Asset-based approaches to health place the emphasis on individual’s and communities’ assets as well as their needs. It enables people to share their views and experiences of health-related issues and services in order to improve their health and the health services within that community. Asset-based approaches allow active participation by the community in the planning, delivery and outcomes of services and the generation of community-based solutions. This approach (sometimes called Asset Based Community Development) has the core idea that communities can drive the development process themselves by identifying and mobilizing existing, but often unrecognised assets. However, it requires a strong commitment to community driven efforts through active citizenship and participatory democratic methods.
As stated in the A Guide To Community-Centred Approaches For Health And Wellbeing published by Public Health England (now the Office for Health Improvement & Disparities) and NHS England in 2015, local government and the NHS have important roles in building confident and connected communities as part of efforts to improve health and reduce inequalities. They state that “communities, both place-based and where people share a common identity or affinity, have a vital contribution to make to health and wellbeing. Community life, social connections and having a voice in local decisions are all factors that underpin good health, however inequalities persist and too many people experience the effects of social exclusion or lack social support. Participatory approaches directly address the marginalisation and powerlessness caused by entrenched health inequalities. The assets within communities, such as the skills and knowledge, social networks and community organisations, are building blocks for good health. Many people in England already contribute to community life through volunteering. Participation is also about representation, community leadership and activism. There are important roles for NHS, local government and their partners in fostering community resilience and enabling individuals and communities to take more control over their health and lives. Community-centred approaches are not just community-based, they are about mobilising assets within communities, promoting equity and increasing people’s control over their health and lives. A new family of community-centred approaches represents some of the available options that can be used to improve health and wellbeing, grouped around four different strands:
- strengthening communities – where approaches involve building on community capacities to take action together on health and the social determinants of health;
- volunteer and peer roles – where approaches focus on enhancing individuals’ capabilities to provide advice, information and support or organise activities around health and wellbeing in their or other communities;
- collaborations and partnerships – where approaches involve communities and local services working together at any stage of planning cycle, from identifying needs through to implementation and evaluation; and
- access to community resources – where approaches connect people to community resources, practical help, group activities and volunteering opportunities to meet health needs and increase social participation.”
They state further state that the “National Institute for Health and Care Excellence (NICE) guidance endorses community engagement as a strategy for health improvement. There is a substantial body of evidence on community participation and empowerment and on the health benefits of volunteering. The current evidence base does not fully reflect the rich diversity of community practice in England. Cost-effectiveness evidence is still limited; nevertheless research indicates that community capacity building and volunteering bring a positive return on investment.”
They conclude that “There is a compelling case for a shift to more person and community centred ways of working in public health and healthcare. A new family of community-centred approaches maps the range of options to achieve this shift. Public Health England and NHS England will continue to make evidence and learning on community engagement and development more accessible as part of efforts to mainstream good practice.
Implications for local leaders, commissioners and service providers:
- consider how community-centred approaches that build on individual and community assets can become an essential part of local health plans;
- recognise the scope for action as there are a diverse range of approaches that can be used to improve physical and mental health;
- use the family of community-centred approaches as a tool to consider potential options for commissioning health improvement and preventive services;
- involve those at risk of social exclusion in designing and delivering solutions that address inequalities in health;
- celebrate, support and develop volunteering as the bedrock of community action; and
- apply existing evidence to the local context, but be prepared to evaluate.”
Office for Health Improvement & Disparities (formerly Public Health England) and NHS England. A guide to community-centred approaches for health and wellbeing, 2015.