Levelling Up can’t address inequalities without addressing the causes of poor health. New research sets out policy recommendations.

The UK government’s levelling up agenda is set to fall short in its mission to address inequalities unless it tackles the root causes of poor health, according to new research published in Contemporary Social Science.

The research, led by the University of Bristol and University of Bath, used data from interviews with 132 key government and industry professionals to assess what needs to happen in central, regional and local government if the 12 ‘missions’ published in the Levelling Up White Paper are to achieve a better quality of urban living to improve public health.

The study is part of TRUUD, a transdisciplinary research project led by the University of Bristol, which aims to reduce non-communicable disease (such as cancers, diabetes, obesity, mental ill-health and respiratory illness) and health inequalities linked to the quality of urban planning and development.

Using seven principles that could underpin a successful ‘levelling up’ strategy for healthy urban developments, researchers recommend how the Government might address the wider determinants of health in the implementation of its ambitions.

These include establishing a cross-government commitment for health, led by the Prime Minister’s office, further local devolution of powers, simplified means of funding and increased use of evidence from local communities and health sources for decision-making.

University of Bristol Professor of Public Policy and Governance Sarah Ayres said:

“Preventing poor health through tackling the wider determinants is critical to ‘level up’ the country but this requires a change in current funding, increased local powers and greater attention to local voices alongside health evidence.

“We know, from our large-scale, qualitative and transdisciplinary dataset alongside a review of the literature on health and the urban environment, that ambitions to reduce inequalities and improve life-expectancy are unlikely to be met. Our recommendations give seven clear actions to help achieve better health outcomes through better quality of urban developments.”

The seven recommendations are:

• Articulate a clear commitment to health prevention and tackling the wider determinants of health
• Health prevention must be designed as a cross-cutting agenda in Whitehall with clear accountability for delivery
• Engaging with local actors, including members of the public, is critical to understanding local health needs
• Local government needs policy autonomy to adopt a systems approach to addressing health inequalities
• Greater flexibility in local government funding is required to enable the integration of health with other policy areas
• Place sensitive approaches are essential for places that suffer the worst health outcomes
• Local health data needs to be used more effectively in urban development to highlight local health priorities

Programme Director for TRUUD, Daniel Black added:

“TRUUD is testing interventions across multiple parts of the urban development system. Though change takes place in fast growing cities, national level engagement is critical given how centralised we are in the UK and the central role of the private sector. Evidence supporting these fundamental messages – such as health prevention being a pan-Governmental issue – are vital if we are to tackle these root cause issues upstream.”

ENDS

Notes for Editors

1. What needs to happen to ‘level up’ public health? was published in Contemporary Social Science by Sarah Ayres, Andrew Barnfield, Geoff Bates, Anna Le Gouais and Nick Pearce.
2. Tackling Root causes upstream of Unhealthy Urban Development (TRUUD) is a research project, based at the University of Bristol, looking at how urban centres can be planned to reduce health inequalities. It brings together experts from academia, industry and government to recommend and create new tools and processes for healthier cities. The project counts the cost of poor health, works with communities to communicate the issues they face and maps out the decision-making process in creating urban centres and includes two active case-studies in Bristol and Manchester. TRUUD is funded by the UK Prevention Research Partnership (UKPRP).