Gaining the best value for local economies and health through Community Wealth Building in Scotland

Dr Fiona Scott, Public Health Registrar at NHS Tayside joined Public Health Scotland (PHS) for a year to work on the health impact assessment of community wealth building. Here, she reflects on the importance of the economy for health in local communities.

Our Health Impact Assessment of Community Wealth Building in Scotland has found that given the many health benefits, community wealth building should be recognised as a public health intervention as well as an approach to economic development. For maximum impact, it should be implemented at scale with sustained commitment across Scotland. Additional policies are also essential to address the income and wealth disparities that lead to unacceptable health inequalities in Scotland.

The economy matters for health
The economy is a critical determinant of health and health inequalities. It shapes the distribution of income and wealth, and there is strong evidence that poverty and inequalities in income and wealth underpin health inequalities. Economic development can help people to gain good-quality employment and access other building blocks of health. The Scottish Government aims to create a ‘Wellbeing Economy’ designed to deliver prosperity for all and enable everyone in Scotland to thrive while protecting our environment.

One way in which the Scottish Government is delivering a wellbeing economy is through a new approach to economic development called community wealth building. This aims to use and circulate wealth within local economies so that more people can own and benefit from the wealth our economy generates. It is being implemented through five ‘pillars’:

• Supporting fair work practices
• Wider ownership of businesses and assets
• Using financial powers and investments to support local places
• Progressive procurement
• Using public land and property for public benefit.

Large organisations, such as local authorities and NHS health boards can greatly impact their communities. They are crucial in putting community wealth building into effect. The Scottish Government plans to introduce a Bill to ensure community wealth building is consistently implemented across Scotland.

Community wealth building and health
PHS has published a health impact assessment of the likely impacts of rolling out community wealth building in Scotland, led by health and economy experts. Professionals involved in community wealth building in councils, NHS Boards and the Scottish Government contributed to discussions to identify potential links to health. We then used data, research evidence and interviews with knowledgeable individuals to assess those links.

We found that community wealth building is likely to have many positive impacts that will bring benefits for health and health inequalities.

The positive impacts of community wealth building include:

• Reducing poverty and income inequality
• Reducing wealth inequality
• Improving access to secure employment
• Improving working conditions
• Improving local environments and reducing environmental externalities
• Improving access to spaces, facilities and amenities
• Providing more people with a stake in their local economy and increasing personal sense of control
• Enhancing community cohesion and resilience.

The assessment found one potential negative health impact of community wealth building: it could put more pressure on individuals and communities taking on new ownership and management roles. They need support to take on these roles and associated responsibilities.

Read more about community wealth building in Scotland 

The assessment made further recommendations to support socially responsible businesses and gain the best value from each of the five pillars of community wealth building. Public Health Scotland will continue to work with partners to support community wealth building. Partnership work, including health impact assessments like this one, are an important way to realise our vision of ‘a Scotland where everyone thrives’.

Read our Health Impact Assessment of Community Wealth Building

Read about our work supporting Anchor Institutions and Community Wealth Building