The contextual development of healthy living centres services: an examination of food-related initiatives.

The Healthy Living Centre (HLC) programme was designed to address the wider determinants of health, in particular social exclusion and socio-economic disadvantage, through targeting services at the most deprived local communities. This paper draws on data collected during an in-depth process evaluation of six Scottish HLC case study sites. Food-related services, which were found to cross-cut all the sites, were used to address social exclusion and to promote health. Three types of service, each linked to a social model of health, were found to be in operation: those which enhance skills; those which promote social inclusion; and those which influence food accessibility. The paper illustrates how food-related services have developed in the case study HLCs to take account of the differing needs of the communities and neighbourhoods that have been targeted. Consideration is then given to how HLCs adapt to meet the practicalities of improving health while addressing social exclusion through targeting health inequalities.