Five times communities sowed the seeds of healthier places

Where you live shouldn’t determine how long you live for, or how much of your life is spent unwell. And yet the links between home and health are stark – people in the most deprived parts of the UK are diagnosed with serious illness earlier and die up to a decade sooner than those in more affluent areas.

This is shaped in no small part by people’s living and working conditions, and the broader socioeconomic, cultural and environmental circumstances in which they are born, grow, learn and age. These wider determinants are etched onto people’s physical and mental health in intricate and interrelated ways that can’t be healed in hospitals. By taking a community-powered approach to narrowing health inequalities in our places, we can orient our system towards keeping people happier and healthier for longer where they live. And it’s already happening.

We measured the impact of Big Local – a Local Trust programme which saw 150 hyperlocal neighbourhoods with high levels of deprivation, low levels of social capital and poor health outcomes receive £1 million each to spend over 10-15 years.

From Merseyside to Cornwall, we found that residents are turning the tides on longstanding health inequalities, finding local solutions to local challenges and changing people’s lives for the better. Despite existing on the margins of the formal health system, these initiatives offer an alternative model of healthcare with the potential to reduce demand pressures on our ailing NHS.

As we launch our new report Well Placed: Big Local’s impact on the health of communities, we hear five brilliant examples of what communities can achieve when money and decision-making power are in their hands.

Brewing community connection in Maryport

Ewanrigg is a rural suburb of Maryport, a town in Cumberland, West Cumbria. Fuelled by high levels of deprivation, the community was concerned about poor mental and physical health locally, drug and alcohol abuse, and the wellbeing of young people, but didn’t know what help and support was available to them.

Ewanrigg Big Local introduced the ‘Hug a Mug’ initiative to provide local people with a friendly place to connect with others in their community over a hot drink, and an opportunity to chat with trained volunteers. In the spirit of Big Local, setting up ‘Hug a Mug’ was a collective effort – a group of local companies renovated the physical space and a local GP practice lent its support.

Coming in for a cup of tea became the start of much bigger change for many residents. New-found connections improved their mental health and reduced feelings of isolation, and whether signposting to support for housing issues, or helping residents to fill in DWP forms, volunteers were on hand to provide instant help without an appointment.

The partnership said: “Everything we do is about health and wellbeing. To make a true difference we need 20-30 years really, but 10 years for Big Local has been fantastic to enable creativity, responsiveness and impact.”

Stitching solutions in Bradford

Despite their proximity, the neighbourhoods of Scholemoor and Lidget Green felt disconnected, with residents rarely crossing paths. Increasing levels of deprivation and a lack of regeneration in the area had cultivated a range of problems affecting the community’s health. Becoming a Big Local area and the investment that followed gave local people the chance to identify how these problems were affecting them and how they could best be addressed.

Among the activities set up after a year-long community consultation were sewing classes to tackle loneliness and depression which particularly affect the local British Pakistani community. A mental health therapist attended the classes every week to talk to residents about their wellbeing, helping them identify solutions to any difficulties they were facing.

After accessing this safe space where they could form social connections and share their problems without fear of stigma, residents reported reduced levels of loneliness and anxiety.

Shape Shifting in Northwood

Located just outside of Liverpool, Northwood has seen a deterioration in residents’ mental and physical wellbeing since the Covid-19 pandemic. Brought together through Big Local, residents understood the specific drivers of ill health locally, including low self-esteem due to weight gain and physical health conditions stemming from poor nutrition and inadequate housing. This meant they could design a programme that was sensitive to the specifics of local challenges.

Through the aptly named Shape Shifters weight loss programme, residents were offered a free gym pass, peer-supported group exercise and nutritional advice, with opportunities to connect with one another online and in person. It has seen reductions in cholesterol levels and diabetes, as well as increased confidence and reduced social isolation among participants.

One said: “Shape Shifters has changed my life. Not only have I lost weight and am eating healthier, but my mental health has vastly improved. My confidence is through the roof thanks to the support of the group. I have met so many great people. It has also brought about other opportunities for me that I didn’t ever feel I would have the strength and courage to do.”

Creating opportunities for the long term in Cornwall

A village and fishing port on the south coast of Cornwall, Par suffers from a range of socioeconomic issues, poor levels of community cohesion, little cross-generational connection, a lack of opportunity, and significant health challenges, including lower life expectancy than the national average and higher rates of teenage pregnancy.

Par Bay Big Local purchased an empty, two-story building and turned it into a bustling community hub known as ‘Cornubia’. A collaboration between Par Bay Community Trust, local NHS providers and Cornwall Council, Cornubia has been home to a number of tenants over the years, responding to changing demands and priorities in the community, most recently hosting a social prescribing service and NHS prediabetes clinics.

The Big Local partnership worked with the community to co-design activities offered in Cornubia and the surrounding area, including weekly health walks, food poverty projects like community larders stocked with surplus items from supermarkets, plus craft groups and fitness classes for vulnerable and isolated residents.

These activities have come with a host of benefits for residents’ health and wellbeing by enabling early intervention and tackling problems before they get worse; encouraging self-management within the community; helping residents develop agency and autonomy; fostering community connection and reducing social isolation; and increasing a sense of pride in the area.

One participant said: “I am eternally grateful to the Cornubia Team for taking me on and giving me the opportunities I needed to become the confident, productive and hardworking person I am today.”

Making Bradley a place to call home

A neighbourhood in the medium-sized town of Nelson in Lancashire, Bradley is one of the most deprived areas in England for income, education, skills, health and disability. With a mission to “make Bradley a place to call home”, the Big Local partnership charted a brighter future for the area. Residents determined the biggest barriers standing in their way, including childhood obesity, malnutrition, diabetes and the rising costs of living.

Solutions to these challenges were proposed and prioritised based on demand from the community and unmet need from existing facilities. A new outdoor play area, football summer camps, a community garden and women-only exercise classes were among those selected, providing opportunities for local people to connect, develop relationships and form healthy lifestyle habits together.

Building on this success, the partnership is developing a state-of-the-art 3G football pitch and club, working collaboratively with the local council, Lancashire Football Association and Sport England.

From the North East to the South West, community-led initiatives are a neglected asset

With the resources and freedom to set priorities and improve their own community, hyperlocal long-term approaches like Big Local have potential to alleviate some of the acute pressures facing today’s health system. From the North East to the South West, community-led initiatives are a neglected asset held back by a model of healthcare which prioritises short-term demand pressures, doesn’t recognise or trust resident-led activity, and lacks the expertise to meaningfully engage with communities.

In neighbourhoods where policy ideas become people’s reality, community-led initiatives reveal the emerging shape of a more preventative system of health and wellbeing. By investing in their development, the NHS and wider health system can shift the dial towards healthier places.

Our new report contains more examples of the change underway in communities and sets out recommendations for the health system to deepen and expand community-led approaches.

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