Friday 23 May 2025 | 12:45–13:45

Format: Presentation

Stream: Populations

Content filters: n/a

PART ONE: How the European Sanitarian Movement Informs Justice-Based Action and Inspired Paul Farmer

QI increasingly focuses on population health and equity. The 19th Century European Sanitary Movement offers powerful lessons about the limitations of QI programs that don’t address social determinants of health or inform equitable, data-driven policy reform. Chadwick documented the association between poverty and poor health but focused narrowly on sanitation. He was more interested in quelling infection and insurrection among the poor and ensuring an able-bodied Industrial Revolution workforce than in fostering a better life for the underserved. In contrast, Virchow pursued policy reforms to address social determinants that influence equitable population health, ultimately inspiring Paul Farmer’s social medicine movement.

After this session, participants will be able to:

• Apply lessons from data-driven population health research by social scientists in the 19th century to current QI and policy


• Design and implement equitable population health programs that include action at all 6 levels of the health and healthcare system


• Apply Paul Farmer’s social medicine approach (e.g., accompaniment) in population health improvement

Don Goldman Institute for Healthcare Improvement (IHI); USA

Jafet Arrieta Institute for Healthcare Improvement (IHI); USA

PART TWO: Using the historical understanding of black maternity and motherhood health experiences for modern-day healthcare quality improvement

Maternity care in the UK today is marked by unequal maternity outcomes, particularly for Black mothers. These health disparities sit within an historical context of social and health inequality experienced by multiple generations, which marks the relationship between Black communities and healthcare services, and impacts on interventions designed to bridge the gap. To shape future public health interventions, we need to understand the experiences of the past. We illustrate this using an oral history project gathering the stories and experiences of 10 Black British, African and Caribbean women living in Leicester region, UK, using local maternity care services 1984-2004. Our session will share findings from this project and co-designed follow-up improvement work, and offer practical activities on applying historical research to community-engaged quality improvement. This session will be of interest to delegates working in public and community health improvement, particularly those working with highly diverse populations and their healthcare needs.

After this session, participants will be able to:

• Understand key contemporary and historical experiences and challenges in maternity care and outcomes for Black women in the UK


• Develop an interdisciplinary understanding of maternity inequalities as a public health problem


• Apply and reflect on historical approaches and understandings to augment quality improvement initiatives in public and community health

Bharathy Kumaravel University of Leicester, Leicestershire County Council; England

Jennifer Creese University of Leicester; England