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How much does where you live matter?

Lucy Terry

Our recent seminar on place-based approaches may have thrown up more questions than answers, but highlighted what we need to focus on next.

In the field of multiple and complex needs research, we have often focused on the detail of people’s experiences. We engage with academics researching the process of desistance from crime or multiple exclusion homelessness. We work with frontline services to understand what effective support looks like, and why it isn’t always there. Getting to grips with macro, theoretical concepts like ‘place’ is a challenge. We’re clearly at an early stage of understanding how the two fit and so it felt quite exciting to see researchers, policymakers and practitioners at our recent place-based seminar grapple with this.  

Those attending highlighted the vagueness of the concept – just what do we mean by place anyway? Some argued for a very local understanding of place and how it interacts with the individual- supported housing can alleviate or exacerbate individual problems. Others pointed out that we must ensure people with multiple and complex needs aren’t forgotten in devolution initiatives and regional policies.

Despite the vagueness, it’s clear why place is key to understanding severe and multiple disadvantage. Place affects people in expected and unexpected ways, as our speakers showed. People from poor areas generally get sicker and die sooner. But children on free school meals achieve better grades in poor areas – perhaps because of targeted policy attention. Place is, of course, part of the detail of people’s experiences and this applies to people with multiple and complex needs as much as anybody else: those who are ‘transient by force’, pushed out of an area due to poverty or criminalisation; those who are driven by their needs to move away from or escape something; those for whom ‘place’ is a fixed structure but also a psychological barrier, like prisoners.

So what next for place-based research in our field? For me, there are a few things we could do to better understand how place fits with multiple and complex needs:

  • Try and define the term: centring the views of people facing multiple needs.
  • Understand which, if any, place-based initiatives have involved marginalised groups, how and with what impact.
  • Ask regional policy makers how they are including people facing multiple needs in their area-wide strategies.

Hard Edges is evidence that place is strongly associated with the prevalence of people caught up in offending, substance misuse and homelessness. Now we need to engage with researchers on poverty, health equity and geography to make sure their fields collect data relevant to multiple and complex needs wherever possible.

So yes- place matters. But there’s a lot more to explore on this question. As our chair said ‘we haven’t cracked it – but we wouldn’t expect to in an afternoon ’.