Measuring the impact of Health Trainers Services on health and health inequalities: does the service's data collection and reporting system provide reliable information?

Urban waterways are underutilised assets, which can provide benefits ranging from climate-change mitigation and adaptation (e.g., reducing flood risks) to promoting health and well-being in urban settings. Indeed, urban waterways provide green and blue spaces, which have increasingly been associated with health benefits. The present observational study used a unique 17-year longitudinal natural experiment of canal regeneration from complete closure and dereliction in North Glasgow in Scotland, U.K. to explore the impact of green and blue canal assets on all-cause mortality as a widely used indicator of general health and health inequalities. Official data on deaths and socioeconomic deprivation for small areas (data zones) for the period 2001–2017 were analysed. Distances between data zone population-weighted centroids to the canal were calculated to create three 500 m distance buffers. Spatiotemporal associations between proximity to the canal and mortality were estimated using linear mixed models, unadjusted and adjusted for small-area measures of deprivation. The results showed an overall decrease in mortality over time (β = −0.032, 95% confidence interval (CI) [−0.046, −0.017]) with a closing of the gap in mortality between less and more affluent areas. The annual rate of decrease in mortality rates was largest in the 0–500 m buffer zone closest to the canal (−3.12%, 95% CI [−4.50, −1.73]), with smaller decreases found in buffer zones further removed from the canal (500–1000 m: −3.01%, 95% CI [−6.52, 0.62]), and 1000–1500 m: −1.23%, 95% CI [−5.01, 2.71]). A similar pattern of results was found following adjustment for deprivation. The findings support the notion that regeneration of disused blue and green assets and climate adaptions can have a positive impact on health and health inequalities. Future studies are now needed using larger samples of individual-level data, including environmental, socioeconomic, and health variables to ascertain which specific elements of regeneration are the most effective in promoting health and health equity.

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Evaluation of Health Equity Impact of Structural Policies

International Journal of Health Services ◽

10.1177/0020731417709960 ◽

2017 ◽

Vol 47 (3) ◽

pp. 432-439 ◽

Cited By ~ 1

Author(s):

Anton E. Kunst

Keyword(s):

Population Health ◽

Health Inequalities ◽

Time Trend ◽

Health Impact ◽

Future Studies ◽

Quantitative Studies ◽

Quasi Experimental ◽

The One ◽

The Impact ◽

Health And Health Inequalities

This article briefly assesses the research methods that were applied in the SOPHIE project to evaluate the impact of structural policies on population health and health inequalities. The evaluation of structural policies is one of the key methodological challenges in today’s public health. The experience in the SOPHIE project was that mixed methods are essential to identify, understand, and predict the health impact of structural policies. On the one hand, quantitative studies that included spatial comparisons or time trend analyses, preferably in a quasi-experimental design, showed that some structural policies were associated with improved population health and smaller health inequalities. On the other hand, qualitative studies, often inspired by realist approaches, were important to understand how these policies could have achieved the observed impact and why they would succeed in some settings but fail in others. This review ends with five recommendations for future studies that aim to evaluate, understand, and predict how health inequalities can be reduced through structural policies.

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RF1 The impact of fiscal policies on population health and health inequalities in scotland: a modelling study

10.1136/jech-2018-ssmabstracts.90 ◽

2018 ◽

Author(s):

E Richardson ◽

A Pulford ◽

J Parkinson ◽

D Agbato ◽

M Robinson

Keyword(s):

Population Health ◽

Health Inequalities ◽

Fiscal Policies ◽

The Impact ◽

Health And Health Inequalities ◽

Modelling Study

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The Impact of Public Employment on Health and Health Inequalities: Evidence from China

The Financial and Economic Crises and Their Impact On Health and Social Well-Being ◽

10.2190/tfac8 ◽

2014 ◽

Author(s):

Wei Zhang

Keyword(s):

Health Inequalities ◽

Public Employment ◽

The Impact ◽

Health And Health Inequalities

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Examining the effectiveness of place-based interventions to improve public health and reduce health inequalities: an umbrella review

BMC Public Health ◽

10.1186/s12889-021-11852-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

V J McGowan ◽

S. Buckner ◽

R. Mead ◽

E. McGill ◽

S. Ronzi ◽

...

