Intersectoral action for health equity: a rapid systematic review

BMC Public Health

Hannah Moffatt¹  Sume Ndumbe-Eyoh¹ 

[1] National Collaborating Centre for Determinants of Health, P.O.Box 5000, Antigonish NS B2G 2 W5, Canada

关键词: Social determinants of health;    Socioeconomic factors;    Health equity;    Intersectoral action;   

Others  :  1161571
DOI  :  10.1186/1471-2458-13-1056

 received in 2013-04-23, accepted in 2013-10-31,  发布年份 2013

【 摘 要 】

Background

Action on the social determinants of health is considered a necessary approach to improving health equity. Most of the social determinants of health lie outside the sphere of the health sector and thus collaboration with governmental and non-governmental sectors outside of health are required to develop policies and programs to improve health equity. Case studies of intersectoral action are available, however there is limited information about the impact of intersectoral action on the social determinants of health and health equity.

Methods

Search and retrieval of literature published between 2001 and 2011 was conducted in 6 databases. A staged screening of titles and abstracts, and later full-text, was conducted by two independent reviewers. Reviewers independently assessed the quality of the articles deemed relevant for inclusion. Data were extracted and synthesized in narrative format for all included studies, conducted by one reviewer and checked by another.

Results

17 articles of varied methodological quality met the inclusion criteria. One systematic review investigating partnership interventions found mixed and limited impacts on health outcomes. Primary studies evaluating the impact of upstream and midstream interventions showed mixed effects. Downstream interventions were generally moderately effective in increasing the availability and use of services by marginalized communities.

Conclusions

The literature evaluating the impact of intersectoral action on health equity is limited. The included studies identified reveal a moderate to no effect on the social determinants of health. The evidence on the impact of intersectoral action on health equity is even more limited. The lack of evidence should not be interpreted as a lack of effect. Rigorous evaluations of intersectoral action are needed to strengthen the evidence base of this public health practice.

