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

Author:

Lee C1ORCID,Buswell M2,Coker J2,Buckner S2,Cowan A2ORCID,Lhussier M3

Affiliation:

1. Cambridge Public Health, Interdisciplinary Research Centre, Department of Engineering, University of Cambridge, and Cambridge Institute for Sustainability Leadership, Trumpington Street, Cambridge, CB2 1PZ, UK

2. Cambridge Public Health, Interdisciplinary Research Centre, University of Cambridge, Cambridge, UK

3. Director, Centre for Health and Social Equity (CHASE), Northumbria University, Newcastle upon Tyne, UK

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.

Funder

School for Public Health Research

Publisher

SAGE Publications

Reference38 articles.

1. Hastings A, Bailey N, Bramley G, et al The cost of the cuts: the impact on local government and poorer communities. Report, Joseph Rowntree Foundation, York, 10 March 2015.

2. British Medical Association (BMA). Feeling the squeeze – the local impact of cuts to public health budgets in England. Report, BMA, London, 14 March 2018.

3. Glasgow Centre for Population Health (GCPH). Asset based approaches for health improvement: redressing the balance. Concepts paper series 9, Report, GCPH, Glasgow, October 2011.

4. McKnight JL, Kretzmann JP. Mapping community capacity. Report, Center for Urban Affairs and Policy Research, Northwestern University, Evanston, IL, 1990.

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