Promoting Social Change: The Experience of Health Action Zones in England
Open accessAbstract
When New Labour came to power in the UK in 1997 it brought with it a strong commitment to reducing inequality and social exclusion. One strand of its strategy involved a focus on area-based initiatives to reduce the effects of persistent disadvantage. Health Action Zones (HAZs) were the first example of this type of intervention, and their focus on community-based initiatives to tackle the wider social determinants of health inequalities excited great interest both nationally and internationally. This article draws on findings from the national evaluation of the initiative. It provides an overview of the HAZ experience, and explores why many of the great expectations associated with HAZs at their launch failed to materialise. It suggests that, despite their relatively limited impact, it is best to consider that they made a good start in difficult circumstances rather than that they failed. As a result there are some important lessons to be learned about the role of complex community-based interventions in tackling seemingly intractable social problems for policy-makers, practitioners and evaluators. Social programs are complex undertakings. They are an amalgam of dreams and personalities, rooms and theories, paper clips and organisational structure, clients and activities, budgets and photocopies, and great intentions. (Weiss, 1998: 48)
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A common description was that the ToC was used to provide a framework for the evaluation.
“A common description was that the ToC was used to provide a framework for the evaluation [27, 32, 33, 48, 64, 72, 74, 78, 79, 81, 82].”
From Using theory of change to design and evaluate public health interventions: a systematic review (2015) · cites this paper as [32]
There were clear overlaps with other theory-driven evaluation approaches, in particular, realist approaches and logic models.
“However, there were clear overlaps with other theory-driven evaluation approaches, in particular, realist approaches [32, 36, 38, 56] and logic models [12, 26, 31, 52, 54, 61, 65, 66, 68, 69, 76, 82].”
From Using theory of change to design and evaluate public health interventions: a systematic review (2015) · cites this paper as [32]
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Using theory of change to design and evaluate public health interventions: a systematic review
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- Authors
- BAULD, L., JUDGE, K., BARNES, M., BENZEVAL, M., MACKENZIE, M., & SULLIVAN, H.
- Affiliations
- University of Glasgow (GB)
- University of Birmingham (GB)
- MRC/CSO Social and Public Health Sciences Unit (GB)
- University of the West of England (GB)
- Venue
- Journal of Social Policy
- Publisher
- Cambridge University Press (CUP)
- Published
- 2005-06-15
- Volume
- 34
- Issue
- 3
- Pages
- 427-445
- ISSN
- 0047-2794 (ISSN-L)
- 1469-7823
- OpenAlex
- W2120473514
- Cited by
- 106
- References
- 22
- Citations by year
- 2025: 20 · 2023: 2 · 2021: 5 · 2020: 7 · 2019: 17 · 2018: 3 · 2017: 1 · 2016: 4 · 2015: 7 · 2014: 2 · 2013: 1 · 2012: 8
- FWCI
- 11.22
- Type
- journal article
- Language
- en
- Open access
- green
- eprints.uwe.ac.uk
- Licence
- Locations
- Journal of Social Policy (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion)
- UWE Research Repository (UWE Bristol) (submittedVersion, cc-by)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
- University of Brighton Repository (University of Brighton) (submittedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Community Health and Development
- Social Sciences › Decision Sciences › Management Science and Operations Research › Evaluation and Performance Assessment
- Social Sciences › Health › Public Health and Social Inequalities
- Keywords
- Health Action Zones, social determinants of health, health disparities, area-based interventions, community-based intervention, New Labour, social exclusion, social change, complex interventions, program evaluation, England
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