Exploring young people's perceptions of health and inequality through art: a co-produced qualitative study

Abstract

BackgroundDespite increased focus on adolescence, young people's voices are often undervalued and underrepresented in inequalities research. Through exploring young people's perceptions of health and inequality, we might understand how public health interventions can be more effective and equitable. Engaging with youth through art enables self-expression on these complex and sensitive topics. This qualitative project aimed to explore young people's perceptions of their health, inequality, and their aspirations within the Bristol context to inform local policy and everyday practice for adolescent health. MethodsCreative focus groups, co-produced with a young artist, were done at three community centres in deprived areas of Bristol, outlined by the Index of Multiple Deprivation. Participants engaged in art and were guided through discussion by a semi-structured topic guide. A thematic approach to analysis was adopted. Written informed consent was obtained for participants aged 16 years and older and parental consent or participant assent obtained from participants younger than 16 years. The study was reviewed by the University of Bristol Health Sciences Faculty Research Ethics Committees. Findings30 children aged 11–18 years took part. Five themes represented how participants understood health and inequality in Bristol. Adolescents felt forgotten, which they exemplified through a scarcity of age-appropriate activities and public spaces. Participants saw mental health and health risk behaviours such as alcohol and unhealthy diet as major problems for their generation, and highlighted inequalities across these factors. They described how inequalities are experienced in their everyday lives, such as through differential Wi-Fi access, gentrification visible in architecture, experiences of crime, and feeling safe. All felt uncertain about their future and thought they could be better supported around education and employment decisions. Participants thought all issues were exacerbated by the Covid-19 pandemic. InterpretationThere is strong awareness of negative health factors and socioeconomic inequalities across youth in Bristol. Young people's perceptions and experiences signal the need for city-wide structural and age-specific policies for adolescents, particularly in deprived areas, to support them in living a healthy life. FundingThe University of Bristol, Wellcome Trust.