The role of the law in shaping local participatory governance initiatives to address health inequities

In the wake of the COVID-19 pandemic, the Chief Public Health Officer of Canada stated that new ways of working together are necessary to improve public health governance and the health system's resilience. Similarly, in the UK, the pandemic and the simultaneous efforts to reform the health system highlighted a pressing need and desire for more agility in public health governance. The pandemic had had a compounding exclusionary effect on marginalized groups facing even greater exclusion, discrimination and deeper social and health disparities. This unprecedented moment is bringing into sharper focus the necessity to re-evaluate governance models to better address health inequities.
The involvement of community groups and organizations at a local level continues to be pivotal in achieving health equity and in fostering health systems resilience. This knowledge synthesis aims at closing a gap in the literature regarding the role of law in shaping local participatory governance to reduce health inequities. In spite of law's notable impact on governance, no cross-disciplinary or interdisciplinary syntheses have examined the role of law- whether as catalyst or a barrier- in the development or implementation of local participatory governance frameworks aimed at addressing health inequalities. Law is a critical component of participatory governance because it shapes both formal structures and informal dynamics. It plays a key role in structuring the distribution of power among actors, in shaping participatory processes and mobilizing principles of governance such as transparency, legitimacy, and effectiveness. Law itself becomes an output of participatory governance as there is an increasing recognition of the normative capacities of citizens.
We will adopt a descriptive and exploratory methodological approach in our synthesis of knowledge to examine relevant studies (a) on local participatory governance as a means to reduce health inequities, and studies that (b) explore the role of law in local health governance. Looking across these two data sets we hope themes will emerge around the role of the law (as a catalyst, barriers or otherwise) in the processes of local participatory governance to reduce health inequities.
With an approach anchored in the theory of law and governance, our synthesis of knowledge will benefit the scientific community by contributing to knowledge shedding light on the relationship between law and governance in public health and open lines of inquiry for future research on the re-evaluation of models of governance. Students will be actively involved in every phase of the project.
Our project will also be of benefit to public health practitioners offering them greater clarity on the regulatory dimensions of governance. This research may be helpful in guiding them in the implementation of governance models to reduce health inequities at a local level, and may also support local governments in designing nuanced public health policies for community-based engagement.