How do community assets support health in a rural community? An ethnographic case study

Community assets (including voluntary, community, social enterprise and grassroots initiatives) have the potential to help address health inequalities. There is a growing understanding of the importance of putting communities at the heart of public health to improve population health. Understanding the mechanisms by which grassroots activities support health and wellbeing is important for making commissioning decisions, for community confidence and for the purposes of evaluation. This study takes an ethnographic case study approach to explore one rural community in the south-west of England. We observed activities and interactions, had informal conversations with residents and community leaders and conducted focus groups. Focus groups were recorded, and transcripts and field notes were analysed thematically. Findings were mapped to South and colleagues' family of community-centred approaches. We explore to what extent this framework applies to grassroots activities in our case study site and consider how outcomes from these community assets (places, activities and people) may link to the evidence base behind this framework. We discuss the mechanisms by which these approaches support health and wellbeing, as well as the factors that may constrain their development. We suggest that, through linking to the evidence base, there is a case for investing in the transformational health-generating work of grassroots organisations.