It's not just pills and potions? Depoliticising health inequalities policy in England

Abstract

In England, health inequalities policy shifted during the Labour term (1997–2010) from initially strong commitments to tackling the ‘upstream’ social determinants of health to a technically-driven emphasis on lifestyle risk factors and healthcare access. This multi-sited study, based in and around Westminster (2006–2007), extends our understanding of how political context influences policy-making by drawing from anthropological studies of policy. Qualitative material from central government is put into conversation with theory concerning policy as zones of practices. The paper explores the bristly process through which public health, healthcare and corporate interests vied to shape the political agenda for health inequalities; the selective use of evidence by civil servants in accordance with their perceptions of what politicians conceive to be electorally palatable; the silencing of critique of the dominant narrative about evidence-based policy; and how technical aids developed a life of their own – as a result of which, health inequalities policy ended up being depoliticised.

Keywords:

• ethnography
• health inequalities
• research-policy relations

Acknowledgements

This research was supported by ESRC doctoral funding. Ethical approval was granted by the London School of Hygiene and Tropical Medicine, where the author completed her PhD. The author would like to thank Ayaz Qureshi, Barbara Harriss-White, Ruhi Saith, Proochista Ariana and the three anonymous reviewers from Anthropology and Medicine for their valuable comments on earlier drafts.

Conflict of interest: none.