Governing the Unhealthy Community: Some Reflections on UK Health Action Zones

Abstract

Recent UK public policy related to New Labour's social exclusion agenda has increasingly targeted the community as a site for interventions that attempt to improve the lives of some of the most excluded groups. Recognition that deprivation is often geographically focussed has led to implementation of area-based policy interventions such as Health Action Zones (HAZ). In common with other area-based initiatives, HAZ communities are identified as at risk of unemployment, exclusion and ill health. This paper draws on the work of Rose to argue that such public policy represents a shift from the social to the community as a target of welfare interventions. This is discussed with reference to the UK HAZs that employ such strategies to attempt to improve the health of disadvantaged communities. Original empirical data from an evaluation of one zone in the North East of England (the NHAZ) is presented. The implications of the targeting of community as a new site of governance and the re-responsibilising of individuals to manage their own health become a key focus.