Community Wealth Building Evaluation: Learning Lessons from Scotland - a mixed method evaluation of the impact of community wealth building on economic and health outcomes and health inequalities
Scotland is testing whether reshaping local economies can reverse a decade of falling life expectancy, and this study will measure whether it works. Since 2012, life expectancy in Scotland and the UK has been dropping, especially among lower-income groups, as inequalities in housing, jobs, and income have widened. The Scottish Government has adopted Community Wealth Building (CWB)—an approach that redirects public spending, hiring, and investment toward local people and businesses—but there is almost no evidence on whether it actually improves health or reduces inequalities. North Ayrshire launched the first CWB strategy in May 2020, followed by five other pilot areas. This study will compare economic and health outcomes in those areas against matched populations in England that are not using CWB, using statistical methods that account for differences over time. If CWB proves effective, the findings could reshape how local authorities across the UK spend public money, hire staff, and invest pensions. That would change the everyday economics of towns and cities—what jobs are available, where money circulates, and how stable local services are—without requiring new laws or central government intervention. The study will also identify which specific CWB components drive results, so councils can prioritise what works.
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Research question What are the health and health inequalities impacts of creating a more inclusive economy through Community Wealth Building (CWB)? Background Since 2012, life expectancy in Scotland and the UK has been falling, particularly in lower socio-economic groups, driven by widening inequalities in the social determinants of health. In response, the Scottish Government has adopted CWB, with interest also growing in England, Wales, and Northern Ireland. CWB aims to create inclusive, sustainable economies and improve social determinants of health, potentially reducing health inequalities. Evidence on CWB's health impacts is limited. A recent study linked Preston’s CWB to positive changes in mental health and economic outcomes, but more research is needed. North Ayrshire launched Scotland's first CWB strategy in May 2020, followed by five other CWB pilot areas. Aim To evaluate the health and health inequalities impacts of CWB as an approach to developing inclusive economies.? Research questions? RQ1 - What are likely to be the most effective pathways for CWB to improve population health and reduce health inequalities? RQ2 - How has CWB been implemented in Scotland and how does it vary across local authorities (LAs)? RQ3 - What are the barriers and facilitators to the implementation of CWB? RQ4 - What is the effect of CWB on health and intermediate economic outcomes? RQ5 - What has been the impact of CWB on inequalities in health across groups defined by their individual or household social position??? RQ6 - What is the contribution of different components of CWB to economic and health outcomes? Methods WP1: stakeholder workshops to refine a draft CWB Theory of Change (ToC) setting out the expected pathways by which CWB will improve health and reduce health inequalities (RQ1). WP2: semi-structured interviews to assess whether and how CWB has been implemented in LAs in Scotland (RQ2) and the barriers and facilitators to progress (RQ3); survey of progress in developing CWB in all 32 LAs in Scotland. WP3a: difference in difference (D-i-D) analysis using generalised synthetic control (GSC) methods to compare economic, health (RQ4) and inequalities (RQ5) outcomes in Scottish LAs developing CWB to matched populations in England that are not undergoing CWB; WP3b: fixed effects panel regression to identify elements of CWB associated with economic and health outcomes (RQ6). WP4: Qualitative Comparative Analysis (QCA) to explore the combinations of causal factors that are necessary and sufficient to achieve particular economic and health outcomes (RQ6). WP5: synthesis and dissemination of results. Timelines for delivery Three-year study beginning in October 2025. Study milestones are as follows: WP1: Review of ToC: months (m)1 to 6.? WP2: Collation of indicator data: m4 to 12? WP2: Qualitative interviews: m4 to 24? WP2: LA survey: m13-24? WP3a: D-i-D and GSC analyses: m1-24? WP3b: Panel regression: m1-30? WP4: QCA: m7-30? WP5: Synthesis and dissemination: m1-36.? Anticipated impact and dissemination Through the involvement of scientific and public expert panels from the outset, the findings will be disseminated to help shape policy and guidance on CWB; guide anchor institutions in refining their purchasing, hiring, and investment strategies; and support local community organisations benefit from the opportunities offered by CWB.
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