Session six of the Symposium. Talks about projects on partnerships with communities done with regard to the Christie Commission. The first is the Healthy Wealthy Children Project, the second the Equally Well test site in Govanhill. Gives the background on GCPH's work in developing inequalities thinking and support partnerships. The Healthy Wealthy Children project spanned 15 months and looked at the impact on service users and models of development for community health partnerships. Partners were NHS midwives and health visitors. He describes the project. It linked issues to do with gender, lone parenthood and risk with action on inequalities and money advice services. It looked at changes in service delivery by midwives and health visitors. It led to increased access to benefits that customers were entitled to. Onward support was increased and there was a good reach to ethnic groups and lone parents. There was excellent engagement from midwives and health visitors. The Govanhill project concerned participatory budgeting and developed from work done in Brazil. It gave local people a democratic involvement in how public money was spent. GOCA was a main driver, it was facilitated by Oxfam UK and evaluated by GCPH. He explains how the money was spent. Lessons learned included that an independent facilitator was important, and that people felt empowered. The money was used wisely. Challenges included time pressures, community representation, perhaps more young people could have been involved. The Healthy Wealthy Children project is ongoing, GCPH has a light touch involvement. They are now looking at new work with the voluntary sector on the changing nature of work, in work poverty and the impact on health. The welfare reforms that are taking place in the UK are very significant with regard to public spending, work and other issues. How can the GCPH extend methods of doing things differently for the challenges ahead?

In the seventh session of the Symposium, Sir Harry Burns gives his personal perception on the GCPH and policy. He talks about the success of the Centre and how its unique set up has led to this success, how the Centre has influenced policy by providing scientifically robust data. Referring to the recent Report, ‘Psychological Social and Biological Determinants of ill Health’, he summarises how the growing body of evidence reinforces the impact of poor early life circumstances, low socioeconomic childhood status and accumulation of risk factors; the clear association between socioeconomic status and cognitive performance; the importance of the individual and their interaction with the world around them as a determinant of health outcomes. He talks about inequalities being the outcomes of a set of processes and the consequences of these outcomes, how the cultural drivers of wellbeing are ignored as they cannot be measured in the same way as, for example unemployment and hospitalisation rates. Compassion needs to be the main driver of wellbeing in society.

The scale and impact of health inequalities in Scotland is well understood: the gaps in healthy life expectancy between our communities are unjust and avoidable. Much of the work on health inequalities has tended to focus on socioeconomic circumstances as a fundamental cause. However a wide range of social circumstances impact on health, including visible identities and the impact of prejudice and discrimination. In this seminar, Professor Laura Serrant explores the issue of health inequalities though the lens of race and inter-sectional identities. She draws on both her personal and professional experience as a Black practitioner to explore why the experiences of some groups and individuals are missing from health research, professional leadership and service development. She uses her considerable experience to explore the importance of breaking silences to develop our understanding and ask whether we need to reflect more on our own identities as part of our practice, as well as that of our communities. The everyday experiences of racism can impact on the health and wellbeing of those racialised. It is important that policy-makers, researchers, service-planners and employers acknowledge the need for a deeper understanding of what is required by organisations in order to serve diverse perspectives in our systems of healthcare.

This lecture explored the relationships between psychology, biology, physiology and socio-economic status. Prof Steptoe shared many interesting insights concerning health and health inequality, developed by the emerging field of psychobiology.

This lecture presented the case for lay knowledge and theories to be taken more seriously. Professor Popay argued that lay knowledge is sophisticated, helps to answer questions about meaning and experience, and should be treated as an equal but different voice in informing decision-making about policy and practice.

