Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Faculty of Health & Medicine, Division of Health Research, Lancaster University, Lancaster, United Kingdom.
PLoS One. 2023 Feb 24;18(2):e0282080. doi: 10.1371/journal.pone.0282080. eCollection 2023.
Public health practice and efforts to improve the social determinants of health operate within a climate characterised by multiple and intersecting crises. This includes the Covid-19 pandemic as well as more protracted crises such as climate change and persistent social inequalities that impact health. We sought to understand and compare how knowledge exchange (KE) processes occur across different crises, and how knowledge on improving social determinants of health can be utilised at times of crisis to reduce health inequalities and strengthen public systems.
We conducted a scoping review to understand how KE on improving social determinants of health can occur across different types of crises (e.g. environmental, pandemics, humanitarian). Relevant studies were identified through electronic searching of Medline, EMBASE, Global Health, Scopus and Web of Science databases.
We identified 86 studies for inclusion in the review. Most studies concerned pandemic or environmental crises. Fewer studies explored KE during technical (e.g. nuclear), terror-related or humanitarian crises. This may reflect a limitation of the searches. Few studies assessed KE as part of longer-term responses to social and economic impacts of crises, with studies more likely to focus on immediate response or early recovery stages. Exchange of research evidence or data with policy or practice contextual knowledge was common but there was variation in the extent that lay (public) knowledge was included as part of KE processes.
As ongoing crises continue with significant public health implications, KE processes should appropriately reflect the complexity inherent in crises and foreground health inequalities. Doing so could include the utilisation of systems or complexity-informed methods to support planning and evaluation of KE, a greater focus on KE to support action to address social determinants of health, and the inclusion of a plurality of knowledge-including lived experience-in planning and responding to crises.
公共卫生实践和改善健康社会决定因素的努力是在一个以多种相互交织的危机为特征的环境中进行的。这包括新冠肺炎疫情以及气候变化和持续存在的社会不平等这些更长期的危机，这些危机对健康产生影响。我们试图了解和比较不同危机中知识交流（KE）过程是如何发生的，以及在危机时期如何利用改善健康社会决定因素的知识来减少健康不平等和加强公共系统。
我们进行了范围界定审查，以了解改善健康社会决定因素的 KE 如何在不同类型的危机（如环境、大流行病、人道主义）中发生。通过电子搜索 Medline、EMBASE、全球健康、Scopus 和 Web of Science 数据库，确定了相关研究。
我们确定了 86 项研究纳入审查。大多数研究涉及大流行病或环境危机。较少的研究探讨了在技术（如核）、恐怖相关或人道主义危机期间的 KE。这可能反映了搜索的局限性。很少有研究评估 KE 作为对危机对社会和经济影响的长期应对的一部分，研究更有可能侧重于直接应对或早期恢复阶段。研究证据或数据与政策或实践背景知识的交流很常见，但将大众（公众）知识纳入 KE 过程的程度存在差异。
随着具有重大公共卫生影响的持续危机的继续，KE 过程应适当反映危机中固有的复杂性，并将健康不平等放在突出位置。这样做可能包括利用系统或复杂性知情方法来支持 KE 的规划和评估，更注重支持解决健康社会决定因素的 KE，以及纳入包括生活经验在内的多种知识，以规划和应对危机。
