For those explicitly tasked with achieving significant and sustained improvements in a population’s health, whether it be the population of a small town or a large country, the challenge is immense. Public health as a whole has a wildly varying track record of successes and failures. While some seemingly impossible goals (such as the eradication of smallpox) have been achieved, other challenges which—in theory, at least—appear relatively straightforward (such as tackling the West’s spiralling obesity rates) have so far proved beyond our capabilities. Nevertheless, we stick to our goals, knowing that public health is rarely a game of ‘quick wins’ and ‘low hanging fruit’. We comfort ourselves with the knowledge that the results of our efforts will only be seen in years, decades or even generations to come, while periodically re-energising ourselves with new variations of longstanding mission statements to shrink health inequalities, change a nation’s eating habits and ‘give every child a healthy start in life’ [1]. Working in public health certainly requires one to be an optimist, but in order to achieve meaningful outcomes one is also required to be a realist.

Increasingly, we have come to understand the devilish complexity of many of the world’s public health problems and the challenges of achieving seemingly simple lifestyle changes in real communities, where people’s circumstances, motivations, barriers and influences frequently prove more varied, more nuanced and more unpredictable than we might have hoped. The public’s stubborn refusal to conform to the convenient cold logic of our textbook models of behaviour change continues to bewilder and frustrate us [2]. The typical problems which modern public health exists to address have been described as ‘wicked issues’—difficult to define, lacking clear workable solutions, socially complex, interrelated and with multiple causes which are not confined to the remits of single sectors or organisations [3]. Based on the principle that a similarly multifaceted and joined-up approach is essential to tackling these ‘wicked issues’, the concept of partnership working has become established as an essential tool of modern public health practice. Since the late 1990s, it has particularly taken hold in the United Kingdom, where ‘partnership working’ has permeated the public health discourse to such an extent that any explicit assertion of the need to be doing it would probably be regarded as a truism.

In order to practice partnership working, public health professionals must, of course, identify suitable and willing stakeholders outside of their own departments and organisations with whom they can partner and who will add tangible value to their efforts to improve the health of the population. Sport, with its myriad manifestations spread across the public, private and third sectors, coupled with its transcendence of social and geographical boundaries, offers a rich mine of opportunities for collaborative public health working. This chapter aims to fire the imagination of readers working within dedicated public health roles, departments and organisations by flagging-up some of these opportunities, outlining some key principles and pitfalls of partnership working, and highlighting an example of a ‘public health-sport’ partnership which is working to address men’s health in the London borough of Haringey.

In the Introduction to this book we discussed the breadth of public health activity to which sport can contribute and the importance of seeing it as more than just a way to encourage physical activity. The potential for public health professionals operating at local level to work in collaboration with sports partners is similarly broad. Inevitably, opportunities will vary from one place to another depending on the scale of the sport economy—some localities will be home to wealthy professional sports clubs whose brands have national or even global reach, while the sport infrastructure in otherwise similar areas may be limited to an unglamorous municipal swimming pool or tennis court, for example. The reach of sport is such, however, that wherever in the world you are based there should be a good chance of finding accessible potential sports partners—even if a little imagination and detective work is required to track them down. Depending on local circumstances, the list may include:

You may wish to work with an individual sports club, organisation or sportsperson in a bilateral partnership or pull together a number of partners to work together. Partnerships may be short term and tied to a single project or they may be enduring collaborations with a long-term view implementing multiple projects. Determining which type of partner—and what type of partnership—is most appropriate will depend on a range of factors, including the available funding and resources, and the specific aims of the work. Some of the potential ways in which public health professionals can work with sports partners are briefly highlighted below, along with accompanying examples from the United Kingdom:

The potential to build constructive public health-sports partnerships is limited by little more than the imagination, but one must resist the temptation to rush in without a clear plan and some essential caveats ringing in the ears. It would be easy to fall into the trap of assuming that the concept of collaborative working is such an apparently straightforward and logical one that the mere existence of a partnership must by default lead to a positive impact on an area of work. While partnership working may seem instinctively to be a universally beneficial approach to tackling public health problems—pooling resources, sharing expertise and learning, and addressing complex issues from multiple angles, unfettered by professional or organisational boundaries—in practice, the effectiveness of public health partnerships has proven far less consistent than the rhetoric that surrounds them. A study of public health partnerships in nine localities across England from 2007 to 2010 found that they were often little more than facades of collaborative working behind which a ‘silo mentality’ prevailed, with an unwillingness among partners to share information or resources, or to put sufficient effort into making the partnership a success [3].

Whether working with a single sports partner on a short-term, one-time project or aiming to build a substantial long-term collaboration with a number of partners, there are some important principles of effective partnership working for ensuring a positive, mutually beneficial relationship which will add real value and achieve results: