Communities in Control Study

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Health Inequalities Research Programme: Communities in Control Study

Research Team: Professor Jennie Popay, Dr Emma Halliday, Dr Michelle Collins, Dr Evie Papavasiliou, Professor Dame Margaret Whitehead, Dr Lois Orton, Dr Katherine Abba, Dr Krysia Canvin, Professor Clare Bambra, Dr Vicki McGowan, Dr Sue Lewis, Dr Jonathan Wistow, Dr Matt Egan, Dr Ruth Ponsford, Dr Courtney Scott, Professor Sarah Salway, Dr Katie Powell, Dr Amy Barnes, Dr Anne Townsend & Dr Steph Buckner

Who's involved: LiLaC, Fuse, London School of Hygiene and Tropical Medicine, University of Cambridge & University of Sheffield

January 2014 - March 2017

Project summary

The Communities in Control Study (CiC) has investigated the implementation and early impacts of a programme called the Big Local. The Big Local uses funding from the Big Lottery to give residents of 150 disadvantaged areas in England £1 million over ten years to use as they see fit to make their area “an even better place to live”. Residents in these areas have control over decisions on how the money is spent, with support from an independent organisation, Local Trust, which was set up to help residents achieve greater control, rather than taking control away from them.

It is thought that indirect effects could include reduction in social isolation and greater social cohesion leading to improved mental health and wellbeing as people participate in activities together. Research has also shown that feeling more in control of decisions that impact on an individual’s life can improve health.

This research project was conducted over the first three and a half years of the scheme and provides an early insight in to its effectiveness.

Phase 1

The first phase of the Communities in Control project began in January 2014 and ended in December 2015. During this period the research team carried out a process evaluation of Big Local. We also looked at if it was possible to conduct a longer term study of Big Local’s impacts on health. During this phase researchers wrote up findings (see resources section for more details) on the following topics:

How features of context (e.g. social relationships, people’s attachment to a place) influence the ways that communities come together to take action
Development of a framework to measure community empowerment/control
Types of spaces for community participation and decision making within a place based initiative
Factors influencing participation and inclusion of communities
How resident control over neighbourhood funding enables people to have a voice about local issues and the challenges of this

Phase 2

The second phase of the Communities in Control Study started in October 2015 and ended in March 2017. This phase researched how residents work together to influence improvements in neighbourhoods or to influence decisions taken by others. During this stage the research team carried out surveys to understand the early impacts on health and wellbeing for engaged residents.

The project provided learning on how community led actions lead to change in:

built environment of neighbourhoods
social relationships between residents
area reputations, including media portrayals

Findings

The research found that residents are becoming more confident about their ability to improve their neighbourhoods and there are many examples of ways in which they are improving the physical environment and social relationships. The findings also show that people can take positive action to improve the reputation of their neighbourhood and the people who live there.

In the future, these improvements all have potential to improve the health of local people and the research suggests being actively involved in Big Local may improve people’s sense of control and mental health.

However, the research highlighted that some residents found that being involved in collective decision making in the early stages was very stressful and felt this had significant negative effects on their wellbeing.

The School has obtained further funding to continue the evaluation of Big Local and look at the longer-term impacts on the health of the residents who are most engaged in the initiative, on the wider community and the social and environmental conditions impacting on people health.

Publications

Popay J, Halliday E, Mead R, Townsend A, Akhter N, Bambra C, Barr B, Anderson de Cuevas R, Daras K, Egan M, Gravenhorst K, Janke K, Kasim AS, McGowan V, Ponsford R, Reynolds J, Whitehead M. Investigating health and social outcomes of the Big Local community empowerment initiative in England: a mixed method evaluation. Public Health Res (Southampt). 2023 Oct;11(9):1-147. doi: 10.3310/GRMA6711. PMID: 37929801.

V J McGowan, N Akhter, E Halliday, J Popay, A Kasim, C Bambra. Collective control, social cohesion and health and well-being: baseline survey results from the communities in control study in England. Journal of Public Health, Volume 44, Issue 2, June 2022, Pages 378–386, https://doi.org/10.1093/pubmed/fdaa227

Popay J, Whitehead M, Ponsford R, Egan M, Mead R. Power, control, communities and health inequalities I: theories, concepts and analytical frameworks. Health Promotion International, 2020, 1–11 https://doi.10.1093/heapro/daaa133.

