Community engagement and empowerment to address health inequalities: A rapid evidence review

Health inequalities in high income countries persist despite decades of policy intervention, with traditional approaches often reinforcing rather than reducing disparities. Community-led strategies offer a more effective alternative, yet they remain underused in public health policy. Here we explore evidence on what works to empower communities and reduce health inequalities.

This rapid evidence review explores the effectiveness of community engagement approaches. There is strong evidence supporting the use of community health workers (CHWs) to reduce health inequalities in cardiovascular disease prevention and cancer screening and care, particularly when roles and training are tailored to specific needs. There is also good evidence for partnerships with faith-based organisations, which yield modest but significant improvements in cardiovascular health, healthy weight, and cancer screening outcomes. However, evidence remains mixed or limited for partnerships with other community venues and peer support programmes. The specific health effects of co-design and empowerment approaches remain inconclusive due to few studies in this area. Cross-cutting themes highlight the importance of cultural tailoring and alignment in community engagement strategies.

Community-centred approaches, especially those targeting upstream determinants of health, remain critically understudied with most studies focusing on the US context. This review highlights an urgent need for further research to strengthen the evidence base and refine community engagement strategies for advancing health equity. Policy makers should consider CHW programmes, partnership with faith-based organisations, and cultural tailoring and congruence in advancing health equity.