Thesis

How do social, economic and health policymakers consider systematic variations in population health?

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Awarding institution
  • University of Strathclyde
Date of award
  • 2025
Thesis identifier
  • T17368
Person Identifier (Local)
  • 202080425
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Qualification Name
Department, School or Faculty
Abstract
  • Systematic and unfair variations in population health have increased in the UK over the last decade, due to factors such as economic austerity, Covid-19 and inflation. Policy approaches to reduce such health inequalities have long faced significant challenges, including the tendency for policy to drift towards individual-level solutions, and difficulties collaborating for ‘Health in All Policies’. Research tends to focus on health policy approaches, but inequalities in health are largely shaped by inequalities in social and economic determinants. Therefore, this thesis explores social, economic and health policy approaches to health inequality. It uses two methods: firstly, a frame analysis (a deductive analysis of text according to five categories constituting a ‘policy frame’) of thirty policy strategy documents; then, semi-structured interviews with thirty-three policy actors. Texts and participants were selected from two devolved sub-state polities: Greater Manchester Combined Authority (GMCA) and the Scottish Government (SG). Documentary analysis and interviews found that health inequalities were framed instrumentally in policy texts by GMCA as part of political dialogue with national government concerning devolution. Further, three ‘health inequality’ policy frames were identified as existing across the devolved policy settings; two of which were achieving high levels of political prioritisation. Social and economic policy actors often used ‘health’ as shorthand for illness, or for health policy. This latter use surfaced tensions between policy teams that were likely to inhibit collaboration. In contrast, the term ‘wellbeing’ was widely supported as aligning closer to the social model of health than ‘health’, and because it was unaffiliated with any specific policy team. These findings imply a need for further research on how and where the term ‘health’ may have counter-productive policy impacts; and whether alternative conceptualisations may facilitate more effective policy approaches to population health.
Advisor / supervisor
  • Fergie, Gillian
  • Hill-O'Connor, Clementine
  • Garnham, Lisa M.
  • Macintyre, Anna
  • Smith, Katherine E.
Resource Type
DOI
Date Created
  • 2024

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