Regional devolution and health inequalities
- The Centre for Local Economic Strategies, in collaboration with The King’s Fund, led this research project.
- Funding of £200,000 was provided to the Centre for Local Economic Strategies to undertake research from October 2023 to April 2026.
This project built knowledge and insights into how regional devolution can improve health and health equity. It has explored how key powers devolved to strategic authorities – including in areas like like transport, housing, planning, and the economy – can be leveraged to achieve best outcomes for the health of populations.
The research consisted of interviews, roundtables and workshops with mayors, strategic and local authority officers and NHS staff, as well as academics and other policy experts, culminating in a set of briefings:
- Tackling health inequalities through English devolution: towards a new framework
- A new health duty for Strategic Authorities: getting it right
- Addressing health inequalities through employment: challenges and opportunities for strategic authorities
- Affordable infrastructure: how strategic authorities can use housing and public transport to tackle health inequalities
- Local growth plans and the building blocks of health
- Integrated care systems and strategic authorities: Coming together to tackle health inequalities and the wider determinants of health
In May 2026, the final report was published, bringing together a set of actions that Strategic Authorities should take to achieve realistic progress:
Strategic authorities and health inequalities: 10 actions for realistic progress
Many levers for shaping the wider determinants of health – for example employment opportunities, transport and planning – are held at a regional level. With the English Devolution and Community Empowerment Bill, the creation of new Strategic Authorities across the country, and a new health duty, this project explored how to maximise the role of Strategic Authorities. In particular, it focused on the important role they hold to improve population health through raising incomes. The final essay makes several recommendations for Strategic Authorities, particularly newer ones, to utilise their powers on employment, housing and transport with the aim of influencing incomes and therefore health outcomes.
This work forms a part of our wider devolution and health programme of work. Separately, our Mayoral Regions programme is working with Strategic Authorities directly to make the most of the levers they have to improve health.