People in disadvantaged areas experience disproportionately poor health outcomes, with underlying factors including a lack of control over decisions which affect health, and reduced access to resources that support health and wellbeing. Aware of this, many Big Local partnerships identified specific needs in their communities, ranging from loneliness among older residents to food provision for children.
Just over ten years into the programme, Big Local areas had collectively spent £6.3m on health and wellbeing activities, with 104 of 150 areas naming this as a way in which they spent their Big Local funding. However, this theme isn’t just about the activities Big Local partnerships did to explicitly support health and wellbeing among residents, as almost all Big Local activity addressed the social determinants of health. Further, resident-led activity has a potentially huge role to play in improving people’s health and reducing health inequality.
The social determinants of health illustrate that life expectancy, quality of life and wellbeing are influenced by multiple factors in people’s environments — much more so than health service provision. Significant determinants include access to green space, social relationships, housing, and education. Many of these factors are themselves shaped by the places in which we live.
Some of the ways Big Local areas addressed health and wellbeing included:
They did this through many different approaches which included long-term projects, working in partnership, providing access to outings and activities, and funding physical and social infrastructure. For some residents, taking part in making decisions was intrinsically good for wellbeing, giving them a sense of control.
Big Local areas also worked in different ways to influence formal delivery of health services. Some focused efforts on making health services more accessible to the community, whilst some worked to develop stronger links between community activity and NHS professionals (including within social prescribing systems).
