This report brings together a decade of evidence from People’s Health Trust’s long-running Active Communities and Local Conversations programmes, alongside the Homes for Health pilot, Living Wage research, and a set of complementary thematic reports. Five evidence-based headlines run through the analysis, connected by the concept of collective control, the idea that when people in disadvantaged communities gain greater power over the decisions and conditions affecting their lives, health and wellbeing improve as a result.
Taken together, the evidence supports a clear argument: community-led approaches can demonstrably improve wellbeing, social connections and build collective power, but they operate within structural conditions that no amount of community action alone can change, and they require long-term investment to realise their full potential.
Key findings
- Community power is real, measurable, and it improves wellbeing.
- People’s Health Trust programmes deliver real wellbeing and social connection gains - and wellbeing is a foundation for health.
- Communities build safety nets the system does not provide.
- Structural conditions constrain community action and must be tackled in parallel.
- Long-term investment is what makes the difference.
The evidence that informed Fair Society Healthy Live, “The Marmot Review”, pointed to the importance for health and well-being of community cohesion and of individual and local control of the conditions of daily life. We were confident about the evidence, but the concern was whether it could be put into practice. This remarkable long-term programme of work from the People’s Health Trust shows that it can be made real.
Professor Sir Michael Marmot
Director of The Institute of Health Equity
Report author
Analysis and the full report were written by Dr Kate Fryer, School of Medicine and Population Health, University of Sheffield. Dr Kate Fryer is a health researcher at the University of Sheffield with more than two decades of experience in health research, expertise in qualitative and mixed-methods research, and a particular focus on health inequalities, marginalised communities and inclusive research.
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Building the Conditions for Health: What over a decade of evidence tells us about creating healthier communities
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