This study sought to understand which types of non-health-care interventions are likely to increase or reduce health inequalities. Using a “rapid overview of systematic reviews” method, the researchers looked for studies that showed a change in health status, or health behaviour, between groups of lower and higher socioeconomic status (SES), following a non-health-care intervention. All of the studies were conducted in high income countries. The researchers found an increase in health status inequalities for two types of interventions: media campaigns and workplace smoking bans. They found a reduction in health inequalities, across the SES spectrum, for three types of interventions: ones that offered employees increased control or participation in the workplace (e.g. changes to working hours), ones that adjusted prices (e.g. tobacco), and ones that provided resources (free folic acid supplements).
The authors note that their findings are consistent with research showing that upstream interventions (pricing and working conditions) are more likely to reduce SES inequalities than are downstream approaches (media campaigns), but caution that their conclusions are provisional.
Use this resource to:
• Initiate a discussion in your health unit or regional health authority about the effect of particular types of interventions on health inequity between SES groups.
• Develop a better understanding of how some public health interventions can unwittingly increase health inequities.
• Learn about the evidence pointing to types of interventions that reduce health inequities.
This report does not have open access.
Lorenc, T., Petticrew, M., Welch, V. & Tugwell, P. (2012). What types of interventions generate inequalities? Evidence from systematic reviews. J Epidemiol Community Health, 67(2), 190-3. Doi: 10.1136/jeck-2012-201257