Communities, both in the sense of place and in social groupings, are a fundamental resource for health and wellbeing. Good social connections and supportive relationships with friends and family are known to be vital, but so is having a voice in local decisions.
The evidence is clear that these social factors are powerful influences on both our physical and mental health. We know from research and from professional experience that using community ‘insider’ knowledge, building social networks, having a safe place to live and a sense of belonging can all help break down the barriers that hinder many people from having good health.
Community empowerment, by which we mean people being involved in the decisions that affect them and having a greater sense of control, can be a vital route to better health and prevent social exclusion.
It is a means to address the big issues about where we live and what services we need. That is why in PHE’s ‘From Evidence into Action’, we signal the importance of place-based approaches and community assets as one of three underpinning themes, along with health inequalities and mental health, that will shape our work on PHE’s seven priority areas.
Today I am pleased to announce the publication of a new guide to community-centred approaches to health and wellbeing, and an accompanying briefing for local leaders and commissioners.
These documents come from a joint project with NHS England to draw together and share the evidence on what works when partnering with communities. When we started the project a year ago, we knew evidence was scattered around and opportunities for shared learning about practical models were being lost.
For a start, everyone uses different labels for community work, and while practice is rich and diverse it is also messy. This is perhaps to be expected as these approaches have to work at a local level – the whole point is that they are shaped by those communities who are involved.
The new guide and briefing start to address these issues – they set out an evidence based case for why communities matter and identify what methods can be used in practice. The new family of community-centred approaches identifies a suite of interventions across four strands:
- Strengthening communities
- Volunteer and peer roles
- Collaborations and partnerships
- Access to community resources
Community-centred approaches are about mobilising the skills, local knowledge, and social networks found in communities, promoting equity and increasing people’s control over their health and lives.
Cut across any of our current priorities and you will see the backing for community development to address the determinants of health. Community development is vital, for we need peer support to reach out and connect, for community ideas and experiences to shape decision making and for connection points to improve people’s access to community activities that keep them healthy.
Thinking about what communities can contribute to improving health and wellbeing is key to making a shift to approaches that support wellness. What the guide does is bring clarity by setting out the range of options that can be applied at a local level and signposting to sources of evidence.
Of course working with communities isn’t new. I would like to acknowledge and honour what has gone before and the work of active citizens and grassroots community organisations who make a real difference to health.
The level of volunteering in England is already high and some of those making a contribution to health and wellbeing include the 10,000 walk leaders who lead health walks in their local areas, the 18,000 plus health champions and the growing number of people who have committed to be a Dementia Friend (over 870,000 since 2013).
You may like to look at some of the health champion Amazing Stories that show just how much difference people can make. We need to highlight these great examples and work to increase still further the numbers volunteering in their areas.
PHE has an vital role to play across the public health system, supporting and amplifying efforts to involve communities as equal partners, connecting organisations and making the best evidence available.
One example of this is PHE’s National Conversation on Health Inequalities which aims to support active involvement of public in developing local action on inequalities.
Another example is PHE’s support to the Think Local Act Personal (TLAP) partnership that is currently working with Health and Wellbeing Boards on community capacity building and personalisation.
NHS England’s Five Year Forward View argues for a new relationship with patients and communities, and PHE wants to see this become the reality. The new guide to community-centred approaches is designed to be used by public health leaders, commissioners and practitioners to support delivery on the NHS Five Year Forward View and PHE’s seven priorities for prevention set out in ‘From evidence into action’.
For public health to thrive it has to come alive in communities and neighbourhoods. PHE will continue to champion community practice wherever it is making a difference to improving health equity. We need to see approaches that build on community strengths to be embedded across all our activities.
Together we can build strong collaborations at national and local levels and support practical actions that build healthier communities.
What do you think needs to happen to mainstream community approaches? How can we ensure people and communities are central to efforts to reduce the health gap? What can PHE do that would help you make this a reality?