Harkness Project Title:

Tackling Health Disparities in the United States: A Study of Organizational Strategies

Mentor: Eugene Washington, M.D.

Placement: University of California, San Francisco

Biography at time of Harkness Fellowship: Mark Exworthy, a 2002-03 Commonwealth Fund Harkness Fellow in Health Care Policy and Practice, is a Senior Research Fellow in the Department of Epidemiology and Public Health at University College London. His research and policy interests include: policy formulation and implementation, clinician-managerial relations, primary care reform, policies to tackle health inequalities/disparities, and the geographical implications of health policy. He has published in all these areas. Exworthy’s research has been funded by the U.K. government, health care agencies, the Economic and Social Research Council, and the Joseph Rowntree Foundation. He was a cofounder of the U.K. Health Equity Network and is a Fellow of the Royal Geographical Society.

Project: Exworthy’s study examined organizational strategies for tackling health care disparities, including what disparities get addressed, what organizational processes and incentives are used, and how these efforts are assessed.  He first conducted a document review and key informant interviews on current policies regarding disparities, and then administered a questionnaire to 800 hospitals identifying the key factors driving their strategies to tackle disparities.  Finally, he conducted two case studies on how individual hospitals design and implement such organizational strategies. 

Career Activity Since Fellowship

• Professor of Health Policy and Management, School of Management, Royal Holloway-University of London, 2011
• Reader in Public Management and Policy, School of Management, Royal Holloway – University of London, 2006
• Senior Lecturer in Public Management and Policy, School of Management, Royal Holloway – University of London, 2004
• Senior Research Fellow, Department of Sociology and Social Policy, Oxford Brookes University, 2004

Current Position: Professor of Health Policy and Management, School of Management, Royal Holloway -- University of London. (Updated October 2011)

E-Mail: m.exworthy@rhul.ac.uk

Harkness-Related Publications

Exworthy, M, “The Illness Narratives of Health Managers: Developing an Analytical Framework,” Evidence and Policy, 2011; 7(3): 345-358.

Exworthy M, Bindman A, Davies H, Washington AE. “Evidence into Policy and Practice? Measuring the Progress of U.S. and U.K. Policies to Tackle Disparities and Inequalities in U.S. and U.K. Health and Health Care,” The Milbank Quarterly 2006 84(1):75–109.

Exworthy M, Washington AE. “Organisational Strategies to Tackle Health-Care Disparities in the US,” Health Services Management Research 2006; 19:44-51.

Oliver A and Exworthy M (eds). Tackling Health Inequalities: Evidence, Policy and Implementation. Proceedings from a Meeting of the Health Equity Network. London: Nuffield Trust. 2003.

Exworthy M. "Tackling Health Inequalities in the United Kingdom: The Progress and Pitfalls of Policy," Health Services Research 2003;  38(6 - special supplement Part  II).