scholarly journals Joint Action Health Equity Europe - turning knowledge on health inequality monitoring into actions

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
G Olsson ◽  
G Henriksson
Keyword(s):  
Health Equity ◽  
Health Inequalities ◽  
Health Inequality ◽  
Joint Action ◽  
Social Inequalities ◽  
National Level ◽  
Health Agency ◽  
Monitoring Systems ◽  
Specific Objective ◽  
The Status

Abstract Growing social inequalities in health challenge a sustainable development. To reduce health inequalities, it will be necessary to provide relevant data to policymakers on how health inequalities and the social determinants of health are distributed within populations over time, i.e. it will be necessary to form appropriate health inequality monitoring systems (HIMS). One of the aims with Joint Action Health Equity Europe (JAHEE) and the specific objective of work package five (WP5) is to advance partner countries ability to monitor national health inequalities. Country assessments has been conducted to assess the status of the HIMS in the participating countries, and a joint framework has been developed, describing the core components of an “ideal” HIMS. All partners have committed to the overall objective of the WP5 through the identification and implementation of concrete actions, which is now ongoing. The countries in JAHEE WP5 are Cyprus, Finland, Germany, Italy, Lithuania, Netherlands, Poland, Romania, Serbia, Slovenia, Spain and Sweden, where The Public Health Agency Sweden is the lead. The aim of this presentation is to present the experiences from JAHEE WP 5, and what they imply is needed to build coherent health inequality monitoring systems at a national level. More specifically, the JAHEE project in general, the WP5 project in particular will be presented, the structured work process described, and some general results and conclusions discussed

scholarly journals Health inequality monitoring - measuring what and how, exactly?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
G Henriksson ◽  
G Olsson
Keyword(s):  
Health Inequalities ◽  
Health Inequality ◽  
Social Determinants ◽  
Joint Action ◽  
National Level ◽  
Monitoring Systems ◽  
Work Package ◽  
Work Process ◽  
Over Time ◽  
The Eu

Abstract The output from health inequality monitoring systems at the national level should be comparable across countries to enable judgements about how health inequalities evolves in the EU. Such comparability presumes a common approach to what kind of data should be compiled, what indicators to focus and what measures to use. Hence, there are many decisions to be made and to agree upon. Only in terms of possible indicators, there is an overwhelming number of possibilities. This is confusing and could easily lead to diverging conclusions on how health inequalities develop within and across countries over time. As part of the Joint Action Health Equity Europe and the work conducted in work package five on monitoring, a core health inequality indicator set is being developed. The set should include a small number of indicators and contain information on health, on social determinants of health and on some measure of social position, preferably education. The indicator set should be based on data already reported to EU and liaised with other indicator initiatives. The final set will be proposed to be included on available EC platforms and specific websites as indicators of health inequalities. Such an indicator set will facilitate valid judgements on how health inequalities evolves in countries and in the EU. In this presentation, we will learn more about the proposed JAHEE indicator set, and about the work process. We will also get a chance to reflect on and discuss the proposed indicators and measures. The auditorium will be invited to reflect on conclusions.

scholarly journals 28.K. Workshop: Advancing health inequality monitoring in Europe – challenges, opportunities and actions

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Monitoring System ◽  
Health Inequalities ◽  
Health Inequality ◽  
National Health ◽  
Joint Action ◽  
Social Inequalities ◽  
Early Stage ◽  
The European Union ◽  
Working Together ◽  
Eu Project

Abstract Much of the focus on health inequality monitoring is based on aggregate descriptions at national levels where averages or proportions are compared. However, inequalities evolve from systematic differences in living conditions, circumstances, and opportunities between population groups within geographical entities. To be able to follow such trends in health, to detect less favourable trends at an early stage, and to reveal the trends in the population and in subgroups of the population, it is essential to have a national health inequality monitoring system (HIMS) in place. In fact, in line with the “no data, no problem” notion, one might even claim that the most essential part of combatting social inequalities in health is a well-functioning health inequality monitoring system. The Joint Action Health Equity Europe (JAHEE) is a Joint Action financed by the Third Health Programme 2014-2020 of the European Union. It represents an important opportunity for countries to work jointly to address health inequalities and achieve greater equity in health outcomes across all groups in society in all participating countries and in Europe at large. One of the aims with JAHEE and the specific focus of work package five (WP5) is to advance member states ability to monitor national health inequalities. The overall objective of the work conducted in JAHEE WP5 is to attract attention to and improve countries' capacity to monitor health disparities in a “do something, do more, do better” manner. The advancement of HIMS varies greatly between countries in Europe. Yet, there is scope for improvement in virtually all countries. In addition, challenges that impede the way health inequality monitoring can be conducted are often common across countries. These challenges cannot be eliminated within the course of a three-year EU project. The JAHEE project, however, offers an unique opportunity to move forward by working together in a structured work process that allow partner countries to share, build and transform available knowledge into concrete actions aimed at strengthening national health inequality monitoring systems in Europe. In this workshop, we will present the experiences from JAHEE WP5 and give examples on concrete actions and initiatives taken across Europe to challenge some of the barriers faced and to strengthen the national health inequality monitoring processes in Europe. There will be room for discussion between each presentation and in the end of the workshop. Key messages Raised awareness a politically committed system infrastructure to assure sustainability in health inequality monitoring. Raised awareness of need for agreed data but also agreed methods to compile data to measure inequalities within populations.

