The impact of New Labour’s English health inequalities strategy on geographical inequalities in infant mortality: a time-trend analysis
Open accessAbstract
Background: The English health inequalities strategy (1999–2010) aimed to reduce health inequalities between the most deprived local authorities and the rest of England. The multifaceted strategy included increased investment in healthcare, the early years, education and neighbourhood renewal. The objective of this study was to investigate whether the strategy was associated with a reduction in geographical inequalities in the infant mortality rate (IMR). Methods: We used segmented regression analysis to measure inequalities in the IMR between the most deprived local authorities and the rest of England before, during and after the health inequalities strategy period. Results: Before the strategy was implemented (1983–1998), absolute inequalities in the IMR increased between the most deprived local authorities and the rest of England at a rate of 0.034 annually (95% CI 0.001 to 0.067). Once the strategy had been implemented (1999–2010), absolute inequalities decreased at a rate of −0.116 annually (95% CI −0.178 to −0.053). After the strategy period ended (2011–2017), absolute inequalities increased at a rate of 0.042 annually (95% CI −0.042 to 0.125). Relative inequalities also marginally decreased during the strategy period. Conclusion: The English health inequalities strategy period was associated with a decline in geographical inequalities in the IMR. This research adds to the evidence base suggesting that the English health inequalities strategy was at least partially effective in reducing health inequalities, and that current austerity policies may undermine these gains.
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- Authors
- Robinson, T., Brown, H., Norman, P. D., Fraser, L. K., Barr, B., & Bambra, C.
- Affiliations
- Newcastle University (GB)
- University of Leeds (GB)
- University of York (GB)
- University of Liverpool (GB)
- Corresponding author
- Bambra, Clare
- Venue
- Journal of Epidemiology and Community Health
- Publisher
- BMJ
- Published
- 2019-03-19
- Volume
- 73
- Issue
- 6
- Pages
- 564-568
- ISSN
- 0141-7681 (ISSN-L)
- 0143-005X
- 1470-2738
- OpenAlex
- W2924492801
- Cited by
- 69
- References
- 25
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 9 · 2023: 5 · 2022: 10 · 2021: 19 · 2020: 11 · 2019: 4
- FWCI
- 10.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Epidemiology & Community Health (publishedVersion)
- PubMed (publishedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- FUSE, the Centre for Translational Research in Public Health (MR/K02325X/1)
- The Leverhulme Trust (RL-2012-006)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Social Sciences › Health › Public Health and Social Inequalities
- Keywords
- infant mortality, socioeconomic deprivation, health policy evaluation, austerity, England
- MeSH terms
- Delivery of Health Care, England, Female, Geography, Health Policy, Humans, Infant, Infant Mortality, Male, Poverty Areas, Residence Characteristics, Socioeconomic Factors, State Medicine, Resource Allocation, Health Status Disparities, Healthcare Disparities
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