title: The return of public health to local government in England: changing the parameters of the public health prioritization debate?
abstract: OBJECTIVE
  To explore the influence of values and context in public health priority-setting in local government in England.
  
  
  METHODS
  Qualitative interview study.
  
  
  METHODS
  Decision-makers' views were identified through semi-structured interviews and prioritization tools relevant for public health were reviewed. Interviews (29) were carried out with Health and Wellbeing Board members and other key stakeholders across three local authorities in England, following an introductory workshop.
  
  
  RESULTS
  There were four main influences on priorities for public health investment in our case study sites: an organizational context where health was less likely to be associated with health care and where accountability was to a local electorate; a commissioning and priority-setting context (plan, do, study, act) located within broader local authority priority-setting processes; different views of what counts as evidence and, in particular, the role of local knowledge; and debates over what constitutes a public health intervention, triggered by the transfer of a public health budget from the NHS to local authorities in England.
  
  
  CONCLUSIONS
  The relocation of public health into local authorities exposes questions over prioritizing public health investment, including the balance across lifestyle interventions and broader action on social determinants of health and the extent to which the public health evidence base influences local democratic decision-making. Action on wider social determinants reinforces not only the art and science but also the values and politics of public health.
authors: Centre for Public Policy and Health, Durham University, School of Medicine, Pharmacy and Health, Wolfson Research Institute for Health and Wellbeing, Durham University Queen's Campus, University Boulevard, Thornaby, Stockton on Tees, TS17 6BH, UK. Electronic address: linda.marks@durham.ac.uk.
authors: L
authors: L
authors: Marks
authors: Centre for Public Policy and Health, Durham University, School of Medicine, Pharmacy and Health, Wolfson Research Institute for Health and Wellbeing, Durham University Queen's Campus, University Boulevard, Thornaby, Stockton on Tees, TS17 6BH, UK. Electronic address: d.j.hunter@durham.ac.uk.
authors: D J
authors: DJ
authors: Hunter
authors: Centre for Public Policy and Health, Durham University, School of Medicine, Pharmacy and Health, Wolfson Research Institute for Health and Wellbeing, Durham University Queen's Campus, University Boulevard, Thornaby, Stockton on Tees, TS17 6BH, UK. Electronic address: silvia.scalabrini@durham.ac.uk.
authors: S
authors: S
authors: Scalabrini
authors: Faculty of Health & Life Sciences, Northumbria University Coach Lane Campus, Benton, Newcastle upon Tyne, NE7 7XA, UK. Electronic address: Joanne3.gray@northumbria.ac.uk.
authors: J
authors: J
authors: Gray
authors: Institute of Health and Society, Newcastle University, The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK. Electronic address: sara.mccafferty@ncl.ac.uk.
authors: S
authors: S
authors: McCafferty
authors: Section of Public Health School of Health and Related Research (ScHARR), The University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK. Electronic address: n.payne@sheffield.ac.uk.
authors: N
authors: N
authors: Payne
authors: Centre for Health Services Studies, George Allen Wing, Cornwallis Building, University of Kent, Canterbury, Kent, CT2 7NF, UK. Electronic address: S.Peckham@kent.ac.uk.
authors: S
authors: S
authors: Peckham
authors: Section of Public Health School of Health and Related Research (ScHARR), The University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK. Electronic address: s.salway@sheffield.ac.uk.
authors: S
authors: S
authors: Salway
authors: Section of Public Health School of Health and Related Research (ScHARR), The University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK. Electronic address: p.thokala@sheffield.ac.uk.
authors: P
authors: P
authors: Thokala
mesh_terms: D034462:Dissent and Disputes; D004739:England; D006292:Health Priorities; D006801:Humans; D009111:Local Government; D011634:Public Health; D036301:Qualitative Research; D013222:State Medicine / Q000458:organization & administration
keywords: Democratic decision-making; Local commissioners; Priority-setting; Public health investment