Tackling the wider determinants of health and health inequalities: evidence from systematic reviews
Completed Start date Oct 2006 End date August 2008
Health is influenced by social and environmental factors which vary depending on an individual’s social position. Factors such as income, class and gender have an impact on people’s employment, housing conditions, education and other aspects of living conditions which in turn have an impact on health. There is a great deal of evidence which describes the nature of these health inequalities in society, but there is much less evidence about effective ways to tackle such inequalities. It is important that such evidence is available to help policy-makers to make decisions about the kind of policies that will help to tackle health inequalities, and also to guide future research in this area.
We conducted an ‘umbrella review’ which aimed to locate and synthesise evidence from existing systematic reviews and primary studies about the impact of non-healthcare interventions on health outcomes and health inequalities. We were interested in finding evaluations of interventions which were aimed at the social determinants of health such as housing, employment conditions and transport. We found 32 reviews of non-healthcare interventions which included health outcomes. Very few of these included data on health impacts on different social groups, although there was some evidence that housing and work environment interventions had the potential to tackle health inequalities. There is a need for more research on how higher level interventions such as welfare and healthcare systems affect health and health inequalities. The full version of the final report can be viewed here, and a short version is available here .
Gibson M, Petticrew M, Bambra C, Sowden AJ, Wright KE, Whitehead M. Housing and health inequalities: a synthesis of systematic reviews of interventions aimed at different pathways linking housing and health. Health & Place 2011;17:175-184pubmed open access
Bambra C, Gibson M, Sowden A, Wright K, Whitehead M, Petticrew M. Tackling the wider social determinants of health and health inequalities: evidence from systematic reviews. Journal of Epidemiology & Community Health 2010;64:284-91pubmed open access
Bond L, Craig P, Egan M, Skivington K, Thomson H. Health improvement programmes: really too complex to evaluate? [letter]. BMJ 2010;340ID - 615:c1332pubmed open access
Bond L, Craig P, Egan M, Skivington K, Thomson H. MRC guidelines and the evaluation of health improvement programmes: are health improvement programmes really too complex to assess their effectiveness? [rapid response]. BMJ 2010;340ID - 614:c185open access
Bambra C, Gibson M, Sowden A, Wright K, Whitehead M, Petticrew M. Working for health? Evidence from systematic reviews on the effects on health and health inequalities of organisational changes to the work environment. Preventive Medicine 2009;48:454-61pubmed
Bond L, Leyland AH, Macintyre S, Wight D. Evaluation of a youth development programme demonstrates the need for the randomised roll-out of community interventions [rapid response] ID - 870. BMJ 2009:July 16thopen access
Egan M, Bambra C, Petticrew M, Whitehead M. Reviewing evidence on complex social interventions: appraising implementation in systematic reviews of the health effects of organisational-level workplace interventions. Journal of Epidemiology & Community Health 2009;63:4-11pubmed open access
Bambra C, Gibson M, Petticrew M, Sowden A, Whitehead M, Wright K. Tackling the wider social determinants of health and health inequalities: evidence from systematic reviews. York, 2008open access
- Systematic review A type of literature review which uses a particular approach involving (among other things) a comprehensive search for literature, and a formal assessment of the quality of each study