Researching Evidence-based Alternatives in Living, Imaginative, Traumatised, Integrated, Embodied Systems.

New REALITIES in Health and Social Care Systems

We often hear ‘the system’ is broken, but what do we mean by this? How can changing the way we think about, define, research, evidence, monitor, evaluate and resource ‘the system’ lead to meaningful change for deprived communities? How will this change benefit those who have first-hand experience of trauma, homelessness, poverty, unemployment, displacement, poor mental health or imprisonment?

REALITIES takes a human-systems approach noting ‘health and social care systems’ (HSCS) are constructed mental representations of relationships existing in the world to promote health for people.

Creating Connections

Our Scottish consortium of 57 people has five established asset hubs in Clackmannanshire, Dundee, Easter Ross, Edinburgh and North Lanarkshire with strong relationships uniting conflicting ways of seeing the world. Through phase 2, we co-produced a systems-level model with deprived communities, policymakers, practitioners and researchers collecting and respecting different types of knowledge and alternative evidence-bases (from arts performances to nature walks; words to statistics) as equally important to understand complexities of unjust and avoidable health differences.

Foundational funding evidenced REALITIES is able to transcend the challenge for our currently imagined HSCS. The medical model of disease shaping who and what is considered to be part of ‘the health system’ has brought benefits to human existence, though key actors within these place-based Health and Social Care System systems understand the limitations of this systems-framing for human flourishing. At present, they don’t have a way to help reimagine them.

REALITIES provides exploration and method for this reimagining. A model representing collective pathways producing creative routes for people to get the healthcare they need at the right time of their journeys by co-researching and co-creating with them the “what, whom, how, and why” – leading to successful connections between individuals with health and social needs and community-based opportunities for health and wellbeing improvement.

Clackmannanshire

Young people with lived experience of poverty, social inequality, poor mental health, rurality, social isolation and loneliness.

(Re)Centering a diverse range of lived experiences augmented by health inequalities within the five REALITIES asset hubs.

Dundee

People with lived experience of homelessness, drug and substance use, poor mental health, and comorbidities.

North Lanarkshire

People with lived experience of displacement (refugees), alcohol and substance misuse, criminal justice system, and young people living in deprived areas.

Easter Ross

People with lived experience of intergenerational trauma, poverty, poor mental health, substance use, and the criminal justice system.

Edinburgh

People with lived experience of long term enduring mental health conditions.

We are a transdisciplinary collective of individuals with lived and felt experience of inequalities working alongside policymakers; local authorities; charities; artists; environmentalists and researchers from policy; health humanities; arts; psychology; human geography; environmental sociology; dentistry; medicine; statistics; economics; counselling; psychotherapy; management; medical anthropology; design and innovation. We will:

A young woman stands next to a carved stone slab.

Understand what work is needed to enable places to reimagine and build ‘systems’ that create equitable health and wellbeing.
Explore and explain how links between creativity, relationships and nature create healthier and more resilient communities and environments for people in deprived areas.
Support creative, participatory processes, enabling communities to construct shared mental models (systems) using different ways of knowing (epistemologies) and perceiving reality (ontologies).
Combine different ways of knowing, enabling a more complete representation of bio-psycho-social-political factors which create ‘health’ and ways in which these are experienced by marginalised people.
Support communities to construct place-based versions of systems encompassing all aspects of health and wellbeing, and make purposeful changes in the nature of their relationships with each other and their environment.
Explore the usefulness of ‘standard’ Health Economic evaluation tools to assess Social Return of Investment, working with communities to re-conceptualise and re-define measures of ‘value’ and ‘quality of life’ in relation to human experience.

Margaret poses in front of her sewing machine.

A boy does a one-arm handstand in a river surrounded by sprays of water.

Performance artists Holly Worton and Yas Mawer dancing in Strathclyde Park.

David positions miniature figures on a sandwich under a railway bridge.

A cameraman films two council workers in their van through the windscreen.

A girl throws her hair around while dancing.

