Roots of recovery: Occupational therapy at the heart of health equity
Introduction
"The health of the population is not just a matter of how well the health service is funded and functions, important as that is: health is closely linked to the conditions in which people are born, grow, live, work and age and inequities in power, and resources – the social determinants of health." 4
Occupational therapists are unique in that they already work across organisations in health and social care, housing, criminal justice, employment, education, and the voluntary sector. Although there is currently limited published evidence of occupational therapists and other allied health professions directly reducing health inequalities, this report explains how decision-makers can create change by using the knowledge and skills of the occupational therapy profession to deliver measurable change. For those who design or manage services, it provides practical recommendations that have the potential to encourage better use of resources for improved outcomes, supported by examples of where occupational therapists are already making a difference.
As the UK recovers from the COVID-19 pandemic it is people who have been disadvantaged by social and economic factors that have been hardest hit.5 Health inequalities in the UK have steadily risen over the last decade2 and they have been magnified by the pandemic. The crisis vividly exposed how our vulnerability varies hugely, determined by a complex web of existing inequalities, across genders, age groups, races, income levels, social classes, and locations. People with long term conditions, disabilities and those shielding have also experienced reduced access to health and social care services as these were reprioritised to manage the COVID-19 demands.6
Governments and organisations across the UK and beyond have recognised these inequalities and have made recommendations,7.8.9.10.11.12 but implementation is complex and multi-faceted. Health and social care providers need to balance need with access to service provision whilst managing existing waiting lists, staff burnout and the risk of losing public support as they seek to re-establish services for illnesses not related to COVID-19.13
Given these mounting pressures and competing demands on the public purse, addressing health inequalities and their causes may not be seen as an immediate priority by health and social care providers, or the complexity of tackling these societal issues and the range of organisations required to work together to do so may put health inequalities in the ‘too difficult’ pile.
For occupational therapy personnel in all sectors, this is a time to challenge the more traditional structures and processes of service provision, to lead on innovation and to demonstrate the unique approach, skills and value of the profession.
For economic, justice and human rights reasons, reducing health inequalities should be a priority, and now is the time to act. This report focuses on two existing assets for delivering change: the occupational therapy profession and existing services. Both assets can be refocused and adjusted following consultation with/working in partnership with local communities and those affected by health inequalities, redirecting thinking and resources to where they will be most effective. Timely intervention in the community can prevent increases in long-term health and care costs, and early intervention in areas such as education, employment and housing can create routes out of poverty, ill health, and lower mortality.