Economic evaluation of participation in Community Led Organisations for individuals living in disadvantaged areas in the UK

Abstract

This paper presents an economic evaluation of community-led and -owned organisations that deliver activities to support health and wellbeing. Because community-led organisations (CLOs) are a vital part of the social and solidarity economy, they increasingly feature in public health policies targeting disadvantaged populations. However, little is known about the value CLOs generate as few economic evaluations of them exist and those available focus on isolated activities (such as exercise classes) and/or specific populations (e.g., men-only collectives). The novelty of our work lies in the inclusion of multiple CLOs, comprehensive coverage of their activities, breadth of participants studied, and control group methodology applied in creating new knowledge of the health and wellbeing outcomes of CLOs and resources consumed to achieve them. We conducted cost-effectiveness and cost-consequence analyses of data collected via a 12-month longitudinal study. We compared 331 CLO participants in 14 UK-based CLOs to a ‘do nothing’ synthetic control group (n=100). Health and wellbeing were measured using the ICECAP-A capability measure for adults, EuroQol EQ-5D-5L, Short-form Warwick Edinburgh Mental Wellbeing Scale and the Revised Social Connectedness Scale. Resource use data included health, social care, and other community sector resources. Data collection occurred at four-points over the study period supported by publicly available accounts and data provided by each CLO. We found an incremental cost per year in full capability of £35,813 and an incremental cost per quality adjusted life year of £29,827. Statistically significant improvement in both social connectedness, and mental wellbeing were observed over the 12 month follow up. This work supports CLOs as an intervention to improve health and wellbeing in disadvantaged communities and identifies challenges for traditional evaluation methodology with regards to costing and comparator groups.