Research-Practice-Policy Partnership Briefings

This is a series of Research-Practice-Policy Partnership (RPPP) briefings evidencing key insights from the REALITIES consortium hub funded by UK Research and Innovation’s (UKRI’s) mobilising community assets to tackle health inequalities programme. Our research takes a transdisciplinary approach to investigate how local, cultural, and natural assets and activities support improvements in health inequalities.

Our briefings were created by and with frontline practitioners in collaboration with community members, community-embedded and university researchers, representatives from the third sector and local authorities alongside artists, environmentalists and other partners.

These resources aim to help policymakers, practitioners, researchers and commissioners understand how collaboration and partnership working can combat health inequalities by paying careful attention to both barriers and enablers. We’re especially interested in relationships and creations between human, non-human and more-than-human connections and entanglements.

Fieldwork was conducted from February to November 2023 across three Scottish hubs in Clackmannanshire, Easter Ross in the Highlands and North Lanarkshire. It also connected with displaced communities such as prisoners, ex-offenders, refugees, asylum seekers and those experiencing homelessness.

Connecting with our communities across our geographical hubs.

We co-analyse our data using the REALITIES model with community-embedded and academic researchers, practitioners and project partners through close collaboration with community members. Our model connects People, Places, Processes, Price, Power and Purpose. It researches, analyses, and tests these 6 Ps simultaneously using different creative, participatory approaches and innovative datasets alongside traditional ones. Through this, we get a nuanced understanding of:

People – at the core of learning, central to systems, ever-changing. We shouldn’t make people fit systems nor living conditions. We cannot lose people through the gaps in ‘the system’
Places – interconnected, relational, deeply personal, fluid. It’s tempting to think of home as a place we all share with similar values and experiences, but this isn’t true for many displaced communities. Connected to memories, myths, dreams, nature, climate, history and ways of being across time.
Processes – movement of energy, linked to politics and money. A space for possibility and potency. We need imaginations for change.
Price – at the root of inequalities. People not getting the care they need. Certain parts of ‘the system’ and communities being under-resourced. Economic models not fitting and resonating with human experience.
Power – the undercurrent to everything we do. Limiting and freeing, all around us. Making us feel hopeless especially when dealing with broken, traumatised systems.
Purpose – necessary for human flourishing and “healthy” health systems. A reason for getting out of bed in the morning.

Publications

An art workshop is filmed on a mobile phone

We’re all about ethics

Ethics is a central thread running through transdisciplinary research from the University of Edinburgh in partnership with the REALITIES consortium…

Arts Strategy

We’ve co-produced North Lanarkshire Council’s first ever Arts Strategy. It sets out strategic aims to integrate the arts into multi-sectoral decision making.

Complex Systems

Wicked Issues and Big Ideas – where do we start, where do we end? Dr Marisa de Andrade, was asked to speak to the United Nations (UN).

Val-YOU-ed

We take a deep dive into how we should be defining and measuring value in humanities and arts-informed place policies and practices.

Creative Natural Assets

The importance of connection and creativity in widening access to greenspace: Being close to nature doesn’t always mean you benefit.

Alive Data

In Art is Everywhere and REALITIES, we engage with data that are ‘alive’ – connecting to the essence of the human lived and felt experience.

REALITIES

Unpacking the Black Box of Successful Research-Practice-Policy Partnerships: How to Achieve Public Health Impact…

Measuring Humanity

REALITIES is a Measuring Humanity project

Capturing the unmeasurable aspects of human experience and addressing health inequalities through creative community engagement. To find out more about the project, visit out home page or check out out latest news below…

A Mirror of Policy and Culture–In Between Death: Embodied research through performative vignettes of the mourning after the 8th European Congress of Qualitative Inquiry (ECQI)

Measuring Humanity2025-09-23T12:33:04+00:00September 23rd, 2025|Comments Off on A Mirror of Policy and Culture–In Between Death: Embodied research through performative vignettes of the mourning after the 8th European Congress of Qualitative Inquiry (ECQI)