A new typology of policies to tackle health inequalities and scenarios of impact based on Rose's population approach
A new typology of policies to tackle health inequalities and scenarios of impact based on Rose's population approach
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DOI：
10.1136/jech-2011-200363
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发表时间：
2013-03-01
影响因子：
6.3
通讯作者：
Miguel Martinez, Jose
中科院分区：
文献类型：
--
作者：
Benach, Joan;Malmusi, Davide;Miguel Martinez, Jose
过去十年，人们对解决卫生不平等问题的政策的兴趣激增。需要对政策模型进行充分的理论发展，以了解如何设计和评估以公平为导向的卫生政策。在本文中，我们回顾了格雷厄姆的政策类型学（关注最贫穷者、差距或梯度），并提出了一种适应（有针对性的、普遍的、额外的目标、再分配和比例普遍主义）。对于每种类型，根据杰弗里·罗斯的人口曲线和战略的思想，描述了对人口健康和健康不平等的潜在影响情景，给出了政策示例，并显示了带有调查数据的模拟。拟议的减少卫生不平等情景类型可以作为一种有效工具，解释干预措施的不同影响，并反映如何充分设计或重新确定政策的方向，以及使用哪些措施来评估政策。
The last decade has witnessed a surge in interest for policies to tackle health inequalities. Adequate theoretical development of policy models is needed to understand how to design and evaluate equity-oriented health policies. In this paper we review Graham's typology of policies (focused on the worst-off, on the gap, or on the gradient) and propose an adaptation (targeted, universal with additional targeting, redistributive, and proportionate universalism). For each type, potential scenarios of impact on population health and health inequalities are depicted following the idea of Geoffrey Rose's population curves and strategies, policy examples are given and a simulation with survey data is shown. The proposed typology of scenarios of health inequality reduction can serve as an effective tool to interpret the differential impact of interventions and to reflect on how to adequately design or re-orient a policy and which measures to use to evaluate it.