Health inequalities in scotland and england: the translation of ideas between research and policy

• Main Author: Smith, Katherine Elizabeth
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01-01-2008
• Subjects: Health disparities; Institutionalization; Public policy

In the decade following the 1997 election of New Labour, both the UK government and the newly-devolved Scottish Executive consistently pledged to reduce health inequalities. Concurrently, both governments emphasised the importance of employing research evidence in policymaking. In light of these commmitments, this thesis set out to explore the relationship between the mass of research on health inequalities in the UK and the policy outcomes which emerged in Scotland and England during this period. Documentary analysis of 42 major policy statements was undertaken and interviews carried out with 60 relevant individuals. Findings provide little evidence to support the notion that policies have been based in available research in either Scotland or England but do suggest research- based ideas have travelled into policy. Whilst this may seem a relatively simple distinction, it is also crucial, for once ideas become separated from the evidence on which they are based they become far more malleable entities. By focusing on these transformations, the thesis illustrates that the journeys of ideas about health inequalities have varied extensively; whilst some have demonstrated a remarkable degree of policy â stickinessâ , others appear to have faltered or splintered along the way. The thesis explores what the data reveal about the development and circulation of ideas by considering the following: the way health inequalities have been constructed as a policy problem; the way ideas about health inequalities have been developed and marketed by researchers; the impact that policy making institutions have on the circulation and translation of ideas; and the influence of actorsâ perceptions of wider political and societal contexts on their actions and interactions. Employing a Weberian theoretical framework, the thesis goes on to explain the differing journeys of research based ideas by focusing on three very distinct ideational genres: (i) institutionalised ideas; (ii) charismatic (transformative) ideas; and (iii) vehicular (chameleon-like) ideas Both interview and documentary data suggest that, for health inequalities in the UK, some ideas have become so extensively institutionalised that the imaginative (intellectual) space from which charismatic ideas might have been expected to emerge has been increasingly squeezed. Hence, in the decade following 1997, the ideas which moved successfully from research into policy were either those which posed no challenge to institutionalised ideas or those with the metamorphic qualities of vehicular ideas.