Health, equity and the north of England: A case study on a new approach

Abstract

Introduction or background: In 2013, responsibility for public health returned to local government from the National Health Service (NHS) in England. This article describes, as a case study, a new fresh approach to tackling health inequalities, which built on a desire by local councils in the north of England to rethink approaches and collaborate on new ideas to improving health and reducing health inequalities. Sources of data: The collaboration was supported by an independently commissioned inquiry that assessed the evidence and proposed new policy options. This article describes the context to the collaboration, called Health Equity North, findings from the independent inquiry and emerging impact. Four areas for action were recommended: linking poverty with economic prosperity, devolution and public sector reform, investment in early years and renewed impetus for the health sector. Areas of agreement: That health service action alone had been limited without addressing the wider determinants of health such as employment, education and housing. Areas of controversy: The so-called north-south divide appears to be widening, and renewed efforts are needed locally and nationally to tackle these wider determinants of health. Growing points: This collaborative approach spanning a large geography supported by local and national leaderships, enabled new work locally and influenced policy nationally, such as devolution of power and resources to local areas. Areas timely for developing research: Research is needed on the economic returns of investing in the social determinants of health. The examples of local action indicate the need for research on 'asset-based approaches' to improving community health, presented so to empower local lay decision makers such as councillor rather than for technical experts.