Baillie Anna, Fergie Gillian, Mackenzie Mhairi, Skivington Kathryn
MRC/CSO Social and Public Health Science Research Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK.
College of Social Sciences, School of Social and Political Sciences, University of Glasgow, Glasgow, UK.
Evid Policy. 2025 Apr 14:1-25. doi: 10.1332/17442648Y2025D000000053.
Deepening democratic engagement in socio-economic policy domains is of increasing interest to the health inequalities research community. However, there is a recognised gap between theory and the practical application of public participation. Viewing income security as a fundamental determinant of health, this Review investigates how, when and where participatory-deliberative processes (PDPs) were applied in policymaking connected to income, in the UK, from Jan 2007-June 2022.
The Review applied the PRIMSA-ScR checklist. Searches were conducted in: EconLit, SOC Index, Sociological Abstracts, MedLine; and grey literature sources: BASE database, government, NGO websites for articles related to PDPs in income-related policymaking in the UK, published after 1 January 2007. Articles were synthesised through a conceptual framework combining Whitehead's typology of actions to tackle health inequalities and Smith's categorisation of democratic goods.
The Review found 20 articles relating to 13 PDPs. A majority of PDPs took place in Scottish Government/ Parliament or at Local Authority /NHS Trust level in England and Wales. A variety of types of PDPs were used by policymaking institutions across a range of socio-economic domains, with varying degrees of information provided about participants and policy outcomes.
Findings demonstrate a multitude of disconnects between participatory rhetoric and reality. There is no evidence of PDPs influencing macro socio-economic policymaking, with participatory decision-making instead dispersed across less empowered, downstream spaces. Democratising socio-economic policy domains requires critical reflection on the fractured nature of participatory policymaking, the locus of decision-making power and how inclusion is realised in participation spaces.
深化社会经济政策领域的民主参与日益受到健康不平等研究界的关注。然而，公众参与的理论与实际应用之间存在公认的差距。本综述将收入保障视为健康的基本决定因素，调查了2007年1月至2022年6月期间，在英国与收入相关的政策制定中，参与式审议过程（PDPs）是如何、何时以及在何处应用的。
本综述应用了PRISMA-ScR清单。检索了以下数据库：EconLit、SOC Index、Sociological Abstracts、MedLine；以及灰色文献来源：BASE数据库、政府网站、非政府组织网站，以查找2007年1月1日之后发表的、与英国收入相关政策制定中的PDPs相关的文章。通过一个概念框架对文章进行综合，该框架结合了怀特海解决健康不平等的行动类型学和史密斯对民主物品的分类。
本综述发现了20篇与13个PDPs相关的文章。大多数PDPs发生在苏格兰政府/议会，或英格兰和威尔士的地方当局/国民保健服务信托基金层面。政策制定机构在一系列社会经济领域使用了多种类型的PDPs，关于参与者和政策结果的信息提供程度各不相同。
研究结果表明，参与式的言辞与现实之间存在诸多脱节。没有证据表明PDPs影响了宏观社会经济政策制定，参与式决策反而分散在权力较小的下游空间。使社会经济政策领域民主化需要对参与式政策制定的碎片化性质、决策权的所在位置以及如何在参与空间中实现包容性进行批判性反思。
