Published: 03/11/2005 Volume 115 No. 5980 Page 19

Deputy chief medical officer Fiona Adshead explains why the Sustainable Communities 2006 awards are a powerful vehicle for change

Better health and well-being go hand in hand with belonging to a sustainable community. A prosperous local economy, quality environment, good education and opportunities for social interaction generally go hand in hand with better health.

By the same token, the link between disadvantaged communities and poor health is stark. Two children, born on the same day in different parts of England, can have a difference in life expectancy of almost a decade.

That is a lot of wasted potential, not to mention unnecessary poor health. In one of the world's richest countries, this is not acceptable. Reducing health inequalities and increasing the life expectancy of those in poverty and disadvantage are of the highest priority for the Department of Health.

The public health white paper identified a range of actions to make it easier for individuals to make healthy choices. But making those choices is also influenced by where you live, your income, and the social capital in a community.

For example, you may know that you can significantly reduce your risk of developing a chronic disease by walking an extra 2,000 steps a day. But if you live in an area with high crime rates, where you do not feel safe to get off the bus a couple of stops earlier after dark, the last thing you're going to do is risk immediate physical harm or distress for the good of your health.

A sustainable community is one that makes it as easy as possible for the people who live and work within it to choose health. All of the elements of the built environment - housing, transport, recreational spaces, community infrastructure - need to work in concert with one another to really deliver health benefits for the population. Sustainable communities need to be built on sustainable development.

Building in safety will determine usage levels of green spaces. Anti-social behaviour should be minimized by reducing the concentration of factors known to increase probability of such behaviours - closing off alleyways, for example - which will help to reduce anxiety, and promote social capital and physical exercise.

But this is just for starters. The whole point of a sustainable community is that it is a product of the actions of its citizens, working to secure their own well-being in order to reach their full potential in life. And they should be supported in pursuing this by the public sector and civil society organisation.

Ideally, local strategic partnerships feeding in to local area agreements are the obvious mechanism by which this should happen. The challenge now is to work with local leaders to ensure it does happen, using the will and talent of frontline staff.

But this is about much more than geographical communities.

Communities of interest - faith communities for example - have a vital role to play in giving people the sense of belonging and worth which is essential for them to become active agents of change.

Ultimately, this is about the great potential people hold within them, and the real and meaningful change they can achieve when they come together.

If you are one of those people, the Sustainable Communities Awards need to know about your work. People listen more to their peers than anyone else.

The most powerful advocates for change are not governments, but people. By learning from what's already working, others may be inspired to follow you.

Dr Fiona Adshead is deputy chief medical officer and is a judge of the Sustainable Communities 2006 awards organised by HSJ and Local Government Chronicle.

The closing date for entering the awards is 4 November. You can enter online, at sustainable communities2006. com