Social Determinants of Health Development Func

The LGA Healthy Communities Programme work stream on the Social Determinants of Health (SDH) sets out to raise awareness of the social determinants of health and the role of local government strengthen local governments capacity to address health inequalities through action on the social determinants of health.

The programme has funded three local authority led projects under the SDH development fund to help develop good practice in addressing health inequalities. The following provides a summary report of two of these projects; the Back to Front Project in Leeds and the Five to Strive project in Cheshire West and Chester. A third that will develop strategic commissioning for health improvement in culture and sport services is being introduced in Hull, North Lincolnshire and North East Lincolnshire.

Below are the descriptions of the two projects “Five to Strive” and “Back to Front”, to view the two products from these projects and full reports click on the following links:

Five to Strive

In response to talking to local people, Cheshire West and Chester Council has devised a group-based confidence course - called Five to Strive - complemented by one-to-one mentor support sessions to help participants achieve personal goals.

Five to Strive: confidence and mentoring - Cheshire West and Cheshire Council (PDF, 20 pages, 557KB)

1. Back to Front, Leeds

" Back to front promotes the transformation of front gardens so they are full and bursting with food to eat, admire and talk about.”

Back to Front encourages people to have front gardens that ‘look good and taste better.' This manual contains information to help you start to grow food in your front garden by starting off small, saving money and space and by using local resources. Back to Front's approach has been informed and inspired by our work in Harehills and Chapeltown, Leeds between 2009 and 2011. The manual can be used by individuals, community organisations and schools. We hope you enjoy reading and using it and that it helps you to grow more food in your front garden.

Back to Front - Food Growing in Front Gardens (PDF, 24 pages, 811KB)
Back to Front - Manual for Growing Food in Front Gardens (PDF, 78067KB)
Part 1 - Back to Front (PDF, 11 pages, 15729KB)
Part 2: Let's Get Growing (PDF, 20 pages, 31202KB)
Part 3 - Let's Get Building (PDF, 28 pages, 32516KB)
Part 4 - Local Resources (PDF, 10 pages, 11718KB)
Part 5 - Last Words (PDF, 2 pages, 10646KB)

The aim of Back to Front is simply to ‘promote growing food crops in front gardens as a socially acceptable norm'.

By creating an enabling environment for growing food in front gardens, the project meets all five principles of the National Sustainable Development Strategy: Securing the Future (2005), in particular by supporting the local production and distribution of food. It contributes therefore to the aims and objectives of the Leeds Food Strategy: Leeds Food Matters itself supported by the Health and Wellbeing Partnership for the Local Strategic Partnership

The project particularly targets disused or un-kept front gardens aiming to provide eye catching, practical and culturally sensitive garden designs to enhance the quality of the neighbourhoods and the wider productive urban landscape.

There are 2 phases to this project with Phase I including 3 stages: stage 1: preliminary research; stage 2: garden construction and stage 3: production of the Back to Front Manual. The LGA Healthy Communities Programme is contributing funding to the production of the Back to Front Manual and the wider promotion of this work.

The objectives are three fold:

  • To make information available on practical designs for food production and adapting design principles to Northern English inner city dwellers
  • Develop training guidelines for community use to form part the above
  • Raise awareness about the project and a future scheme through available channels

A number of activities associated with Phase II include the establishment of a membership scheme to ensure the sustainability of the project, composting in the community and cooperative buying of materials (topsoil, seeds, tools) and limited practical help garden re-conversion particularly for social housing properties
The project is led by Leeds City Council working in close collaboration with a range of diverse partners including:

  • Design Leeds (DL) : Leeds Metropolitan University
  • Permaculture UK: Charity promoting permaculture practice with national HQ in Leeds
  • Schumacher North (SN): Leeds society promoting sustainable development and eco-philosophy
  • Groundwork: Environmental regeneration charity
  • NHS Leeds: Commissioner of Primary Care Services
  • Leeds Tenants Federation (LTF): represents the views of residents on strategic decision-making

Progress and achievements

Phase1: Preliminary research

There are 476 Lower Super Output Areas in Leeds and 24 of these are both within the survey area and also within the 10 per cent most deprived nationally. Interviews were conducted on streets deemed to be representative of the housing stock in the deprived areas. These included back to back terraces with no front or back garden and often with shared bin yard, back to backs with front gardens, terraces with back yards and with our without front gardens, semidetached houses and flats. A mixture of 13 male and female interviewers with ethnic language skills undertook door to door surveys. Over 400 householders were interviewed. In addition, the views of over 100 were obtained at 10 focus groups.

Of the 400 interviewed through door knocking, a third of these were between 26 and 35 years of age and evenly split between male and female. Only a quarter of those interviewed described themselves as ‘White British'

Graph - cons of garden

Some 80 (20 per cent) of households already grew some food. The main barriers for not doing so appear below. In relation to using front gardens to grow food, 45 (just under 20 per cent) of the 231 who gave an answer, said they would be happy to use their front gardens to grow food.

