Interventions to deliver inclusive economies

Research specification

Research question

• What are the health and health inequality impacts of interventions to deliver inclusive economies?

A recent analysis suggests the UK is the most regionally unequal advanced economy, with some growing regional inequalities in outcomes including productivity, income, employment, pollution, emissions, and education. The link between economic factors and health is well evidenced in the public health literature. As life expectancy follows a ‘social gradient’, people living in more deprived areas of the UK have shorter life expectancies, higher levels of avoidable mortality, and spend more of their lives in ill-health.

Health and wealth inequalities increased significantly between 2010 and 2020 and were further exacerbated during the Covid-19 pandemic. The current cost-of-living crisis represents a significant threat of widening health and wealth inequalities, particularly as lower-income households spend comparatively more of their income on essential goods (e.g. food, energy), the cost of which has risen above headline inflation. Additionally, a 2022 report highlighted that black and ethnic minority people have been disproportionately affected by the pandemic and cost-of-living crisis and are more likely to be in poverty and deep poverty than white people. They are over-represented in the lowest-income groups, experience higher levels of food insecurity, and are significantly more likely to experience fuel poverty due to the rising energy costs. Health and wealth inequalities can also be caused by disability, age, gender, sexuality, experience of mental health, etc.

There is growing interest in pursuing inclusive economies in UK governments. In Scotland, for example, an inclusive and sustainable economy is one of the six national public health priorities. The other three UK nations are undertaking similar work. In England, Public Health England’s 2021 inclusive and sustainable economies strategy focused on place-based approaches to reducing health inequalities. The Marmot Review 10 Years On highlighted that these types of inclusive economy approaches hold promise for reducing health inequalities and redefining ‘progress’ to mean more than economic growth. They recommend placing value on health and wellbeing as well as (or more than) economic efficiency in the pursuit of inclusive growth.

A number of frameworks have been proposed to understand the core tenets of an inclusive economy. For example, Public Health England’s inclusive and sustainable economies strategy sets out a framework to support local areas to take whole-system action (see Figure 1). The framework describes 3 domains requiring action on the economic, social and environmental determinants of health and 12 sub-domains (or ‘building blocks’) of a sustainable and inclusive economy.

We are interested in research on the health and health inequality impacts of interventions intended to deliver inclusive economies at local or regional authority level. While the evaluation of national policy is outside of the Programme’s remit, researchers can investigate the variation in outcome of implementation of national policy at local or regional level. We are interested in a broad range of interventions that deliver inclusive economies. For example, interventions might focus on one sub-domain of the framework set out by Public Health England’s Inclusive and Sustainable Economies Strategy (see Figure 1 in the report and executive summary) or interventions might target more than one sub-domain of the framework (or other equivalent frameworks).

Research areas of interest could include, but are not limited to, the evaluation of the health and health inequality impacts of new or existing:

• Interventions that target any (sub)domains of the framework mentioned in the Public Health England report (or equivalent frameworks) to build inclusive economies. This includes whole system approaches that might target multiple (sub)domains.
• Local variations to national minimum wage or living wage
• Initiatives that encourage investments in the local economy
• Initiatives that impact local provision of, and demand for, services e.g. 20-minute neighbourhoods.
• A major employer (e.g. university, the NHS) in the local community, acting as an anchor institution
• Local schemes to establish inclusive labour markets (e.g. ensuring a focus on inclusivity or good work, skills building and routes into employment), including those tailored for specific populations or sectors

We recognise that, for some proposals, underpinning work to understand epidemiology or intervention development might be beneficial to inform the evaluation of interventions. We are willing to consider applications that include underpinning or development work. Please contact the PHR Programme before applying to discuss further.

Applicants are encouraged to read the guidance notes, paying particular attention to the points highlighted below:

Population (P) – While PHR Programme funding opportunities are broad, applicants need to specify and justify their choice of population. We recognise that interventions are likely to impact different (sub)populations in different ways.

Intervention (I) – We are predominantly interested in the evaluation of interventions that operate at a population level rather than at an individual level. The PHR Programme does not fund research into the treatment of disease but is interested in research that addresses the wider determinants of health. The description of the intervention may include the setting.

