Urban health

Neighbourhood-level initiatives in Birmingham, England

21 April 2021
3 min read

In Birmingham, we explored hyperlocal interventions to improve the health of neighbourhoods.

This city profile is part of a series of ten, exploring how cities around the world are addressing health inequalities. Read the full report and sign up to receive more insights from us.

About Birmingham

Birmingham is the UK’s second largest city, but only a fifth of London’s size. Despite its small size, it has similar density rates to London, with 4,200 people per square kilometre. Birmingham is also racially diverse and projected to become a majority-minority city within the next decade. Overall, there is a young age structure with 64% of the population of working age and only 13% aged 65 and older.

Birmingham is the third most deprived English city, with 43% of the population living in areas with high rates of deprivation. Growing wealth inequality in the city is further exacerbating existing social disparities. The highest-paid full-time workers earn 6.5 times as much as the lowest-paid, compared to 3.5 as much nationally (2020 figures). The distribution of personal wealth is even more unequal, with the wealthiest 10% having 850 times the wealth of the bottom 10%.

Like London, Birmingham benefits from a comparatively high level of healthcare provision compared to similar cities in other countries, but equitable access to healthcare and the determinants of health and wellbeing remain a challenge. Compared to Birmingham’s most affluent residents, those living in the most deprived communities have lower life expectancies, are three times more likely to be admitted to hospital for treatable conditions, and three times more likely to have a long-term health condition. These disparities are compounded when race is factored in: Black Caribbean residents make up 17% of all in-patients, four times more than expected based on population proportions.

In numbers


people living in Birmingham


of residents were born overseas


of children in certain areas live in poverty

Working in hyperlocal settings to improve health in cities

Birmingham, a city with similar neighbourhoods to Lambeth and Southwark, offered an opportunity for us to explore neighbourhood-level interventions. We found that physical spaces and the people running them can provide strong foundations for healthy neighbourhoods.

We visited a number of neighbourhood projects, each of which relied heavily on the provision of physical and accessible space, underpinned by social support and a well networked community. Space for people to interact and build neighbourhood-based networks and activities supports mental and physical wellbeing in different ways.

The challenge across the board at the neighbourhood level was tailoring the provision to the specific needs of the community to ensure not only physical access, in terms of location and affordability, but also social accessibility, so people felt the service was welcoming and relevant to them.


How has this approach supported improvements in health?

Many of these initiatives drove positive outcomes across sectors. However, inadequate resources, lack of recognition of their work and lack of a voice on the issues they dealt with, often created a disconnect with other sectors whose services or priorities impacted on neighbourhoods or communities. Despite the willingness of community leaders to build valuable relationships with others outside of their sector, they found collaboration difficult when decision makers did not appear to be acting in the best interests of their communities.

Mother and child at a street market

Read the 'Global perspectives on urban health' report

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