Ponsford R, Collins M, Egan M, Halliday E, Lewis S, Orton L, Powell K, Barnes A, Salway S, Townsend A, Whitehead M, Popay J. Power, control, communities and health inequalities. Part II: measuring shifts in power. Health Promotion International, 2020, 1–10 https://doi.10.1093/heapro/daaa019

Powell K, Barnes A, Anderson de Cuevas R, Bambra C, Halliday E, Lewis S, McGill R, Orton L, Ponsford R, Salway S , Townsend A , Whitehead M, Popay J. Power, control, communities and health inequalities III: participatory spaces—an English case. Health Promotion International, 2020, 1–11 https://doi.10.1093/heapro/daaa059

Egan M, Abba K, Barnes A, Collins M, McGowan V, Ponsford R, Scott C, Halliday E,Whitehead M, Popay J. Building collective control and improving health through a place-based community empowerment initiative: qualitative evidence from communities seeking agency over their built environment. Critical Public Health 2 https://doi.org/10.1080/09581596.2020.1851654

McGowan V, Akhter N, ,Halliday E, Popay J,Kasim A, Bambra C. Collective control, social cohesion and health and well-being: baseline survey results from the communities in control study in England. Journal of Public Health 2021; fdaa227, https://doi.org/10.1093/pubmed/fdaa227

Halliday E, Brennan L, Bambra C, Popay J.‘It is surprising how much nonsense you hear’: How residents experience and react to living in a stigmatised place. A narrative synthesis of the qualitative evidence. Health & Place 2021; 68: 102525

Townsend A, Abraham C, Barnes A, Collins M, Halliday E, Lewis S, Orton L, Ponsford R, Salway S, Whitehead M, Popay J. “I realised it weren’t about spending the money. It’s about doing something together:” the role of money in a community empowerment initiative and the implications for health and wellbeing. Social Science & Medicine 2020; 260 :

Halliday E, Collins M, Egan M, Ponsford R, Scott C, Popay J. ‘strategy of resistance’? How can a place-based empowerment programme influence local media portrayals of neighbourhoods and what are the implications for tackling health inequalities? Health & Place May 2020; 63: 102353.Halliday, EC, Popay, J, Anderson De Cuevas, R and Wheeler, P, The elephant in the room? Why spatial stigma doesn’t receive the public health attention it deserves. Journal of Public Health. December 2018

Ponsford R, Halliday EC, Collins M, Egan M, Scott C, Popay J. Area reputation as an under-acknowledged determinant of health inequalities: evidence from a systems evaluation of a major community empowerment initiative in England. The Lancet. 2018 Nov;392(Suppl. 2). S72.

Lewis SJ, Bambra C, Barnes A, Halliday EC, Orton L, Ponsford R, Powell K, Salway SM, Townsend A, Whitehead M, Popay J. Reframing “participation” and “inclusion” in public health policy and practice to address health inequalities: evidence from a major resident-led neighbourhood improvement initiative. Health and Social Care in the Community (e-publication ahead of print). 2018.

Reynolds, J. Boundary work: understanding enactments of ‘community’ in an area-based, empowerment initiative. Critical Public Health 2018: 28(2), 201-212.

Orton L, Halliday E, Egan M, Lewis S, Powell K, Salway S, Townsend A, Whitehead M, Popay J. Putting context centre stage: evidence from a systems evaluation of an area based empowerment initiative. Critical Public Health. October 2017.

Reynold J., ‘Missing out’: Reflections on the positioning of ethnographic research within an evaluative framing. Ethnography, 2017: 18(3), 345-365.

Ponsford, R., Collins, M., Egan, M., Lewis, S., Orton, L., Salway, S., Townsend, A., Halliday, E., Whitehead, M. and Popay, J., 2015. Development of a framework for identifying and measuring collective control as a social determinant of health: findings from an evaluation of a natural policy experiment in empowerment. The Lancet, 386, p.S64.

Halliday, E., Orton, L., Egan, M., Lewis, S., Powell, K., Townsend, A., Tyrrell, R., Whitehead, M. and Popay, J., 2015. Understanding area-based community empowerment initiatives as events in systems and the implications for evaluating their potential to affect health inequalities. The Lancet, 386, p.S41.

Reynolds, J. Egan, M, Renedo, A, and Petticrew, M. Conceptualising the ‘community’ as a recipient of money–A critical literature review, and implications for health and inequalities. Social Science & Medicine. 2015 143: 88-97.

Resources

The research team have produced a series of research summaries for practitioners and members of the public interested in community empowerment and engagement:

Communities in Control Briefing

Communities in Control: Overview

Communities in Control: Collective Control

Communities in Control: Social Context

Communities in Control: The Role of Money