Decentralising health management
Heterogenous effects on health behaviours and health outcomes
Bibliographic Data
| ID | 23309563 |
|---|---|
| Authors | Yi Wei (0000-0002-8291-1320, Manchester Academic Health Science Centre, corresponding author), Laura Anselmi (0000-0002-2499-7656, University of Manchester), Luke Munford (0000-0003-4540-6744, University of Manchester), Madeline Sutton (0000-0002-6635-2127, Monash University) |
| Year | 2026 |
| Volume | 406 |
| Pages | 119632 |
| Publication date | 2026-10-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Social Science & Medicine (JOURNAL) |
| Journal identifiers | ISSN: 0277-9536 • E-ISSN: 1873-5347 |
| Publisher | Elsevier BV (PUBLISHER) |
| DOI | 10.1016/j.socscimed.2026.119632 |
| PMID | 42520621 |
| OpenAlex | W7171077421 |
| Language | EN |
| References cited | 29 |
Many countries have implemented decentralisation reforms to address efficiency and equity concerns in health management. Most evidence on their impact focuses on average health outcomes and provides mixed results. We examine effects of administrative decentralisation of population health management on health behaviours in Greater Manchester, England, in 2016. Using data on 26,773 adult respondents to the UK Household Longitudinal Study between 2009 and 2020, we use a generalized random forests framework to examine how the effects of the decentralisation vary across individuals. We find that decentralisation was associated with reductions in smoking, alcohol misuse, and poor diet, but had no impact on physical inactivity. Individuals with higher socioeconomic status and better health and well-being before decentralisation experienced the largest beneficial impacts. Lifestyle improvements following decentralisation were unequally distributed, suggesting that more targeted interventions are needed for more disadvantaged groups.
Decentralization · Disadvantaged · Equity (law) · Health equity · Population · Psychological intervention · Public health · Socioeconomic status · Global Health Care Issues · Health disparities and outcomes · Healthcare Policy and Management
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| Citation velocity | historical |
|---|---|
| Highly cited | No |