Adams Jean, White Martin, Moffatt Suzanne, Howel Denise, Mackintosh Joan
Public Health Research Group, School of Population and Health Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne, UK.
BMC Public Health. 2006 Mar 29;6:81. doi: 10.1186/1471-2458-6-81.
Socio-economic variations in health, including variations in health according to wealth and income, have been widely reported. A potential method of improving the health of the most deprived groups is to increase their income. State funded welfare programmes of financial benefits and benefits in kind are common in developed countries. However, there is evidence of widespread under claiming of welfare benefits by those eligible for them. One method of exploring the health effects of income supplementation is, therefore, to measure the health effects of welfare benefit maximisation programmes. We conducted a systematic review of the health, social and financial impacts of welfare rights advice delivered in healthcare settings.
Published and unpublished literature was accessed through searches of electronic databases, websites and an internet search engine; hand searches of journals; suggestions from experts; and reference lists of relevant publications. Data on the intervention delivered, evaluation performed, and outcome data on health, social and economic measures were abstracted and assessed by pairs of independent reviewers. Results are reported in narrative form.
55 studies were included in the review. Only seven studies included a comparison or control group. There was evidence that welfare rights advice delivered in healthcare settings results in financial benefits. There was little evidence that the advice resulted in measurable health or social benefits. This is primarily due to lack of good quality evidence, rather than evidence of an absence of effect.
There are good theoretical reasons why income supplementation should improve health, but currently little evidence of adequate robustness and quality to indicate that the impact goes beyond increasing income.
健康方面的社会经济差异，包括根据财富和收入划分的健康差异，已被广泛报道。改善最贫困群体健康状况的一种潜在方法是增加他们的收入。由国家资助的经济福利和实物福利项目在发达国家很常见。然而，有证据表明，符合条件的人普遍存在福利申领不足的情况。因此，探索收入补充对健康影响的一种方法是衡量福利最大化项目对健康的影响。我们对在医疗环境中提供的福利权益咨询的健康、社会和经济影响进行了系统综述。
通过搜索电子数据库、网站和互联网搜索引擎获取已发表和未发表的文献；对期刊进行手工检索；向专家咨询；以及查阅相关出版物的参考文献列表。由两名独立评审员提取并评估关于所实施干预、进行的评估以及健康、社会和经济指标的结果数据。结果以叙述形式报告。
该综述纳入了55项研究。只有7项研究设有比较组或对照组。有证据表明，在医疗环境中提供的福利权益咨询能带来经济收益。几乎没有证据表明这种咨询能带来可衡量的健康或社会效益。这主要是由于缺乏高质量的证据，而非表明没有效果的证据。
从理论上讲，收入补充应该能改善健康状况，但目前几乎没有足够有力和高质量的证据表明其影响超出了增加收入的范畴。
