.


A striking theme from the research was children’s sense of loss after a bereavement. As a result of this, a Children and Young People’s Bereavement Network (CYPBANG) was set up. They have created a website resource that will be launched in June across Cumbria to support children to deal with grief and bereavement.

Child Bereavement UK picked up on this theme and showcased some of the resources they have to support children, parents and schools dealing with this difficult issue.


The Barnardo’s Youth Steering Group had also picked up on this issue and had created a leaflet about coping with pet loss that will soon be in all vetinarian surgeries. An excellent example of young people leading important practical changes.

Next up were Red Boxes team and Period Poverty North Cumbria, both leading crucial initiatives to get sanitary protection into primary, secondary, further education and higher education establishments. This will support the 1 in 10 young women who cannot afford sanitary protection, 49% of whom therefore miss at least one day of school a month.


Cumbria Children in Care Council shared their youth forum work with the participants and showed a film the group had made of their experiences of living in care. This gave a further example of positive outcomes from youth participation / youth voice.


What else?

Well alongside these amazing examples from practice, the participants also got to take part in some amazing activities. We made our own dream jars, took part in the ‘My Time’ team’s decision making exercise, pledged to use youth voice in our own work and identified our own ‘boulders’. And then there was the showcase of stands and lunchtime networking.

Much excellent work is underway, and it is not enough. There are many things to improve for young people and solving those problems is important. And we must remain focussed on the skills of children and young people to sort these issues for themselves. We must remain asset-balanced as well as participatory. And, we can’t forget the societal issues – the policies and laws, expectations and norms – that keep some people living in adverse situations, in poverty. So along with dealing with these issues I hope we also work to challenge poverty at the highest levels. To that end, please come to the Equalities Group Cumbria on the 28th May 2019 – University of Cumbria.

Screenshot 2019-03-23 19.01.39

Amazing event – thank you to Julie Fletcher of Barnardos, to the youth steering group who designed the day and to all the other ‘Giants’ of Cumbria who make such a different to children and young people.

Great North Children’s Research Community

The conference took place in the ‘Life’ centre in Newcastle, a spectacular new build hospital, science museum and event venue. The theme was Child Health Research Across Organisational Boundaries.

There was a wealth of early career researchers, young researchers, and old hands at the conference all engaging in discussions about child health outcomes.

Several themes repeatedly emerged and are worth reflecting on:

  1. Working across organisational boundaries (boundary spanning) is never going to be easy and takes focus, effort and time. That said, it is very possible, as illustrated by Carol Ewing outlining the Greater Manchester model. All the effort is worthwhile for more streamlined services to children and more effective use of resources. Nina Modi also gave insights of how to get out of our organisational silos to support children better with internationally connected research.
  2. People live in very difficult life circumstances created by inequitable structures. These need to be addressed. Just one example of this was brought to life by Professor Greta Defeyter’s research on holiday hunger and its impact on health outcomes. I think we need to do all we can (publish, petition, protest) about these structures in order to get them to change as individuals and as a collective.
  3. Whilst we work on the structural issues we also need to support people in the moment, in those dire life circumstances. Front line practice is needed – more of what we know works, and more innovation. These services / interventions need to be owned by the people and developed with the people that will use them (co-ownership and co-production).
  4. We need to develop the evidence that these work through proportionate evaluation – that is, using the right tool, with the right community and intervention, and collecting the right amount of data for the balance of stakeholder needs as Stuart Logan eloquently pointed out. This should also be owned by the people it affected and conducted by them – as illustrated by the work of the Young People’s Action Group North East – YPAGne.
  5. Spend time with amazing people, doing amazing things, debate and discuss, re-energise and re-focus – we all have the power to change the world, and we all need support to do so.

It was fantastic to also share my work on strengths-based / asset-based practice. I covered the need for a fully integrated approach that goes beyond ideology and tokenistic use of the terms to a fully holistic approach at all levels of intervention and indeed organisational life. I also presented the case for an asset-balanced approach as it would be as inappropriate to completely ignore need as it is to completely ignore strengths. I really enjoyed some great conversations with colleagues following this and am looking forward to working with Niina Kolehmainen on this area.

Thanks GNCRC for an inspiring day – looking forward to working with you more.



Youth Identity in Australia

This week Marnee Shay, Annette Woods and Grace Sarra visited the University of Cumbria from sunny old Queensland Australia.

In a ‘deadly’ (means good in Australia) presentation they talked of their extensive research with Indigenous Youth. 3% of the Australian population is Indigenous, and 80% of that 3% are in ‘flexi schools’ having been pushed out of the mainstream education system.

Marnee, Annette and Grace spent time in a range of flexi schools across Australia speaking to these youth about their identity.

This was not a quick dip in, ask a few questions, and dip out exercise. The academics employed local staff as co-researchers to ensure that local knowledge was privileged in the process and local capacity and employment boosted. Marnee and her team spent two weeks in each school working in a relational and participatory way with young people.

The activities were built slowly, young people’s preferences respected, sessions tailored to be culturally sensitive, research tools were creative, and the youth given a budget of $5000 to make an artefact or product of their choice that reflected their identities.

The process was respectful, empowering and profound. Many youth who would not normally show up for school did for this project showing the potential of educational processes that are meaningful and respectful.

The research was socially just, ensuring that the participants gained as much from the process as the researchers, and that the knowledge was co-created, respectful, equitable. There are many lessons here about slow relational respectful research.

The end products are breathtaking – highly professional printed clothing, videos, artwork, poetry, all expressing something of what it is to be Indigenous youth in Australia. Impressive as artefacts, profound when the layers of meaning and considered – what the totems mean, what the young people rapped. We should take heed at the wisdom of youth on who they are and what they want.

