We use community-centred approaches because they help us meet the needs of Leeds’ many and diverse communities, and because there is strong evidence that they improve health and reduce health inequalities.
There are inequalities in health between communities in Leeds
Leeds covers a wide and varied geography, from urban areas to rural communities. This means that areas with high levels of deprivation often sit alongside more affluent areas. Neighbourhoods across the city have different characteristics, strengths and health needs.
People in more deprived neighbourhoods of the city are more likely to die earlier and be unwell for more of their lives. In the parts of Leeds within the most deprived 10% of England, life expectancy is 73.2 years (men) and 78.2 years (women), compared to 83.6 years (men) and 86.7 years (women) in the parts of Leeds in the least deprived 10% of England*. People living in the most deprived areas live around a third of their lives in ill-health, compared to less than a fifth in the least deprived areas**.
The most deprived neighbourhoods are younger, with more children and families, and more ethnically diverse. People from ethnically diverse communities may experience inequalities in health, the building blocks of health - such as housing, education and employment, and access to support and services.
People belong to multiple communities, all of which shape our health and wellbeing. For example, people living in the most deprived neighbourhoods are more likely to be from ethnically diverse communities, or people who are homeless may also have challenges with substance use. Together, these can have significant, overlapping impacts on health inequalities.
(Source: *ONS population and mortality data 2022-2024 and IMD 2025 at LSOA level; **Healthy life expectancy data 2013-15 and 2020-22).
Understanding deprivation
Deprivation means not having the resources, opportunities, or living conditions necessary for a good quality of life and good health.
The Index of Multiple Deprivation (IMD) provides a picture of how deprived a neighbourhood is by using measures of daily life, including income, health and the local environment. The way deprivation is measured in England was updated in October 2025, so we cannot make a direct comparison with previous figures.
Life expectancy at birth 2022-24
A baby born in Harewood can expect to live 12.9 years (men) or 11.5 years (women) longer than a baby born in Hunslet and Riverside.
Other areas:
Harewood
84.5 years (men) or 88 years (women)
Alwoodley
82.5 years (men) or 86.7 years (women)
Moortown
80.9 years (men) or 84.1 years (women)
Chapel Allerton
76.9 years (men) or 81.3 years (women)
Little London and Woodhouse
72 years (men) or 76.5 years (women)
Hunslet and Riverside
71.6 years (men) or 76.5 years (women)
(Source: Wards, calculated using ONS MYE populations, and ONS mortality data).
Communities experiencing extreme health inequalities in Leeds
People who face extreme health inequalities
Some communities in Leeds face extreme health inequalities, such as people who experience homelessness, people with drug dependence, at risk migrants, the Trans community, Gypsy and Traveller communities, Roma communities, people with learning disability, street sex workers, people in contact with the justice system and victims of modern slavery.
- 128 (estimate) people who are sleeping rough (5)
- 45 (men), 43 (women) - average age at death in England and Wales (6)
- 2,086 in prison in Leeds (15)
- People arriving in prison are 4 times more likely to smoke than the general population in England (16)
- 5,380 people who use opiates or crack (7)
- 60-70 deaths in Leeds from drug use per year in Leeds (8)
- 4,754 people with a gender identity different from sex registered at birth (21)
- 46% of trans people thought about taking their life in 2017 in the UK (22)
- 3,409 people seeking asylum (Ukraine, Afghan resettlement, and other Asylum seekers receiving support) (9)
- 31% of displaced adults have PTSD in the UK (10)
- 5,079 people with learning disabilities (19)
- 51 (men), 55 (women) - average age at death in Leeds (20)
- 1,010 (census) 1,500 (local estimate) Gypsy or Irish Traveller population
- Over 10 years difference in life expectancy in England (14)
- 110 Sex workers known to local services in Leeds (17)
- 41 years – average age at death for a female on-street sex worker in Leeds (18)
(Note: Intelligence and data on many of these communities are not collected at national or local level. Therefore, many of their needs are hidden. Some data has only recently started to be collected, for example, ‘Roma’ ethnic heritage was only added to the census in 2021. There are many reasons for this, including barriers to accessing services, low levels of trust in statutory organisations and wariness of sharing personal details).
People in these communities often experience multiple, overlapping social and economic challenges, as well as stigma and discrimination. They have worse access to services, poorer health, lower quality of life, and shorter lives. For example, people who sleep rough die at age 45 (men) or 43 (women) on average. For several reasons, they are often missing from data records, so their needs may be ignored when services are being planned.
Work to address these inequalities is often called "inclusion health". It focuses on the individual and their circumstances, including understanding and responding to the impact of trauma, and involving them in planning and delivery of services so that they meet their needs (23, 24).
Working with communities is an effective way to improve health and wellbeing and reduce inequalities
There is strong and growing evidence that community-centred approaches improve people’s health and reduce inequalities. This is not a new idea - community participation and empowerment have been central throughout the history of public health and health promotion (23, 24). But recent evidence has improved our understanding of how and why these approaches work.
Reducing health inequalities
Many communities face barriers to accessing health and wider services, including a lack of trust, stigma or discrimination, and communication challenges. Working with communities to develop culturally appropriate and effective ways of connecting with people can improve access to services and reduce health inequalities.
Health messages are more likely to be believed and have an impact when they are delivered by people in the same community or a trusted community organisation, in safe and familiar settings. Peer support approaches and volunteers can reach people who have not been supported by other services. Often, the person delivering the message can be as important as the message itself. For example, collaborative work with mosques, churches and faith-based organisations to deliver culturally-sensitive health programmes have led to improvements in health, including mental health and heart disease (25, 26).
A lack of social connection is one of the key mechanisms that create and perpetuate health inequities.
