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This paper draws on the experience of two Romani and three non-Romani scholars in knowledge production on the health and social inequalities experienced by European Roma populations. Together, we explore how we might better account for, and work against, the complex web of dynamic oppressions embedded within processes of academic knowledge production. Our aim is to encourage careful scrutiny through which sociologists of health and illness might better recognise our own complicity with oppression and identify concrete actions towards transforming our research practices. Drawing on a well-known domains of racism typology (Annual Review of Public Health, 40, 2019, 105), we use examples from our own work to illustrate three interconnected domains of oppression in which we have found ourselves entangled (structural, cultural and interpersonal). A new conceptual framework is proposed as an aid to understanding the spectrum of different “types” of complicity (voluntary–involuntary, conscious–unconscious) that one might reproduce across all three domains. We conclude by exploring how sociologists of health and illness might promote a more actively anti-racist research agenda, identifying and challenging subtle, hidden and embedded negative ideologies and practices as well as more obviously oppressive ones. We hope these reflections will help revitalise important conversations.

While social and spatial determinants of biomarkers have been reported, no previous study has examined both together within an intersectional perspective. We present a novel extension of quantitative intersectional analyses using cross-classified multilevel models to explore how intersectional positions and neighbourhood deprivation are associated with biomarkers, using baseline UK Biobank data (collected from 2006 to 2010). Our results suggest intersectional inequalities in biomarkers of healthy ageing are mostly established by age 40–49, but different intersections show different relationships with deprivation. Our study suggests that certain biosocial pathways are more strongly implicated in how neighbourhoods and intersectional positions affect healthy ageing than others.

The whole study aims to develop support for local authority-based public health commissioners and other stakeholders in prioritising investment in health and addressing health inequalities, and in deciding on disinvestment. In addition, it seeks to understand the issues surrounding the decision-making process. The specific research questions addressed in the overall study are: 1. Which prioritisation tools do commissioners find useful for prioritising public health investment and why? 2. What are the enablers and barriers for decision-making related to prioritising investment in public health? 3. What difference does the use of specific decision-making support exert on spending within and across programmes with reference to improving health and addressing health inequalities?

High rates of immigration in recent years in the United Kingdom presents service design and delivery challenges to primary care. At a time when resources are stretched, services must be both efficient and equitable for patients. Migrants are often healthy on arrival but some groups, such as refugees and asylum seekers, may have many healthcare needs. This study sought to explore how primary care is managing demand on its services by new migrants and how it addresses need in provision.APPROACHThe research was exploratory and formative. It looked at the services delivered in primary care organisations. The study took place between November 2015 and March 2016. Its methods were:Survey and contact form: Non-probability sampleof GPs, other health professionals, practice managers and third sector providers who hadserved new migrant populations in the last fiveyears (n=70); Responses were sifted for contact details and selected for case studies.In-depth case studies: Documentary analysis andin-depth interviews and focus groups with eightcase study primary care organisations.University of Sheffield’s School of Health and Related Research ethics committee (ref no 006009)The report was produced by the School of Health and Related Research (ScHARR) and the Academic Unit of Primary Medical Care (AUMPC), University of Sheffield. ISBN 978-0-9571207-3-0

It is now widely accepted that context matters in evaluations of the health inequalities impact of community-based social initiatives. Systems thinking offers a lens for uncovering the dynamic relationship between such initiatives and their social contexts. However, there are very few examples that show how a systems approach can be applied in practice and what kinds of evidence are produced when this happens. In this paper, we use data from ethnographic fieldwork embedded within a multi-site mixed method evaluation to demonstrate how a systems approach can be applied in practice to evaluate the early stages of an area-based empowerment initiative – Big Local (funded by the Big Lottery Fund and delivered by Local Trust). Taking place in 150 different local areas in England and underpinned by an ethos of resident-led collective action, Big Local offers an illustration of the applicability of a systems approach to better understand the change processes that emerge as social initiatives embed and co-evolve within a series of local contexts. Findings reveal which parts of the social system are likely to be changed, by what mechanisms, and with what implications. They also raise some salient considerations for knowledge generation and methods development in public health evaluation, particularly for the evaluation of social initiatives where change does not necessarily happen in linear or predictable ways. We suggest future evaluations of such initiatives require the use of more flexible designs, encompassing qualitative approaches capable of capturing the complexity of relational systems processes, alongside more traditional quantitative methods.

A national survey was carried out in autumn 2014, using Bristol Online Surveys , to collect the views of selected core members of Health and Wellbeing Boards (HWBs) across England. Invitations to complete the survey were sent to 610 members of HWBs. Overall, after repeated follow-ups, there were 47 responses received between 30th September 2014 and 1st December 2014 (a 7.7% response rate). Of the 47 respondents, 28 (58%) were senior public health professionals, eight (14%) were councillors or executive/cabinet members and six (13%) were senior CCG professionals. Given the low response rate, the results of this survey do not allow for generalisation.