Health inequalities research capacity in the UK: preliminary findings from a realist explanatory case study

Abstract

BackgroundDespite growing evidence on health inequalities over four decades, global efforts to strengthen the capacities to produce research on this topic are urgently needed to inform effective policy interventions. Yet, what determines the capacity to produce health inequalities research in different social contexts? How can these capacities be strengthened? To answer these questions, an in-depth understanding of the sociohistorical and institutional processes that generate health inequalities research in different contexts is needed. A 2018 bibliometric analysis of health inequalities scientific research (1966–2015) found striking global research inequalities by countries and regions. The study found the UK to be the second highest global contributor to this research field after the USA. We aimed to understand why and how the UK has produced so much scientific research on health inequalities over the last few decades, and what potential set of determinants and mechanisms might have been involved. MethodsWe did a realist explanatory case study to iteratively identify the potential mechanisms and causal linkages to characterise the outcome of interest (ie, health inequalities research) in a specific context (ie, the UK). We used a guiding conceptual model and data triangulation through semi-structured interviews with researchers, and in-depth selective reviews of scientific and grey literature. FindingsOur preliminary findings include: identification of the process(es) and potential phases of developing health inequalities research capacities in the UK over the last few decades, and the potential key set of determinants, such as a strong tradition of public health research, availability of reliable health and sociodemographic data, motivated individuals and their values, informal networks, research funders, and varying political support over time. Informed by previous frameworks, our study presents a specific model of why and how the UK has been able to develop strong health inequalities research capacities. This model might be applicable to other contexts in which a high production of health inequalities research is found. Our full findings are expected to be available by early 2020. InterpretationValuable insights on why and how health inequalities research capacities have been developed can be derived from the UK's experience at the national, local, and global levels. More research is needed to expand and further understand these processes in other contexts, and their implications for research, policy, and practice. FundingNone.