Supporting strong, connected communities
Social connection improves our health and wellbeing. Strong relationships help people to be more resilient and protect against poor health (28). In contrast, social isolation and loneliness can be very damaging to health. It can lead to a higher risk of heart disease, stroke, and mental ill health (27). It has also been estimated that loneliness increases the chance of death by 26% (29). This is comparable to well-known risks to health such as smoking or obesity.
There is good evidence on what works to build social connection, reduce loneliness and improve health (30, 31). Community groups such as gardening clubs, walking groups and women’s groups have often been thought of as 'nice to have' in communities, but have in fact been shown to improve social connection and make a difference to health.
Enabling voice and greater control
Having a voice in local decisions is important for people’s health and wellbeing (28). Existing services do not have all the answers. When organisations work in partnership with communities, more people can access support and health outcomes improve (32).
However, community involvement needs to be meaningful. This means not just providing information or running a consultation, but working together and shifting power and control to communities. The more the community is involved in joint decision making, the more embedded and successful the solution is likely to be. This is often referred to as ‘Community Power’, and there is a strong history of working in this way in Leeds, putting people at the heart of decision making in the city.
Community Power
Community Power means the transfer of power and resources to communities so that they can have greater influence and control over the plans, decisions, and public services that affect their lives. This reflects the belief that, given the tools and the opportunity, those who are part of a community can change the things that they believe need changing in their community better than anyone else.
Healthwatch Leeds
Healthwatch Leeds is an independent organisation that listens to people’s experiences of health and social care services. They make sure people’s voices are heard and at the heart of shaping health and care services in Leeds.
A ladder of participation
- Supporting local initiatives: ‘We can help you achieve what you want, within guidelines’
- Acting together: ‘We want to carry out joint decisions together’
- Deciding together: ‘We want to develop options and decide together’
- Consultation: ‘These are the options what do you think?’
- Information: ‘Here’s what we are going to do…’
Learning from the COVID-19 pandemic
The COVID-19 pandemic shone a light on the value of communities for health and wellbeing (33). Communities and local organisations responded rapidly to provide support to people who were isolated or excluded. Support ranged from neighbours looking out for each other to co-ordinated emergency provision by VCFS organisations.
Trust was central. Globally, countries with higher levels of trust had higher rates of vaccination and lower rates of COVID-19 infections (34). In the UK, local approaches with communities, understanding beliefs and building sustained, trusting relationships were key to improving vaccination rates (35).
For example, approaches that included working with communities and culturally appropriate resources were more effective than incentives and mandates at engaging ethnically diverse populations (36). Community champion approaches were a widely used, effective approach to increase vaccination and support diverse and disadvantaged communities (37, 38).
Case Study: Community Champions – local volunteers sharing trusted information and promoting health
Community Champions are local volunteers who draw on their own experience to share trusted information about services with people in their communities. Evidence shows this approach is especially effective in communities where trust in public services is low (39).
The Leeds Community Vaccine Champions programme is delivered by Forum Central and Voluntary Action Leeds, in partnership with Public Health, West Yorkshire Integrated Care Board and NHS England. Volunteers work with their local communities to improve understanding of vaccination, particularly in areas with lower uptake. Small grants support local, grassroots groups to take part. The programme builds on trusted ways of working developed during the COVID-19 pandemic.
Since the pandemic, more than 300 Community Champions, speaking over 40 community languages, have been active across Leeds. Champions have had more than 5,000 conversations with people from diverse communities. An ongoing evaluation has found the programme to be effective at raising awareness through informal community networks and supported vaccine pop-ups. This is thought to be a key factor in improving vaccination rates.
“You can spend thousands and millions on… printing out things and giving them to people. But nobody’s gonna have a look and they’ll just go straight in the bin. But you have one meaningful conversation and that lingers. And then that next person will end up saying it to somebody else.”
Volunteer, Community Champions
Communities have assets to build on
All communities have assets: the people, places and resources within a community that help protect and improve health and wellbeing. These can include local VCFS organisations, transport links, and green spaces such as parks. These are only community assets if the community itself says they are.
Not all communities have the same access to local assets, which affects health unequally. For example, people living in some deprived, central neighbourhoods may have strong community cohesion and VCFS organisations, but limited access to green space.
We have developed the Leeds Asset Framework to understand the different assets communities have available to them. These are grouped into:
People and communities
Skills and knowledge in the community, for example:
- Community knowledge and skills
- Friendships, good neighbours, and social networks
- Community spirit/cohesion
- Volunteering
- Local groups and networks (informal and formal)
- Local VCFS organisations
- Councillors and community leaders
Local services
Services provided by the health system, council, businesses or others, for example:
- Health and care services including GP surgeries
- Schools
- Libraries
- Housing services/supported housing
- Transport services
- Businesses
- Other services
Places
Buildings, infrastructure and green space, for example:
- Environment and green space, for example, parks
- Community centres /hubs
- Housing
- Local economy and jobs
- Getting around – walking, cycling, transport
- Places of worship, for example, mosques/churches
- Shops and amenities
- Culture and history
Asset-based approaches - building on the strengths of communities
Asset-based approaches focus on what is strong in communities, not just on what is wrong. When we focus only on needs or problems, we risk labelling and stigmatising people. Building on community assets helps create the conditions for better health and fairer outcomes.
Asset-Based Community Development (ABCD) is a neighbourhood approach to community development. It brings people together around shared action to bring about change. ABCD recognises the strengths in communities, and that everyone has skills and something to contribute. It makes visible the strengths that are often invisible in communities. This is a shift to a bottom-up approach, run by the community themselves.
The 6 principles of ABCD are:
- Citizen driven
- Relationship oriented
- Asset-based
- Inclusion-focused
- Place-based
- People and communities
