英国存在健康不平等仍然是个持久存在的问题。其原因之一可能是健康不平等在专业和公众的辩论中所采用的框架。主流对健康的理解侧重于个体、个人选择、生活方式和（不）健康行为。本项目试图以现有指导为基础，将健康不平等重新框定为“系统性”或结构性问题，以支持英格兰某地方政府解决健康不平等的工作。 采用学术-实践者参与式知识动员方法，与地方政府公共卫生团队进行合作，利用最新指导资料和反思反馈，以及循序渐进地开发可操作工具。该过程分为四个独立阶段，其中包括两次在线会议和一次面对面会议的参与式研讨会，旨在基于团队组合共同创建重新构思的公共卫生挑战和解决方案。研究人员提供迭代反馈，以支持可行工具的开发。六个主题领域采取了系统性的框架：1. 食物不安全；2. 肥胖；3. 黑人男性的前列腺癌；4. 生活成本；5. 心理健康、自杀预防和吉普赛人、罗姆人、旅行者社群；6. 健康街道。该过程的反思揭示了在更广泛的卫生决定因素上采用系统性框架的一些感知优势，以及在地方环境中需要考虑的一些局限和问题。其中的优势包括：在复杂领域中提供清晰性；有关如何进行沟通的结构化思考；消除了术语障碍；可在地方上实现相关性。挑战包括：保持一致的框架；保持技巧；了解是否产生了差异；特别是在自由讨论中滑回到主导（个体化）的框架。 在地方政府环境中采用最新指导重新构思更广泛的卫生决定因素的方法，在公共卫生团队中发展一致性和一致性方面具有广泛的帮助。采取这种方法面临一些挑战，评估其在地方层面的影响将是有益的。 © 2023 The Authors.

Health inequalities remain a persistent problem in the UK. One contributing factor may be how health inequalities are framed in professional and public debate. Dominant understandings of health focus on the individual, personal choice, lifestyle and (un)healthy behaviour. This project sought to reframe health inequalities as a 'systemic' or structural problem using extant guidance. This was intended to support the work of a local authority in England working to address health inequalities.An academic-practitioner participatory knowledge mobilisation exercise with a local authority public health team using recent guidance and reflective feedback and the iterative development of actionable tools. There were four discrete stages to the exercise.Two on-line and one face-to-face participatory, deliberative workshops designed to co-create reframed public health challenges and solutions based on team portfolios. Iterative feedback provided by the researcher to support the development of actionable tools.Six topic areas were developed with a systemic framing: 1. Food insecurity, 2. Obesity, 3. Prostate cancer among Black men, 4. Cost of living, 5. Mental health, suicide prevention and Gypsy, Roma, Traveller communities, 6. Healthy streets. Reflections from the process revealed some perceived advantages of engaging in a systemic framing of the wider determinants of health, some limitations and issues to consider in a local setting. Benefits included: Clarity in a complex field; structured thinking about what to communicate and how; eliminated jargon; could be made locally relevant. Challenges included: Sustaining a consistent framing; maintaining the technique; knowing if was making a difference; slipping back into dominant (individualised) framings, especially in free-flowing discussion.The process of reframing the wider determinants of health using recent guidance in a local authority setting was broadly helpful in developing coherence and consistency across the public health team. There were challenges to adopting the approach and evaluation of its impact locally would be beneficial.© 2023 The Authors.