Urban health

Diversifying evidence to tackle urban health inequalities

25 January 2021
4 min read

Evidence and Impact Director Anne Kazimirski shares how we use evidence both to inform our programmes and influence national and international policy.


I’ve long been an advocate that all types of evidence are valuable, it’s how you interpret and use it that matters. At Impact on Urban Health, we need to meet both our internal evidence needs for well-informed programmes, and our external evidence needs to enable us to influence national and international policy.

Naturally the aim is for our research to increase the impact of our work, by making sure that it is focused on the right needs to achieve our goals, and is effective in addressing these. We use a wide range of data sources to plan our programmes and understand the impact our interventions are having. We are also constantly improving our work in light of new evidence and striving to influence a wide range of policy makers and key players in our areas of focus.

Some of our work lends itself to exciting trials, like our recent study on changing pricing, positioning or labelling to increase the purchase of healthier foods. This showed clear potential for supermarkets to improve consumer health and shape consumer demand.


The power of individual stories

Qualitative studies and certain quantitative designs can be disregarded for not meeting a certain standard of evidence, but these are sometimes the best option to understand early stage complex intervention. The rich detail of individual stories can be hugely powerful, but is often dismissed as subjective. The key is to use them wisely alongside other data sources. Increasing value is being placed on taking account of lived experience, which qualitative research has always strived to channel, but more effort is being made across the social sector to make research inclusive, for example through communities leading their own studies.

We are working on getting the right balance of all these different types of insights and are regularly making decisions on which research questions we should prioritise. Our approach is to use a wide range of evidence to inform our work, including:

  • Statistics on prevalence of needs. For example: what proportion of young people are diagnosed with mental health issues?
  • Our delivery partners’ experiences. For example: what changes are they seeing in demand for support?
  • And community research. For example: how much do people trust health services?

We are committed to creating more inclusive models for generating insight. We want this to apply to all of our evidence-gathering, but are particularly pursuing this aim in our community research. We are recruiting and training community researchers from our boroughs, including those with lived experience of the health issues we are exploring. You can read more about this approach in researcher Elaine’s blog.

We want the voices and experiences of people living in our place to be integral to the design and delivery of both research and the social interventions we fund.

Anne Kazimirski Evidence and Impact Director

Tackling the biases inherent in research

We don’t just want our research to capture the lived experience of the communities we support. We want the voices and experiences of people living in our place to be integral to the design and delivery of both research and the social interventions we fund. Lived experience is “personal knowledge about the world gained through direct, first-hand involvement in everyday events rather than through representations constructed by other people”.

Quantitative surveys, which inevitably sacrifice nuance for statistical validity, tend to dilute lived experience. But some qualitative approaches can also stifle personal knowledge, through overly extractive approaches – for example, not offering follow-ups after data collection, or unconscious biases in design and analysis. Uninhibited insights from those with personal knowledge are so important for policies to be meaningful and to make a difference.

With this in mind we need our research to ensure that strategies and interventions are empathetic and grounded in the experiences of both the communities we aim to support, and of our delivery partners. And our research needs to be conducted empathetically too – that means questionnaire options that reflect the language people use and involving community researchers in all stages of the research process.


Delivery partners from our communities

As a significant commissioner of research in our area, we also have a responsibility to invest in the infrastructure that generates research. In the same way that we currently support underfunded organisations through an emergency fund, who might one day become our delivery partners, we also want to support the research organisations we might partner with in the future. Through them we can achieve closer integration with the communities we support.

As we strive to get the balance right in our generation and use of evidence, I am keen to share our experiences. We are still relatively early days in working out what types of evidence are most useful when. As a place-based, systems change funder, we will share what we learn about how to evaluate and collaborate well, alongside the lessons we learn from tackling health inequalities.