Wednesday, August 12, 2009

[EQ] Tackling the wider social determinants of health and health inequalities: Evidence from systematic reviews

Tackling the wider social determinants of health and health inequalities:
Evidence from systematic reviews

 

Bambra C.,1 Gibson M.,2 Petticrew M.,3 Sowden A.,4 Whitehead M.,5 Wright K.4

1. Centre for Public Policy & Health, Durham University

2. MRC Social and Public Health Sciences Unit, Glasgow

3. Public and Environment Health Research Unit, London School of Hygiene and Tropical Medicine

4. Centre for Reviews and Dissemination, University of York

5. Division of Public Health, University of Liverpool.

The Public Health Research Consortium funded by the UK Department of Health Policy Research Programme
University of York, November 2008

 

Available online as PDF file [102p.] at: http://www.york.ac.uk/phrc/D2-06%20Final%20Report.pdf

 

“……We know already that there are few evaluations of “wider public health” interventions, such as policies which affect the social determinants of health and health inequalities. From this project we find some suggestive evidence that certain categories of intervention may impact positively on inequalities, in particular interventions in the fields of housing, and employment, though further evidence is needed.

In the case of employment for example there is evidence that the effects of employment change are experienced differently by employees in different occupational categories, and some evidence about how this may be addressed.

 

This suggests that the workplace may indeed be an important setting in which inequalities may be addressed. Similarly, there is some evidence that housing improvements may positively affect physical health, but the effects may be quite small. The most striking gap in the evidence base however is in relation to interventions to improve access to health and social care.

 

The few reviews that we identified in the “access to healthcare” domain were limited to small-scale interventions to improve the access of very specific groups (and mainly in the US, where the nature of the highly commercialised healthcare system limits generalisability of findings to the rest of the world). No reviews were found that assessed the effects of wider health policies and health systems on access to health and social care for different groups in the population. As we also carried out additional searches to attempt to identify primary studies which would not have been included in the reviews…”

 

CONTENTS
 

Preface: What this study adds to knowledge

1. Executive summary

2. Introduction/background

3. Purpose of the study

4. Design & methods

4.1 Search Strategies

4.2 Inclusion and exclusion criteria

4.3 Data extraction

4.4 Critical Appraisal

5. Main findings

5.1 Housing and regeneration

5.2 The work environment

5.3 Unemployment and Welfare

5.4 Access to health and social care

5. 5 Transport and health

5.6 Agriculture and food

5.7 Water and sanitation

5.8 Education

6. Contribution to PHRC themes

7. Conclusions

8. Dissemination/Outputs

Acknowledgements

References

Appendices

 

Related paper:
The harvest plot: A method for synthesising evidence about the differential effects of interventions

David Ogilvie1,4  , Debra Fayter* 2  , Mark Petticrew* 1,5  , Amanda Sowden* 2  , Sian Thomas* 1  , Margaret Whitehead* 3  and Gill Worthy* 2 

1Medical Research Council Social and Public Health Sciences Unit, Glasgow, UK - 2Centre for Reviews and Dissemination, University of York, York, UK -3Department of Public Health, University of Liverpool, Liverpool, UK - 4Medical Research Council Epidemiology Unit, Cambridge, UK - 5London School of Hygiene and Tropical Medicine, London, UK

URL: http://www.biomedcentral.com/1471-2288/8/8

 

 

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