Table 2.

Round 1 key item generation from Workshops 1 and 2, and Round 1 Delphi Survey

Key questions: 1.What are the top three health inequalities issues in the north? 2. What are the top three health inequalities issues in your local area? 3. What evidence gaps are there that need filling?
Overarching themes	Linked issues	Evidence gaps
Infrastructure	Roads Poor transport links Access/affordability	Value of joined up, inter-sectoral approaches—PH and voluntary sector Asset-based interventions rather than deficit or mitigation approaches Developing and evaluating proportionate universalism interventions Impact of devolution
Poverty/deprivation	Low wages Working poor Welfare cuts Food Banks Shame/Stigma Gambling and Debt	Effectiveness of new financial models/policies Economic evaluation of inequality reduction interventions—cost-effectiveness, wtp, E-B allocation, impact of cuts
(Un)Employment	Paucity of jobs Educational requirements	Identifying specific links between decision-making about jobs, economy and health outcomes
Education	Early years School readiness Lack of good quality teachers
Housing and planning	Unhealthy/unfit housing Lack of affordable homes Lack of Accessible homes Homelessness
Environment	Rural Isolation Access to green space ‘Broken windows’	Effectiveness of local actions, community control, community-led (priorities for action) Barriers/facilitators to community engagement/participation
Substance misuse/smoking	Alcohol Legal highs and illicit drug use Smoking	Interventions to address new/emerging health challenges
Chronic illness	Aging population in The North CVD, Respiratory Co-morbidity
Obesity/childhood obesity	Diet/affordability of and access to (healthy) food Educational impact on health Physical activity
Early years	Education Early interventions Access to healthy foods Breastfeeding	Effectiveness of family based interventions at reducing health/social inequalities
Mortality/life expectancy	Higher rates of chronic illness (e.g CVD, respiratory Unhealthy behaviours (e.g smoking, substance misuse)) Pockets of high socio-economic deprivation	Interventions to achieve healthy life expectancy—longer term effects of interventions
Mental health	Access to services Impact of poverty / deprivation	Effectiveness of targeted mental health prevention
Social isolation	From wider society Within ‘communities’, rural settings Aging population	Interventions to reduce loneliness, isolation, social exclusion How best to support/enable key groups—long term: conditions, disabilities, unemployed, NEETS
Disability	Higher rates in the North Loss of services/implications of austerity/welfare cuts Access
Poverty/Absence of aspiration	Learned help/hopelessness Lack of opportunities Nihilism and apathy Disconnected Youth Stigma Shame
Opportunity	Lack of opportunities Lack of assistance in accessing opportunities Resource drain—mass exodus of talent pool
Health lit. (and education)	Low health literacy Educational impact on health Low understanding of the healthcare system	How best to get evidence into practice (implementation)—key groups, current constrained environ
(Sub)culture/embedded behaviours	Unhealthy learned behaviours Socio-cultural reinforcement of problematic behaviours Unhealthy/fatalistic coping behaviours	Critical appraisal of Public Health research—re-balance structural drivers and lifestyle (drift) work

What is the key role of PH researchers in helping local policymakers and practitioners?* (Only asked in online survey Round 1)

Presenting/disseminating evidence—what works (intervention effectiveness and evidence syntheses) Generating high quality evidence of effectiveness (and implementation effectiveness) Collaborating to promote knowledge translation, knowledge exchange Working more closely with decision-makers, HWBs, local groups to understand local issues Working rapidly to provide timely evidence—even if this requires reducing methodological purity Collaborating to co-produce evidence (relevant, local) and owned by all parties Providing training/learning opportunities so policymakers have better skills to understand evidence Building multi-sector teams to help produce joined up evidence generation/interpretation Producing ‘how to guides’ so that local practitioners can generate evidence themselves Developing a handbook for local elected members on ‘their role’ in tackling inequalities Developing new methods, e.g. so social value can be measured as well as health outcomes Working at a higher scale, i.e. natural experiments and system changes Lobbying for effective change—based on their knowledge of current evidence of what works Developing (jointly funded) embedded researchers (conversely academic homes/bases for others) Conducting pragmatic, real world research work—focused on the North (i.e. not UK, international) Carrying out more health economics research—return on investment approach Becoming local community advocates rather than bystanders/observers