Phase 2: Garden construction

As an outcome from the above research, Leeds City Council Area Management Team funded the construction of three model front vegetable plots to use as demonstrations of what can be achieved. The gardens were constructed and designed by staff and students of Leeds School of Architecture, Landscape and Design (Leeds Met). These have all been completed.

Three types of gardens have been built. The first is a garden above ground, which is ideal for people who rent their house or want to avoid disturbing the ground. It features modular, stackable beds, raised planters and a free standing timber and rope structure for climbers. The second garden is a garden for time, ideal for people who own their garden and want to make something individual and long lasting. The many small beds can be used for crop rotation and annual change within the garden. The third garden is a garden to share and is a communal garden with large raised beds made from reclaimed timber.

Phase 3: Front Garden Food Growing Manual

The manual will document the garden building process and will:

  • Include results from the initial survey (phase1)
  • include beautiful and practical design plans for vegetable front gardens
  • relate the cosmopolitan nature of the area and the food people like and are familiar with to what will grow in northern England

The project team including students from the Leeds School of Art and Architecture and Design has began work on the manual and aim to publish in March 2011. They and will be consulting with the project think tank and more widely as work on the manual progresses. The various draft versions of the manual will be placed on the project website at with comments and suggestions invited.

The next steps

  • Continue to develop the Back to Front manual
  • Continue developing ideas through student projects at Leeds Met (landscape architects and design students will be primarily involved here)
  • Considering how we assess the social impact that the gardens have made
  • Agreeing how we want to conduct the community engagement and forum element of this project
  • Considering the development of local partnerships

The healthy communities programme is considering how we can contribute to assessing the social impact of the project and engaging communities through links with other work streams and contributions from peers.

Five to Strive - Cheshire West and Chester (CWAC)


Research undertaken in 2007 by the North West Improvement Network identified:

  • The majority of individuals shared the same aspirations to increase confidence, independence and progress
  • Mentoring and support are instrumental to retaining engagement
  • External factors, such as debt, childcare and lifestyle choices, need to be considered and addressed within any model for change

The first stage of implementing the lessons from this research was to develop and pilot a flexible community-led confidence course - ‘On Course for Confidence'.

The research also identified the lack of a ‘community friendly' health and wellbeing measurement tool that would allow individuals, communities and partners to have a shared understanding of priorities by all stakeholders and residents.

The Five to Strive project sets out to increase the skills and capabilities of some of those residents living in the most deprived areas of Cheshire West and Chester by enabling them to identify and address their own and their community's, health and wellbeing needs, leading to measurable improvements through improved life chances and community-led service delivery. It has the following objectives:

  • To recruit, train and support 30 volunteer mentors from CWaC, the local PCTs and Age Concern Cheshire, to be able to support the delivery of individual's wellbeing goals and act as navigators through differing organisational systems
  • To deliver a user-led, flexible, modular confidence course in 3 areas of deprivation, to a maximum of 30 participants and to support those participants to achieve 3 personal wellbeing goals
  • To develop ‘community friendly' wellbeing tools to assess the wellbeing of individuals and areas, capturing the positive aspect of living in an area, recognising localism and preventing a ‘one size fits all' approach. To support participants to identify wellbeing issues in their own communities and take forward possible solutions through the LSP and APB for action
  • To use the Foresight 5 Ways to Wellbeing to help evaluate the effectiveness of the measurement tools, working with partners to establish suitable baselines

The project is led by Cheshire West and Chester Council with a partnership that includes NHS Western Cheshire, Age Concern Cheshire, Central and Eastern Cheshire PCT, the Cheshire West Together Partnership (LSP) and area partnership boards.

Progress and achievements

To Date the Five to Strive Project has focussed on:

  • Introducing and engaging partners, Members and Officers to/in the project
  • Starting to develop the confidence course for the targeted audience
  • Starting to develop the Health and Wellbeing Toolkit
  • Developing a Volunteer Mentor recruitment, selection and training package
  • Developing the logo, branding and marketing of the project

Reports and presentations explaining the project have been taken to various partner organisations including the relevant area partnership boards. Member engagement includes a presentation to the councils Health Select Panel, a member briefing and face to face meetings with the ward members for the targeted areas.

Three critical friends with expertise in community engagement and mental health and wellbeing have been brought in to assist the project. LGA have also funded an associate to run a workshop to assist with the forward planning for the community wellbeing. Discussions have also taken place with the nef, the authors of the Foresight 5 ways to wellbeing, on the development of the measurement tool.

Volunteer mentors have been recruited with over 80 volunteers answering the call within the first week. Volunteers have come from a range of partner organisations including police, jobcentre plus, housing associations and parish councils as well as the PCT and Council

The next steps

The confidence courses will be delivered in October/ November 2010.

Further discussions are planned with nef with the view to developing the measurement tool incorporating participatory appraisal techniques. This will lead to a one day workshop in October to produce the measurement tool. Pilot testing of the tool will take place over the following months.

For more information visit the:

Five to Strive website


Martin Seymour
Healthy Communities Programme
Principal Consultant

Contributions from Jackie Thornhill and Julia Hope, Cheshire West and Chester Council and Roxanna Summers and Emma Oldroyd, Leeds.

14 December 2011

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