Addressing health inequalities in the Black Country

By, Michael Salmon, Head of Insight, Health and Wellbeing, Active Black Country

The Black Country is the most inactive part of England. The most recent Active Lives data release shows that 35.9% of adults across Dudley, Sandwell, Walsall and Wolverhampton are doing less than 30 weekly minutes of moderate intensity activity. For our geography to just be on par with the national average of 25.8%, it would require an additional 97,262 people over the age of 16 to be more active. These are structural issues, following almost identical patterns of the health inequalities that integrated care has been set up to tackle and such structural issues need to be addressed through a system-wide approach.

Active Black Country have been working closely with the recently established Black Country Integrated Care System (called Healthier Futures) to develop pathways to physical activity, support the workforce to incorporate activity into their suite of patient-based solutions and, where possible, to develop pilots that further our learning.

In late 2021, we undertook a piece of research with health and allied health professionals in the Black Country to explore the barriers to them referring people into physical activity-related opportunities. Around 70 members of the workforce responded, with clear feedback that there were two main issues at play;

• Lack of knowledge about appropriate activity opportunities
• Lack of confidence engaging in condition-specific conversations about physical activity

The Commonwealth Games was a great showcase for sport and physical activity and a fantastic opportunity to take stock of the learnings from London 2012 and enable a legacy of grassroots physical activity across the West Midlands. The Commonwealth Active Communities programme, funded by Sport England, provided a real opportunity to do this and a partnership was established between Active Black Country along with the four Black Country Local Authorities and Voluntary Sector Councils to take this forward. We opted to utilise some of this funding to invest in a new open data-powered Activity Finder and Wayfinding platform called Black Country Moving (using the OpenActive standard) to directly address the issue relating to lack of knowledge, providing the local paid and volunteer workforce with real-time access to a plethora of physical activity opportunities across our footprint, ranging from small-scale led walks in local parks for beginners to more advanced exercise sessions, such as HIIT and zumba, in leisure centres.

An activity finder such as this is only as good as the amount of content that sits on there, and this requires working with a number of local partners to upskill them appropriately around ensuring their offer is advertised in a way that’s open-data compliant. There was an immediate need to build digital capacity.

We started to hold regular community drop-in sessions in the lead-in to the launch of the platform, explaining the opportunity for deliverers to reach more people and have access to health pathways all free of charge. It was important to not over-complicate these conversations, and we made it clear that there were different levels of engagement that people could commit to, ranging from simple signposting of their services to utilising it as a full bookings system. As a result, at launch, there were over 1,000 opportunities that people could access.

There is still considerable work to do. Not all of the Black Country leisure providers use booking systems that are open-data compliant, so we’ve had to look at alternative solutions for some of the other partners who are still interested in being involved. Raising awareness of the platform, both amongst residents and the paid and volunteer workforce isn’t straightforward; it’s part of the training programme for health and allied health professionals and anyone receiving funding from Active Black Country is contractually obliged to advertise their sessions on Black Country Moving. However, we are considering means by which we can increase people’s exposure to the site. Members of the Active Black Country team have spoken about it on local radio and a large quantity of business card-sized marketing resources have been produced for health centres and community facilities. To take this further, we are now in the process of developing a more structured plan for driving people to the platform, taking advantage of iFrames to embed the site within partners’ existing online structures, utilising existing means of reaching large proportions of the population (such as advertising via Council Tax documents or payslips) and continuing the effort to drive provision to the site, such as HAF activities and smaller community-based activities.