How best to tackle health inequalities?

A new report led by LJMU’s Public Health Institute has examined the effectiveness of public health interventions to tackle inequalities which arise from poverty, access to services and behaviours. 

The study, commissioned by Public Health Wales, analysed around 150 published reviews covering thousands of individual research studies. 

The findings identified key areas having beneficial impacts that reduce health inequalities as:

• price/tax increases on tobacco and high energy density foods and subsidies on fruit and vegetables
• comprehensive smoke free policies
• interventions targeted towards people in low socio-economic groups, that improve healthcare navigation and support decision making about healthcare, community engagement, parenting education, breastfeeding promotion, food subsidy programmes and improvements to housing conditions.  

However, the report found benefits from interventions aimed specifically at those in more deprived socio-economic groups were less clear in the areas of:

• changes to the urban and built environment
• school and community-based health promotion for health behaviours including smoking, alcohol, diet and physical activity
• community-based health promotion for adults. 

The report identified a number of areas where evidence of positive or negative effects was lacking especially interventions aimed at influencing living and working conditions. 

Dr Lisa Jones, Reader in Public Health, who led the study, said: “The impacts of socioeconomic inequalities in health are well described and there’s broad agreement that action is needed to reduce them. However, the extent and scope of the evidence available to guide action is less well understood. By bringing together high-quality reviews from the international literature our report provides a useful resource about the evidence available to tackle one of public health’s most important challenges.”

Professor Mark Bellis, Director of Health Research and Innovation, and Director of the Public Health Institute, added: Health inequalities mean many individuals in more deprived communities develop ill health far earlier in their lives than should be the case, often resulting in them dying at much younger ages than those in more affluent communities. This report shows there is still a great deal to be learnt about the best ways to tackle health inequalities.  However, it also highlights that there is already enough evidence to move from repeated descriptions of the problem to plans and actions to solve them.”