IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v72y2011i12p1965-1974.html
   My bibliography  Save this article

A Qualitative Comparative Analysis of factors associated with trends in narrowing health inequalities in England

Author

Listed:
  • Blackman, Tim
  • Wistow, Jonathan
  • Byrne, David

Abstract

This study explores why progress with tackling health inequalities has varied among a group of local authority areas in England that were set targets to narrow important health outcomes compared to national averages. It focuses on premature deaths from cancers and cardiovascular disease (CVD) and whether the local authority gap for these outcomes narrowed. Survey and secondary data were used to create dichotomised conditions describing each area. For cancers, ten conditions were found to be associated with whether or not narrowing occurred: presence/absence of a working culture of individual commitment and champions; spending on cancer programmes; aspirational or comfortable/complacent organisational cultures; deprivation; crime; assessments of strategic partnership working, commissioning and the public health workforce; frequency of progress reviews; and performance rating of the local Primary Care Trust (PCT). For CVD, six conditions were associated with whether or not narrowing occurred: a PCT budget closer or further away from target; assessments of primary care services, smoking cessation services and local leadership; presence/absence of a few major programmes; and population turnover. The method of Qualitative Comparative Analysis was used to find configurations of these conditions with either the narrowing or not narrowing outcomes. Narrowing cancer gaps were associated with three configurations in which individual commitment and champions was a necessary condition, and not narrowing was associated with a group of conditions that had in common a high level of bureaucratic-type work. Narrowing CVD gaps were associated with three configurations in which a high assessment of either primary care or smoking cessation services was a necessary condition, and not narrowing was associated with two configurations that both included an absence of major programmes. The article considers substantive and theoretical arguments for these configurations being causal and as pointing to ways of improving progress with tackling health inequalities.

