Closing the health equity gap: a social determinants focus for population level Cochrane Reviews

Article type
Authors
Doyle J1, Waters E1, Armstrong R1
1Cochrane Public Health Review Group, Australia
Abstract
Background: In 2005 theWorld Health Organisation (WHO) convened the Commission on Social Determinants of Health to determine the available evidence globally on health inequities with an ultimate goal of identifying strategies to curb the increase in inequities. Results suggested that inequities were not naturally occurring and could be avoidable by improving policy choices - acting on the social and structural determinants of population health.

Objectives: The Cochrane Public Health Group (CPHG) was registered with the Collaboration in 2008, with a mandate to produce reviews of interventions that sought to address these ‘upstream’ determinants of health, filling a gap in the existing coverage of review topics relevant to global health.

Methods: CPHG authors, guided by the editorial team, have utilised methods to identify the ability of these interventions to reduce inequities, as well as pointers to potential ineffectiveness (and inequities) due to implementation or resource issues. Review authors are also asked to highlight issues for LMICs, often in the absence of good quality evidence in these countries.

Results: We will present an overview of the reviews published and underway within the CPHG, using case studies to highlight reviews of interventions that are characterised by multi-sectoral involvement, and those looking to reduce health inequities for disadvantaged populations in particular.

Conclusions: Disease prevention and control strategies will continue to have sub-optimal impact on the health prospects of the most vulnerable groups unless the root causes of poor health are also addressed. The CPHG will continue to facilitate and promote methods to highlight reasons and solutions to disparities in health as it focuses on reviews of the effects of interventions seeking to act on the social and structural determinants of population health globally.