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


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

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


© 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.







1 Policy development and implementation


2 The nature of public health evidence and its application


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


4 Managing system change


Conclusions and recommendations






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
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...

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