A substantial body of research describes the distribution, causes and potential reduction of health inequalities, yet little scholarship examines public understandings of these inequalities. Existing work is dominated by small-scale, qualitative studies of the experiences of specific communities. As a result, we know very little about what broader publics think about health inequalities; and even less about public views of potential policy responses. This is an important gap since previous research shows many researchers and policymakers believe proposals for ‘upstream’ policies are unlikely to attract sufficient public support to be viable. This mixed methods study combined a nationally representative survey with three two-day citizens' juries exploring public views of health inequalities and potential policy responses in three UK cities (Glasgow, Manchester and Liverpool) in July 2016. Comparing public opinion elicited via a survey to public reasoning generated through deliberative processes offers insight into the formation of public views. The results challenge perceptions that there is a lack of public support for upstream, macro-level policy proposals and instead demonstrate support for proposals aiming to tackle health inequalities via improvements to living and working conditions, with more limited support for proposals targeting individual behavioural change. At the same time, some macro-economic proposals, notably those involving tax increases, proved controversial among study participants and results varied markedly by data source. Our analysis suggests that this results from three intersecting factors: a resistance to ideas viewed as disempowering (which include, fundamentally, the idea that health inequalities exist); the prevalence of individualising and fatalistic discourses, which inform resistance to diverse policy proposals (but especially those that are more ‘upstream’, macro-level proposals); and a lack of trust in (local and national) government. This suggests that efforts to enhance public support for evidence-informed policy responses to health inequalities may struggle unless these broader challenges are also addressed.

Reducing health inequalities remains a challenge for policy makers across the world. Beginning from Lewin’s famous dictum that “there is nothing as practical as a good theory”, this paper begins from an appreciative discussion of ‘fundamental cause theory’, emphasizing the elegance of its theoretical encapsulation of the challenge, the relevance of its critical focus for action, and its potential to support the practical mobilisation of knowledge in generating change. Moreover, it is argued that recent developments in the theory, provide an opportunity for further theoretical development focused more clearly on the concept of power (Dickie et al. 2015). A critical focus on power as the essential element in maintaining, increasing or reducing social and economic inequalities – including health inequalities – can both enhance the coherence of the theory, and also enhance the capacity to challenge the roots of health inequalities at different levels and scales. This paper provides an initial contribution by proposing a framework to help to identify the most important sources, forms and positions of power, as well as the social spaces in which they operate. Subsequent work could usefully test, elaborate and adapt this framework, or indeed ultimately replace it with something better, to help focus actions to reduce inequalities.

Public engagers are officials tasked with facilitating collaborative performances in the theatres of deliberation that increasingly populate local governance. In Scotland, they work to involve citizens, communities and organisations in deliberative policy-making. Drawing on 2 years of ethnographic fieldwork, this paper shows how these policy workers deploy their own field of specialist knowledge during the scripting of participatory processes. The analysis eschews conventional notions of 'scripted participation' as tokenistic or manipulative, thus seeking a more sophisticated understanding of the know-how that animates engagement practice. The findings reveal the micro-politics of official participation processes through the 'behind-thescenes' work of engagement practitioners.

This article examines the way in which innovation in science policy in the UK over the last 25 years has been built around a discourse of changing preference for modes of communication with citizens. The discussion, framed in debates and developments that deal with deliberative democracy and public engagement, draws on discourse analysis of key policy documents, statements made by members of the science policy network, and on interviews with public engagement practitioners. The relationship between science and society emerges as a 25-year old project of crisis management organised into three distinct models: Public Understanding of Science (PUS), Public Engagement, and Public Dialogue. The analysis questions the existing narrative of progress and evolution constructed around key switch points, highlights the overwhelming influence of PUS approaches, and attends to the question of the viability of Public Dialogue as the mainstream activity in science communication and policy making.

Classic pragmatism laid the foundations for a practice-based notion of citizenship that views democracy as a fragile accomplishment in need of constant self-actualisation. This article revisits this heritage to explore different notions of pluralism and democratic participation developed over the last century. Drawing on James and Dewey, the article interrogates how different understandings of democracy deal with pluralism and the meaning of democratic life. The focus is on three prominent models in contemporary democratic theory and practice, namely: representative, participatory and deliberative. The purpose is to review different ways of thinking and enacting citizen participation and explore key distinctions, overlaps and productive tensions. The conclusion argues that a vibrant democratic ecology requires combining the practices that underpin these models in order to develop deeper, and more sustainable, forms of citizenship and democratic life.