tackling health in equalities

Topics: Policy, Health economics, Public health Pages: 28 (15011 words) Published: November 12, 2014
Health Development Agency

Tackling health inequalities:
turning policy into practice?
David J. Hunter and Amanda Killoran

i

Authors
Dr David J. Hunter, Professor of Health Policy and Management, School for Health, University of Durham Dr Amanda Killoran, Public Health Specialist, Health Development Agency

Acknowledgements
We are grateful to the authors of the papers commissioned for the seminars. We also wish to thank all the seminar participants who commented on the papers and provided valuable insights from their own experiences.

Copies of this publication are available to download from the HDA website (www.hda.nhs.uk). Health Development Agency
Holborn Gate
330 High Holborn
London
WC1V 7BA
Email:
Website:

communications@hda-online.org.uk
www.hda.nhs.uk

© Health Development Agency 2004
ISBN 1-84279-229-6

About the Health Development Agency
The Health Development Agency (www.hda.nhs.uk) is the national authority and information resource on what works to improve people’s health and reduce health inequalities in England. It gathers evidence and produces advice for policy makers, professionals and practitioners, working alongside them to get evidence into practice.

ii

Contents

Summary

1

Introduction

4

1 Policy development and implementation

6

2 The nature of public health evidence and its application

9

3 Effective approaches to regeneration and reducing health inequalities at neighbourhood level

11

4 Managing system change

18

Conclusions and recommendations

21

References

24

iii

Summary

The government is firmly committed to tackling health
inequalities and seeing its inequalities targets met. This report summarises the key issues in achieving these policy goals,
which emerged from a series of seminars organised by the
Health Development Agency (HDA). The seminars were
designed to explore how government policy gets, or does not
get, translated into practice, and to identify the factors that help or hinder implementation as well as the criteria that lead to success or failure. The seminars brought together an
invited audience of policy makers, managers and
practitioners from across the health policy field, as well as academic researchers.
National policy has a range of routes to tackling health
inequalities. The focus of the seminars was on narrowing the health gap, particularly through addressing area inequalities in health, and health disadvantages of the poor. Securing
sustainable change in health inequalities is now the priority. A set of background papers was commissioned for the
seminars. These sought to distil the lessons from existing
evidence and experience on local implementation of policies
aimed at tackling health inequalities, and to identify gaps in the evidence. This report draws on their analyses and
findings. It is in four parts, focusing on:






The process of policy development and implementation
The nature of the evidence, and how it informs policy and
practice
Effective interventions and gaps in the evidence
Managing system change.

Policy development and implementation
The ability to get policies and decisions implemented
effectively has become a key concern in the delivery of the
government’s reform programme in health. Implementing
policy and delivering improved health poses a significant
Tackling health inequalities: turning policy into practice?

challenge. The complexity and breadth of the health
inequalities agenda, at both national and local levels, are not in doubt. If progressive policies are to succeed, there needs to be a shift from hierarchical and command-and-control modes
of operating to more lateral network models. An optimal
balance between the top-down approach and bottom-up
translation is required. This is not solely a management process – politics and power are fundamental. Power imbalances and powerlessness must be addressed if the needs of...

References: Audit Commission (2002) Neighbourhood Renewal. Audit
Commission, London.
Benington, J. (1997) Risk and reciprocity: local governance
rooted within civil society
Bentley, T. (2002) Letting go: complexity, individualism and the
left
Cropper, S. (2002) What contributions might ideas of social
capital make to policy implementation for reducing health
neighbourhood change. www.hda.nhs.uk/evidence
Department of Health (1998) Independent Inquiry into
Department of Health (2001) A Research and Development
Strategy for Public Health
Department of Health (2003) Tackling Health Inequalities: A
Programme for Action
Exworthy, M., Berney, L. and Powell, M. (2002) How great
expectations in Westminster may be dashed locally: the local
Benzeval, M. and Judge, K. (1996) Access to health care in
England: continuing inequalities in the distribution of GPs.
Ferlie, E. (2002) What is known about effective approaches to
managing strategic systems change and what are the
Blamey, A., Judge, K. and Mackenzie, M. (2002) Theory-based
evaluation of complex community-based health initiatives.
experience and lessons so far. www.hda.nhs.uk/evidence
Cabinet Office (1999) Modernising Government
Cabinet Office (2001a) Strengthening Leadership in the Public
Sector
Cabinet Office (2001b) Better Policy Delivery and Design: A
Discussion Paper
Cabinet Office (2002) Social Capital: a discussion paper.
Chapman, J. (2002) System Failure: Why governments must
learn to think differently
Chinamasa, C., Edwards, R. and Heller, D. (2002) A report of
synthesis of literature on the public health role of primary care in
Coleman, J. (1988) Social capital in the creation of human
capital
Fulop, N., Allen, P., Clarke, A. and Black, N. (2001) Issues in
studying the organisation and delivery of health services
Gillam, S. and Florin, D. (2002) Reducing health inequalities:
primary care organisations and public health
Graham, H. (2002) ‘Tackling inequalities in health in England:
remedying disadvantage, narrowing gaps or reducing
Marks, L. (2002) Evidence-Based Practice in Tackling Inequalities
in Health
Continue Reading

Please join StudyMode to read the full document

You May Also Find These Documents Helpful

  • equality Essay
  • Equality: Discrimination and Health Sector Essay
  • Health Equality Essay
  • Essay about equality and diversity
  • equality diversity Essay
  • Health promotion Essay
  • equality diversity Essay
  • Essay about The Equality Act

Become a StudyMode Member

Sign Up - It's Free