欧洲福利国家公共卫生政策对人群健康及健康不平等的影响：一项伞状综述方案
The effects of public health policies on population health and health inequalities in European welfare states: protocol for an umbrella review.
作者信息
Thomson Katie, Bambra Clare, McNamara Courtney, Huijts Tim, Todd Adam
机构信息
Centre for Health and Inequalities Research, Department of Geography, Durham University, Lower Mountjoy, South Road, Durham, DH1 3LE, UK.
Department of Sociology and Political Science, Norwegian University of Science and Technology, Dragvoll, Building 9, Level 5, 7491, Trondheim, Norway.
出版信息
Syst Rev. 2016 Apr 8;5:57. doi: 10.1186/s13643-016-0235-3.
BACKGROUND
The welfare state is potentially an important macro-level determinant of health that also moderates the extent, and impact, of socio-economic inequalities in exposure to the social determinants of health. The welfare state has three main policy domains: health care, social policy (e.g. social transfers and education) and public health policy. This is the protocol for an umbrella review to examine the latter; its aim is to assess how European welfare states influence the social determinants of health inequalities institutionally through public health policies.
METHODS/DESIGN: A systematic review methodology will be used to identify systematic reviews from high-income countries (including additional EU-28 members) that describe the health and health equity effects of upstream public health interventions. Interventions will focus on primary and secondary prevention policies including fiscal measures, regulation, education, preventative treatment and screening across ten public health domains (tobacco; alcohol; food and nutrition; reproductive health services; the control of infectious diseases; screening; mental health; road traffic injuries; air, land and water pollution; and workplace regulations). Twenty databases will be searched using a pre-determined search strategy to evaluate population-level public health interventions.
DISCUSSION
Understanding the impact of specific public health policy interventions will help to establish causality in terms of the effects of welfare states on population health and health inequalities. The review will document contextual information on how population-level public health interventions are organised, implemented and delivered. This information can be used to identify effective interventions that could be implemented to reduce health inequalities between and within European countries.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42016025283.
背景
福利国家可能是健康的一个重要宏观层面决定因素，它还会调节在接触健康的社会决定因素方面社会经济不平等的程度和影响。福利国家有三个主要政策领域：医疗保健、社会政策（如社会转移支付和教育）以及公共卫生政策。这是一项伞状综述的方案，旨在研究后者；其目的是评估欧洲福利国家如何通过公共卫生政策在制度上影响健康不平等的社会决定因素。
方法/设计：将采用系统综述方法，从高收入国家（包括另外28个欧盟成员国）识别描述上游公共卫生干预措施对健康和健康公平影响的系统综述。干预措施将侧重于一级和二级预防政策，包括财政措施、监管、教育、预防性治疗以及在十个公共卫生领域（烟草；酒精；食品和营养；生殖健康服务；传染病控制；筛查；心理健康；道路交通伤害；空气、土地和水污染；以及工作场所规定）的筛查。将使用预先确定的搜索策略搜索20个数据库，以评估人群层面的公共卫生干预措施。
讨论
了解特定公共卫生政策干预措施的影响将有助于确定福利国家对人群健康和健康不平等影响方面的因果关系。该综述将记录有关人群层面公共卫生干预措施如何组织、实施和提供的背景信息。这些信息可用于确定可实施的有效干预措施，以减少欧洲国家之间和国家内部的健康不平等。
系统综述注册
PROSPERO CRD42016025283。
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