【 授权许可】

   
2013 Ndumbe-Eyoh and Moffatt; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Public Health Agency of Canada: Lessons learned from Canadian experiences with intersectoral action to address the social determinants of health. In Chomik Consulting & Research Edited by Chomik TA. 2007.
• [2]Public Health Agency of Canada: Canadian Reference Group on social determinants of health. 2011. [World Health Organiziation. World Conference on Social Determinants of Health]
• [3]Public Health Agency of Canada: World Health Organization. 2008. [Health equity through intersectoral action: an analysis of 18 country case studies]
• [4]Canadian Institutes of Health Research - Institute for Population and Public Health, Canadian Institute for Health Information - Canadian Population Health Initiative: Population health intervention research casebook. Ottawa, ON: Canadian Institutes of Health Research - Institute for Population and Public Health,Canadian Institute for Health Information - Canadian Population Health Initiative; 2011.
• [5]Public Health Agency of Canada: Crossing sectors - experiences in intersectoral action, public policy and health. Ottawa, ON: Public Health Agency of Canada; 2007.
• [6]World Health Organization: Intersectoral action to tackle the social determinants of health and the role of evaluation. Geneva: World Health Organization; 2010. Report of the first Meeting of the WHO Policy Maker Resource Group on Social Determinants of Health, Viña del Mar, Chile, 27-29 January 2010
• [7]Shankardass K, Solar O, Murphy K, Greaves L, O’Campo P: A scoping review of intersectoral action for health equity involving governments. Int J Publ Health 2012, 57:25-33.
• [8]World Health Organization: “Equity Team” definition. Health and Human Rights and Equity Working Group Draft Glossary Unpublished 2005. 2005 cited by Solar O, Irwin A: A conceptual framework for action on the social determinants of health. Geneva: World Health Organization; 2010.
• [9]Whitehead M, Dahlgren G: Concepts and Principles for tackling social inequities in health: levelling up part 1. WHOLIS E89383. Geneva: World Health Organization; 2006. Studies on social and economic determinants of population health, No. 2
• [10]Mikkonen J, Raphael D: Social determinants of health: the Canadian facts. Toronto, ON: York University School of Health Policy and Management; 2010.
• [11]Federal Provincial and Territorial Advisory Committee on Population Health (ACPH): Intersectoral action…towards population health. Cat. No. H39-507/1999. Ottawa, ON: Health Canada Communications Directorate; 1999.
• [12]Public Health Agency of Canada: What determines health?. 2011. 3-9-2012
• [13]Solar O, Irwin A: A conceptual framework for action on the social determinants of health. Geneva: World Health Organization; 2010.
• [14]Sudbury & District Health Unit: 10 promising practices to guide local public health practice to reduce social inequities in health: technical briefing. Sudbury, ON: Sudbury & District Health Unit; 2011.
• [15]Sutcliffe P, Snelling S, Laclé S: Research-oriented decision-making to guide local public health practice to reduce social inequities in health. Sudbury, ON: Sudbury & District Health Unit; 2009. Intervention Progress Report 2
• [16]Mkandawire T: Targeting and universalism in poverty reduction. Geneva, Switzerland: United Nations Research Institute for Social Development; 2005. Social Policy and Development Program Number 23
• [17]Skocpol T: Targeting within universalism: politically viable policies to combat poverty in the United States. In The Urban Underclass. Jencks C, Peterson PE edition. Washington, DC: Brookings Institution Press; 1991:411-436. [Skocpol T]
• [18]Ganann R, Ciliska D, Thomas H: Expediting systematic reviews: methods and implications of rapid reviews. Implement Sci 2010, 5:56. BioMed Central Full Text
• [19]Shea BJ, Hamel C, Wells GA, Bouter LM, Kristjansson E, Grimshaw J, et al.: AMSTAR is a reliable and valid measurement tool to assess the methodological quality of systematic reviews. J Clin Epidemiol 2009, 62:1013-1020.
• [20]Shea BJ, Bouter LM, Peterson J, Boers M, Andersson N, Ortiz Z, et al.: External validation of a measurement tool to assess systematic reviews (AMSTAR). PLoS One 2007, 2:e1350.
• [21]Shea BJ, Grimshaw JM, Wells GA, Boers M, Andersson N, Hamel C, et al.: Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol 2007, 7:10. BioMed Central Full Text
• [22]Thomas BH, Ciliska D, Dobbins M, Micucci S: A process for systematically reviewing the literature: providing the research evidence for public health nursing interventions. Worldviews Evid Based Nurs 2004, 1:176-184.
• [23]Mulrow CD, Cook DJ, Davidoff F: Systematic reviews: critical links in the great chain of evidence. Ann Intern Med 1997, 126:389-391.
• [24]Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, et al.: Assessing the quality of reports of randomized clinical trials: is blinding necessary? Contr Clin Trials 1996, 17:1-12.
• [25]Deeks JJ, Higgins JP, Altman DG: Analysing and presenting results. In Cochrane Handbook for Systematic Reviews of Interventions 4.2.6. [Section 8]. Edited by Higgins JP, Green S. Chichester, UK: John Wiley & Sons, Ltd; 2006. [The Cochrane Library]
