Lessons from a decade

01 December 2021

Over the past decade, the Trust has learnt a huge amount about the importance of supporting neighbourhoods experiencing the highest levels of disadvantage. Communities have worked to develop their skills, wisdom and connections to help them build community power that has transformed lives and neighbourhoods.

All this has taken place within a challenging context – health inequalities have increased overall across Great Britain and are continuing to increase. This has also been a period when our funded partners have provided a critical role in sustaining communities and neighbourhoods. Their action has shone through in what has been a difficult time for many. The networks they have created have been essential to their ability to withstand the impacts of the pandemic and many have even expanded their reach, with 78% of funded partners engaging new people.

The Trust’s evidence has revealed that building social connections is essential to any work with neighbourhoods and communities experiencing disadvantage. They not only provide a platform for building priorities and action, but also provide an important function in protecting people’s health. The impact of isolation is known to be as bad for your health as smoking 15 cigarettes a day. People living in poorer neighbourhoods with receding public services may experience stigma and be more likely to withdraw from social activity. So bringing people together in a safe environment is critical. 94% of participants in our Active Communities programme indicated they were making new connections and friends through the project.

What happens when you bring people together is even more important. Our funded partners have provided leadership as trusted members of the communities they work with. They have ensured that people’s voices are listened to and that their ideas direct activity and action. Community leaders often adopt an approach that allows people to shape projects and set priorities for action on things that matter to them. We have learnt that this process of coming together and building community power requires patience. It takes time to build control when people are experiencing a lack of it in their lives. But when people have the chance to build connections and direct projects, it gives them confidence and the opportunity to build skills, knowledge and enhance the aspirations they have for themselves and the communities they are part of.

Across our programmes, people are experiencing much stronger outcomes in relation to social connectedness, trust, belonging and agency compared to the averages for similarly disadvantaged neighbourhoods and even national averages. They also feel a much greater sense of agency and willingness to get involved in local initiatives.Working with evaluation partners such as New Economics Foundation, Leeds Beckett University and Ecorys UK has been critical in this journey and provided the robust evidence needed to persuade people of the benefits of this approach.

Our research which looked at nearly 3,000 responses over four years, from residents in our Local Conversations found:

  • They are much more likely to agree that when people in the area get involved in their local community, they can really change the way the area is run (82% compared to 51% in similarly deprived areas and 54% in England as a whole)
  • That people in their neighbourhood pull together to improve their neighbourhood (76%) – more than in similarly-deprived areas (47%), and in England as a whole (58%)
  • They talk to their neighbours on most days (46%), significantly more than the England average (21%) and the average for similarly disadvantaged neighbourhoods (17%). 

These outcomes have been achieved for some of the most disadvantaged neighbourhoods and communities that experience high levels of marginalisation including many Black and minoritised ethnic communities, disabled people, people with learning disabilities, LGBT+ groups, refugees and asylum seekers, and care and prison-leavers.

Through a process of priority-setting and partnership-building with local stakeholders, some of our funded partners have targeted specific social determinants of health to co-produce outcomes that directly impact people’s health and wellbeing:

  • Social connections – creating strong networks has transformed thousands of people’s lives – offering a lifeline for many living in disadvantaged neighbourhoods and marginalised communities throughout the pandemic
  • Control and agency – by building confidence and connections, people have built individual and collective control that has enabled them to make decisions about themselves and their neighbourhoods to improve health and wellbeing individually and collectively
  • Housing – residents have taken community organising approaches to successfully build campaigns and commit landlords to providing better housing standards for thousands People’s Health Trust Annual Review 2021
  • Transport – residents have advocated for better transport to reduce isolation and sustain social connections
  • Jobs and income – projects have focused on developing employability skills for people further away from employment, alongside creating opportunities with local businesses
  • Local environment – residents have prioritised making changes to their local environment from community gardening to reclaiming abandoned public spaces.

These achievements have taken place in an exceptionally difficult time. As emphasised in the Institute of Health Equity’s report, Health Equity in England: The Marmot Review 10 Years On, which featured eight of the Trust’s funded projects, health inequalities have increased. Life expectancy has stalled and even decreased for some groups, even before the pandemic took hold and exacerbated things further, with similar patterns seen in Wales and Scotland.

The Trust is now building on the foundation of knowledge we have gathered. We are committed to using this learning to influence national policy and that will make an even bigger difference to unjust and avoidable inequalities

This story was published as part of our Annual Review 2021 which you can read here.

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