Desperately seeking reductions in health inequalities: perspectives of UK researchers on past, present and future directions in health inequalities research

Following government commitments to reducing health inequalities from 1997 onwards, the UK has been recognised as a global leader in health inequalities research and policy. Yet, health inequalities have continued to widen by most measures, prompting calls for new research agendas and ‘advocacy’ to facilitate greater public support for the upstream policies that evidence suggests are required. However, there is currently no agreement as to what new research might involve or precisely what public health egalitarians ought to be advocating. This paper presents an analysis of discussions between 56 academic researchers to consider the feasibility that research-informed advocacy around particular ‘solutions’ to health inequalities may emerge in the UK. The data indicate there is a consensus that more should be been done to learn from post-1997 efforts to reduce health inequalities, and an obvious desire to provide clearer policy guidance in future. However, discussions regarding where researchers should now focus their efforts, and who researchers ought to be engaging with, reveal three distinct ways of approaching health inequalities, each of which has its own epistemological foundations. Such differences imply consensus around reducing health inequalities is unlikely to materialise. Instead, progress seems most likely if all three approaches are simultaneously enabled.