Publication year: 2011
Source: Social Science & Medicine, In Press, Accepted Manuscript, Available online 13 May 2011
Tim, Blackman , Jonathan, Wistow , David, Byrne
This study explores why progress with tackling health inequalities has varied among a group of local authority areas in England that were set targets to narrow important health outcomes compared to national averages. It focuses on premature deaths from cancers and cardiovascular disease (CVD) and whether the local authority gap for these outcomes narrowed. Survey and secondary data were used to create dichotomised conditions describing each area. For cancers, ten conditions were found to be associated with whether or not narrowing occurred: presence/absence of a working culture of individual commitment and champions; spending on cancer programmes; aspirational or comfortable/complacent organisational…
Highlights: ► England’s policy of narrowing gaps in premature mortality between the national average and 70 deprived ‘Spearhead’ areas has seen variable progress. ► Narrowing of cancer gaps was associated with three configurations of conditions in which individual commitment and champions was a necessary condition. ► Not narrowing was associated with a group of conditions sharing a high level of bureaucratic-type work. ► Narrowing gaps in cardiovascular disease mortality was associated with three configurations in which a high assessment of either primary care or smoking cessation services was a necessary condition. ► Not narrowing CVD gaps was associated with two configurations that shared an absence of major programmes.