Thank you to Marnee, Annette and Grace for sharing this important work with us in the UK, we who had a hand in dispossessing these youth of their lands in the first place. I applaud your work and admit my cultural shame.


Want to do something about equality?

I’m convening an Equality Cumbria and Lancashire group for people who care about equality of all kinds in these regions as a local group for the Equality Trust.

If the issues raised in this blog, your personal experience, or watching the news makes you uncomfortable, anxious or angry then come along!


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We will decide what we want to do as a group when we first meet, so the first one will be an exploration of who is in the room, what the issues are that bother us and what we want to do about – chat, research, prod, petition, publish, protest – its all possible.

If you are interested then book here:

Join the new Equality group based in Cumbria and Lancashire. The UK is one of the most unequal countries in the developed world in terms of its gap between rich and poor a situation that has been shown to have negative impacts evident for everyone (Wilkinson and Pickett, 2009; 2018). * Are you concerned about inequality in Cumbria and Lancashire? * Do you want to join like-minded people to discuss these issues? * Do you want to challenge the gaps in education, employment, wealth, health and wellbeing? Then join us for the first meeting of this group to explore the local issues, who we are as a group, and how we might want to work together.

Join the new Equality group in Cumbria and Lancashire. The UK is one of the most unequal countries in the developed world in terms of its gap between rich and poor a situation that has been shown to have negative impacts evident for everyone (Wilkinson and Pickett, 2009; 2018). * Are you concerned about inequality in Cumbria and Lancashire? * Do you want to join like-minded people to discuss these issues? * Do you want to challenge the gaps in education, employment, wealth, health and wellbeing? Then join us for the first meeting of this group to explore the local issues, who we are as a group, and how we might want to work together.

The Sell Out of the UK

This week’s read has been George Monbiot’s Captive State. This shocking book shows how corporations in the UK and overseas have become so powerful in the UK. The  Private Finance Initiative is documented to have enabled a range of private investors to buy into and then profit from the Skye Bridge, hospitals, schools, land use, shops, the food chain, many key areas of our economic life are controlled by private companies rather than the government.

Monbiot’s solution? “Engaging in democratic politics, using exposure, enfranchisement and dissent to prise representatives out of the arms of the powers they have embraced”  (2000,p.358).

“Only one thing can reverse the corporate take over of Britain. It’s you.” (2000, p.360).

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The Impact of Inequality and Need for Economic Democracy

This weeks read has been Richard Wilkinson and Kate Pickett’s latest (2018) book – The Inner Level. This text maps the social and psychological processes that mean that income inequality diminishes wellbeing – a fact they evidenced in their first book, The Spirit Level (2007).

The collate huge evidence bases for the worsening of all of the following issues in countries where income inequality is widest (pp268-272):

  • Life expectancy
  • Infant mortality
  • Adult mortality
  • Obesity
  • HIV infection
  • Mental illness (all)
  • Depression
  • Schizophrenia
  • Psychotic symptoms
  • Status anxiety
  • Narcissism
  • Substance use or deaths
  • Problem gambling
  • Trust / social capital
  • Solidarity
  • Agreeableness
  • Civic participation
  • Cultural participation
  • Ambiguous stereotyping (bastards but contribute to economy)
  • Social comparisons
  • Imprisonment
  • Women’s status
  • Child wellbeing
  • Bullying
  • Child mistreatment
  • Educational attainment
  • Dropping out of school
  • Social mobility
  • Teenage pregnancy
  • Biodiversity
  • Water /meat / petrol consumption
  • Air pollution
  • Status consumption
  • Compliance with international environmental agreement

How can we look on whilst these blight our lives?

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They identify some key reasons for these issues escalating:

Inequality makes problems with social gradients worse – it increases the prevalence of almost all socially graded problems such as health etc as shown above P232-33

Inequality affects social mixing – it reduces social mobility and increases segregation. P233-34

Inequality affects social cohesion – as cohesion drops so status anxiety increases with inequality – people are more judgemental, more anxious of comparison and put down, and this increases the prevalence of coping mechanisms – eating, not going out, drink, drugs et. P234

Inequality increases anxieties about status – low self esteem and low confidence result from the social anxiety. This increases depression and other diagnosable psychological disorders. This includes self-aggrandisement and narcissism, and disdain for anyone of a lower rank P234-35

Inequality heightens consumerism and consumption – people use money to show that they are worth and so endlessly buy status symbols. Increased working hours and debt to accrue those goods p235-36.

So what do we do about it? Wilkinson and Pickett recommend moving to a Democratic Economy. This would include tax reforms, end to tax evasion, co-operatives, employee representation on boards, employees as stakeholders, (these have been proved to boost productivity and to be more innovative), with countries striving to increase GDP through business models that benefit all rather than solely benefitting the rich. Such models would even income inequality and enable countries to afford increased welfare p244-251.

The current massive differentials in pay, lack of employee voice and lack of control in organisational life makes employees feel disaffected and stressed as they generate wealth for their ‘owners’ p250-51.

They suggest an easy step would be to create a ‘Democratic Company’ movement like ‘Fairtrade’ p256.

These are interesting ideas. I have certainly noted and believe the negative impact of income inequality such as they mapped in The Spirit Level. It has been interesting to read the links between inequality and the phenomenon’s it produces in this book. What this text has really achieved, in my opinion however, is to start to generate clear and simple actions every organisation globally can put in place to create more equality. It is not just a political issue that only governments can address, it is within many more people’s gift. That said, campaigning and taking action politically is still important so that some of these changes can be legislated for.

To that end, i am proposing to establish an Inequality Group in line withe the Inequality Trust, to meet twice a year at the University of Cumbria Lancaster and Carlisle campus. I envisage creating a democratic space for like minded people to meet, discuss issues and solutions, and who knows what else from there. If anyone is interested in joining, please let me know and I will set up dates.