Ayres Sarah, Barnfield Andrew, Bates Geoff, Le Gouais Anna, Pearce Nick
School for Policy Studies, University of Bristol, Bristol, UK.
Institute for Policy Research, University of Bath, Bath, UK.
Contemp Soc Sci. 2023 Jul 10;18(3-4):500-526. doi: 10.1080/21582041.2023.2232765.
The aim of this article is to examine what needs to happen in central, sub-regional and local government to 'level up' public health in the United Kingdom (UK). The Government's recent White Paper outlined ambitious targets for reducing regional disparities, including a 'mission' to tackle inequalities in healthy life expectancy and reduce inequalities in the social determinants of health outcomes. However, the approach has been criticised for failing to integrate population health policy objectives, programmes and interventions into the implementation of the levelling up agenda and its associated 'missions'. Drawing on a case study of promoting healthy urban development in the UK, we examine how the wider determinants of health might be incorporated into the Government's levelling up strategy. Based on in-depth interviews with 132 urban development actors, our findings reveal that long-term investment in healthy urban development could play a key role in levelling up public health but is not currently part of the Government's plans. We make a timely contribution to the levelling up debate by placing public health centre stage in social science debates. We conclude by offering a series of recommendations for transformative policy change to level up health.
本文旨在探讨英国中央、次区域和地方政府需要采取哪些措施来“提升”公共卫生水平。政府近期的白皮书概述了减少地区差距的宏伟目标,包括一项解决健康预期寿命不平等问题以及减少健康结果社会决定因素不平等的“使命”。然而,该方法因未能将人口健康政策目标、计划和干预措施纳入提升议程及其相关“使命”的实施过程而受到批评。基于英国促进健康城市发展的案例研究,我们研究了如何将更广泛的健康决定因素纳入政府的提升战略。通过对132名城市发展参与者的深入访谈,我们的研究结果表明,对健康城市发展的长期投资可能在提升公共卫生水平方面发挥关键作用,但目前并非政府计划的一部分。我们将公共卫生置于社会科学辩论的核心位置,为提升辩论做出了及时贡献。我们最后提出了一系列变革性政策变革建议,以提升健康水平。