Identifying adverse effects of area-based health policy: An ethnographic study of a deprived neighbourhood in England

Oli Williams

Research output: Contribution to journalArticlepeer-review

16 Citations (SciVal)


Health interventions commonly have adverse effects. Addressing these could significantly improve health outcomes. This paper addresses an adverse effect common in the promotion of health behaviours: exacerbation of health inequalities between low- and high-socioeconomic groups. Health behaviours – particularly, physical activity - are positioned within the context of social inequality and the inequitable spatial distribution of resources. Area-based health policy that targets deprived areas is assessed for its capacity to promote health behaviours without exacerbating inequality. Data are derived from a 16-month ethnography in a deprived English neighbourhood that was the target of area-based intervention that prioritised the promotion of physical activity. Findings provide evidence of adverse intervention effects that further disadvantaged the low-socioeconomic population. Analysis demonstrates how this was ultimately the outcome of localised policy drifting away from initial commitments to equitable service access. These findings increase understanding of the processes through which adverse intervention effects arise and how they can be mitigated.

Original languageEnglish
Pages (from-to)85-91
Number of pages7
JournalHealth & Place
Early online date17 Mar 2017
Publication statusPublished - 1 May 2017


  • Health equity
  • Health inequalities
  • Inequality paradox
  • Lifestyle drift
  • Physical activity

ASJC Scopus subject areas

  • Health(social science)
  • Geography, Planning and Development
  • Public Health, Environmental and Occupational Health


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