What makes us healthy?

There is well established evidence that socio-economic factors play a bigger part in people’s physical and mental health than their own behaviour. And these factors - the building blocks of health - are considerably influenced by where we live. Research shows that the main reason for your level of health and even your life expectancy is not your lifestyle.

People living in the most disadvantaged areas of the UK have their lives cut short, and live in worse health than people living in the most affluent areas. We all depend on certain things to stay well and healthy . These basic requirements, or building blocks, can be economic (jobs, income, education and skills, the local economy), social (social connections, having a say in what’s happening locally) or environmental (our homes, the local neighbourhood, the local environment).

These building blocks of health – often called the social determinants of health – are the reasons for the differences in quality of health and life expectancy in the UK. As well as where we are born and live, other factors, such as discrimination and racism, are also a critical part of the inequality picture.

That means that good health is a community issue, not just an individual issue. And that is why as a charity, we focus on the building blocks of health which have an impact on our life expectancy and the quality of our health.

Key health factors

We know from our own work and research– that there are two factors which are vital to our health and wellbeing in themselves and are also key to tackling other issues. These are:

• Social connections: bringing people together with a sense of purpose and hope.
• Community power: people getting together to influence decisions in their own communities.

When these are in place and working well, change can start to happen - for individual people and in their wider communities. That is why these are at the core of all our projects.

There are other, more specific building blocks that each have a clear connection to how long we live and how long we live in good health. The main ones are:

• Jobs and income: good working conditions, fair contracts, stable employment, a Living Wage.
• Local environment: green spaces, safe streets, public transport, accessible shops, safe air quality.
• Local economies: locally-owned businesses, access to quality jobs, shops with affordable, healthy food.
• Housing: stable, affordable and quality accommodation.
• Education and skills: better jobs, confidence and self-esteem, lifelong learning, early years.
• Food security: access to affordable, healthy food.
• Digital inclusion: access to the technology to participate access services online

Research on the social determinants of health

Our work is based on, and has fed into, studies on the social determinants of health. Two important pieces of research are:

Fair Society Healthy Lives (The Marmot Review): The influential report on evidence-based strategies for reducing health inequalities in England, 2010. One of its key messages was that action on health inequalities requires action across all the social determinants of health.

Health Equity in England: The Marmot Review 10 Years On: Report produced by the Institute of Health Equity and commissioned by the Health Foundation, 2020. This includes case studies of People’s Health Trust funded projects.