Social Inequalities in health: Challenges, knowledge gaps, key debates and the need for new data

Eikemo, Terje Andreas; Øversveen, Emil

doi:10.1177/1403494819866416

Cited by 26 publications

(19 citation statements)

References 21 publications

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“…Yet, although the comprehensive framework offered by the SDoH approach has proved very useful for analysis and policy recommendations, there have been fewer examples of actual policy changes following the recommendations made. Still, there are ongoing discussions around how to take further steps in order to develop the SDoH approach as well as the policy recommendations that can be derived from it (see, for example, [3, 4, 5]).…”

mentioning

confidence: 99%

Next steps in the development of the social determinants of health approach: the need for a new narrative

Lundberg

2020

Scand J Public Health

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During the past 15–20 years the Social Determinants of Health (SDoH) framework has become the main approach to understand health inequalities. With this model a range of factors important for health and inequalities in health over the life-course have been connected into a larger framework. Despite its usefulness and popularity within the field, and wide use in influential reviews, the SDoH framework has not been easy to communicate to stakeholders in other sectors, and we cannot as yet see much of substantial societal change as a result of it. In this Commentary I try to discuss possible reasons behind our difficulties to communicate the SDoH perspective. Some of these reasons relate to how we frame and present the different parts of the framework, others are more linked to common beliefs and practices that I think we should rethink. In both cases, I believe that we would benefit from a more general discussion around these fundamental issues, both in order to communicate our important insights but also to better understand our own key study objective, namely how health inequalities are generated, sustained and potentially reduced.

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confidence: 99%

Next steps in the development of the social determinants of health approach: the need for a new narrative

Lundberg

2020

Scand J Public Health

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“…Public health researchers will need to maintain the important work of quality control and to continuously assess the validity and completeness of the Nordic registers. One crucial component of this work is to promote linkages with other types of material, including survey data [13]. Doing so will ensure that the Nordic population registers maintain their unique relevance and significance in the future.…”

Section: The Illusion Of Universalitymentioning

confidence: 99%

The illusion of universality: The use of Nordic population registers in studies of migration, employment and health

Gauffin

2020

Scand J Public Health

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Aims: Nordic register material is often considered to be a gold standard for studies of social epidemiology and population health, but it comes with certain limitations. This short communication aims to draw attention to lacking coverage as a potentially growing problem of Nordic register material. Methods: The article is based on a short review of previous studies and commentaries on the strengths and limitations of Nordic register data with a particular focus on studies of employment and migration. Results: In times of institutional and demographic change in the Nordic countries, the assumption of universal register coverage can be challenged. Precarious and informal employment arrangements, important social determinants of health, provide a good illustration of the problem. Work that is carried out in the semi-legal margins of the labour market, sometimes by a ‘hidden population’ of non-resident, short-term labour immigrants, will not be covered by the registers. Researchers may therefore run the risk of misrepresenting reality if they maintain the belief that population registers cover the entire population. Conclusions: The Nordic registers are an extraordinary resource for public health researchers, but continuous quality control and assessment of validity and completeness will be crucial to maintain relevance in a transitioning society.

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“…Additionally, this study shows that women need to report higher levels of pain than men in order for it to be registered [ 13 ]. As a result of this emerging evidence, the status quo of considering the palliative care patients “male by default” has recently been contested [ 12 , 14 ]. Furthermore, this bias is compounded as it coexists with other stereotypical depictions of men and women.…”

Section: Introductionmentioning

confidence: 99%

Gender and Observed Complexity in Palliative Home Care: A Prospective Multicentre Study Using the HexCom Model

Busquet-Duran

Moreno-Gabriel

Jiménez-Zafra

et al. 2021

IJERPH

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This study analyses gender differences in the complexity observed in palliative home care through a multicentre longitudinal observational study of patients with advanced disease treated by palliative home care teams in Catalonia (Spain). We used the HexCom model, which includes six dimensions and measures three levels of complexity: high (non-modifiable situation), medium (difficult) and low. Results: N = 1677 people, 44% women. In contrast with men, in women, cancer was less prevalent (64.4% vs. 73.9%) (p < 0.001), cognitive impairment was more prevalent (34.1% vs. 26.6%; p = 0.001) and professional caregivers were much more common (40.3% vs. 24.3%; p < 0.001). Women over 80 showed less complexity in the following subareas: symptom management (41.7% vs. 51,1%; p = 0.011), emotional distress (24.5% vs. 32.8%; p = 0.015), spiritual distress (16.4% vs. 26.4%; p = 0.001), socio-familial distress (62.7% vs. 70.1%; p = 0.036) and location of death (36.0% vs. 49.6%; p < 0.000). Men were more complex in the subareas of “practice” OR = 1.544 (1.25–1.90 p = 0.000) and “transcendence” OR = 1.52 (1.16–1.98 p = 0.002). Observed complexity is related to male gender in people over 80 years of age. Women over the age of 80 are remarkably different from their male counterparts, showing less complexity regarding care for their physical, psycho-emotional, spiritual and socio-familial needs.

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Social Inequalities in health: Challenges, knowledge gaps, key debates and the need for new data

Cited by 26 publications

References 21 publications

Next steps in the development of the social determinants of health approach: the need for a new narrative

Next steps in the development of the social determinants of health approach: the need for a new narrative

The illusion of universality: The use of Nordic population registers in studies of migration, employment and health

Gender and Observed Complexity in Palliative Home Care: A Prospective Multicentre Study Using the HexCom Model

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