Papering over the cracks: How residents and professionals experience market-led regeneration in four English coastal towns

English coastal towns were once celebrated for their salutogenic qualities; today, however, many experience persistent deprivation and poor health. Successive governments have responded with market-led regeneration programmes focused on physical infrastructure, yet health inequalities remain entrenched. This paper draws on interviews and focus groups with 140 residents and local professionals in Hartlepool, Blackpool, Hastings, and Torbay, conducted in 2023 as part of a wider study of the north-south health divide. Across all four towns participants experienced market-led regeneration as highly visible but superficial, producing short-lived improvements to the built environment while leaving the structural drivers of poor health untouched. Residents described schemes designed for tourists and wealthier incomers, reshaping their towns around middle-class tastes while obscuring poverty. Professionals recognised these limits but felt compelled to compete for whatever funding was available. I interpret these narratives through three concepts. Slow violence captures how harm accumulates across decades of cosmetic investment, symbolic violence highlights the devaluing of local culture and residents’ needs, and cruel optimism helps explain why people stay attached to the promise of revitalisation despite this approach consistently failing to deliver. I argue that market-led regeneration, shaped by policy that rewards visible outcomes over redistribution, sustains inequality rather than reducing it. As governments across the globe turn to competitive funding and private capital to revive similar locales, these accounts offer caution about the ability of such approaches to reduce health inequalities. Health equity requires reforming the political and economic structures that produce inequality, rather than papering over the cracks.