Keyword(s):

Public Health ◽

Systematic Review ◽

Health Outcomes ◽

Health Inequalities ◽

Systematic Reviews ◽

Future Research ◽

Primary Study ◽

Umbrella Review ◽

The Impact ◽

Health And Health Inequalities

Abstract Background Locally delivered, place-based public health interventions are receiving increasing attention as a way of improving health and reducing inequalities. However, there is limited evidence on their effectiveness. This umbrella review synthesises systematic review evidence of the health and health inequalities impacts of locally delivered place-based interventions across three elements of place and health: the physical, social, and economic environments. Methods Systematic review methodology was used to identify recent published systematic reviews of the effectiveness of place-based interventions on health and health inequalities (PROGRESS+) in high-income countries. Nine databases were searched from 1st January 2008 to 1st March 2020. The quality of the included articles was determined using the Revised Assessment of Multiple Systematic Reviews tool (R-AMSTAR). Results Thirteen systematic reviews were identified - reporting 51 unique primary studies. Fifty of these studies reported on interventions that changed the physical environment and one reported on changes to the economic environment. Only one primary study reported cost-effectiveness data. No reviews were identified that assessed the impact of social interventions. Given heterogeneity and quality issues, we found tentative evidence that the provision of housing/home modifications, improving the public realm, parks and playgrounds, supermarkets, transport, cycle lanes, walking routes, and outdoor gyms – can all have positive impacts on health outcomes – particularly physical activity. However, as no studies reported an assessment of variation in PROGRESS+ factors, the effect of these interventions on health inequalities remains unclear. Conclusions Place-based interventions can be effective at improving physical health, health behaviours and social determinants of health outcomes. High agentic interventions indicate greater improvements for those living in greater proximity to the intervention, which may suggest that in order for interventions to reduce inequalities, they should be implemented at a scale commensurate with the level of disadvantage. Future research needs to ensure equity data is collected, as this is severely lacking and impeding progress on identifying interventions that are effective in reducing health inequalities. Trial registration PROSPERO CRD42019158309

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P085: A low-cost solution to high-risk problem: enhancing communication of emergency physician x-ray interpretations to reading radiologist

CJEM ◽

10.1017/cem.2016.261 ◽

2016 ◽

Vol 18 (S1) ◽

pp. S106-S107

Author(s):

D.J. MacKinnon ◽

M. McGowan ◽

T. Dowdell ◽

G. Bandiera

Keyword(s):

Quality Improvement ◽

High Risk ◽

Data Collection ◽

Reporting System ◽

Low Cost ◽

Emergency Physicians ◽

X Ray ◽

It Systems ◽

User Friendly ◽

The Impact

Introduction: There was a recognized lack of available system for Emergency Physicians (EPs) to communicate their x-ray interpretations to the reading Radiologist; this resulted in unnecessary flagging of cases with significant findings already seen by the EP or the possibility of incorrectly assuming a finding was seen by the EP. Our aim was to develop an IT-based system that permitted Radiologists to view EPs documented x-ray interpretations real-time. Based on engagement with both groups, it was essential that the system be user friendly and not add significantly to an already busy workload. Methods: An online reporting system was introduced in 2011, but with complaints that interpretations were not readily accessible, nor automatic. A revised system was launched in 2014 with 2 improvements: i) EP entered interpretation onto “sticky note” in PACs directly; and ii) EP interpretation “popped up” when a film was opened by Radiologist. Results: Both systems allowed data collection of the percentage of events EPs entered an interpretation. Prior to 2011, 0% of films had EP interpretations available to Radiologist, 33% with initial, and 53% with PACS. The revised system has enabled EPs to enter their x-ray interpretation which has resulted in improvement both subjectively, based on regular feedback from both EPs and Radiologists, and objectively. Conclusion: From this and other quality improvement initiatives, we have learned the importance of engaging frontline practitioners in process changes, specifically the impact on workflow. Also, utilizing existing IT systems and resources can result in positive change with minimal costs.

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