1. Give out session notes from Unit 10 and the programme for Unit 11. In Part 1 we looked at a number of issues that we identified as being a problem or of concern. In this unit we will be looking at how we identify the real causes of the problems or issues in the community - looking upstream, so that we can tackle them at source.

2. We will be looking at one particular issue – food and diet – and how this can be tackled using a community development approach.

3. We will also be sharing progress on the community action research projects.



1. Introduction - There are different explanations for the causes of health problems and this exercise is a way of looking at some of them. Remind people about the Zola ‘Looking Upstream’ session in Unit 1.

2. Take the issue of ‘food’ as an example.

Read out the following quotes. The first is from ‘Towards a Healthier Scotland’ which was issued by The Scottish Office Department of Health in 1999.

“The Scottish Diet is notoriously high in fat, salt and sugar and low in fruit and vegetables. Next to smoking, our diet is the single most significant cause of our poor health, contributing to a range of serious illnesses, which includes coronary heart disease, certain cancers, strokes, osteoporosis and diabetes. The poor diet of deprived communities is a major reason why they experience such poor health.”

The second quote is from ‘The Review of the Scottish Diet Action Plan’ in September 2006.

“The dietary trends in Scotland over the last 10 years show a small improvement (reduction) in fat consumption as a percentage of food energy. According to the panel’s analysis, there has also been an increase in the amount of fruit and fruit juice consumed but a reduction in the amount of vegetables eaten. There has been no improvement in the consumption of bread, breakfast cereal and fish over the period from 1996 to 2003/04. Of particular concern is that the intake of Free Sugars has moved in the wrong direction, i.e. increased rather than decreased. The consumption of bread (total and brown/wholemeal bread) has fallen over the past 10 years instead of increasing by 45% and the consumption of potatoes has fallen by 25% instead of increasing by 25%. A further worrying trend is that consumption levels of the ‘healthy’ foods, which were targeted to increase, are significantly lower in the most deprived groups of the population.”

Ask the group to think of reasons why people don’t eat well.  Stress that they might not agree with all of these points of view, but encourage them to think of all the reasons they have heard.

3. Write WHY DO PEOPLE HAVE POOR DIETS? in large letters on the top of a flipchart and then brainstorm reasons given and write them up. Try to encourage a mix of structural (unemployment, level of benefits, lack of availability, transport) and individual reasons (too lazy to cook, don’t manage their money, lack of skills and motivation), prompting if necessary.

4. You might ask: What do you hear on the TV?  What have you read in the newspapers? What have you heard people say?  Which reasons do you disagree with? Which do you agree with?

5. Sort out those reasons which are to do with individual behaviour and those which are about the way society is organised.  Colour them differently or underline them then introduce the idea of individual and structural explanations about health.

You could quote from any items in the news or that you have seen on TV recently.

6. Give out Handout A ‘Structural and Individual Explanations’ and read this together. Read out the quotes or points one at a time, or select one from each section and ask for responses.

Use the following discussion points:

  • How much can an individual influence her or his diet?
  • What are the constraints?
  • What do people need in order to have a healthy diet?
  • What needs to change?
  • Who can make these changes?
  • How much can we influence the changes needed?

Use this quote if you think it is helpful.

‘... when I give food to the poor, they call me a saint.  When I ask why the poor have no food, they call me a communist’.

Dom Helder Camara


TAKING ACTION (90 minutes)

1. Split the group into two or three small groups.

2. As the groups to think about how they could begin to tackle the issue of people not having enough good food - if that had been identified in their area - using a community development approach.  Remind people about the idea of not only helping in the immediate, practical sense but also about ‘looking upstream’ to see if they can think of ways to tackle some of the causes of the problem.  Give each group a piece of flipchart paper to make notes on.

3. Ask groups to discuss and write down their ideas about how they would start to take some action on this. If they have not been involved in anything like this before, it doesn’t matter. Think back to Unit 6 and the key elements of a community development approach. Encourage people to decide what to do in practical terms - how they would take action.  Rather than say, ‘we should make sure that the local shops have fresh food’ try to think through how a local group could make this happen and exactly what to do.

4. The groups should set out their ‘action plan’ clearly on flipcharts and prepare to present this to the rest of the group.

5. Bring the large group back together and ask each small group to ‘present’ their action plan to the rest of the group. Each small group should be given 5 minutes to do this.

6. Give out Handouts B and C. Allow participants 20 minutes to read them.

Additional information and alternative case studies can be found on the Community Food and Health Scotland website:


Ask people to identify all the different ways in which people involved with Clydesdale Community Food Market and Cove’s Kitchen have used community action to tackle the issue of low income and diet.


Write up the main points on the flipchart.



1. Split participants into their action research groups and ask them to discuss and note down any main points about what they’ve covered so far.

2. After 10 minutes bring the groups back together to share their main points.

Discuss progress made so far and what the next steps should be.


1. Recap over the main points of this session referring to flipcharts if necessary:

  • Individual and Structural explanations
  • Taking Action
  • Community Research update session

2. Give out Unit 11 Learning Log and allow participants time to fill this in before they go.