Collective control, social-cohesion and health and wellbeing: baseline survey results from the communities in control study in England

Abstract

Background: Area-based initiatives (ABIs) are receiving renewed interest as part of ‘place-based public health’ approaches to reducing health inequalities. Purpose: Examine associations between collective control, social-cohesion and health amongst residents involved in the Big Local ABI. Methods: Survey data on general health, mental wellbeing, perceptions of individual and collective control, and social-cohesion was obtained in 2016 for 1600 residents involved in the 150 Big Local ABI areas in England, 862 responded - a response rate of >50%. Adjusted mean differences and adjusted odds ratios were calculated using random effect linear and generalised estimating equation models. Subgroup analysis by gender and educational level was conducted. Results: Mental wellbeing was positively associated with collective control (Mean Difference 3.06 units, 1.23-4.90) and some measures of social cohesion (‘people in the area are willing to help each other’ [Mean Difference 1.77 units, 0.75-2.78]). General health was positively associated with other measures of social cohesion (area-belonging [Odds Ratio 4.25, 2.26-7.97]). Conclusion: Collective control and some aspects of social cohesion were positively associated with better mental wellbeing and self-rated health amongst residents involved with Big Local. These positive associations were often greater amongst women and participants with a lower education. Increasing the collective control residents have in ABIs could improve the health effects of ABIs.