Health inequalities in European welfare states

在保健方面存在社会不平等是众所周知的。福利国家（社会政策、医疗保健、公共卫生政策）可以在调节健康的社会决定因素的影响方面发挥重要作用；然而，比较研究表明，在慷慨和包容的福利国家中，健康不平等实际上是最大的。该项目将重点关注以下问题：为什么欧洲福利国家在健康方面存在社会不平等，以及如何减少这种不平等？该项目的预期成果和影响包括：改进、检验和发展健康理论中的社会不平等，确定有可能减少健康不平等的政策和干预措施，以及关于如何最有效地减少健康不平等的新政策议程。该项目由跨越三个项目阶段交付的六个相互关联的工作包组成。在第一阶段，我们将对福利国家和医疗保健系统影响病因学和减少健康方面的社会不平等的途径进行理论阐述。在第二阶段，我们将使用发病率和死亡率指标探索和测试这些途径。我们还将使用证据审查方法来检查宏观政策干预在减少卫生不平等方面的影响。在第三阶段，我们将把各项工作组合起来，编制针对具体国家的政策工具包。因此，该项目将对学术和政策领域产生影响。我们将在微观和宏观层面使用各种尖端数据源，并采用最先进的统计技术，如反事实政策分析和多层次模型。

The existence of social inequalities in health is well established. The welfare state (social policy, healthcare, public health policy) can play an important role in mediating the effects of the social determinants of health; however, comparative studies have shown that health inequalities are actually amongst the largest in generous and inclusive welfare states. This project will focus on the following question: why do social inequalities in health persist in European welfare states and what can be done to reduce them? Expected outcomes and the impact of this project include the refinement, testing and development of social inequalities in health theory, the identification of policies and interventions with the potential of reducing health inequalities, and a new policy agenda on how health inequalities can be reduced most effectively. The project consists of six interrelated work packages delivered across three project phases. In the first phase, we will provide theoretical elaboration on the pathways whereby welfare states and healthcare systems influence the aetiology and reduction of social inequalities in health. In the second phase, we will explore and test these pathways using morbidity and mortality indicators. We will also use evidence review methods to examine the effects of macro policy interventions in reducing health inequalities. In the third phase, we will combine the work packages to produce country specific policy toolkits. The project will thus impact on both the academic and policy spheres. We will use a variety of cutting edge data sources at the micro and macro level and employ state-of-the-art statistical techniques, such as counterfactual policy analyses and multilevel models.