Addressing health inequalities in times of austerity: implementation of a place-based approach in multitiered local government

IF 3.5 4区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Perspectives in Public Health Pub Date : 2024-04-27 DOI:10.1177/17579139241241194
C Lee, M Buswell, J Coker, S Buckner, A Cowan, M Lhussier
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Abstract

Aims:This article focuses on how local authorities in England are tackling wider determinants of health and inequalities in their population’s outcomes while budgets for public services are diminishing.Methods:It reports the experience from one case study engaged in rolling out a devolved, place- and asset-based strategy over multiple tiers of local government. Relating these findings to relevant social theory, we draw out aspects of context and mechanisms of change. We offer plausible hypotheses for the experiences observed, which supports transferability and implementation of place-based strategies in other local authority areas struggling with similar challenges.Results:Findings highlight the importance of high-level and political buy-in, as well as the role of the COVID-19 pandemic as a potential catalyst to rollout. Creating the foundations for a new, place-based working was important for achieving coherence among partners around what local government was trying to achieve. These included investment in infrastructure, both relational and tangible inputs such as organisational and human resources, to establish the conditions for systemic change towards early intervention and prevention.Conclusion:This study identified clear foundations for place-based action, plus enablers and barriers to significant transformation of practice towards asset-based approaches between local authorities, partners and the public.
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在紧缩时期解决卫生不平等问题:在多级地方政府中实施基于地方的方法
目的:本文重点关注英格兰地方政府如何在公共服务预算不断减少的情况下,解决更广泛的健康决定因素及其人口结果的不平等问题。方法:本文报告了一个案例研究的经验,该案例研究在多级地方政府中推出了一项权力下放、以地方和资产为基础的战略。我们将这些研究结果与相关的社会理论联系起来,总结出变革的背景和机制。我们为所观察到的经验提出了合理的假设,这有助于在面临类似挑战的其他地方当局地区推广和实施以地方为基础的战略。研究结果:研究结果强调了高层和政治支持的重要性,以及 COVID-19 大流行病对推广工作的潜在推动作用。为新的、以地方为基础的工作奠定基础,对于实现合作伙伴之间围绕地方政府努力实现的目标的一致性非常重要。这些包括对基础设施的投资,既包括关系投入,也包括组织和人力资源等有形投入,为实现早期干预和预防的系统性变革创造条件。
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来源期刊
Perspectives in Public Health
Perspectives in Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
4.50
自引率
1.70%
发文量
74
期刊介绍: Perspectives in Public Health is a bi-monthly peer-reviewed journal. It is practice orientated and features current topics and opinions; news and views on current health issues; case studies; book reviews; letters to the Editor; as well as updates on the Society"s work. The journal also commissions articles for themed issues and publishes original peer-reviewed articles. Perspectives in Public Health"s primary aim is to be an invaluable resource for the Society"s members, who are health-promoting professionals from many disciplines, including environmental health, health protection, health and safety, food safety and nutrition, building and engineering, primary care, academia and government.
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