New Research: Community-powered initiatives help tackle health inequalities
In-depth study highlights significant role played by Big Local programme in preventing ill-health and alleviating demand pressures on healthcare services
Analysis of over 150 areas where residents were given freedom to spend £1 million has found that health improved significantly compared to other places.
Between 2011 and 2021, census data shows a larger increase in people from ‘Big Local’ areas reporting their health as ‘very good’ over this period, compared to England as a whole.
Big Local areas were each given at least £1 million to create lasting change in their communities, which all experience high levels of deprivation, low levels of social capital and lower-than-average health outcomes.
The research, conducted by New Local, focused on the impact of the programme on health and wellbeing. It found seven ways in which Big Local’s activities improve this, including through physical activity, mental health support and responding to the cost-of-living crisis.
In Kirkby, Merseyside, for example, residents chose to invest in a ‘Shape Shifters’ weight loss programme, which offered a free gym pass, organised peer-supported group exercise, and nutritional advice. It has seen reductions in cholesterol levels and diabetes, as well as increased confidence and reduced social isolation among participants.
In HAVA Big Local in Leeds, residents used funding to provide a warm space, food, and an opportunity to socialise every evening throughout the winter. Elsewhere, Big Local funding has gone to support activities such as a mindfulness café, a community garden, and art-based therapy classes.
As well as having a significant impact on individuals, the report argues that activities like these have the potential to alleviate demand pressures on the NHS, by preventing ill-health from developing.
It calls the NHS and wider health system to recognise and foster these community-based approaches, including by investing more money into their development.
Report author Imran Hashmi, Senior Policy Researcher, New Local, says:
“The NHS and new Integrated Care Systems (ICSs) have ambitions to become genuine forces for prevention and self-management, rather than just treatment.
“Community-powered initiatives like those in Big Local show them how it’s done. Their work is inherently preventative, supporting positive health behaviours so there is greater likelihood of preventing poor health, or when it does occur slowing it down and spotting it early.
“But this new frontier in health is currently inhibited by the formal health system’s lack of investment and engagement. We need the NHS and wider health system to wake up to the potential of community-powered health if we are going to cure the system’s acute pressures.”
James Goodman, Director of Legacy Projects at Local Trust, which delivers the Big Local scheme, says:
“This research shines a light on some of the exceptional work done by people when you give them the freedom to make positive change in the communities they know best.
“It tells us what we instinctively know; that health is about far more than GP surgeries and hospitals – it is also about agency, confidence, wider social fabric and a sense of belonging.
“There is now an urgent a need to close the gap between where health happens and what formal institutions do, and put in place the conditions that enable communities to create their own good health.”
Jenny Chigwende, from W12 Together Big Local, who participated in the study, says:
“It’s truly inspiring to see what other Big Locals are doing to enhance the health of their communities. Recognising that wellbeing transcends beyond hospital walls, communities possess the inherent capability to devise solutions that foster healthier lifestyles among local residents.
“The Big Local programme has given us the opportunity to truly discover what matter most within our community and with long-term funding, has given us the time to implement these solutions.”
“The bottom line is that it’s crucial to boost communities, hook them up to tackle issues that matter most to their community without holding their hands.”
The report identified four conditions that have helped Big Local projects to flourish: flexible, long-term funding; agency and control and being imbedded in communities.
Notes to Editors
- The report: Well Placed: Big Local’s impact on the health of communities will be available on the following link from 00.01 on 11 December 2023: www.newlocal.org.uk/publications/well-placed
- The research was commissioned by Local Trust and conducted by New Local in partnership with the International Futures Forum
- Using data from the Census, over a ten-year period reflecting the operation of the programme, there was a greater than average increase in the proportion of residents in Big Local areas that reported their health as ‘very good’ compared to nationally and to other similar areas. In addition, there has been a greater than average reduction in the share of residents reporting their health as ‘bad’ compared to national levels.
- The report identifies four core conditions that enabled Big Local partnerships to set up, fund and run health activities. We identify seven different themes for this activity, which address different aspects of health and wellbeing in those communities. The impact generated by this activity is observed through the framing of three key social determinants of health outcomes.
- The below table shows the range of Big Local activities identified and the health and wellbeing themes they fell into.
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