ArticleSocial theory & health : STH2023
What shapes local health system actors' thinking and action on social inequalities in health? A meta-ethnography.
Article in Social theory & health : STH, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Between the clinic and the community: a qualitative study of logics of action on social determinants of health in general practices serving disadvantaged communities.BMC public health · 2026Article
- Research on dementia and inequalities in care and support - a map of the terrain and discussion of key issues.International journal for equity in health · 2026Review
- [Working across sectors and with citizens to create a healthy living environment: what works, why, and in what context].TSG : tijdschrift voor gezondheidswetenschappen · 2026Article
- [How to select a qualitative meta-synthesis for evidence-based practice in health].Revista de salud publica (Bogota, Colombia) · 2025Review
- Understanding the challenges, opportunities, and drivers to addressing health inequalities within local health systems: the UNFAIR case study qualitative project.BMC health services research · 2025Article
- Re-politicizing the WHO's social determinants of health framework.Health promotion international · 2024Article
- Article
- Tapping into the power of coproduction and knowledge mobilisation: Exploration of a facilitated interactive group learning approach to support equity-sensitive decision-making in local health and care services.Health expectations : an international journal of public participation in health care and health policy · 2023Article
- Strengthening local government policies to address health inequities: perspectives from Australian local government stakeholders.International journal for equity in health · 2023Article
- Article
- 'It All Kind of Links Really': Young People's Perspectives on the Relationship between Socioeconomic Circumstances and Health.International journal of environmental research and public health · 2022Article
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Abstract
Local health systems are increasingly tasked to play a more central role in driving action to reduce social inequalities in health. Past experience, however, has demonstrated the challenge of reorienting health system actions towards prevention and the wider determinants of health. In this review, I use meta-ethnographic methods to synthesise findings from eleven qualitative research studies that have examined how ambitions to tackle social inequalities in health take shape within local health systems. The resulting line-of-argument illustrates how such inequalities continue to be problematised in narrow and reductionist ways to fit both with pre-existing conceptions of health, and the institutional practices which shape thinking and action. Instances of health system actors adopting a more social view of inequalities, and taking a more active role in influencing the social and structural determinants of health, were attributed to the beliefs and values of system leaders, and their ability to push-back against dominant discourses and institutional norms. This synthesised account provides an additional layer of understanding about the specific challenges experienced by health workforces when tasked to address this complex and enduring problem, and provides essential insights for understanding the success and shortcomings of future cross-sectoral efforts to tackle social inequalities in health. Supplementary Information: The online version contains supplementary material available at 10.1057/s41285-022-00176-6.
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