• [26]Letts L, Wilkins S, Law M, Stewart D, Bosch J, Westmorland M: Critical review form - qualitative Studies (Version 2.0). Hamilton, ON: McMaster University; 2007. [Qualitative Review Form]
• [27]Smith KE, Bambra C, Joyce KE, Perkins N, Hunter DJ, Blenkinsopp EA: Partners in health? A systematic review of the impact of organizational partnerships on public health outcomes in England between 1997 and 2008. J Publ Health (Oxf) 2009, 31:210-221.
• [28]Freeman R, Oliver M, Bunting G, Kirk J, Saunderson W: Addressing children’s oral health inequalities in Northern Ireland: a research-practice-community partnership initiative. Publ Health Rep 2001, 116:617-625.
• [29]Wills R, Morris MK, Hedley C, Freer T, Morris H: Improving school readiness with the before school check: early experience in Hawke’s Bay. N Z Med J 2010, 123:47-58.
• [30]Hollar D, Lombardo M, Lopez-Mitnik G, Hollar TL, Almon M, Agatston AS, et al.: Effective multi-level, multi-sector, school-based obesity prevention programming improves weight, blood pressure, and academic performance, especially among low-income, minority children. J Health Care Poor Underserv 2010, 21:S93-S108.
• [31]Jackson G, Thornley S, Woolston J, Papa D, Bernacchi A, Moore T: Reduced acute hospitalisation with the healthy housing programme. J Epidemiol Community Health 2011, 65:588-593.
• [32]Findley SE, Irigoyen M, Sanchez M, Guzman L, Mejia M, Sajous M, et al.: Community-based strategies to reduce childhood immunization disparities. Health Promot Pract 2006, 7:191S-200S.
• [33]Bruzzese JM, Evans D, Wiesemann S, Pinkett-Heller M, Levison MJ, Du Y, et al.: Using school staff to establish a preventive network of care to improve elementary school students’ control of asthma. J Sch Health 2006, 76:307-312.
• [34]Cheadle A, Bourcier E, Krieger J, Beery W, Smyser M, Vinh DV, et al.: The impact of a community-based chronic disease prevention initiative: evaluation findings from Steps to Health King County. Health Educ Behav 2011, 38:222-230.
• [35]Sherring J, Robson E, Morris A, Frost B, Tirupati S: A working reality: evaluating enhanced intersectoral links in supported employment for people with psychiatric disabilities. Aust Occup Ther J 2010, 57:261-267.
• [36]Pechter E, Azaroff LS, Lopez I, Goldstein-Gelb M: Reducing hazardous cleaning product use: a collaborative effort. Public Health Rep 2009, 124:49-52.
• [37]Fazel M, Doll H, Stein A: A school-based mental health intervention for refugee children: an exploratory study. Clin Child Psychol Psychiatr 2009, 14:297-309.
• [38]Melvin CS: A collaborative community-based oral care program for school-age children. Clin Nurse Spec 2006, 20:18-22.
• [39]Peifer K, Perez L: Effectiveness of a coordinated community effort to promote early literacy behaviors. Matern Child Health J 2011, 15:765-771.
• [40]Bailie R, McDonald E, Stevens M, Guthridge S, Brewster D: Evaluation of an Australian indigenous housing programme: community level impact on crowding, infrastructure function and hygiene. J Epidemiol Community Health 2011, 65:432-437.
• [41]Macnab AJ, Rozmus J, Benton D, Gagnon FA: 3-year results of a collaborative school-based oral health program in a remote first Nations community. Rural Remote Health 2008, 8:7.
• [42]Collie-Akers VL, Fawcett SB, Schultz JA, Carson V, Cyprus J, Pierle JE: Analyzing a community-based coalition’s efforts to reduce health disparities and the risk for chronic disease in Kansas City, Missouri. Prev Chronic Dis 2007, 4:A66.
• [43]Metzel DS, Foley SM, Butterworth J: State-level interagency agreements for supported employment of people with disabilities. J Disabil Pol Stud 2005, 16:102-114.
• [44]Brownson RC, Seiler R, Eyler AA: Measuring the impact of public health policy. Prev Chronic Dis 2010, 7(4):A77. PM:20550835
• [45]Torgersen TP, Giaever O, Trygve Stigen O: Developing an intersectoral national strategy to reduce social inequalities in heatlh - The Norwegian Case. Oslo; 2007. Retrieved from http://www.who.int/social_determinants/resources/isa_national_strategy_nor.pdf webcite
• [46]World Health Organization, Canadian Public Health Association. Intersectoral action for health: a cornerstone for health for all in the 21st century. WHO/PPE/PAC/97.6: World Health Organization. 1997. [Report of the International Conference] Ref Type: Report
• [47]CSDH: Closing the gap in a generation: health equity through action on the social determinants of health. Geneva: World Health Organization. Final Report on the Commission on Social Determinants of Health; 2008.
• [48]Marmot M, Friel S, Bell R, Houweling TA, Taylor S: Closing the gap in a generation: health equity through action on the social determinants of health. Lancet 2008, 372:1661-1669.
• [49]Bambra C, Gibson M, Sowden A, Wright K, Whitehead M, Petticrew M: Tackling the wider social determinants of health and health inequalities: evidence from systematic reviews. J Epidemiol Community Health 2010, 64:284-291.
• [50]Barten F, Mitlin D, Mulholland C, Hardoy A, Stern R: Integrated approaches to address the social determinants of health for reducing health inequity. J Urban Health 2007, 84:i164-i173.