What makes us healthy?

Good health is shaped by the conditions in which we are born, grow, live, work and age – the building blocks of health.

These building blocks include a safe and secure home, enough money to live on, good work, education and skills, supportive social connections, and a healthy local environment. When these foundations are in place, people are more likely to live longer and healthier lives. This creates health equity, and reduces health inequality.

But health is not equal. Across Great Britain, people living in communities experiencing the greatest disadvantage are more likely to die younger and spend more years in poor health. These inequalities are avoidable, and they are driven by poverty, discrimination, racism and other unfair barriers to good health.

That is why People’s Health Trust works with communities and partners to improve the building blocks of health. We support action that strengthens neighbourhoods, builds community power and helps create fairer conditions for longer, healthier lives.

Key health factors

Our evidence and experience show that two factors are especially important: Social connections and community power. They matter for health and wellbeing in their own right, and they also help people take action on the wider issues affecting their lives.

• Social connections: bringing people together, building trust and creating a sense of belonging, purpose and hope.
• Community power: people coming together to shape decisions, influence change and improve their neighbourhoods.

When these are strong, change can happen — for individuals, for communities and for the conditions that shape health. That is why social connections and community power sit at the heart of all our work.

There are other building blocks of health that also have a clear impact on how long we live and how long we live in good health. These include:

• Jobs and income: secure work, fair pay, safe working conditions and enough money to live well.
• Local environment: green spaces, clean air, safe streets, accessible transport and local places people can use and enjoy.
• Local economies: thriving local businesses, access to quality jobs and affordable, healthy goods and services.
• Housing: homes that are safe, secure, affordable and of good quality.
• Education and skills: early years support, lifelong learning, confidence and opportunities to thrive.
• Food security: reliable access to affordable, healthy and culturally appropriate food.
• Digital inclusion: access to devices, connectivity and digital skills so people can participate fully in everyday life.

Research on the social determinants of health

Our work is grounded in evidence on the social determinants of health, and our learning continues to contribute to the wider understanding of what helps reduce health inequalities. Two important pieces of research are:

Fair Society, Healthy Lives (The Marmot Review): a landmark report published in 2010 setting out evidence-based action to reduce health inequalities in England. One of its key messages is that improving health means acting on the wider social and economic conditions that shape our lives.

Health Equity in England: The Marmot Review 10 Years On: a 2020 report from the Institute of Health Equity, commissioned by the Health Foundation, looking at how health inequalities have changed over the decade and what action is needed next. It includes case studies from People’s Health Trust funded projects.