scholarly journals Tackling health inequality at the local level: Some critical reflections on the future of Norwegian policies

2017 ◽  
Vol 45 (18_suppl) ◽  
pp. 56-61 ◽  
Author(s):  
Wenche Bekken ◽  
Espen Dahl ◽  
Kjetil Van Der Wel
Keyword(s):  
Public Health ◽  
Health Inequalities ◽  
Health Inequality ◽  
Social Inequalities ◽  
Local Level ◽  
Government Documents ◽  
Challenges And Opportunities ◽  
Recent Developments ◽  
Research Findings ◽  
Public Health Act

Aim: In this paper we discuss recent developments in the policy to reduce health inequalities in Norway in relation to challenges and opportunities associated with tackling health inequality at the local level. Methods: We discuss government documents and research findings on the implementation of policies to diminish health inequalities at the municipality level. Recent policy developments are briefly reviewed in relation to the 10-year strategy to reduce health inequalities passed by the Parliament in 2007. We then identify opportunities and obstacles to successful action on health inequalities at the local level. Results: The 2012 Public Health Act represented a powerful reinforcement of the strategy to reduce health inequalities at all three levels of government: the national, the regional and the local. However, some aspects of the policies pursued by the current government are likely to make local action to tackle health inequality an uphill struggle. In particular, health equity policies that have hitherto been based on universalism and had a focus on the gradient seem to be running out of fuel. Other challenges are an insufficient capacity for effective action particularly in smaller municipalities, and a rather weak knowledge base, including systems to monitor social inequalities and a general lack of evaluations of trials and new initiatives. Conclusions: We conclude that the Public Health Act opened up many new opportunities, but that a number of municipalities face obstacles that they need to overcome to tackle health inequalities comprehensively. Furthermore, local efforts need to be coupled with sustained national momentum to be efficient.

Health Difference, Disparity, Inequality, or Inequity—What Difference Does It Make What We Call It?

2016 ◽  
Author(s):  
Paula Braveman
Keyword(s):  
Human Rights ◽  
Empirical Evidence ◽  
Health Equity ◽  
Health Inequalities ◽  
Health Inequality ◽  
Social Disadvantage ◽  
The Past ◽  
Health Differences ◽  
Technical Issues

Over the past two and a half decades, distinct approaches have been taken to defining and measuring health inequalities or disparities and health equity. Some efforts have focused on technical issues in measurement, often without addressing the implications for the concepts themselves and how that might influence action. Others have focused on the concepts, often without addressing the implications for measurement. This chapter contrasts approaches that have been proposed, examining their conceptual bases and implications for measurement and policy. It argues for an approach to defining health inequalities and health equity that centers on notions of justice and has its basis in ethical and human rights principles as well as empirical evidence. According to this approach, health inequality or disparity is used to refer to a subset of health differences that are closely linked with—but not necessarily proven caused by—social disadvantage. The term “inequity,” which means injustice, could also be used, but arguments are presented for using it somewhat more sparingly, for those inequalities or disparities in health or its determinants that we know are caused by social disadvantage.

scholarly journals Towards a national health equity monitoring strategy

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
G Costa ◽  
N Zengarini ◽  
M Marra
Keyword(s):  
Health Outcomes ◽  
Longitudinal Studies ◽  
Health Equity ◽  
Health Inequalities ◽  
National Level ◽  
Differential Mortality ◽  
Area Deprivation ◽  
Italian Population ◽  
Monitoring Strategy ◽  
The Social

