designCares: Co-designing equitable health futuresto enable health-creating communities

The pressing need for community leadership in health is driven by a preventative and equitable health promotion agenda. This agenda builds on well-established correlations between physical, mental, and social wellbeing and on the major role of social determinants in health outcomes, which have been extensively researched (e.g.,
NHS 10-year plan (https://assets.publishing.service.gov.uk/media/6888a0b1a11f859994409147/fit-forthe-
future-10-year-health-plan-for-england.pdf)). It also draws on the OttawaCharter (https://www.who.int/teams/health-promotion/enhanced-wellbeing/first-global-conference), which emphasised health as created and experienced in people’s everyday lives. In an under-resourced health system, written evidence (
Health Foundation (https://data.parliament.uk/writtenevidence/committeeevidence.svc/evidencedocu
ment/nhs-sustainability-committee/longterm-sustainability-of-thenhs/
written/39736.html),
UK Health Forum (https://data.parliament.uk/writtenevidence/committeeevidence.svc/evidencedocu
ment/nhs-sustainability-committee/longterm-sustainability-of-thenhs/
written/38866.html)) estimated that 40% of conditions presented to theNHS could be prevented, reinforcing the importance of community leadership. In this context, co-design and co-production practices have been widely used to engage communities in preventative non-clinical approaches, requiring effective cross-sector collaboration. Examples of initiatives include community-centred programmes, social prescribing and the Greater Manchester Live Well (https://www.greatermanchesterca.
gov.uk/what-we-do/live-well/) partnership. Within these, participatory approaches are vital for establishing health equity from the outset. By co-designing culturally sensitive health practices with global majority groups, these approaches can counter exclusionary health cultures.