A Community-Led Approach to Health Improvement

A community-led approach to health improvement is now a significant feature of health improvement policy and practice, both in the UK and internationally.

Community-Led Development
To understand a community-led approach to health it is important to understand the wider concept of community-led development.  Community-led development is an approach to social change that is based on the premise that changing situations of disadvantage and social injustice cannot be achieved by top-down solutions alone.  Because of the complexity of the factors that contribute to and perpetuate inequality and disadvantage, including institutional discrimination and the sense of alienation experienced by disadvantaged groups and individuals, change also requires community-led action, whereby those who are affected by social injustice bring their collective experience to bear in defining the issues they face; identifying what needs to change; identifying solutions and acting for and influencing change.

A community-led approach to health then is an application of this approach in the context of health improvement and addressing health inequalities.

A community-led approach to health is not a new concept; it has (explicitly or implicitly) informed the work of community health initiatives in the UK for many years.  Internationally, it is the approach to health improvement and addressing inequality that is advocated by the World Health Organisation and is the approach that underpins international policy and practice frameworks for health promotion like the Ottawa Charter (WHO, 1986).

A Community-Led Approach to Health Improvement
A community-led approach to health improvement is concerned with supporting communities experiencing disadvantage and poor health outcomes to identify and define what is important to them about their health and wellbeing; the factors that impact on their wellbeing and take the lead in identifying and implementing solutions.  It is an approach that is based on a holistic or social model of health that recognises the many and complex social factors that affect people's health.

A community-led approach to health aims to address health inequalities by enhancing the level of control and influence that disadvantaged communities have over the factors that impact on health and wellbeing.

For a full discussion of a community-led approach to health improvement see the SCDC Paper Understanding a Community-Led Approach to Health (Barr and Dailly, 2008). For a summary report of this paper download Healthy Communities: Meeting the Shared Challenge Support Programme Briefing.