In a city which prides itself on friendliness and yet has inequalities in health which persist despite our best attempts to tackle them, questions about our relationships to others are of key significance.This issue of otherness is ancient and contemporary, local as well as global, and of significance both in everyday life and periods of cultural crisis. In this lecture, Aftab Omer will consider how to develop core principles and practices that are responsive to the challenges of otherness both within the city and beyond. The diversity we see in the human race is often treated as a problem rather than an asset. For example, we see this in various forms of social oppression such as inequality, racism and cultural trauma. Omer argues that responding effectively to the fragmentation that characterises this global cultural crisis, calls for leadership that practices a profound engagement with all that is other. Such a perspective will raise important insights and questions about how people, organisations and cultures relate to each other, with important consequences for the pursuit of wellbeing.

Public health is facing a cruel paradox. On the one hand, concern about the public's health has never been higher and issues like obesity, alcohol misuse, growing inequalities in health, and environmental degradation compete for attention on the policy agenda. On the other hand, there is widespread dismay over the means available to address these complex public health challenges. Either they seem inadequate for the task or they are poorly implemented. Whether it is the workforce charged with health improvement and its fitness for purpose, the slender finances available for public health causes, the weak incentive structure to bring about the shift from sickness to health, or the ethical tension between the nanny state and the individual in making lifestyle choices, those engaged in improving the public's health have arguably never worked in such a fraught and confused environment. In this seminar Prof Hunter will explore whether we need a new approach to health leadership and governance in order to provide public health policy with a new sense of purpose and the means to succeed. Does the political will exist to undertake the necessary action? Or is the "culture of contentment" too entrenched to bring about the necessary paradigm shift?

Professor Bruce Link’s research has focused on how and under what conditions socioeconomic disparities are translated into health inequalities. In this lecture, Professor Link will introduce the fundamental-social-causes concept and present evidence related to its scope and validity by focusing on health patterns and trends in New York. Using data from New York and elsewhere he will argue that the association between socioeconomic status and mortality has persisted for over a century despite dramatic changes in the diseases afflicting humans and radical changes in the risk factors presumed to account for those diseases. Drawing upon a range of sources, he will suggest that socioeconomic disparities endure because socioeconomic status embodies an array of flexible resources, such as knowledge, money, power, prestige and beneficial social connections that can be used to protect health no matter what the risk factors or diseases are at any given time. His lecture will end with some considerations concerning the policy implications which arise from this perspective.

In this lecture Dr Burns reflects that recent trends show relative improvements in some Scottish health indices compared to other countries. However, health inequality remains an obstinate challenge in Scotland, with the greatest difficulties found largely in the Clydeside conurbation. The policy implications of this and the findings of recent research on the effects of stress on brain structure are considered.

This lecture took place at the Royal College of Physicians and Surgeons of Glasgow. Economic growth is supposed to deliver rising prosperity: higher incomes increasing wellbeing and leading to prosperity for all. But this conventional formula is failing. Growth has delivered its benefits, at best unequally. Moreover, the ecological and social consequences of unfettered growth are devastating. Climate change threatens long-term wellbeing. Resource scarcities undermine the basis for future prosperity. Persistent inequalities still divide the world and a growing ‘social recession’ haunts the market economies. Development remains essential for poorer countries. But are ever-increasing incomes for the ‘already rich’ still a legitimate goal for advanced nations? Or should we be aiming for prosperity without growth? In this seminar, Tim Jackson, an advisor to the UK Government and author of Prosperity without Growth: Economics for a Finite Planet (Earthscan, 2009), will argue that society faces a profound dilemma: economic growth is unsustainable; but ‘de-growth’ - or economic contraction - is unstable. He will show that the prevailing ‘escape route’ from this dilemma - to try and ‘decouple’ economic activity from its impact - is not working. How can we proceed in a world where global resource consumption is still rising yet meeting climate change targets will require reductions in carbon intensity two orders of magnitude higher than anything achieved historically? In the light of these challenges, Professor Jackson engages in a critical re-examination of the economic structure and social logic of consumerism. He will set out a new vision of a shared prosperity: the capability to flourish as human beings - within the ecological limits of a finite planet.