Suggested Citation

  • Blackman, Tim & Wistow, Jonathan & Byrne, David, 2011. "A Qualitative Comparative Analysis of factors associated with trends in narrowing health inequalities in England," Social Science & Medicine, Elsevier, vol. 72(12), pages 1965-1974, June.
    • Handle: RePEc:eee:socmed:v:72:y:2011:i:12:p:1965-1974
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953611002383
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Ragin, Charles C., 2000. "Fuzzy-Set Social Science," University of Chicago Press Economics Books, University of Chicago Press, edition 1, number 9780226702773.
    2. Rachel Parker & Lisa Bradley, 2004. "Bureaucracy or Post-Bureaucracy? Public Sector Organisations in a Changing Context," Asia Pacific Journal of Public Administration, Taylor & Francis Journals, vol. 26(2), pages 197-215, December.
    3. John Seddon & Carlton Brand, 2008. "Debate: Systems Thinking and Public Sector Performance," Public Money & Management, Taylor & Francis Journals, vol. 28(1), pages 7-9, February.
    4. Wai Lam & Elinor Ostrom, 2010. "Analyzing the dynamic complexity of development interventions: lessons from an irrigation experiment in Nepal," Policy Sciences, Springer;Society of Policy Sciences, vol. 43(1), pages 1-25, March.
    5. Islam, M. Kamrul & Gerdtham, Ulf-G. & Gullberg, Bo & Lindström, Martin & Merlo, Juan, 2008. "Social capital externalities and mortality in Sweden," Economics & Human Biology, Elsevier, vol. 6(1), pages 19-42, March.
    6. Vie, Ola Edvin, 2010. "Have post-bureaucratic changes occurred in managerial work?," European Management Journal, Elsevier, vol. 28(3), pages 182-194, June.
    7. repec:ucp:bkecon:9780226702766 is not listed on IDEAS
    8. Gatrell, Anthony C., 2005. "Complexity theory and geographies of health: a critical assessment," Social Science & Medicine, Elsevier, vol. 60(12), pages 2661-2671, June.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Brito, Thiago Luis Felipe & Moutinho dos Santos, Edmilson & Galbieri, Rodrigo & Costa, Hirdan Katarina de Medeiros, 2017. "Qualitative Comparative Analysis of cities that introduced compressed natural gas to their urban bus fleet," Renewable and Sustainable Energy Reviews, Elsevier, vol. 71(C), pages 502-508.
    2. Walton, Mat, 2014. "Applying complexity theory: A review to inform evaluation design," Evaluation and Program Planning, Elsevier, vol. 45(C), pages 119-126.
    3. J. M. Núñez-Pomar & P. Escamilla-Fajardo & V. Prado-Gascó, 0. "Relationship between entrepreneurial orientation and social performance in Spanish sports clubs. The effect of the type of funding and the level of competition," International Entrepreneurship and Management Journal, Springer, vol. 0, pages 1-19.
    4. McGill, Elizabeth & Er, Vanessa & Penney, Tarra & Egan, Matt & White, Martin & Meier, Petra & Whitehead, Margaret & Lock, Karen & Anderson de Cuevas, Rachel & Smith, Richard & Savona, Natalie & Rutter, 2021. "Evaluation of public health interventions from a complex systems perspective: A research methods review," Social Science & Medicine, Elsevier, vol. 272(C).
    5. María del Carmen Giménez‐Espert & Vicente Javier Prado‐Gascó, 2018. "The role of empathy and emotional intelligence in nurses’ communication attitudes using regression models and fuzzy‐set qualitative comparative analysis models," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(13-14), pages 2661-2672, July.
    6. J. M. Núñez-Pomar & P. Escamilla-Fajardo & V. Prado-Gascó, 2020. "Relationship between entrepreneurial orientation and social performance in Spanish sports clubs. The effect of the type of funding and the level of competition," International Entrepreneurship and Management Journal, Springer, vol. 16(3), pages 981-999, September.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Alrik Thiem, 2014. "Navigating the Complexities of Qualitative Comparative Analysis," Evaluation Review, , vol. 38(6), pages 487-513, December.
    2. Beynon, Malcolm J. & Jones, Paul & Pickernell, David, 2018. "Entrepreneurial climate and self-perceptions about entrepreneurship: a country comparison using fsQCA with dual outcomes," Journal of Business Research, Elsevier, vol. 89(C), pages 418-428.
    3. Wendy Olsen, 2019. "Bridging to Action Requires Mixed Methods, Not Only Randomised Control Trials," The European Journal of Development Research, Palgrave Macmillan;European Association of Development Research and Training Institutes (EADI), vol. 31(2), pages 139-162, April.
    4. Michael Baumgartner & Ruedi Epple, 2014. "A Coincidence Analysis of a Causal Chain," Sociological Methods & Research, , vol. 43(2), pages 280-312, May.
    5. Ostrom, Elinor & Basurto, Xavier, 2011. "Crafting analytical tools to study institutional change," Journal of Institutional Economics, Cambridge University Press, vol. 7(3), pages 317-343, September.
    6. Kamini Gupta & Donal Crilly & Thomas Greckhamer, 2020. "Stakeholder engagement strategies, national institutions, and firm performance: A configurational perspective," Strategic Management Journal, Wiley Blackwell, vol. 41(10), pages 1869-1900, October.
    7. Cheng, Cheng-Feng & Chang, Man-Ling & Li, Chu-Shiu, 2013. "Configural paths to successful product innovation," Journal of Business Research, Elsevier, vol. 66(12), pages 2561-2573.
    8. Markus Mayer & Markus Voeth, 2022. "Improving negotiation success in B2B sales organizations: is structured negotiation management a success factor?," Journal of Business Economics, Springer, vol. 92(2), pages 163-196, February.
    9. Mina Baliamoune-Lutz, 2004. "On the Measurement of Human Well-being: Fuzzy Set Theory and Sen's Capability Approach," WIDER Working Paper Series RP2004-16, World Institute for Development Economic Research (UNU-WIDER).
    10. Kusa, Rafał & Suder, Marcin & Duda, Joanna, 2023. "Impact of greening on performance in the hospitality industry: Moderating effect of flexibility and inter-organizational cooperation," Technological Forecasting and Social Change, Elsevier, vol. 190(C).
    11. Gary Goertz & Tony Hak & Jan Dul, 2013. "Ceilings and Floors," Sociological Methods & Research, , vol. 42(1), pages 3-40, February.
    12. Yamamura, Eiji, 2011. "Different effects of social capital on health status among residents: Evidence from modern Japan," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 40(5), pages 475-479.
    13. Skarmeas, Dionysis & Lisboa, Ana & Saridakis, Charalampos, 2016. "Export performance as a function of market learning capabilities and intrapreneurship: SEM and FsQCA findings," Journal of Business Research, Elsevier, vol. 69(11), pages 5342-5347.
    14. Arts, Bas & de Koning, Jessica, 2017. "Community Forest Management: An Assessment and Explanation of its Performance Through QCA," World Development, Elsevier, vol. 96(C), pages 315-325.
    15. Grohs, Reinhard & Raies, Karine & Koll, Oliver & Mühlbacher, Hans, 2016. "One pie, many recipes: Alternative paths to high brand strength," Journal of Business Research, Elsevier, vol. 69(6), pages 2244-2251.
    16. Jantunen, Ari & Tarkiainen, Anssi & Chari, Simos & Oghazi, Pejvak, 2018. "Dynamic capabilities, operational changes, and performance outcomes in the media industry," Journal of Business Research, Elsevier, vol. 89(C), pages 251-257.
    17. Barry Cooper & Judith Glaesser, 2016. "Analysing necessity and sufficiency with Qualitative Comparative Analysis: how do results vary as case weights change?," Quality & Quantity: International Journal of Methodology, Springer, vol. 50(1), pages 327-346, January.
    18. Gustav Lidén, 2013. "What about theory? The consequences on a widened perspective of social theory," Quality & Quantity: International Journal of Methodology, Springer, vol. 47(1), pages 213-225, January.
    19. Ayham A. M. Jaaron & Chris J. Backhouse, 2017. "Operationalising “Double-Loop” Learning in Service Organisations: A Systems Approach for Creating Knowledge," Systemic Practice and Action Research, Springer, vol. 30(4), pages 317-337, August.
    20. Wang, Huanming & Ran, Bing, 2022. "How business-related governance strategies impact paths towards the formation of global cities? An institutional embeddedness perspective," Land Use Policy, Elsevier, vol. 118(C).

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:72:y:2011:i:12:p:1965-1974. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.