Informing Investment to Reduce Inequalities: A Modelling Approach
| Autor: | Martin Taulbut, Cheryl Denny, Barbara Graham, Andrew McAuley, Gerry McCartney, Ian Grant, Colin Fischbacher, David A. McAllister, Paul O'Hagan, Rory Mitchell |
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| Rok vydání: | 2015 |
| Předmět: |
Physiology
Economics medicine.medical_treatment Psychological intervention Social Sciences Habits 0302 clinical medicine Patient Admission Income tax Medicine and Health Sciences Smoking Habits Salaries Public and Occupational Health 030212 general & internal medicine Multidisciplinary Relative index of inequality Tobacco control Taxes Socioeconomic Aspects of Health Policy Physiological Parameters Medicine 0305 other medical science Behavioral and Social Aspects of Health Research Article Tobacco Control Death Rates Science Population health Health Promotion 03 medical and health sciences Population Metrics Environmental health medicine Humans Social determinants of health Obesity Investments Mortality Demography Behavior 030505 public health Population Biology Body Weight Biology and Life Sciences Health Status Disparities Models Theoretical United Kingdom Health Care Taxation Years of potential life lost Labor Economics People and Places Smoking cessation Finance |
| Zdroj: | PLoS ONE PLoS ONE, Vol 11, Iss 8, p e0159256 (2016) McAuley, A, Denny, C, Taulbut, M, Mitchell, R, Fischbacher, C, Graham, B, Grant, I, O'Hagan, P, McAllister, D & McCartney, G 2016, ' Informing Investment to Reduce Inequalities : A Modelling Approach ', PLoS ONE, vol. 11, no. 8, pp. e0159256 . https://doi.org/10.1371/journal.pone.0159256 |
| ISSN: | 1932-6203 |
| DOI: | 10.1371/journal.pone.0159256 |
| Popis: | BACKGROUND: Reducing health inequalities is an important policy objective but there is limited quantitative information about the impact of specific interventions.OBJECTIVES: To provide estimates of the impact of a range of interventions on health and health inequalities.MATERIALS AND METHODS: Literature reviews were conducted to identify the best evidence linking interventions to mortality and hospital admissions. We examined interventions across the determinants of health: a 'living wage'; changes to benefits, taxation and employment; active travel; tobacco taxation; smoking cessation, alcohol brief interventions, and weight management services. A model was developed to estimate mortality and years of life lost (YLL) in intervention and comparison populations over a 20-year time period following interventions delivered only in the first year. We estimated changes in inequalities using the relative index of inequality (RII).RESULTS: Introduction of a 'living wage' generated the largest beneficial health impact, with modest reductions in health inequalities. Benefits increases had modest positive impacts on health and health inequalities. Income tax increases had negative impacts on population health but reduced inequalities, while council tax increases worsened both health and health inequalities. Active travel increases had minimally positive effects on population health but widened health inequalities. Increases in employment reduced inequalities only when targeted to the most deprived groups. Tobacco taxation had modestly positive impacts on health but little impact on health inequalities. Alcohol brief interventions had modestly positive impacts on health and health inequalities only when strongly socially targeted, while smoking cessation and weight-reduction programmes had minimal impacts on health and health inequalities even when socially targeted.CONCLUSIONS: Interventions have markedly different effects on mortality, hospitalisations and inequalities. The most effective (and likely cost-effective) interventions for reducing inequalities were regulatory and tax options. Interventions focused on individual agency were much less likely to impact on inequalities, even when targeted at the most deprived communities. |
| Databáze: | OpenAIRE |
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