From front-line defence to back‑foot retreat: the diminishment of local government’s role in social health outcomes

Abstract

This chapter investigates the diminishment of local government's role in social health outcomes. The 20th century led to radical improvements in public health across England and the United Kingdom (UK). Modern local government in the UK was born out of a growing concern about the links between social conditions and the state of public health. Yet while 'social determinants of health' has become a global discipline, local government has ceded its role over the last decade as its capacity has withered during the time of austerity. The COVID-19 crisis of 2020 has shown the capacity of local government to mobilise anew around public health issues, but its fundamental fiscal and constitutional weaknesses show that a new settlement is needed more than ever.