The effects of public health policies on health inequalities in high-income countries: an umbrella review.
The effects of public health policies on health inequalities in high-income countries: an umbrella review.
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DOI：
10.1186/s12889-018-5677-1
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发表时间：
2018-07-13
影响因子：
4.5
通讯作者：
Bambra C
中科院分区：
文献类型：
--
作者：
Thomson K;Hillier-Brown F;Todd A;McNamara C;Huijts T;Bambra C
社会经济不平等与不平等地暴露于社会、经济和环境风险因素有关，这反过来又加剧了健康不平等。了解具体公共卫生政策干预措施的影响将有助于确定对健康不平等的影响方面的因果关系。采用系统评价方法从高收入国家确定描述上游公共卫生干预措施对健康公平影响的系统评价。从开始日期到2017年5月，共搜索了20个数据库。使用多系统评价工具(AMSTAR)确定纳入文章的质量。确定了29项系统评价，报告了150项独特的相关初步研究。审查总结了七个公共卫生领域(烟草、酒精、食品和营养、生殖健康服务、传染病控制、环境和工作场所法规)的所有类型一级和二级预防政策(财政、监管、教育、预防性治疗和筛查)的证据。没有对针对心理健康的干预措施进行系统审查。公共卫生领域的结果好坏参半；一些政策干预措施被证明减少了健康不平等(例如，食品补贴计划、免疫接种)，另一些没有效果，一些干预措施似乎加剧了不平等(例如，每小时20英里和低排放区)。纳入的审查(及其初步研究)的质量普遍较差，突出了证据基础中的明显差距。这项审查确实初步建议了政策制定者可能用来减少健康不平等的干预措施，尽管目前尚不清楚这些计划是否可以在高收入国家之间转移。PROSPERO注册号：CRD42016025283本文的在线版本(10.1186/s12889-0185677-1)包含补充材料，授权用户可以获得。
Socio-economic inequalities are associated with unequal exposure to social, economic and environmental risk factors, which in turn contribute to health inequalities. Understanding the impact of specific public health policy interventions will help to establish causality in terms of the effects on health inequalities. Systematic review methodology was used to identify systematic reviews from high-income countries that describe the health equity effects of upstream public health interventions. Twenty databases were searched from their start date until May 2017. The quality of the included articles was determined using the Assessment of Multiple Systematic Reviews tool (AMSTAR). Twenty-nine systematic reviews were identified reporting 150 unique relevant primary studies. The reviews summarised evidence of all types of primary and secondary prevention policies (fiscal, regulation, education, preventative treatment and screening) across seven public health domains (tobacco, alcohol, food and nutrition, reproductive health services, the control of infectious diseases, the environment and workplace regulations). There were no systematic reviews of interventions targeting mental health. Results were mixed across the public health domains; some policy interventions were shown to reduce health inequalities (e.g. food subsidy programmes, immunisations), others have no effect and some interventions appear to increase inequalities (e.g. 20 mph and low emission zones). The quality of the included reviews (and their primary studies) were generally poor and clear gaps in the evidence base have been highlighted. The review does tentatively suggest interventions that policy makers might use to reduce health inequalities, although whether the programmes are transferable between high-income countries remains unclear. PROSPERO registration number: CRD42016025283 The online version of this article (10.1186/s12889-018-5677-1) contains supplementary material, which is available to authorized users.
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影响因子：
4.5
作者：
Bergqvist K;Yngwe MA;Lundberg O
通讯作者：
Lundberg O
影响因子：
6.3
作者：
Egan, Matt;Petticrew, Mark;Drever, Frances
通讯作者：
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影响因子：
4.5
作者：
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影响因子：
6.3
作者：
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通讯作者：
Bambra, Clare
影响因子：
6.3
作者：
Bambra, C.
通讯作者：
Bambra, C.