ArticleBMC health services research2025
Understanding the challenges, opportunities, and drivers to addressing health inequalities within local health systems: the UNFAIR case study qualitative project.
Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
2 citing papers in PubMed.
- Mapping ActEarly: Using a child health map to evaluate a City Collaboratory programme on early promotion of good health and wellbeing.PloS one · 2026Article
- Teaching medical trainees to see societal infrastructure as a clinical issue.Frontiers in medicine · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundDespite policy prominence and frameworks focusing on health inequalities, healthcare leaders do not feel they have the skills and knowledge to reduce health inequalities. This comparative case study explored four areas in England to understand the challenges, opportunities, and drivers of local health systems addressing health inequalities and what ‘good’ practice might look like.
methodsInterviews were held with 46 people working in health care services across the NHS, local authority or voluntary, community, social enterprise sectors. Key documents (n = ~ 10) in each of the four areas relating to reducing health inequalities were analysed using documentary analysis methods. Interviews and documents were coded and analysed independently before being integrated to synthesise findings. Analysis was conducted using a two-stage approach - firstly, an inductive analysis of emergent themes; secondly, to build knowledge on each case studys’ system approach of reduction of health inequalities, principles of the Action Scales Model were used.
resultsNineteen themes were identified across the four case studies; some themes were not apparent in all the case studies, nor in either the documentary analysis or interviews. These themes allowed us to compare between cases to explore what might be contributing to good practice. Themes identified included: understanding the local context; facilitators of how to tackle health inequalities and improve health and wellbeing; and future concerns. The secondary analysis highlighted potential levers for action from each case study; these included optimising retention and recruitment of workforce and allowing time and resources for longer-term planning. Two case study areas which appeared to have system resilience, demonstrated having a shared vision, strong partnerships, understanding of the system, and putting people and communities at the heart of decision making.
conclusionThis comparative case study makes a crucial contribution in the understanding of health systems addressing health inequalities in their local areas. The combined interview and documentary analysis findings provide rich insights of local systems’ documented strategies, plans and what is happening ‘on the ground’.
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Registered trials
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