What types of interventions generate inequalities? Evidence from systematic reviews
TLDR
The findings are consistent with the idea that ‘downstream’ preventive interventions are more likely to increase health inequalities than ‘upstream” interventions.Abstract:
Background Some effective public health interventions may increase inequalities by disproportionately benefiting less disadvantaged groups (‘intervention-generated inequalities’ or IGIs). There is a need to understand which types of interventions are likely to produce IGIs, and which can reduce inequalities. Methods We conducted a rapid overview of systematic reviews to identify evidence on IGIs by socioeconomic status. We included any review of non-healthcare interventions in high-income countries presenting data on differential intervention effects on any health status or health behaviour outcome. Results were synthesised narratively. Results The following intervention types show some evidence of increasing inequalities (IGIs) between socioeconomic status groups: media campaigns; and workplace smoking bans. However, for many intervention types, data on potential IGIs are lacking. By contrast, the following show some evidence of reducing health inequalities: structural workplace interventions; provision of resources; and fiscal interventions, such as tobacco pricing. Conclusion Our findings are consistent with the idea that ‘downstream’ preventive interventions are more likely to increase health inequalities than ‘upstream’ interventions. More consistent reporting of differential intervention effectiveness is required to help build the evidence base on IGIs.read more
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Applying an equity lens to interventions: using PROGRESS ensures consideration of socially stratifying factors to illuminate inequities in health
Jennifer O’Neill,Hilary Tabish,Vivian Welch,Mark Petticrew,Kevin Pottie,Mike Clarke,Timothy G Evans,Jordi Pardo Pardo,Elizabeth Waters,Howard White,Peter Tugwell +10 more
TL;DR: The acronym PROGRESS is a framework and aide-memoire that is useful in ensuring that an equity lens is applied in the conduct, reporting, and use of research.
Journal ArticleDOI
Inequalities in non-communicable diseases and effective responses
Mariachiara Di Cesare,Young-Ho Khang,Perviz Asaria,Tony Blakely,Melanie J. Cowan,Farshad Farzadfar,Ramiro Guerrero,Nayu Ikeda,Catherine Kyobutungi,Kelias P. Msyamboza,Sophal Oum,John Lynch,John Lynch,Michael Marmot,Majid Ezzati +14 more
TL;DR: Effective actions to reduce NCD inequalities include equitable early childhood development programmes and education; removal of barriers to secure employment in disadvantaged groups; comprehensive strategies for tobacco and alcohol control and for dietary salt reduction that target low socioeconomic status groups.
Journal ArticleDOI
PRISMA-Equity 2012 Extension: Reporting Guidelines for Systematic Reviews with a Focus on Health Equity
Vivian Welch,Mark Petticrew,Peter Tugwell,Peter Tugwell,David Moher,Jennifer O’Neill,Elizabeth Waters,Howard White +7 more
TL;DR: Vivian Welch and colleagues present consensus-based guidelines for reporting equity-focused systematic reviews, the PRISMA-Equity extension, which is presented as a guide for firms to conduct equity- focused systematic reviews.
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Portion, package or tableware size for changing selection and consumption of food, alcohol and tobacco.
Gareth J Hollands,Ian Shemilt,Theresa M. Marteau,Susan A. Jebb,Hannah B Lewis,Yinghui Wei,Julian P T Higgins,David Ogilvie +7 more
TL;DR: A meta‐analysis of 86 independent comparisons from 58 studies found a small to moderate effect of portion, package, individual unit or tableware size on consumption of food, alcohol or tobacco products in adults and children, which suggests that, if sustained reductions in exposure to larger‐sized food portions, packages and tableware could be achieved across the whole diet.
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Community engagement to reduce inequalities in health: a systematic review, meta-analysis and economic analysis
Alison O'Mara-Eves,Ginny Brunton,David McDaid,Sandy Oliver,Josephine Kavanagh,Farah Jamal,Tihana Matosevic,Angela Harden,Angela Harden,James Thomas +9 more
TL;DR: A multimethod systematic review builds on the evidence that underpins the current UK guidance on community engagement to identify theoretical models underpinning community engagement and to explore mechanisms and contexts through which communities are engaged to identify community engagement approaches that are effective in reducing health inequalities.
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