Levelling up health: A practical, evidence-based framework for reducing health inequalities

Fiona Davey · Victoria J. McGowan · Jack Michael Birch · Isla L. Kuhn · Anwesha Lahiri · Anna Gkiouleka +4 more

30 citations0/0 files storedPublic Health in Practice

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Public Health and Social Inequalities Public Health Policies and Education Health disparities and outcomes

Abstract

There are substantial inequalities in health across society which have been exacerbated by the COVID-19 pandemic. The UK government have committed to a programme of levelling-up to address geographical inequalities. Here we undertake rapid review of the evidence base on interventions to reduce such health inequalities and developed a practical, evidence-based framework to ‘level up’ health across the country. This paper overviews a rapid review undertaken to develop a framework of guiding principles to guide policy. To that end and based on an initial theory, we searched one electrotonic database (MEDLINE) from 2007 to July 2021 to identify published umbrella reviews and undertook an internet search to identify relevant systematic reviews, primary studies, and grey literature. Titles and abstracts were screened according to the eligibility criteria. Key themes were extracted from the included studies and synthesised into an overarching framework of guiding principles in consultation with an expert panel. Included studies were cross checked with the initial theoretical domains and further searching undertaken to fill any gaps. We identified 16 published umbrella reviews (covering 667 individual studies), 19 grey literature publications, and 15 key systematic reviews or primary studies. Based on these studies, we develop a framework applicable at national, regional and local level which consisted of five principles - 1) healthy-by-default and easy to use initiatives; 2) long-term, multi-sector action; 3) locally designed focus; 4) targeting disadvantaged communities; and 5) matching of resources to need. Decision-makers working on policies to level up health should be guided by these five principles.

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References

2020The COVID-19 pandemic and health inequalities 2009Tackling the wider social determinants of health and health inequalities: evidence from systematic reviews 2016Evaluating Strategies For Reducing Health Disparities By Addressing The Social Determinants Of Health 2020Ethnic and racial disparities in COVID-19-related deaths: counting the trees, hiding the forest 2012Food Pricing Strategies, Population Diets, and Non-Communicable Disease: A Systematic Review of Simulation Studies 2018The effects of public health policies on health inequalities in high-income countries: an umbrella review 2016Interactive social media interventions to promote health equity: an overview of reviews 2010Injustice is killing people on a large scale--but what is to be done about it?

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