I had the pleasure of attending the second Global Determinants of Health and Wellbeing conference at University College London on 4 June 2026, hosted by Professor Adrian Bonner and supported by Bristol University Press and The Salvation Army. The conference set out to explore the interconnected factors that shape health and wellbeing, with a particular focus on poverty, social deprivation, people in transition and social justice.
Sir Michael Marmot’s keynote was, for me, both stimulating and frustrating in equal measure. Stimulating because few people explain the social gradient in health with such clarity and moral force. Frustrating because the evidence is now so compelling, yet our institutional systems still seem to struggle to respond at the scale and depth required. The principle of proportionate universalism remains powerful: action must be universal, but with intensity proportionate to need. The growing number of Marmot Places in the UK and internationally is a hopeful sign that this thinking is moving from evidence into place-based practice.
Pause for thought: If the evidence on health inequalities is so clear, what prevents systems from responding with the scale, urgency and proportionality required?
The morning keynotes also underlined the breadth of the agenda. Professor Nicholas Pleace brought a vital focus on homelessness, while Commissioner Christine MacMillan, Dr Josiah Kaplan and Professor Nathan Davies widened the discussion across social justice, children’s needs, food, nutrition and the wider conditions that shape health. Professor Adrian Bonner’s introduction to the discussion panels then reinforced the purpose of the conference: to bring together academic, practitioner and policy perspectives on the social determinants of health.
One of the frustrations of any good conference is that the best conversations are often happening at the same time. I was sorry not to be in Panel A, particularly with Dr Jessica Allen contributing to the discussion on health inequalities, and with food insecurity also on the agenda. I was also struck by Caroline Monkhouse Flower’s work at Feast With Us, because it connects directly with something I have seen in practice: food is rarely just about food & nutrition. Food can be a natural starting point for dignity, trust, connection and community capacity.
That resonated strongly with my previous role at The Active Wellbeing Society in Birmingham, where we encountered food precarity regularly. We found that offering food, and creating opportunities for people to eat with others, could be a simple but powerful way to build trust. From that trust, relationships could form, stories could be shared, and community capacity could begin to grow. In that sense, food can become a practical entry point into health creation and Asset-Based Community Development.
Pause for thought: What if sharing food is not just a response to basic nutritional need, but also a key first step towards trust, conversation and community capacity?
I joined Panel C, focused on health and wellbeing inequalities in the community. The discussion ranged from adverse childhood experiences and ageing, to AI and mental health, nutrition and homelessness, food security, community development and behavioural change. The range of perspectives was genuinely international, diverse and rich, and it was striking how many of the contributions, although coming from different fields, returned to questions of safety, belonging, agency and social connection.
I also presented two posters at the conference: one validating the Health Creation Index for adults and children, and another exploring the relationship between physical activity, health-creating conditions and children’s happiness. The first argued that public health measurement still focuses too heavily on disease, risk and individual behaviour, while the Health Creation Index offers a way to measure protective social, psychological and environmental conditions across People, Place and Purpose. The second showed that children’s happiness was more strongly associated with health-creating conditions than with physical activity alone, suggesting that activity works best when it takes place in contexts of safety, belonging and participation.
Pause for thought: Are we still better at measuring what harms health than what helps create it?
This led me to reflect on whether we need to complement social determinants thinking with a more explicit health creation lens. Social determinants help us understand what drives inequality. Health creation asks what conditions allow people and communities to thrive. It shifts the question, borrowing from Cormac Russell’s asset-based framing, from “what is wrong?” to “what is strong?” This is also the logic behind our recent joint paper on measuring the maturity of Asset-Based Community Development, which argues that community capacity, relationships, associations, local stories and civic life can be understood and measured as part of place-based change (Rose, Russell and Bird, 2026).
This feels especially relevant to Marmot Places. If place-based equity work is to succeed, it needs not only data on deprivation and risk, but also insight into trust, belonging, agency, safety, community capacity and the lived experience of place. These are not soft outcomes. They are part of the infrastructure of health.
A question I left with: Could Marmot Places be strengthened by measuring the conditions of trust, belonging and agency, as well as deprivation and risk?
That is why the emerging SDH Insights platform feels timely. Its stated purpose is to connect rigorous academic research with grounded community health interventions, while supporting blogs, uploads, resources, networking and shared learning. If developed well, it could become more than a repository. It could become a space for story-building: helping researchers, practitioners, communities and policymakers connect evidence with lived experience.
The challenge now is not simply to describe inequality better. It is to build the relationships, narratives and measures that help places create health. Marmot gives us the frame. Health creation may help us work out what needs to be built, strengthened and measured if that ambition is to become real in people’s lives.
Reference:
Rose, S., Russell, C. and Bird, W. (2026). Measuring the Maturity of Asset-Based Community Development: Findings and Implications Applied in a Community Walking Programme. Baltic Journal of Sport and Health Sciences. https://doi.org/10.33607/bjshs.v2i139.2136
Steve Rose – Mini bio
Steve Rose is a strategic insight and data science leader with extensive experience across local government, public health, community development, behaviour change and social impact. He specialises in turning complex data, research and evidence into practical insight that supports better strategy, service improvement and population outcomes. His work combines mixed-method research, geospatial analytics, predictive modelling, evaluation and stakeholder engagement, with particular expertise in health creation, social determinants of health, physical activity and Asset-Based Community Development. Steve holds an MSc in Data Science with Distinction from Loughborough University and has published peer-reviewed research on community health, wellbeing and behaviour change.
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