A new typology of policies to tackle health inequalities and scenarios of impact based on Rose's population approach

Benach, Joan; Malmusi, Davide; Yasui, Yutaka; Martı́nez, José Miguel

doi:10.1136/jech-2011-200363

Cited by 118 publications

(103 citation statements)

References 31 publications

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“…In general, ‘downstream’ preventive interventions with focus on individual behavioural changes are more likely to increase health inequalities than ‘upstream’ social or policy interventions 31. Among the former, media campaigns may be particularly likely to increase inequalities while the latter tend to reduce health inequalities, as they are usually ‘structural’ 32 33. Furthermore, the risk of hypertension associated with low parental social status can be modified by an improvement in social status later in life,34 suggesting effective targets for public health policies and political interventions.…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic inequality in salt intake in Britain 10 years after a national salt reduction programme

Cappuccio

2014

BMJ Open

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ObjectivesThe impact of the national salt reduction programme in the UK on social inequalities is unknown. We examined spatial and socioeconomic variations in salt intake in the 2008–2011 British National Diet and Nutrition Survey (NDNS) and compared them with those before the programme in 2000–2001.SettingCross-sectional survey in Great Britain.Participants1027 Caucasian males and females, aged 19–64 years.Primary outcome measuresParticipants’ dietary sodium intake measured with a 4-day food diary. Bayesian geo-additive models used to assess spatial and socioeconomic patterns of sodium intake accounting for sociodemographic, anthropometric and behavioural confounders.ResultsDietary sodium intake varied significantly across socioeconomic groups, even when adjusting for geographical variations. There was higher dietary sodium intake in people with the lowest educational attainment (coefficient: 0.252 (90% credible intervals 0.003, 0.486)) and in low levels of occupation (coefficient: 0.109 (−0.069, 0.288)). Those with no qualification had, on average, a 5.7% (0.1%, 11.1%) higher dietary sodium intake than the reference group. Compared to 2000-2001 the gradient of dietary sodium intake from south to north was attenuated after adjustments for confounders. Estimated dietary sodium consumption from food sources (not accounting for discretionary sources) was reduced by 366 mg of sodium (∼0.9 g of salt) per day during the 10-year period, likely the effect of national salt reduction initiatives.ConclusionsSocial inequalities in salt intake have not seen a reduction following the national salt reduction programme and still explain more than 5% of salt intake between more and less affluent groups. Understanding the socioeconomic pattern of salt intake is crucial to reduce inequalities. Efforts are needed to minimise the gap between socioeconomic groups for an equitable delivery of cardiovascular prevention.

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Section: Introductionmentioning

confidence: 99%

Socioeconomic inequality in salt intake in Britain 10 years after a national salt reduction programme

Cappuccio

2014

BMJ Open

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“…There are three approaches that are commonly used to conceptualize and measure health inequalities: worst-off, gap, or whole spectrum (gradient) [27],[28].…”

Section: Approaches To Monitoring Health Inequalitiesmentioning

confidence: 99%

Equity-Oriented Monitoring in the Context of Universal Health Coverage

et al. 2014

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“…In addition to levelling down, three other intervention scenarios were investigated: (1) ideal (all social groups achieve risk factors target), (2) more realistic (risk factor target is achieved, but the social gradient across risk factors remains) and (3) poverty focused (only the most disadvantaged group is targeted and benefits from a risk factor reduction). Benach et al 37 present an example of using simulation modelling to investigate a new typology of policies to reduce social inequalities in health, defined as targeted, universal with additional targeting, redistributive and proportionate universalism.…”

Section: Simulation Modelling: Understanding Solutions To Reduce Socimentioning

confidence: 99%

Reducing social inequalities in health: the role of simulation modelling in chronic disease epidemiology to evaluate the impact of population health interventions

Smith

Harper

et al. 2013

J Epidemiol Community Health

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Reducing health inequalities has become a major public health priority internationally. However, how best to achieve this goal is not well understood. Population health intervention research has the potential to address some of this knowledge gap. This review argues that simulation studies can produce unique evidence to build the population health intervention research evidence base on reducing social inequalities in health. To this effect, the advantages of using simulation models over other population health intervention research methods are discussed. Key questions regarding the potential challenges of developing simulation models to investigate population health intervention research on reducing social inequalities in health and the types of population health intervention research questions that can be answered using this methodology are reviewed. We use the example of social inequalities in coronary heart disease to illustrate how simulation models can elucidate the effectiveness of a number of ‘what-if’ counterfactual population health interventions on reducing social inequalities in coronary heart disease. Simulation models are a flexible, cost-effective, evidence-based research method with the capacity to inform public health policy-makers regarding the implementation of population health interventions to reduce social inequalities in health.

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A new typology of policies to tackle health inequalities and scenarios of impact based on Rose's population approach

Cited by 118 publications

References 31 publications

Socioeconomic inequality in salt intake in Britain 10 years after a national salt reduction programme

Socioeconomic inequality in salt intake in Britain 10 years after a national salt reduction programme

Equity-Oriented Monitoring in the Context of Universal Health Coverage

Reducing social inequalities in health: the role of simulation modelling in chronic disease epidemiology to evaluate the impact of population health interventions

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