Framing health inequalities to tell political stories: Devolution makes the difference

Progress on health inequalities in England following the New Labour era has been undone by austerity policies, COVID-19, and the cost-of-living crisis. Meanwhile, New Labour’s devolution agenda, which led to the creation of Scottish, Welsh and Northern Irish legislatures, has been followed by a longer-term focus on city-regional devolution. These devolutionary processes have provided opportunities for political actors to compare newly empowered places in various ways. By analysing policy texts and policymaker interview data from Greater Manchester Combined Authority (GMCA) and the Scottish Government (SG), this paper explores the intersection between place-based health inequalities and the place-making processes of devolution. In GMCA, health inequalities were used to emphasise difference with the nation, to ‘justify devolution’ and to make the case for further powers. Similar ‘poor us’ comparisons were prominent in Scottish policy texts shortly after devolution, but are now almost entirely absent. Instead, Scottish policy texts focus on within-Scotland inequalities: the ‘poor among us’. GMCA also appears to be moving towards this focus, suggesting a pattern of health inequality po