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.
|Title of host publication||The Wiley Handbook of Healthcare Treatment Engagement|
|Subtitle of host publication||Theory, Research, and Clinical Practice|
|Editors||Andrew Hadler, Stephen Sutton, Lars Osterberg|
|Publisher||John Wiley & Sons, Ltd|
|Number of pages||15|
|Publication status||Published - 31 Jan 2020|
Crawshaw, P. (2020). Governing by Risk, or Why Interventions to Improve Health Fail. In A. Hadler, S. Sutton, & L. Osterberg (Eds.), The Wiley Handbook of Healthcare Treatment Engagement: Theory, Research, and Clinical Practice (pp. 582-596). John Wiley & Sons, Ltd. https://doi.org/10.1002/9781119129530.ch31