Abstract The 2017 Italian Review on health inequalities identified two main needs with regards to Italian health equity monitoring. (1) The need to collect a social covariate at individual level in each health information system at local, regional and national level. Such a social covariate is fundamental for monitoring if any avoidable inequality in access, use, quality of care and health outcome is occurring at local, regional, national level. (2) The need to re-engineer and frame the different health equity monitoring surveys already established into an explicit health inequalities monitoring strategy (HIMS). Both challenges are accounted for by Italy in the Joint Action Health Equity Europe workplan. As for the social covariate, a pilot project is conducted. Data from 2011 census (education and area deprivation) and the national identification code used to link individual data on health and services utilization in four representative regions is linked. This will allow monitoring the social variation in selected performance indicators by region, across regions and through time. As for HIMS, previous research projects have designed and successfully piloted different models of low-cost data linkage for already established longitudinal studies. Now these pilot results will evolve into a national HIMS. As a first step, a special project of consensus building will be implemented among institutional partners responsible for the following national longitudinal studies based on record linkage: a) Work Histories Italian Panel followed up prospectively for health outcomes; b) Italian Longitudinal Study: 2000, 2015, 2013 Health Interview Surveys followed up prospectively for health outcomes; c) differential mortality 2011-2017 in the 2011 censused Italian population; d) the network of the metropolitan and regional census based longitudinal studies followed up prospectively for mortality disease registries and health care utilization. Experiences gained will be shared and discussed.

scholarly journals Monitoring health inequalities to inform action- the Pan-Canadian Health Inequalities Reporting Initiative

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Miszkurka
Keyword(s):  
Public Health ◽  
Health Equity ◽  
Health Inequalities ◽  
Social Deprivation ◽  
Health Agency ◽  
Functional Health ◽  
Systematic Assessment ◽  
Measurement Monitoring ◽  
Canadian Health ◽  
Statistics Canada

Abstract Improving national health inequalities monitoring and reporting systems is critical for informing effective action to improve health equity. The Pan-Canadian Health Inequalities Reporting Initiative (HIRI) provides a foundation of data and evidence to support collaborative efforts to reduce health inequalities in Canada. HIRI is led by the Public Health Agency of Canada, in collaboration with the Pan-Canadian Public Health Network, Statistics Canada, First Nation Information Governance Centre and other partners. HIRI brings together inequity measures for more than 100 indicators of health outcomes, risk factors, and social determinants of health disaggregated across a range of socioeconomic and sociodemographic variables meaningful to health equity including: sex/gender; age; income; education; employment; occupation; immigrant status; Indigenous identity; race/ethnicity; urban/rural residence; material and social deprivation, functional health/participation and activity limitation and sexual orientation. HIRI aims to strengthen health inequalities measurement, monitoring, and reporting capacity in Canada. It informs policy and program decision making to more effectively reduce health inequalities, and enables the monitoring of progress in this area. This presentation will provide an overview of the HIRI along with the key health inequalities in Canada. It will elaborate on the importance of the engagement with multiple partners in creating a broad range of data and knowledge translation products, and discuss how making it accessible to others: Allows for a comprehensive and systematic assessment of the state of health inequalities in CanadaSupports focused action through increased access to health inequalities knowledgePromotes collaboration and accountability for the reduction of health inequalities in order to achieve SDGs

scholarly journals Health inequalities among middle-aged and elderly people in China: analyses of cross-sectional surveys from the China Health and Retirement Longitudinal Study 2011–2016

2020 ◽  
Author(s):  
Qinxiao Qiu ◽  
Jinfeng Zeng ◽  
Liyuan Han ◽  
Zhuo Chen ◽  
Hongpeng Sun
Keyword(s):  
Longitudinal Study ◽  
Chronic Diseases ◽  
Health Equity ◽  
Health Inequalities ◽  
Health Inequality ◽  
Gdp Per Capita ◽  
Calculated Concentration ◽  
Kendall’S Τ ◽  
Per Capita ◽  
Concentration Indices

Abstract Objectives: China has a history of striving to achieve health equity, including efforts to prevent and control infectious diseases. However, to date, there is no comprehensive assessment of inequalities in chronic diseases in China. Methods: Data for this study were obtained from the China Health and Retirement Longitudinal Study (CHARLS) conducted from 2011 to 2016. A total of 50,244 Chinese adults aged 45 years and older were included (16,128 in 2011, 16,646 in 2013, and 17,470 in 2015). Principal component analysis was used to construct the socioeconomic status indicator. We calculated concentration indices and corresponding CIs for 14 chronic diseases and comorbidities. We then estimated the Kendall rank correlation coefficient for inequalities and GDP per capita among provinces. Results: For 10 of the 14 chronic diseases, prevalence rates were higher for the poorest tertiles than for the richest tertiles. The concentration indices of dyslipidaemia, diabetes or high blood sugar, and cancer or malignant tumour were, respectively, 0.1256 (95% confidence interval, 0.1052–0.151), 0.098 (0.0704–0.1244), and 0.1305 (0.0528–0.215) in 2015–2016, which indicated pro-rich inequality. Health inequality for chronic lung diseases and eight other diseases grew markedly from 2011 to 2016. Overall, health inequality was lower for urban residents (−0.035 in 2011–2012, −0.036 in 2013–2014, and −0.05 in 2015–2016) than rural residents (−0.053, −0.064, and −0.08, respectively), and inequality was twice as high among women (−0.051, −0.05, and −0.072, respectively) than among men (−0.023, −0.02, and −0.032, respectively). Provinces that were ranked higher for GDP per capita were also ranked higher in the degree to which disease prevalence was higher in people with lower income (Kendall’s τ=−0.2328, p=0.015; Kendall’s τ=−0.3545, p=0.0077; Kendall’s τ=−0.2646, p=0.0079, respectively). Conclusions: Pro-poor health inequalities for many diseases in China are large and widening. Policies associated with health equity, including free public health services and community health programmes, are needed to achieve the Sustainable Development Goals.

