Social determinants of health

The social determinants of health are the socioeconomic circumstances that affect our life expectancy and the quality of our health.

These include: social connections; community power; local environment; jobs and income; local economies; housing and education and skills. 

The evidence we have collected from our own evaluations and research from our peers suggests that, in particular, social connections and community power are critical foundations if we are to address some of the wider issues driving ill health.

We also recognise that many people with shared identities, experiences, characteristics or common interests face additional barriers to good health due to discrimination and further inequality. This is why we fund Communities of Interest as well as neighbourhood based projects.

Find out more below about how these circumstances affect our health and how projects funded by the Trust are addressing them.

Download our infographic about the things that make us healthy.


Social connections

Strong social connections within and between communities is one factor in achieving good health and living longer lives. Social connections protect health and are also a very important foundation for other positive changes to health and wellbeing.

All of our funding programmes place a strong emphasis on building social connections as the foundation for increased confidence, skills, voice and aspiration.

Examples of how funded partners are fostering strong social connections

“Being involved with Proud2Be has literally changed my life in the most positive and inspiring way. It’s a safe space where, for the first time in my life, I could actually be myself. I have gained confidence, met some wonderfully supportive friends and no longer feel isolated and alone.”

Ange Hoey, project member and volunteer, Proud2Be, Active Communities

Find out more about our evidence on social connections.

Download our infographic about social connections.


Community power

People and communities need to have greater power over the decisions and actions that affect their lives in order to improve and maintain their health. Community power emerges when people come together to respond to a common concern or issue.

Having more power over things that matter to us increases confidence and self-esteem which has benefits on our physical and mental health. It is also an important first step that can lead to change in other factors that affect our health. For example, residents might come together to identify shared concerns and influence their housing provider to improve their housing conditions, which also improves their health.

Examples of how funded partners are fostering community power

“Real and lasting change happened when disabled people and unpaid carers got together and built community power to tackle barriers they face in their own communities. From organising safe and accessible activities to forming new organisations and campaigning for change, the journey local people have been on shows what is possible when people get together.”

Julia Ajayi, Project Coordinator, Scope, Active Communities

Download our infographic about community power.


Our local environment

Our local environment has an impact on our health by enabling healthy living and a safe environment. Having an accessible green space; community space; safe, well-lit roads and good air quality helps enable people to build social connections, access services and be physically active. Access and proximity to green space are unequally distributed across the population. The most affluent 20% of neighbourhoods in England have five times the amount of green space compared with the most disadvantaged 10% of neighbourhoods. [1]

Taking action to improve our local environment also brings other benefits through building confidence and skills and strengthening local control.

Examples of how funded partners are improving their local environment and surroundings

“Those facing daily battles find solace in the community garden as they work alongside others who share similar experiences. The community garden provides a great opportunity for informal learning and a huge amount of work is carried out through peer support.”

Karen Clark, Director, Justice Prince, Local Conversation in Longbenton

Download our infographic about our local environment.

[1] CABE. Urban green nation: Building the evidence base. London: CABE; 2010.


Jobs and income

Having good working conditions, fair contractual conditions, and stable employment that pays at least the real Living Wage all have a big impact on our health.

People need sufficient income to live healthily, including being able to buy quality affordable food.

Conversely, being out of work or being in low-paid employment has a significant and long-term negative impact on your health and your wellbeing. The welfare system also has a big impact and benefit sanctions can be particularly detrimental. 

How funded partners are supporting jobs and income in local communities 

“The Living Wage means for me that I get to enjoy a better quality of life not just for me but also for my family. I also feel that my employers really value me and the work that I’m doing.”

Rehana Begum, Centre Manager for Aspire and Succeed, Local Conversation in Lozells

Find out more about the Living Wage and health inequalities

Download our infographic about jobs and income.


Local economies 

The places in which we live have a huge impact on our health. This includes how money flows locally to ensure what is invested re-circulates and contributes to local wealth building. A thriving local economy can include locally owned community assets and shops with affordable, healthy food; access to quality jobs that pay at least the real Living Wage with opportunities to build skills, and the distribution of wealth more equitably within local communities.

Areas including Preston and Wigan have shown that when local authorities work together with local organisations such as universities and hospitals, and with businesses and the voluntary sector, they ensure that the benefits of growth are invested in their local area and that local people are in control.

How funded partners are supporting strong local economies 

“Support from volunteers, schools, businesses, funders and the local authority has helped us revive Lee Gardens Pool as an important place in the community. Training provided at the pool has led to people gaining employment and the community has become more connected and economically active as people have become more involved in activities.”

Diane Locke, Lee Gardens Pool, Active Communities.

Download our infographic about local economies.



The conditions in which we live have a big impact on our health. Problems with housing include physical problems such as damp, cold and overcrowding, as well as issues of instability, temporary housing and rising costs. Housing issues often lead to people feeling powerless and isolated.

Costs and eviction fears have an impact on people’s health and wellbeing, as well as preventing people from raising issues and speaking out. Being homeless has a negative impact on someone’s health. It makes it difficult to access health and support services and reduces life expectancy by up to 38 years.

How funded partners are addressing local housing issues

“One of our campaigns is against Section 21 “no fault” evictions. The law currently means people can be evicted by a landlord without giving a reason. This is the biggest fear of a lot of the people we see - that if they ask for repairs then they can just be evicted. So changing that law would improve people’s wellbeing.”

Tom Scott, Development Officer for for ACORN, Active Communities

Find out more about housing as a social determinant of health

Download our infographic about housing.


Education and skills

Education, skills and training are critical for people to develop supportive social connections; access good work; develop an aptitude for life-long learning and problem solving, and to feel empowered, valued  and have control over their lives. As people build their skills, they also build their confidence. There is a large body of evidence which strongly and consistently links education with health, even when other factors like income are taken into account.[1]

Evidence from our evaluations and project reports shows that people with active roles have gained skills in communicating, influencing and negotiating with other organisations.

Examples of how our funded partners are supporting education and skills in local communities

If you lack confidence, don’t speak English, or you’re not digitally skilled, you can feel like your kids think you’re nothing. I can’t tell you how powerful it is when a mother takes back her pride and finds her confidence again. When they learn something new… everything changes.”

Leyla Laksari, CEO, Living Under One Sun, Active Communities.

Find out more about education and skills as social determinants of health. 

Download our infographic about education and skills.

[1]Robert Wood Johnson Foundation's Education and Health report (2011).




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