Health Inequalities and Territorial Governance in England

The Limits of Devolution and the Potential of an Integrated Approach

Abstract

The study examines the relationship between health inequalities and regional development disparities in the United Kingdom, with a particular focus on the devolution reforms in England launched after 2010 and the processes of healthcare system transformation. The substantive elements of these processes indicate that English devolution was primarily aimed at establishing new structures of regional governance based on associations of local governments and at achieving economic development goals; consequently, it had only a limited impact on the determinants of health inequalities. Relying on the relevant literature, working papers and regulations the study argues that one of the most important tools for reducing health inequalities is the coordination of regional catch-up initiatives, economic development, and health policies. The experiences of devolution in England and healthcare reforms also underscore, in a broader sense, the importance of place-based and place-sensitive development strategies, as well as the need to establish multi-level institutional coordination to facilitate their implementation.