scholarly journals Going upstream – an umbrella review of the macroeconomic determinants of health and health inequalities

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yannish Naik ◽  
Peter Baker ◽  
Sharif A. Ismail ◽  
Taavi Tillmann ◽  
Kristin Bash ◽  
...  
Keyword(s):  
Health Inequalities ◽  
Systematic Reviews ◽  
Health Impact ◽  
Determinants Of Health ◽  
Market Regulation ◽  
Umbrella Review ◽  
Positive Health ◽  
Mixed Effect ◽  
Macroeconomic Determinants ◽  
Health And Health Inequalities

Abstract Background The social determinants of health have been widely recognised yet there remains a lack of clarity regarding what constitute the macro-economic determinants of health and what can be done to address them. An umbrella review of systematic reviews was conducted to identify the evidence for the health and health inequalities impact of population level macroeconomic factors, strategies, policies and interventions. Methods Nine databases were searched for systematic reviews meeting the Database of Abstracts of Reviews of Effects (DARE) criteria using a novel conceptual framework. Studies were assessed for quality using a standardised instrument and a narrative overview of the findings is presented. Results The review found a large (n = 62) but low quality systematic review-level evidence base. The results indicated that action to promote employment and improve working conditions can help improve health and reduce gender-based health inequalities. Evidence suggests that market regulation of tobacco, alcohol and food is likely to be effective at improving health and reducing inequalities in health including strong taxation, or restriction of advertising and availability. Privatisation of utilities and alcohol sectors, income inequality, and economic crises are likely to increase health inequalities. Left of centre governments and welfare state generosity may have a positive health impact, but evidence on specific welfare interventions is mixed. Trade and trade policies were found to have a mixed effect. There were no systematic reviews of the health impact of monetary policy or of large economic institutions such as central banks and regulatory organisations. Conclusions The results of this study provide a simple yet comprehensive framework to support policy-makers and practitioners in addressing the macroeconomic determinants of health. Further research is needed in low and middle income countries and further reviews are needed to summarise evidence in key gaps identified by this review. Trial registration Protocol for umbrella review prospectively registered with PROSPERO CRD42017068357.

scholarly journals Correction to: The macro-economic determinants of health and health inequalities—umbrella review protocol

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Yannish Naik ◽  
Peter Baker ◽  
Ian Walker ◽  
Taavi Tillmann ◽  
Kristin Bash ◽  
...  
Keyword(s):  
Health Inequalities ◽  
Determinants Of Health ◽  
Umbrella Review ◽  
Economic Determinants ◽  
Review Protocol ◽  
Health And Health Inequalities

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

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

scholarly journals The macro-economic determinants of health and health inequalities—umbrella review protocol

2017 ◽  
Vol 6 (1) ◽  
Author(s):  
Yannish Naik ◽  
Peter Baker ◽  
Ian Walker ◽  
Taavi Tillmann ◽  
Kristin Bash ◽  
...  
Keyword(s):  
Health Inequalities ◽  
Determinants Of Health ◽  
Umbrella Review ◽  
Economic Determinants ◽  
Review Protocol ◽  
Health And Health Inequalities

scholarly journals Go slow: an umbrella review of the effects of 20 mph zones and limits on health and health inequalities

2014 ◽  
Vol 37 (3) ◽  
pp. 515-520 ◽  
Author(s):  
Jo Cairns ◽  
Jon Warren ◽  
Kayleigh Garthwaite ◽  
Graeme Greig ◽  
Clare Bambra
Keyword(s):  
Health Inequalities ◽  
Umbrella Review ◽  
Health And Health Inequalities

scholarly journals Evaluation of Health Equity Impact of Structural Policies

2017 ◽  
Vol 47 (3) ◽  
pp. 432-439 ◽  
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.

Addressing Social Determinants of Health and Health Inequalities

JAMA ◽  
2016 ◽  
Vol 316 (16) ◽  
pp. 1641 ◽  
Author(s):  
Nancy E. Adler ◽  
M. Maria Glymour ◽  
Jonathan Fielding
Keyword(s):  
Social Determinants Of Health ◽  
Health Inequalities ◽  
Social Determinants ◽  
Determinants Of Health ◽  
Health And Health Inequalities
Sign in / Sign up

Export Citation Format

Share Document