Levelling up : a serious attempt to reduce regional inequalities in health?

Ralston, Rob and Smith, Kat and Hill O'Connor, Clementine and Brown, Alistair (2022) Levelling up : a serious attempt to reduce regional inequalities in health? BMJ. ISSN 0959-8138 (In Press)

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The Levelling Up white paper,[1] released in February after significant delay, outlines the UK government's much anticipated strategy for tackling regional inequality. The centrepiece of the Conservative's reform agenda, 'levelling up' is presented as a solution to the UK's long-standing, stark geographical inequalities (e.g. see Box 1). Although 'levelling up' is already permeating political and media discourse,[2] the white paper is the first UK government attempt to translate this broad idea into specific policy commitments to address place-based inequalities ('white papers' are government documents that set out proposals for future legislation). It has already been criticised for failing to provide any additional resources, in the context of a cost of living crisis,[3] and for not acknowledging that the Conservative Party has been in power, at UK level, 'for 30 of the last 43 years and is [therefore] responsible for much of the damage' described.[4] Nonetheless, it has been cautiously welcomed by combined authorities in the north of England[5] and some think tanks.[6,7] Here, we present an analysis of: (i) potential opportunities for tackling geographical health inequalities; (ii) tensions and concerns that may inhibit effective policy action; and (iii) blind spots and omissions. We conclude by arguing for a far bolder policy response to the UK’s health inequalities.