The Mental Health And Wellbeing Impact of A Community Wealth Building Programme – A Difference-In-Differences Study

Background There are wide differences in health between places in the UK with economic inequalities potentially underlying these differences. Previous regeneration initiatives have failed to alleviate these disparities. Preston, a relatively deprived city in the North West of England, has implemented a new approach to economic development, known as Community Wealth Building, which initially focused on large public or not-for profit organisations modifying their procurement policies to support the development of local supply chains, improve employment conditions and the socially productive use of wealth and assets. This paper evaluates if this programme had led to changes in mental health and wellbeing across the local population. Methods.A natural experiment was used, with difference-in-differences techniques to compare trends in mental health as measured by the Small Area Mental Health Index (SAMHI) relative to matched control group before (2011-2015) and after (2016-2019) the introduction of Community Wealth Building. Each of the local neighbourhoods were matched with a similar group of neighbourhoods. Additional analysis compared local authority measures of life satisfaction, median wages and employment rate to synthetic counterfactuals created using Bayesian structural time-series, over the same time periods.Findings.The introduction of the Community Wealth Building programme was associated with a 0.12 decrease in the SAMHI score [95% CI 0.062 to 0.17, p<0.001]– indicating a 11% improvement in mental health, relative to the control group During the same time period the local population experienced a 9% improvement in life satisfaction (95% Cr I,-1% to 18%), 11 % increase in median wages (95% Cr I , 1.8% to 18%) and 7% increase in employment (95% Cr I, -6% to 22%), relative to expected trends. Interpretation. During the period in which Community Wealth Building was introduced there were fewer mental health problems than would have been expected compared to other similar areas, as life satisfaction and economic measures improved. The Community Wealth Building approach to economic development potentially provides an effective model for economic regeneration that leads to substantial health benefits