Health Inequalities across GroundsWell
Rob Bushby, Avril Johnstone and Mariam Jack share how GroundsWell is approaching health inequalities across it's different work packages.
Health Inequalities across GroundsWell
What is GroundsWell?
GroundsWell is all about maximising the potential of Urban Green and Blue Spaces, or nature spaces — think parks, gardens, woodlands, canals, rivers and coastlines — to help prevent and reduce health inequalities. It’s no secret that spending time in nature is good for all of us. Research consistently shows this can offer a wide range of health benefits, from encouraging physical activity to boosting mental wellbeing. The problem? Not everyone has the same opportunity to access and enjoy these benefits, which feeds into health inequalities.
GroundsWell's approach to health inequalities[i] calls attention to differences in access, availability, and use of nature spaces — and how these disparities shape health outcomes. Whether it's due to age, disability, social class, geography, or ethnicity, people’s ability to connect with these settings varies greatly, with real impacts on lifestyles and on health and wellbeing. Understanding and tackling inequality is at the heart of GroundsWell. Its focus is to ensure that everyone, regardless of their circumstances, has the chance to reap the benefits that nature has to offer.
As a UK-wide consortium, a programme of research, community partnership and policy work (with bases in Edinburgh, Liverpool, Belfast) GroundsWell is implemented through seven interlinked Work Packages and a Health Inequalities cross-cutting theme.
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The GroundsWell approach: a holistic view on health inequality
GroundsWell takes a ‘systems approach’. That means understanding how policy, practice, perception, and people are all interconnected. These components collectively shape how, where, and when people can use green and blue spaces. But it’s not enough to just understand these systems and how they interact—GroundsWell aims to move the dial to achieve greater impact and benefits. In tandem
How? Blending innovative theoretical frameworks with advanced data science techniques, including simulations, health economics, and policy analysis, helps to drive this transformation, together with jointly planned and evaluated community engagement. Lasting change comes from listening to—and working alongside—the people directly impacted by these inequalities.
GroundsWell Work Packages – an overview
Work Package 1: Systems-Oriented Conceptual Framework - examines how different factors interact within larger systems to either widen or reduce inequalities in access to Urban Green and Blue Spaces. Understanding these dynamics helps find ways to build more equitable systems from the ground up.
Work Package 2: Agent-Based Models - uses advanced simulation models to explore the needs of people who don’t (or can’t) use Urban Green and Blue Spaces. Models focus on key indicators that highlight the health effects of these inequalities, aiming to offer real-world solutions.
Work Package 3: Community Innovation, Co-production, & Citizen Science - works hand-in-hand with disadvantaged communities. It co-develops strategies for building partnerships, engaging in citizen science, and creating health-focused, evidence-based interventions. This is where local voices really come into play.
Work Package 4: Data Infrastructure - dives deep into the data—whether it’s administrative records or survey data— to map out where health inequalities exist and how they play out across different populations. This information helps to pinpoint exactly where change is needed most.
Work Package 5: Economic Evaluation - extends the reach of GroundsWell beyond health benefits of Urban Green and Blue Spaces to analyse their economic impact. It looks at how factors like income and social status influence access, and how these economic disparities contribute to broader health inequalities.
Work Package 6: Political & Decision-Making Contexts - examines policy and how decisions made at national, regional and local levels affect access to green and blue spaces. It focuses on identifying gaps (as well as good practice) in decision-making processes and pushes for more community-driven solutions.
Work Package 7: Impact Evaluation - ensures that all GroundsWell activity is viewed through a health inequalities lens. This perspective is applied to all communications, outreach, and impact assessments to make sure that findings and results are relevant, far-reaching and equitable.
Cross-cutting Theme: Health Inequalities - considers the spectrum of activity to ensure that all aspects of GroundsWell’s work programme are continuously informed by an understanding of how health inequalities emerge in nature and society, driving the consortium’s mission to prevent and reduce them.
The Bigger Picture
GroundsWell is about much more than generating health inequalities insights. A wealth of research and evidence on nature, health and inequalities already exists, but with gaps and a lack of integration. Its focus is on finding and developing evidence-based ways to close disparities in access and use of nature spaces.
[i] “‘Health inequalities are the systematic, avoidable and unfair differences in health outcomes that can be observed between populations, between social groups within the same population or as a gradient across a population ranked by social position.”
McCartney G, Popham F, McMaster R, Cumbers A. Defining health and health inequalities. Public health. 2019 Jul 1; 172:22-30.
