Levelling up health: A practical, evidence-based framework for reducing health inequalities

Davey, Fiona; McGowan, Vic; Birch, Jack M; Khun, Isla; Lahiri, Anwesha; Gkiouleka, Anna; Arora, Ananya; Sowden, Sarah; Bambra, Clare; Ford, John

doi:10.1016/j.puhip.2022.100322

Cited by 12 publications

(12 citation statements)

References 40 publications

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“…Namely, as our analysis showed, deprivation was a strong predictor of COVID-19 mortalities across all localities. This finding is consistent with calls to include health in the Levelling-Up policy agenda that has aimed to reduce the spatial socioeconomic inequalities across the UK ( Couper et al, 2023 ; Davey et al, 2022 ). Some even have argued that the inclusion of health in such a national policy to address geographical inequalities is a necessity now because COVID-19 has made the inequalities worse ( Couper et al, 2023 ; Davey et al, 2022 ).…”

Section: Discussionsupporting

confidence: 85%

“…This finding is consistent with calls to include health in the Levelling-Up policy agenda that has aimed to reduce the spatial socioeconomic inequalities across the UK ( Couper et al, 2023 ; Davey et al, 2022 ). Some even have argued that the inclusion of health in such a national policy to address geographical inequalities is a necessity now because COVID-19 has made the inequalities worse ( Couper et al, 2023 ; Davey et al, 2022 ). This issue is coupled with other findings of our study that ethnic populations disproportionately suffered from the pandemic across all localities.…”

Section: Discussionsupporting

confidence: 85%

“…There is evidence that structural inequalities are the reason for such suffering and the Levelling-Up policy might improve the situation for these people too ( Irizar et al, 2023 ). Considering all these and informed by a systematic review findings, Davey et al (2022) ( Davey et al, 2022 ) postulated that a post-pandemic, health-oriented Levelling-Up policy to address social determinants of spatial health inequalities across England can include the following elements and interventions: ( Burlina & Rodríguez-Pose, 2023 ) healthy-by-default and easy-to-use initiatives, e.g., subsidies for healthy food purchases or taxing alcohol and cigarette trade and purchase, to improve the conditions supportive for health-positive choices. This type of intervention can lead to healthier populations across the localities who will be less susceptible to chronic conditions like obesity and diabetes (as two of the main preconditions exacerbating COVID-19 outcomes) ( Mansour et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

“…This agenda is designed with the overarching objective of mitigating regional disparities and augmenting the socio-economic standing of local communities. Some scholars posit that this policy initiative is a manifestation of accumulated evidence now finding resonance in political spheres ( Davey et al, 2022 ; Fransham et al, 2023 ). However, notwithstanding the wealth of insights into inequalities and the concerted drive toward Levelling-Up, a substantial void in knowledge persists regarding the intricate nexus between socioeconomic factors, the social determinants of health and chronic health conditions, and the pandemic experience across diverse spatial strata ( Albani et al, 2022 ; Feng, 2023 ).…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Social determinants of spatial inequalities in COVID-19 outcomes across England: A multiscale geographically weighted regression analysis

Khedmati Morasae,

Derbyshire,

Amini

et al. 2024

SSM - Population Health

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Social determinants of spatial inequalities in COVID-19 outcomes across England: A multiscale geographically weighted regression analysis

Khedmati Morasae,

Derbyshire,

Amini

et al. 2024

SSM - Population Health

View full text Add to dashboard Cite

“…Portugal, Germany, and other European nations are embedding social prescribing in their primary care systems [ 3 ]. If social prescribing is to “level up” the gradient in health [ 4 ], then screening and referral interventions should occur in hospital settings to overcome the barriers that disadvantaged patients may face to access primary care [ 5 ]. Even in wealthy countries with universal healthcare such as Australia, disadvantaged populations struggle to access primary care [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

In-person versus electronic screening for social risks among carers of pediatric inpatients: A mixed methods randomized trial

Smithers,

MacPhail,

Chan

et al. 2024

Eur J Pediatr

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We aimed to compare disclosure of social risks according to self-report on an iPad versus face-to-face questions from a health professional and to explore carers’ experiences of screening. This two-arm, parallel group, randomized trial was conducted from January 19, 2021, to December 17, 2021, in a public hospital pediatric ward serving a disadvantaged area of an Australian capital city. Carers of children aged ≤ 5 years admitted to the Children’s Ward were eligible. The primary outcome was disclosure of social risks. The screener included nine items on food security, household utilities, transport, employment, personal and neighborhood safety, social support, housing and homelessness. Disclosure of social risks was similar between the self-completion (n = 193) and assisted-completion (n = 193) groups for all 9 items, ranging 4.1% higher for worrying about money for food (95% CI − 11.4, 3.1%) among the assisted-completion group, to 5.7% (−1.6, 13.0%) higher for unemployment among the self-completion group. In qualitative interviews, participants were positive about screening for social risks in the hospital ward setting and the majority indicated a preference for self-completion. Conclusion: Differences in the disclosure of social risks according to self- versus assisted-completion were small, suggesting that either method could be used. Most carers expressed a preference for self- completion, which is therefore recommended as the ideal mode for such data collection for Australian pediatric inpatient settings. Trial registration: Australia New Zealand Clinical Trial Registry (www.anzctry.org.au; #ACTRN12620001326987; date of registration 8 December 2020). What is Known:• Most evidence on screening of social risks in pediatric inpatient settings is from the USA.• Little is known about disclosure of social risks in countries with universal health care and social welfare. What is New:• Disclosure of social risks was similar for electronic compared with face-to-face screening.• Carers preferred electronic completion over face-to-face completion.

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Levelling Up for health in towns? Development of a new deprivation index: the ‘Stronger Towns Index’ and its association with self-rated health and migration in England, between 2001 and 2011

Duke‐Williams

Stockton

Shelton

2023

J Public Health (Berl.)

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Aim To develop the ‘Stronger Towns Index': a deprivation index that took into account characteristics of areas encompassing towns that may be eligible for redevelopment funding and explore how this index was associated with self-rated health and migration within England between 2001 and 2011. Subject and methods All members of the ONS Longitudinal Study in England aged 16 and over in 2001 whose records included a self-rated health response and a valid local authority code. Local authorities in England were ranked using a composite index developed using the five metrics set out in the Stronger Towns Funding: productivity, income, skills, deprivation measures, and the proportion of people living in towns. The index was split into deciles, and logistic regression carried out on the association between decile and self-rated health in 2001 in the main sample (n = 407,878) and decile change and self-rated health in 2011 in a subsample also present in 2011, with migration information (n = 299,008). Results There were areas in the lowest deciles of Town Strength who did not receive funding. After multiple adjustment, LS members living in areas with higher deciles were significantly more likely (7% to 38%) to report good health than those in the lowest decile in 2001. Remaining in the same decile between 2001 and 2011 was associated with 7% lower odds of good self-rated health in 2011. Conclusion It is important to consider health in towns when allocating funding. Areas in the Midlands may have missed out on funding which might help mitigate poor health.

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Levelling up health: A practical, evidence-based framework for reducing health inequalities

Cited by 12 publications

References 40 publications

Social determinants of spatial inequalities in COVID-19 outcomes across England: A multiscale geographically weighted regression analysis

Social determinants of spatial inequalities in COVID-19 outcomes across England: A multiscale geographically weighted regression analysis

In-person versus electronic screening for social risks among carers of pediatric inpatients: A mixed methods randomized trial

Levelling Up for health in towns? Development of a new deprivation index: the ‘Stronger Towns Index’ and its association with self-rated health and migration in England, between 2001 and 2011

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