Tackling the wider social determinants of health and health inequalities: evidence from systematic reviews.
- 1 University of Durham, United Kingdom;
- 2 MRC Glasgow, United Kingdom;
- 3 University of York, United Kingdom;
- 4 York, United Kingdom;
- 5 University of Liverpool, United Kingdom;
- 6 LSHTM, United Kingdom
- * Corresponding author; email: clare.bambra{at}durham.ac.uk
- Received 14 January 2009
- Accepted 3 June 2009
- Published Online First 19 August 2009
Abstract
Background: There is increasing pressure to tackle the wider social determinants of health, through the implementation of appropriate interventions. However, turning these demands for better evidence about interventions around the social determinants of health into action requires identifying what we already know and highlighting the evidence gaps.
Methods: Systematic review methodology was used to identify systematic reviews (from 2000-2007, developed countries only) that described the health effects of any intervention based on the wider social determinants of health: water and sanitation, agriculture and food, access to health and social care services, unemployment and welfare, work conditions, housing and living environment, education, and transport.
Results: Thirty systematic reviews were identified. Certain categories of intervention may impact positively on health, in particular interventions in the fields of housing and work. However, there were clear gaps in the evidence, and the effects of interventions on health inequalities were unclear.
Conclusion: Intervention studies which address inequalities in health are a priority area for future public health research.
