Blog: Are co-ops a public health intervention that we’ve been missing?
Posted on Wednesday 25 March 2026
Walk into many a supermarket and you’re participating in a system that tends to concentrate wealth at the top, pay lower wages at the bottom, and leave many struggling to afford the basics. The public health consequences are plain to see: diet-related disease, mental health crises, and communities fractured by inequality.
But in pockets across the UK, something different is happening. Food co-operatives - enterprises owned and run democratically by workers in our communities - are quietly demonstrating that another way is possible: that we can build a good society, together.
What our research shows
Our new research, supported by The York Policy Engine, reveals that food co-ops aren’t just nice alternatives; they’re actively creating conditions for better health and in ways that our current economy systematically undermines.
We’ve identified three types of co-ops, that are all doing something important for health: distributing power so people are in more control of their lives. As the Ottawa Charter of Health Promotion, which was written 50 years ago this year, reminds us, this is what health is all about: it is the power to live a life we value.
Established worker co-ops - think ethical food wholesalers that have been around for decades (Suma, Essential Trading, Highland Wholefoods, Infinity Foods, GreenCity Wholefoods and more) - pay everyone the same hourly wage whether you’re in the warehouse or managing the finances or HR. Workers vote on everything from annual leave to climate policies. The result? Well paid jobs with job security.
Smaller, newer worker co-ops are using approaches like food-growing to deliver mental health support, build social connection and help strengthen ties in marginalised communities - all while giving workers meaningful control over their working lives.
Community organising co-ops - some of which have endured remarkable changes in urban neighbourhoods over the last 30 years - bring people together to bulk-buy food and save money. Yet they do something more profound: they grow solidarity. As an organiser Aisha* put it:
“you’ll have in the same room, the slightly bigoted neighbour and the migrant mum and they have a common interest and they actually now speak to each other… and our community is stronger for that” (April, 2024).
Why does this matter for public health?
We’re used to thinking about health interventions as clinical - GP appointments, prescriptions, counseling sessions. These are about addressing specific medical issues.
But health, preventing medical problems and having the power to live a life you value, fundamentally depends on the control we have over our living conditions: decent income, meaningful work, social connection, a sense that our voice actually matters.
We’ve found that food co-ops can create these conditions systematically, through:
- Economic security: equal wages and job security, or income savings through collective buying
- Agency: a real say in decisions at work and in the food system (i.e. what is bought, sold)
- Status and recognition: your contribution matters regardless of your role in a co-op
- Build social connection and shared purpose: critical for mental wellbeing
- Address environmental concerns: through daily practices and collective decisions
Amongst others, we spoke to Dan and Alicia, members of a smaller, newer co-op, who explained how having control over what you did and how you spent time at work positively impacted their mental wellbeing.
This kind of control is not just a nice to have ‘perk’, it’s a fundamental health determinant that our current economy tends to systematically deny too many people.
The Catch
But there is a problem. While co-ops can work well for their members, they’re often operating in relative isolation. They are "pockets of possibility” struggling against a system designed for hierarchy and extraction, not democracy and solidarity.
Our research reveals a number of constraints:
- Financial precarity: smaller co-ops often depend on short-term grants, with workers sometimes needing second jobs to survive
- Policy neglect: co-operative development infrastructure that existed in the 1970s has been systematically dismantled
- Isolation: co-ops can sometimes lack the networks and mutual support systems to help each other thrive
- Compromises: even successful co-ops sometimes reproduce the inequalities they were founded to challenge - casualising some workers, relying on unpaid (often women’s) labour, which matters for health
Without broader collective mobilisation to scale them up, their full public health potential is unlikely to be realised.
What needs to happen?
The good news? The Labour manifesto pledged to double the size of the co-operative sector in the UK and there has been an evidence call on business support for co-ops. More broadly, the UN declared last year The International Year of Co-operatives. So there is momentum. But more action is needed.
National government needs to restore co-operative development infrastructure - the advice funding, legal frameworks and institutional support that has been stripped away.
Local and regional authorities should consider co-ops in their procurement strategies to maximise social value, could provide subsidised premises, and invest in building co-operative ecosystems.
A different kind of prevention
We spend billions in treating the health consequences of an economy that concentrates power and generates inequality. What if we invested more in growing institutions that predistribute power from the start?
Food co-ops can’t fully transform this situation, or solve our public health crisis. But they do show us that when people start to have control in their lives, then public health can follow.
They show us that when you design equality into the bedrock of institutions, the economy itself can become a public health intervention.
Want to learn more about the research? Contact Dr Amy Barnes amy.barnes@york.ac.uk
Want to learn more about co-ops near you? Visit the UK Federation of worker-led cooperatives
* Please note that pseudonyms are used in this blog, rather than the real names of people who took part in our research.