Comparator (C) – While we recognise that conducting a randomised controlled trial is not necessarily possible or appropriate in many situations, encourage applicants to consider including a suitable comparator.

Outcomes (O) – The primary outcome must be a health outcome. Researchers will need to clearly describe and justify their choice of primary and secondary outcomes.

Researchers will need to specify how outcomes will be measured in the short, medium, and long term. Where a primary health outcome is not feasible then intermediary and proxy outcomes are accepted, if appropriately justified. Researchers are encouraged to consider additional outcome measures including those relating to the broader determinants of health and health inequalities, and the life course, which should be specified and justified.

Health inequalities - Of particular importance to the PHR Programme is an understanding of inequalities in impact of policy and access to services. Evaluations of interventions seeking to reduce health inequalities are also of specific interest.

Application design

A range of study designs can be used. Innovative methodologies are welcomed.

Researchers should clearly describe their methodological approach, and the rationale for this approach. The PHR Programme recognises that this funding opportunity is broad and expects researchers to be targeted in their research. Applicants are expected to be aware of other relevant studies in their area of research, to identify the gaps in the existing evidence base, and to articulate why their research is important for decision makers.

In line with the NIHR principles of inclusion, you must consider inclusion throughout the research lifecycle, and ensure that these considerations are costed appropriately. This includes (but is not limited to): your research design; the participants you recruit and how you have considered diverse, under-served groups and health inequalities, and justified exclusion criteria; research methods; data and statistical analysis; and knowledge mobilisation and dissemination of findings. NIHR welcomes partnerships between research active and other less active institutions and those located in geographical areas of deprivation. We encourage applications from people from all backgrounds and communities bringing diverse skills and experiences.

Health economics – Understanding the value of public health interventions - whether the outcomes justify their use of resources - is integral to the PHR Programme, where resources relating to different economic sectors and budgets are potentially relevant.

The main outcomes for health economic evaluation are expected to include health (including health-related quality of life) and the impact on health inequalities as a minimum, with consideration of broader outcomes welcomed. Different approaches to health economic evaluation are encouraged as long as they assess the value and distributive impact of interventions. Applications that do not include a health economic component should provide appropriate justification.

Pathways to Impact – The Programme is focused on the impact of the research it funds. Researchers are encouraged to maximise the impact of their research by explaining how they will mobilise knowledge and share their findings, to ensure that it is used, with the relevant policy makers, public health officers, special interest groups, charities, community audiences and other stakeholders.

Application guidance

Please read our Domestic Outline Application guidance to help you complete all aspects of your application. You must read this alongside the information below, which details specific requirements our PHR Programme looks for in applications. You can also check our PHR Programme page for details about the Programme’s scope and remit. 

Research Plan

Your Research Plan must be a maximum of four A4 pages. Please include the following when writing your Research Plan. 

Methodology/plan

Include the below detail in your methodology/plan:

Application process

Find out how to apply for this funding opportunity and what you need to do to get your application ready.

How to apply 

When you are ready to apply, you will need to log in to our application system to apply. This funding opportunity is on our new Awards Management System and you will need to create a new account to apply.

The closing date is 25 April 2025 at 1pm. Applications received after 1pm on the closing date will not be considered. 

Please read the following guidance before submitting an application:  

• all of the application guidance detailed in the 'application guidance' section in this funding opportunity

Download application form template

You can download a Word document template of the application form below. Please use this template as a guide only, to help you prepare your application. For example, to see how many characters are accepted in each section and to see how information in the form is laid out. Please do not try to use this as an application form; it cannot be submitted as an application. You must submit your application online via our Awards Management System.

Research inclusion and reasonable adjustments

At NIHR we are committed to creating a diverse and inclusive culture. We encourage applications from people from all backgrounds and communities bringing diverse skills and experiences. If you need any reasonable adjustments throughout the application process, please contact the programme team via the information in the Contact Details tab.

Research Support Service

Got a research idea and not sure how to turn it into a funding application? The free NIHR Research Support Service (RSS) supports researchers in England to apply for funding. It can help you develop and deliver clinical and applied health, social care and public health research post award.

Please speak to the NIHR Specialist Centre for Public Health (SCPH) about the design of your research as soon as possible by completing their online form. A successful application takes a long time (several months) to develop.