Governing by Risk, or Why Interventions to Improve Health Fail

Paul Crawshaw

Research output: Chapter in Book/Report/Conference proceedingChapter


At the end of the second decade of the twenty‐first century, inequalities in health continue to be a pressing concern within Western nations. Despite recent emphasis on individual and behavioral approaches, policymakers have continued to recognize the importance of adopting whole systems methods for tackling the risk factors that are deleterious to health and wellbeing, with the ultimate aim of improving health and reducing inequalities. Typically implemented at a local level, initiatives work with whole communities in areas of identified need to improve health and wellbeing through provision of additional resources and programs designed to facilitate increased engagement in physical activity, promote healthy food choices, and ultimately improve the “lifestyles” of those most likely to experience poor health. These objectives are often supported by the use of models of “communication” such as social marketing. This chapter critically considers the effectiveness of whole systems approaches to improving the health of populations. The challenges of implementing complex modes of governance across multiple organizations and stakeholders and in open environments subject to diverse variables are considered. The inevitability of governance failure becomes a key focus.
Original languageEnglish
Title of host publicationThe Wiley Handbook of Healthcare Treatment Engagement
Subtitle of host publicationTheory, Research, and Clinical Practice
EditorsAndrew Hadler, Stephen Sutton, Lars Osterberg
PublisherJohn Wiley & Sons, Ltd
Number of pages15
ISBN (Electronic)9781119129530
ISBN (Print)9781119129493
Publication statusPublished - 31 Jan 2020


Dive into the research topics of 'Governing by Risk, or Why Interventions to Improve Health Fail'. Together they form a unique fingerprint.

Cite this