Health inequalities tackled through intersectoral collaboration: longitudinal process issues and insights

This study contributes to ongoing reflections and debate on the legacy of the Ottawa Charter by illustrating how contemporary forms of intersectoral collaboration can be mobilized to address persistent health inequalities. Collaborations involving organizations from diverse sectors are often viewed as well-positioned to tackle complex health challenges, yet they frequently encounter political, organizational and cultural barriers that hinder their effectiveness. This paper uses a longitudinal approach to explore issues in relation to the formation and sustainability of a multi-sector collaboration in one geographic area in the UK, working under the banner of the Health Determinants Research Collaboration (HDRC)-a programme which seeks to further understand health determinants and to improve health outcomes in communities. Through qualitative interviews at two time points-12 months apart-with constituents of the collaboration, the data demonstrated a clear and shared vision for the collaboration and a neat 'dovetailing' of skill-sets related to community brokerage; academic rigour; and statutory legitimacy. While the collaboration under focus here was in its infancy, cultural, and practical tensions in ways of working; trust issues; pace of working; and philosophy were predicted to, and indeed did, emerge and required careful monitoring to ensure intended outcomes were not derailed.