Do Social Policies and Political Context Matter for Health in the United Kingdom?

Abstract

This U.K. case study combines lessons from historical assessments with new empirical analyses of trends over the last decade to inform an appraisal of the impact of social actions on health. The empirical analyses examine life expectancy in the 354 local government councils in England by first identifying those that have better or worse health than expected from their socioeconomic profile, and then selecting paired sets of “overachievers” and “underachievers” for more in-depth analysis. The findings taken as a whole provide evidence that social policies and political context do indeed matter for health. The historical material from the first industrial revolution, in particular, provides some of the most compelling evidence for this proposition. The empirical analyses over the last decade found a very powerful inverse association: the more deprived the local council, the lower the life expectancy of the population within that locality. However, even for the same level of deprivation and socioeconomic characteristics, some councils were doing much better than others in terms of health: for example, more than three years difference in life expectancy for carefully matched “urban fringe” councils. The article then examines the councils' political makeup and hence their likely policy perspective.