What this assignment does
The essay examines the social determinants of health as a concept and then does something most answers avoid: it takes a single upstream intervention — the Soft Drinks Industry Levy — and evaluates it properly, including the parts that do not work.
The theoretical frame is Dahlgren and Whitehead's model and the CSDH report; the empirical anchor is Marmot's finding that people in deprived neighbourhoods not only die earlier but spend a greater proportion of their shorter lives in poor health.
How it is built
Concept, then evidence of inequality in England, then one intervention evaluated in depth, then implications for practice. Narrowing to a single case is a deliberate choice — it buys the depth that makes section four possible.
The closing section returns to the tension the essay opened with, between individual and structural approaches, now with evidence to settle it rather than assert it.
Annotated extracts
Three passages, each with a note on why it earns marks and what a weaker answer does in the same place — enough to teach the move, not enough to stand in for the assignment.
Despite these positive findings, several limitations must be acknowledged. First, observational evaluations of natural experiments cannot fully exclude confounding by other concurrent changes, such as the wider sugar reduction programme or changes in marketing. Interrupted time series designs strengthen causal inference but remain vulnerable to co-interventions (Scarborough et al., 2020). Second, the differential findings by sex are not fully explained.
Why this marks well
The essay argues for upstream structural intervention and then subjects its own best example to methodological criticism. That is the hardest thing to do in a policy essay and the most heavily rewarded.
The criticism is methodological rather than political. Natural experiments cannot exclude concurrent change; interrupted time series help but do not solve co-intervention. Both are specific, named threats to validity, and the second is cited — so a marker can check the reasoning rather than weigh an opinion.
“Not fully explained” about the sex differences is the right move too. An unexplained finding is reported as unexplained rather than smoothed over, which is what distinguishes evaluation from advocacy.
What a weaker answer does here
A weaker answer reports that the levy reduced sugar content and cites the evaluation as evidence that upstream intervention works. The finding is real, the inference is unguarded, and the essay has shown nothing about the quality of evidence it is relying on.
People living in the most deprived neighbourhoods not only die earlier but also spend a far greater proportion of their shorter lives in poor health (Marmot et al., 2020).
Why this marks well
One sentence, and it does the work of a page. The standard framing of health inequality is mortality; this adds morbidity compression and makes the gap compound — fewer years, and a greater share of them spent unwell.
It also sets up the whole argument for upstream action. If the disadvantage accumulates across the life course rather than arriving at the end of it, then interventions targeted at individuals at the point of illness are structurally too late. The introduction is not scene-setting; it is laying the premise the conclusion will need.
Citing Marmot's 2020 review rather than the 2010 original is a small thing that markers notice — it is the current evidence, and the ten-year follow-up is the one that shows the trend.
What a weaker answer does here
A weaker answer opens by stating that health inequalities persist in England despite decades of policy attention, cites a life-expectancy gap, and moves on. Accurate, familiar, and it commits the essay to nothing.
The evidence supports the principle that structural interventions tend to be more equitable than those that depend on individual agency.
Why this marks well
This is the essay's thesis, and notice where it sits — after the evidence, derived from it, rather than announced in the introduction and then illustrated.
The mechanism implied by “depend on individual agency” is the important part. Interventions requiring individual action are differentially taken up by people with the resources to act, so they can widen the gap even while improving the average. The levy works precisely because it does not require the consumer to do anything.
“Tend to be” is correctly hedged. The claim is a tendency supported by one well-evaluated case, not a law, and the essay does not overreach beyond what it has shown.
What a weaker answer does here
A weaker answer concludes that both individual and structural approaches are needed and should be combined. It is true, it is unarguable, and it is what an answer writes when the evidence has not been made to decide anything.
What makes this a strong answer
It narrows to one intervention and evaluates it properly, rather than surveying five and assessing none.
It criticises the evidence for its own position, on methodological grounds, with citations a marker can check.
The thesis is derived from the evidence and arrives after it, and it is hedged to exactly the strength the evidence supports.
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Model answer written by a Global Projects Help mentor · © Global Projects Help
Published 8 October 2026 · Questions? mia@globalprojectshelp.com