scholarly journals The Measurement of Health Inequalities: Does status matter?

2016 ◽  
Author(s):  
Joan Costa-Font ◽  
Frank Cowell
Keyword(s):  
Health Outcomes ◽  
Health Inequalities ◽  
Health Inequality ◽  
World Health ◽  
World Health Survey ◽  
Correlation And Regression Analysis ◽  
Measurement Tools ◽  
The Status ◽  
Self Assessed Health ◽  
Health Variable

The measurement of health inequalities usually involves either estimating the concentration of health outcomes using an income-based measure of status or applying conventional inequality-measurement tools to a health variable that is non-continuous or, in many cases, categorical. However, these approaches are problematic as they ignore less restrictive approaches to status. The approach in this paper is based on measuring inequality conditional on an individual's position in the distribution of health outcomes: this enables us to deal consistently with categorical data. We examine several status concepts to examine self-assessed health inequality using the sample of world countries contained in the World Health Survey. We also perform correlation and regression analysis on the determinants of inequality estimates assuming an arbitrary cardinalisation. Our findings indicate major heterogeneity in health inequality estimates depending on the status approach, distributional-sensitivity parameter and measure adopted. We find evidence that pure health inequalities vary with median health status alongside measures of government quality.

scholarly journals The measurement of health inequalities: does status matter?

2021 ◽  
Author(s):  
Joan Costa-Font ◽  
Frank A. Cowell
Keyword(s):  
Regression Analysis ◽  
Health Inequalities ◽  
Health Inequality ◽  
Categorical Data ◽  
World Health ◽  
World Health Survey ◽  
The World ◽  
The Status ◽  
Consistent Treatment ◽  
Self Assessed Health

AbstractApproaches to measuring health inequalities are often problematic because they use methods that are inappropriate for categorical data. In this paper we focus on “pure” or univariate health inequality (rather than income-related or bivariate health inequality) and use a concept of individual status that allows a consistent treatment of such data. We take alternative versions of the status concept and apply methods for treating categorical data to examine self-assessed health inequality for the countries included in the World Health Survey. We also use regression analysis on the apparent determinants of these health inequality estimates. We show that the status concept that is used will affect health-inequality rankings across countries and the way health inequality is related to countries’ median health, income, demographics and governance.

scholarly journals Developing a strategic plan for sustainable health inequality monitoring – the basic step towards tackling health inequalities in long run

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
T Lesnik
Keyword(s):  
Health Inequalities ◽  
Health Inequality ◽  
Strategic Plan ◽  
Basic Step ◽  
Long Run ◽  
The Status ◽  
Long Term Monitoring ◽  
Set Up ◽  
Term Monitoring

Abstract Slovenia has had periodic reporting on health inequalities for almost a decade. The importance of reporting is well recognised and stated in the National strategy on health care 2015-2025. Yet, the assessment of the status of the national health inequality monitoring system (HIMS) conducted within the Joint Action Health Equity Europe project, made the unsystematic nature of current practices obvious. A need for developing a more systematic and sustainable HIMS and to have a long-term monitoring strategic plan in place was acknowledged. The set-up of systematic and sustainable long-term monitoring of health inequalities will provide reliable and comparable longitudinal data on the direction, magnitude and trend of health inequalities in Slovenia. This is in turn necessary to inform any future policies and/or programmes, thus stimulating action. Furthermore, identifying relevant stakeholders will facilitate formation of a network of partners who take part in tackling health inequalities, thus allowing for a more proactive (i.e. bridging) role in addressing health inequalities in Slovenia. The aim of this presentation is to demonstrate the process and the steps taken to prepare a document (strategic plan) detailing a systematic approach to long-term monitoring of health inequalities complete with goals, objectives, methodology, a pragmatic set of indicators and an evaluation plan that will inform and facilitate most reporting/monitoring activities

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