Tackling health inequalities through people-led projects

Grassroots initiatives created in collaboration with communities can help to reduce unfair disparities in health outcomes

Being healthy is not entirely within our control. Health inequalities – the preventable and unjust differences in health outcomes that arise between different demographics – can present in many ways, including lower life expectancy, reduced access to healthcare services, and higher prevalence of diseases such as cancer or cardiovascular disease.

Across the country, local, community-led projects are making strides in identifying and targeting the specific problems that different groups face. The HSJ Awards “Innovation and Improvement in Reducing Healthcare Inequalities” category, sponsored by NHS England and Novartis Pharmaceuticals UK Ltd, celebrates those projects that have driven tangible health improvements for local communities. Below, we explore the work of some past winners and finalists in more detail, as well as spotlight other great initiatives.

Co-production with communities

Producing health initiatives in collaboration with local communities is crucial to making them effective. To address the issue that Bradford’s South Asian population presents with heart attacks, strokes and diabetes at a much younger age than their white counterparts, Improvement Academy created a series of 10 “health check” events, designed and advertised in partnership with the community.

Improvement Academy associate director Vishal Sharma explains the first event took place in a local mosque to increase attendee confidence. Translators and bilingual health professionals were available. Events were advertised via posters in local shops and were printed in multiple languages, while the team identified key community figures who could share the events via WhatsApp.

“We always talk about that ‘hard-to-reach’ population, and in fact, they’re not hard to reach,” says Dr Sharma. “Expand the right measures to reach them, and when you do, their engagement is phenomenal.”

The events involved measuring blood pressure, blood sugar, height and weight, educating attendees on healthy lifestyle changes, and providing opportunities to socialise over refreshments. Roughly 30 per cent of people were flagged as being at risk of diabetes, and 35 per cent at risk of high blood pressure, with some people requiring emergency services. The project was also a finalist in the “Innovation and Improvement in Reducing Healthcare Inequalities” category in 2023.

Meanwhile, working with The Health Creation Alliance, East London-based charity The Limehouse Project created a “one-stop shop” support pack for ethnic minority women who have been through breast cancer treatment. The idea was to help these women access the appropriate healthcare services and maintain a healthy life during recovery, says Farida Yesmin, the charity’s CEO.

Working with women with lived experience helped to create a guide which uses simpler language and includes translations in the women’s native languages and more subtle imagery.

“They feel it’s a bit embarrassing for them to look at images [of breasts] within family settings,” Ms Yesmin says. “That can be removed, and we can use something in an artistic form or maybe a metaphor like a lotus flower to describe things instead.”

Partnering with local organisations

Well Farmers for Wiltshire ran a series of health events to address inequalities facing farmer and rural populations. They took place weekly for 18 months at a livestock market in Wiltshire, and were jointly run by the NHS, local government and voluntary organisations. The collaboration won the “Innovation and Improvement in Reducing Healthcare Inequalities” category in 2025.

Different specialists would attend every week. Many health issues were detected early, including sepsis due to injuries, skin cancers from working outside, and high-risk stroke or heart attack cases. Working with local partners like the rural chaplaincy service built greater trust among the community, says Emma Higgins, head of combined place at the Bath and North East Somerset, Swindon and Wiltshire Integrated Care Board. Other partners, such as Citizens Advice Bureau, offered broader advice on topics such as financial wellbeing.

“It’s about building an ecosystem,” says Ms Higgins. “You wouldn’t get the same impact from a once-a-month GP appointment. I think people declared things that were far in excess of what would normally happen in a health-related setting, because we built up those relationships, actively listened to them, and did what they asked us to do.”

Having a data-driven approach

Successful projects use data to target the right people, tailor interventions and measure impact.

Among the issues the Health Equity Liverpool Project  – a joint effort between local government, health providers, creative groups and the Liverpool School of Tropical Medicine (LSTM) – sought to tackle was low breast cancer screening uptake among women in the more deprived areas of Anfield and Everton. Before designing interventions, a survey was conducted, and local GP practice data was analysed to better understand the reasons behind low uptake. The team identified anxiety and embarrassment as key factors, so they devised a creative campaign to tackle this stigma.

It culminated in #BeBreastSavvy, a roadshow aimed at increasing education around mammograms and challenging misinformation. This included fun, visual interventions such as bra-laden washing lines, breast-shaped pin cushions and cupcakes, and poetry printed on a giant cardboard bra.

Data from the campaign revealed 200 women booked for mammography on the mobile screening bus and the breast screening unit during events, reducing the number of women who did not attend breast screening appointments by 13.5 per cent across the primary care network. The project was an HSJ Awards finalist in 2024.

“For tackling health equity, it’s about making it hyperlocalised, then having this collaborative approach so you’re not competing or duplicating,” says Miriam Taegtmeyer, head of LSTM’s community health systems research group.

Beneficial impacts – individual health and beyond

At a population level, place-based interventions can help to shift to a prevention agenda – as the above examples show, using community rather than clinical settings to detect problems before they develop can improve patient outcomes and reduce the burden on the NHS.

But alongside this, many of the projects also increased general healthy lifestyle awareness, and in some cases taught other life skills such as financial proficiency.

Education can empower people to take ownership of their health, says Dr Sharma. “People we spoke to felt like, because their mum and dad had diabetes, it was a foregone conclusion that they were going to get diabetes,” he says. “But… we’ve educated people to know they can take control and change the course of what’s going to happen.”

There was also a ripple effect. Both the Bradford and Wiltshire projects relied heavily on word of mouth, with event attendance increasing thanks to participants telling their families and friends. In Bradford, some attendees would also make lifestyle changes, such as diet improvements, for their entire households.

Working collaboratively rather than in silos can also improve information sharing and relationship building between organisations, says Ms Higgins. Having voluntary organisations at events made farmers in Wiltshire more aware of the free support available to them via charities.

Co-producing targeted healthcare interventions in ways that make people more comfortable can ultimately break down barriers to access and increase overall confidence in the healthcare sector. As an added benefit, community events can increase social cohesion and reduce loneliness and isolation, which can also positively impact health outcomes.