Goldblatt Peter O
Department of Epidemiology and Public Health, UCL Institute of Health Equity, London, United Kingdom;
Glob Health Action. 2016 Feb 25;9:29627. doi: 10.3402/gha.v9.29627. eCollection 2016.
England has a long history of government-commissioned reviews of national inequalities. The latest review, the Marmot Review, was commissioned by a government headed by the same party (the Labour Party) that had introduced the National Health Service in 1948, but the review was implemented by a coalition of different parties (Conservatives and Liberal Democrats). At the same time, a government reform of health services took place, and the monitoring of the existing inequality strategy was changed.
This paper examines the lessons that can be learned about indicators for monitoring social determinants of health inequalities from the Marmot Review and recent health inequality strategies in England.
The paper provides a narrative review of key findings on the collection, presentation, and analysis of routine data in England in the past 5 years, comparing what has been learned from the Marmot Review and other evaluations of the first health inequality strategy in England.
The emphasis on monitoring has progressively shifted from monitoring a small number of targets and supporting information to frameworks that monitor across a wide range of determinants of both the causes of ill-health and of health service performance. As these frameworks become ever larger, some consideration is being given to the key indicators.
Although the frameworks used in England for monitoring health inequality strategies have developed considerably since the first strategy began, lessons continue to be learned about how monitoring could be improved. Many of these are applicable to countries initiating or reviewing their strategies.
英国政府委托开展全国不平等状况审查已有很长历史。最新的审查即《马尔莫特审查》，是由在1948年引入国民医疗服务体系的同一政党（工党）领导的政府委托进行的，但该审查是由不同政党（保守党和自由民主党）组成的联合政府实施的。与此同时，政府对医疗服务进行了改革，对现有不平等战略的监测也发生了变化。
本文探讨从《马尔莫特审查》以及英国近期的健康不平等战略中可以汲取哪些有关监测健康不平等社会决定因素指标的经验教训。
本文对过去5年英国常规数据收集、呈现和分析的关键发现进行了叙述性综述，比较了从《马尔莫特审查》以及对英国首个健康不平等战略的其他评估中学到的内容。
监测重点已逐渐从监测少数目标和辅助信息转向监测涵盖健康不良原因和医疗服务绩效的广泛决定因素的框架。随着这些框架日益庞大，人们开始考虑关键指标。
尽管自首个战略启动以来，英国用于监测健康不平等战略的框架有了很大发展，但在如何改进监测方面仍不断有经验教训可汲取。其中许多经验教训适用于正在启动或审查其战略的国家。
