Research
You will find a complete range of our peer-reviewed monographs, multi-authored and edited works, including original scholarly research across the social sciences and aligned disciplines. We publish long and short form research and you can browse the Bristol University Press and Policy Press archive.
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
The book concludes with a compelling argument that reducing health inequalities is not only possible but essential. However, achieving this goal demands strong political will to implement long-term, comprehensive policies that address the social determinants of health in ways that promote equity. By reflecting on various case studies and theories about political change, the chapter explores what is necessary to cultivate the political will to tackle health disparities effectively. It emphasises the importance of motivating policymakers to adopt new approaches that prioritise equitable health outcomes for all.
Available open access digitally under CC-BY-NC-ND licence.
Health inequality has reached a crisis point. Your income or hometown can have a devastating impact on how well and how long you live. This injustice, exacerbated during the COVID-19 pandemic, continues as the cost of living rises and other sources of inequity grow. What can be done to make things better?
This book, written by the authors behind the award-winning The Unequal Pandemic, explores successful international case studies of governments reducing health inequalities – from the USA and Brazil to Germany and England – stretching over fifty years from the 1960s to the 2000s.
Essential reading for students and scholars of public health and the social sciences, and for health and social care professionals and policy makers, this book demonstrates that reducing health inequalities is possible and provides a roadmap for today’s governments to follow.
The chapter analyses the effects of the 1960s ‘Great Society’ reforms on health inequalities, and the accompanying civil rights movement. It provides a context for health and social policy before and after these reforms, which aimed to reduce disparities in medical care, civil rights, education and poverty. A significant body of research indicates that from 1966 to the mid-1970s, racial and income disparities in premature and infant mortality decreased. Although expansions in healthcare access were central to the reforms introduced in this period, the chapter argues that evidence suggests the decline in health inequalities is primarily attributed to social and welfare reforms. This included the ‘War on Poverty,’ increased social welfare investments, and the expansion of civil rights protections.
This chapter addresses health inequalities as a significant societal challenge, emphasising a consistent pattern across countries: those who are socially and economically advantaged tend to have better health outcomes than their disadvantaged counterparts. It presents the reduction of these inequalities as the ‘holy grail’ of public health, highlighting concerning evidence that health inequalities have been widening in several countries over the past decade. The chapter outlines various perspectives on the causes and definitions of health inequalities and introduces Walter Scheidel’s concept of ‘inequality levellers’. It makes the case for examining long-term, national case studies as a means of understanding how and why health inequalities reduce (and widen) over time. The chapter concludes with an overview of the book’s structure, introducing the four historical case studies of the USA, Brazil, Germany and the UK.
The chapter examines the impact on health inequalities of England’s National Health Inequalities Strategy, which was enacted between 2000 and 2010, under the ‘New Labour’ governments led by Tony Blair and Gordon Brown. The strategy aimed to reduce health inequalities by supporting families, engaging people living in disadvantaged neighbourhoods, enhancing preventive health services, improving access to healthcare, and tackling some of the underlying social determinants of health. The chapter outlines the health and social policy landscape before and after these reforms, highlighting research that shows that these reforms led to reductions in health inequalities between the most deprived areas in England and the rest of the country.
This chapter examines Brazil’s transition to democracy from 1985 onwards, and its impact on population health and health inequalities. It starts by describing life under mid-century military dictatorship, which contributed to Brazil’s extreme inequality. The 1988 constitution and subsequent reforms increased political participation, particularly among lower-income, indigenous, and Afro-Brazilian groups. The new government expanded health and welfare programs, using cash transfers and employment policies to alleviate poverty and to help reduce the country’s massive inequalities in wealth. Brazil became a significant global health policy leader, advocating for affordable pharmaceuticals and supporting international tobacco control efforts. The chapter presents evidence that these reforms led to substantial reductions in poverty and inequality, resulting in improved health outcomes, such as lower infant mortality rates, and helped decrease health disparities.
This chapter reflects on the four country-level case studies included in the book to identify four common levelling mechanisms for reducing health inequalities that are evident across time and space during periods of ‘waxing’ health equity: welfare state expansion, improved healthcare access, reduced income inequality and enhanced democratic participation. It contrasts these mechanisms with the adverse effects observed during ‘waning’ periods of declining health equity, characterised by weakened social safety nets, rising social and economic inequalities, healthcare access challenges, high poverty levels, political alienation and diminished labour rights. The chapter highlights how these contrasting situations impact health inequalities over time, across contexts, emphasising the importance of maintaining robust welfare systems to support equitable health outcomes.
This chapter examines the impact of the fall of communism and the reunification of East and West Germany on health inequalities, starting in 1990. It outlines the health, social policy, and inequality contexts before and after these reforms. Reunification led to significant improvements in the East, including better living standards, wages, nutrition, pensions and healthcare services. The chapter summarises research examining the effects of these changes on regional health disparities. Initially, in 1990, the life expectancy gap between East and West Germany was nearly three years for women and three and a half years for men. By 2010, this gap had narrowed to just a few months for women and one year for men, reflecting the positive health impacts of enhanced living conditions, integration into a comprehensive welfare state, and democratic reforms.
Chapter 7 examines the way in which the Premenstrual Syndrome (PMS) study participants appeared limited in their ability to describe healthy (pre)menstrual physiology. The first part discusses the patients’ lack of knowledge regarding the menstrual cycle. The second part examines the way in which the experts tended to reduce the menstrual cycle to hormonal changes only. It is argued that this reduction may contribute to the group’s tendency to conflate symptom correlation with ‘hormonal’ causation and to position contradictory data as due to the ‘mysterious’ female reproductive system, rather than alternative physiological explanations. The third part describes some other factors that further limited the expert accounts of PMS. The chapter ends with a summary of content and a ‘why this matters’ overview.
Chapter 8 makes some conclusions about the themes identified in the Premenstrual Syndrome (PMS) study data and what they mean for women’s health research and practice more widely. The first part outlines how and why the participant descriptions of PMS reflect three key societal gender myths more than the available population data. The second part summarises the wider implications of these findings and makes some suggestions for improving women’s health research and associated clinical practice. The book ends with an urgent call to action: we must improve menstrual health literacy if we are ever to alleviate female prevalent symptoms and conditions, and successfully counter the myth of the hysterical hormonal female.
