The effects of public health policies on health inequalities: an umbrella review
PHE ePoster Library. Hillier-Brown F.
Sep 12, 2017; 186614
Frances Hillier-Brown
Frances Hillier-Brown
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Abstract
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Abstract Introduction: Socio-economic inequalities are associated with unequal exposure to social, economic and environmental risk factors, which in turn contribute to health inequalities. Understanding the impact of specific public health policy interventions will help to establish causality in terms of the effects on health inequalities. Methods: Systematic review methodology was used to identify systematic reviews from high-income countries that describe the health equity effects of upstream public health interventions. Twenty databases were searched from their start date until March 2016. The quality of the included articles was determined using the Assessment of Multiple Systematic Reviews tool (AMSTAR).Results: Twenty systematic reviews were identified reporting 109 unique relevant primary studies. The reviews summarised evidence of all types of primary and secondary prevention policies (fiscal, regulation, education, preventative treatment and screening) across nine public health domains (tobacco, food and nutrition, the control of infectious diseases, screening, road traffic injuries, air, land and water pollution, built environment and workplace regulations). There were no systematic reviews of interventions targeting alcohol, mental health or reproductive health. Most of the reviews were of moderate quality, although the included primary studies were generally considered to be low in quality. Results were mixed across the public health domains; however, there is evidence to suggest that fiscal and regulation type policies are more beneficial for reducing or preventing health inequalities than educational campaigns. Conclusions: This umbrella review has identified effective public health regulation interventions that could reduce socio-economic inequalities in health. External funding details This research is part of the HiNEWS project - Health Inequalities in European Welfare States funded by the NORFACE (New Opportunities for Research Funding Agency Cooperation in Europe) Welfare State Futures programme (grant reference:462-14-110).
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