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

Abstract

Abstract Background Area-based initiatives (ABIs) are receiving renewed interest as a part of the ‘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 (BL) ABI. Methods Survey data on general health, mental well-being, perceptions of individual and collective control and social cohesion was obtained in 2016 for 1600 residents involved in the 150 BL ABI areas in England, and 862 responded—a response rate of >50%. Adjusted mean differences and adjusted odds ratios (ORs) were calculated using random effect linear and generalized estimating equation models. Subgroup analysis by gender and educational level was conducted. Results Mental well-being 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 [OR: 4.25, 2.26–7.97]). Conclusions Collective control and some aspects of social cohesion were positively associated with better mental well-being and self-rated health amongst residents involved with BL. 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.