You will find a complete range of our monographs, muti-authored and edited works including peer-reviewed, original scholarly research across the social sciences and aligned disciplines. We publish long and short form research and you can browse the complete Bristol University Press and Policy Press archive of over 1400 titles.

Policy Press also publishes policy reviews and polemic work which aim to challenge policy and practice in certain fields. These books have a practitioner in mind and are practical, accessible in style, as well as being academically sound and referenced.

Books: Research

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This chapter examines the regional impact of the COVID-19 economic crisis. Through analysing ONS data it examines regional trends in furlough rates, unemployment rates, and wage levels. The chapter shows that the negative economic impacts of the pandemic were higher in the North. Productivity costs to the UK economy from higher COVID-19 mortality (Chapter Two), mental health morbidity (Chapter Three) are calculated and it is found that the North was disproportionately affected. The chapter also explores the differing levels of COVID-19 restrictions and finds harsher lockdown restrictions were experienced in the North.

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This chapter concludes by reflecting on what can be done to reduce health inequalities. Drawing on international case studies of when inequalities in health have been reduced, this chapter outlines what public policy response is needed now to reduce regional health inequalities so that they do not increase for future generations and in any future pandemics.

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This chapter describes the pre-pandemic context of inequalities in health and wealth in England. It provides a brief historical overview of the North–South regional health and economic divide. This chapter also introduces the reader to the core concepts and theories which underpin the rest of the book including: the deprivation amplification thesis, intersectionality, and the syndemic pandemic concept. It discusses common approaches in the field of health geography to understanding place-based health inequalities, including: compositional, contextual, relational and political economy approaches. It concludes by providing a summary for each of the following chapters of the book.

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COVID-19 and Regional Inequalities in Health and Wealth

EPDF and EPUB available Open Access under CC-BY-NC-ND licence.

Whilst the COVID-19 pandemic affected all parts of the country, it did not do so equally. Northern England was hit the hardest, exposing more than ever the extent of regional inequalities in health and wealth.

Using original data analysis from a wide range of sources, this book demonstrates how COVID-19 has impacted the country unequally in terms of mortality, mental health and the economy.

The book provides a striking empirical overview of the impact of the pandemic on regional inequalities and explores why the North fared worse.

It sets out what needs to be learnt from the pandemic to prevent regional inequality growing and to reduce inequalities in health and wealth in the future.

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This chapter examines regional trends and inequalities in the ‘parallel pandemics’ of mental health, hospital pressure, and long COVID. Using mental health survey data, NHS prescribing data, NHS hospital data, and official estimates of long COVID prevalence, the chapter shows that these three parallel pandemics have been regionally unequal with worse outcomes in the North. In addition, the analyses reveal stark intersectional inequalities in self-reported mental health by ethnicity and gender in the North.

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This discussion chapter places the results from the empirical analyses in Chapters Two–Four within the wider conceptual and empirical context. It sets out how the regional inequalities in health and wealth that have been identified during the pandemic reflect longer-term health divides across the country. Drawing on the conceptual material outlined in the introductory chapter, this chapter reflects on how, through the concepts of the syndemic pandemic, intersectionality and of deprivation amplification, COVID-19 had such an unequal regional impact.

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This chapter presents original analyses of regional inequalities in COVID-19 mortality in the first year (pre-vaccine) of the pandemic. Using mortality data and a conceptual model to guide the analyses, this chapter demonstrates that COVID-19 deaths were higher in the North of England. It also demonstrates that this higher mortality in the North was not just a case of higher levels of area-level deprivation, but a case of deprivation amplification.

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The CTOC contends that the effectiveness of services and interventions is determined not by the efficiency of internal processes, but by how effectively public service systems can engage with the innate complexity of outcomes. In this chapter we transpose the challenges posed by complexity into design parameters for public service reform. We draw from Teece et al’s (1997) theory of dynamic capabilities to articulate three core capabilities we consider necessary in tackling complex outcomes: stewardship, coordination, and adaptation. We argue that investment in and management of these three capabilities in consort could inform an alternative logic of outcome-focussed service reform.

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Writing more than two decades ago, Smyth and Dow (1998, p 291) wrote that ‘outcomes appear to have become part of a naturalised and largely uncontested discourse’, which has ‘rendered others irrelevant’. Recently however, public management scholarship has begun to engage seriously with the measurement and management of social outcomes as a theoretical and conceptual matter. A viable and compelling alternative conception to the RTOC has since developed within public health, social epidemiology, and health geography scholarship, positioning outcomes not as products of service production chains but as the emergent properties of complex systems. We expand on this model in a public administration context to construct an alternative model, the CTOC.

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ePDF and ePUB available Open Access under CC-BY-NC-ND licence.

How can public services and social interventions create and sustain good outcomes for the populations they serve?

Building on research in public health, social epidemiology and the social determinants of health, this book presents complexity theory as an alternative basis for an outcome-oriented public management praxis. It takes a critical approach towards New Public Management and provides new conceptual inroads for reappraising public management in theory and practice. It advances two practical approaches: Human Learning Systems (a model for public service reform) and Learning Partnerships (a model for research and academic engagement in complex settings).

With up-to-date and extensive discussions on public service reform, this book provides practical and action-oriented guidance for a radical change of course in management and governance.

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