Moving from research to policy and practice in tackling health inequalities: Lessons from the UK and Australia

Don Nutbeam, University of Sydney, Australia

Countries like Australia and the United Kingdom have publicly funded health and welfare systems offering access to health care and social benefits based on need. Although both countries have seen increased prosperity and reductions in mortality over the last 50 years, the gap in health outcomes between those at the top and bottom ends of the social scale remains large and continues to widen. Some parts of both countries have the same life expectancy as the national average for the 1950s.

The reasons for these stubborn differences in health have been closely researched, especially in the past twenty years. This research has identified differences in opportunity, in access to services, especially health care services, and in material resources, as well as differences in the lifestyle choices of individuals. Yet the transfer of this research knowledge into policy and public health practice is patchy at best.

This paper examines the reasons for this gap in the transfer of evidence on health inequalities drawing upon experience and examples from both the UK and Australia. It attempts to identify ways in which we can maximise the use of evidence in the development of policies to support public health, and the ways in which research can be managed to support public health policy development, as well as the connection between more local “intelligence” on public health, and local public health practice.

Key challenges include the need to develop public health evidence that is more overtly directed towards informing policy, and producing evidence derived from practical interventions.  Research evidence also needs to be available at the time it is needed, and improved techniques need to found for communicating and managing the uncertainties that arise through scientific research. In this more complex environment, the development of networks, and cultivation of relationships between public health practitioners and policy makers will often provide more adaptable and durable opportunities to influence the policy process.