Status report - Identifying equity-focussed interventions to promote healthy weights

Abstract

Introduction We developed screening criteria to identify population health interventions with an equity focus for inclusion on the Public Health Agency of Canada’s Canadian Best Practices Portal. We applied them to the area of “healthy weights,” specifically, obesity prevention. Methods We conducted a review of the literature and obtained input from expert external reviewers on changes to midstream environments. Interventions had to identify outcomes for groups with an underlying social disadvantage. We included papers with a focus on equity and vulnerable populations, intervention and/or evaluation studies, social determinants of health and healthy weights or obesity prevention. We then appraised the shortlisted studies for quality of evidence to determine eligibility for inclusion as promising practices on the Canadian Best Practices Portal. Results Few of the references reviewed passed the equity screening criteria (26 out of 2823 published papers reviewed, or 0.9%). Six (of the 26) interventions qualified as promising practices. Conclusion The ability of the equity screening criteria to distinguish midstream-level interventions for obesity prevention suggests that the criteria have potential to be applied to other public health topics. What is most important about our work is that the Portal, which is no longer being updated but is still accessible, was broadened to include interventions with a focus on equity.

At-a-glance - Bringing equity into the fold: a review of interventions to improve mental health

“…Innovative examples of 'midstream' interventions have the potential to sustain health benefits for those who are more vulnerable. 14 Funding agencies and the recipients of funding are now experimenting with appropriate ways to capture evidence of impacts on equity so that we may learn from existing examples of innovation.…”

“…This article describes work undertaken in 2015 to identify mental health interventions on the Portal that were equityfocused in both design and impact, building on earlier efforts that focused on healthy weights. 14 All mental health interventions that met the equity criteria were also rated using the detailed assessment tool developed for the Portal. 14 This rating tool assesses interventions within three broad domains: impact, adaptability and quality of evidence.…”

“…Interventions were required to: 1) report positive outcomes specifically for people living in conditions of disadvantage (these outcomes may or may not be compared to people living in more advantaged conditions); and either 2) explicitly target people living in conditions of disadvantage or 3) include activities that are focussed on specific health equity goals (e.g., that address the disproportionate exposure to health-damaging factors). 14…”

Editorial - Reducing premature mortality among young and middle-aged adults

“…22 Those predisposed to food addiction also tend to have higher depression scores, 20 a greater likelihood of having been abused as a child 23 and less access to physical activity facilities, especially in areas with low socioeconomic status and among certain minority groups, 24 including Indigenous children and youth. 25 Certainly, acknowledgement of and proper accounting for these and other inequities can help young adult populations to achieve a healthier body mass, as highlighted in the current issue of Health Promotion and Chronic Disease Prevention in Canada, by Bhawra et al, 25 Frankish et al 26 and Rao et al 27 In another paper published in the current issue, Steensma and colleagues present national data on health-adjusted life expectancy (HALE)-a hybrid measure not only of quantity of life, but of quality of life as well. 28 Across Canada, about 45% of the variation of HALE by health region was previously explained by differences in socioeconomic status, 29 and Steensma et al suggest that things may be worse in Newfoundland and Labrador and Prince Edward Island, especially among males.…”