Beyond the public health/political science stalemate in health inequalities : can deliberative forums help?

Smith, Katherine E. and Macintyre, Anna and Weakley, Sarah; Fafard, Patrick and Cassola, Adele and de Leeuw, Evelyn, eds. (2022) Beyond the public health/political science stalemate in health inequalities : can deliberative forums help? In: Integrating Science and Politics for Public Health. Palgrave Studies in Public Health Policy Research . Palgrave, Cham, Switzerland, pp. 127-152. ISBN 9783030989842 (

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Recent efforts to counter the shortcomings of 'evidence-based policy' include strategies for democratising the utilisation of evidence. Deliberative forums involving a small number of lay citizens ('mini publics') are one of the most popular innovations. This chapter explores a specific type of mini-public known as 'citizens’ juries', using health inequalities in the UK as a case study. After introducing citizens' juries, this chapter reflects on earlier research by the lead author, which identified a presumption among policy actors and researchers that the British public were unsupportive of the kind of macro-level policy proposals research suggests are required to reduce health inequalities. This chapter challenges this presumption via a review of existing qualitative studies, a national representative survey and three citizens' juries. This analysis is used to reflect on the potential for citizens' juries to help overcome the apparent tensions that exist between evidence, policy and publics. This chapter concludes that deliberative spaces offer constructive discursive spaces in which it appears possible to overcome tensions between evidence, policy and publics for at least some long-standing societal challenges. However, it also acknowledges reasons to be cautious, given limited political engagement, the high resources required, and challenges around ethically representing minority groups.