Pharmacies have a valuable role at the heart of local communities suggest Nelly Araujo and Florence Gildea of the Royal Society of Public Health (RSPH).
In England, 90% of people live within a 20-minute walk of a community pharmacy, making them among the most commonly found community assets in the country and the closest health and wellbeing hubs for people to access primary health care and support. As such, they can play an important role in supporting the community spirit of a local area, which not only helps the pharmacy work more effectively, but can also in and of itself support the health and wellbeing of local residents.
What is community spirit and why is important?
As part of our Community Spirit programme, in partnership with Locality and six community organisations, we developed a working definition of community spirit as: ‘The feelings of connection and belonging to a community and our ability to come together to improve wellbeing for everybody.’
In our view, there are four central characteristics to community spirit – sense of belonging, collective action, cohesion and quality of relationships – and community pharmacies are well-positioned to develop each of these.
Being part of a strong community can provide all sorts of health and wellbeing benefits. For one, we know that loneliness is connected to depression, poor sleep quality, accelerated cognitive decline, increased risk of stroke and coronary heart disease, and impaired immunity at every stage of life.Bringing residents together can also help connect people to training and employment opportunities, to health information and services, and can create a support network which may be called upon in times of need. This has been clearly demonstrated during the Covid-19 pandemic: with those shielding reliant on neighbours or mutual aid groups to deliver groceries, prescriptions and other essentials, community spirit has been pivotal to meeting the needs of the most vulnerable in our communities.
How can community pharmacies contribute to community spirit?
Quality of relationships
This aspect of community spirit refers to the feelings of connection, reciprocity and mutual support between members of the community. Community pharmacies support this by making their customers feel respected, listened to, and supported when they enter the store and seek help for health issues. These relationships can be deepened further by offering user-friendly health services out in the community or by allowing other community groups to make use of the pharmacy’s premises.
The Priory Community Pharmacy in Dudley exemplifies this, having become fully integrated within the community by working with wide range of community groups and organisations, including libraries, colleges, supermarkets, places of worship and community centres. This includes offering the pharmacy as a setting for other groups to meet or run classes. They also organise an annual health funfair for the community and a carol service in support of the local area’s community spirit.
Cohesion refers to the ability of all communities to function and grow in harmony together. It implies that individuals have the right to equality (of treatment, in access to services) and involves respect and appreciation of the diverse nature of communities. Community pharmacies can help promote cohesion through developing an understanding of the socio-demographic make-up of their local area, the respective health needs of different groups, and tailoring their services accordingly.
By identifying underserved groups within the community, pharmacies can increase their access to services and support their integration into community life. Promoting these services can, in turn, increase awareness amongst the wider community of the particular health needs or lifestyles of other residents and thereby build mutual understanding.
One example from RSPH’s Healthy Living Pharmacies programme came from pharmacies across London who supported their local Muslim population to celebrate Ramadan by offering smoking cessation services to help those who wanted to quit smoking as part of their fast.
Sense of belonging
When people see their needs and preferences reflected in the services and infrastructure of an area, it is bound to increase their sense of belonging. This may especially be the case with pharmacies as, in a YouGov survey, an overwhelming majority (91%) listed them as a feature of their ideal high street (making them one of the most desirable assets, falling just slightly below banks and post offices).
Given how much members of the public value their local pharmacy, if it is apparent that the pharmacy cares about their needs in turn, then those residents are likely to feel more embedded in their community.
Community pharmacies can make sure everyone feels an equally valued part of their local community by: ensuring information is displayed in the languages spoken within the area; supporting locally celebrated special occasions or festivities, and identifying how they can be used to promote public health messages.
Collective action refers to people coming together to tackle an issue, support others or improve the conditions of their local area. Community pharmacies can integrate efforts to build this facet of community spirit into their public health campaigns, by running them in collaboration with the community.
Rather than viewing local residents as a target audience, community pharmacists could think about ways of harnessing the energy of local groups and organisations by identifying common interests and priorities. Nurseries, schools and colleges; parents’ groups; choirs, drama group and other special interest societies; as well as local businesses, places of worship, and care homes could all be potential partners, making health promotion campaigns even more effective, and giving residents the opportunity to be engaged in social action, which brings its own wellbeing benefits.
Community pharmacies already go to great efforts to provide accessible and socially inclusive services to their local communities. But we believe there is a role for community pharmacists to support the health and wellbeing of the populations they serve not through providing clinical services, but by making the local area a resilient, welcoming and inclusive place to live. We hope our Community Spirit Level framework and toolkit provide guidance and inspiration in that work.
 NICE (2018), Community pharmacies: promoting health and wellbeing (NG102). Available online: https://www.nice.org.uk/guidance/ng102
 Hawkley, L. C., & Capitanio, J. P. (2015). Perceived social isolation, evolutionary fitness and health outcomes: a lifespan approach. Philosophical Transactions of the Royal Society B: Biological Sciences, 370(1669). doi.org/10.1098/rstb.2014.0114; Grant, N., Hamer, M., & Steptoe, A. (2009) Social isolation and stress-related cardiovascular, lipid, and cortisol responses, Annals of Behavioural Medicine, 37(1), pp.29-37; Hawkley, L.C., Thisted, C.M. and Cacioppo, J.T. (2010) Loneliness predicts increased blood pressure: 5-year cross-lagged analyses in middle-aged and older adults, Psychology and Ageing, 25(1), pp.132−141; Valtorta, N., Kanaan, M., Gilbody, S., Ronzi, S., & Hanratty, B.