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What types of interventions generate inequalities? Evidence from systematic reviews

Lorenc, T; Petticrew, M; Welch, V; Tugwell, P; (2013) What types of interventions generate inequalities? Evidence from systematic reviews. Journal of Epidemiology & Community Health , 67 (2) 190 - 193. 10.1136/jech-2012-201257. Green open access

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Abstract

Background Some effective public health interventions may increase inequalities by disproportionately benefiting less disadvantaged groups (‘intervention-generated inequalities’ or IGIs). There is a need to understand which types of interventions are likely to produce IGIs, and which can reduce inequalities. Methods We conducted a rapid overview of systematic reviews to identify evidence on IGIs by socioeconomic status. We included any review of non-healthcare interventions in high-income countries presenting data on differential intervention effects on any health status or health behaviour outcome. Results were synthesised narratively. Results The following intervention types show some evidence of increasing inequalities (IGIs) between socioeconomic status groups: media campaigns; and workplace smoking bans. However, for many intervention types, data on potential IGIs are lacking. By contrast, the following show some evidence of reducing health inequalities: structural workplace interventions; provision of resources; and fiscal interventions, such as tobacco pricing. Conclusion Our findings are consistent with the idea that ‘downstream’ preventive interventions are more likely to increase health inequalities than ‘upstream’ interventions. More consistent reporting of differential intervention effectiveness is required to help build the evidence base on IGIs.

Type: Article
Title: What types of interventions generate inequalities? Evidence from systematic reviews
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/jech-2012-201257
Publisher version: http://dx.doi.org/10.1136/jech-2012-201257
Language: English
Additional information: This is an author pre-print, full text published version can be found by following DOI link. © BMJ Publishing Group Ltd 2012
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > STEaPP
URI: http://discovery.ucl.ac.uk/id/eprint/1408909
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