Going upstream – an umbrella review of the macroeconomic determinants of health and health inequalities
| Autor: | Wikum Jayatunga, Gill Kelly, Ben Barr, Taavi Tillmann, Peter Roderick, Clare Bambra, Michelle Black, Sharif Ismail, Darryl Quantz, Peter Baker, Kristin Bash, Yannish Naik, Frances Hillier-Brown, Anya Gopfert |
|---|---|
| Přispěvatelé: | Wellcome Trust, National Institute for Health Research |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Economics Social Determinants of Health media_common.quotation_subject Psychological intervention Population health 1117 Public Health and Health Services 03 medical and health sciences 0302 clinical medicine Economic inequality Humans Medicine 030212 general & internal medicine Social determinants of health Macroeconomy Health inequalities media_common Public health 030505 public health Public economics business.industry lcsh:Public aspects of medicine Public Health Environmental and Occupational Health lcsh:RA1-1270 Welfare state Health Status Disparities Economy Systematic review Economic policy 0305 other medical science business Welfare Systematic Reviews as Topic Research Article Regulation |
| Zdroj: | BMC public health, 2019, Vol.19(1), pp.1678 [Peer Reviewed Journal] BMC Public Health BMC PUBLIC HEALTH BMC Public Health, Vol 19, Iss 1, Pp 1-19 (2019) |
| ISSN: | 4201-7068 |
| Popis: | BackgroundThe social determinants of health have been widely recognised yet there remains a lack of clarity regarding what constitute the macro-economic determinants of health and what can be done to address them. An umbrella review of systematic reviews was conducted to identify the evidence for the health and health inequalities impact of population level macroeconomic factors, strategies, policies and interventions.MethodsNine databases were searched for systematic reviews meeting the Database of Abstracts of Reviews of Effects (DARE) criteria using a novel conceptual framework. Studies were assessed for quality using a standardised instrument and a narrative overview of the findings is presented.ResultsThe review found a large (n = 62) but low quality systematic review-level evidence base. The results indicated that action to promote employment and improve working conditions can help improve health and reduce gender-based health inequalities. Evidence suggests that market regulation of tobacco, alcohol and food is likely to be effective at improving health and reducing inequalities in health including strong taxation, or restriction of advertising and availability. Privatisation of utilities and alcohol sectors, income inequality, and economic crises are likely to increase health inequalities. Left of centre governments and welfare state generosity may have a positive health impact, but evidence on specific welfare interventions is mixed. Trade and trade policies were found to have a mixed effect. There were no systematic reviews of the health impact of monetary policy or of large economic institutions such as central banks and regulatory organisations.ConclusionsThe results of this study provide a simple yet comprehensive framework to support policy-makers and practitioners in addressing the macroeconomic determinants of health. Further research is needed in low and middle income countries and further reviews are needed to summarise evidence in key gaps identified by this review.Trial registrationProtocol for umbrella review prospectively registered with PROSPEROCRD42017068357. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|