Department of Political and Social Sciences, Research Group on Health Inequalities, Environment, Employment Conditions Knowledge Network (GREDS-EMCONET), Universitat Pompeu Fabra, Mercè Rodoreda 24 Building, Campus Ciutadella UPF, Ramon Trias Fargas, 25-27, 08003, Barcelona, Catalonia, Spain.
Johns Hopkins University-Pompeu Fabra University Public Policy Center (UPF-BSM), Barcelona, Catalonia, Spain.
Health Res Policy Syst. 2023 Mar 23;21(1):23. doi: 10.1186/s12961-023-00968-w.
Evidence on health inequalities has been growing over the past few decades, yet the capacity to produce research on health inequalities varies between countries worldwide and needs to be strengthened. More in-depth understanding of the sociohistorical, political and institutional processes that enable this type of research and related research capacity to be generated in different contexts is needed. A recent bibliometric analysis of the health inequalities research field found inequalities in the global production of this type of research. It also found the United Kingdom to be the second-highest global contributor to this research field after the United States. This study aims to understand why and how the United Kingdom, as an example of a "high producer" of health inequalities research, has been able to generate so much health inequalities research over the past five decades, and which main mechanisms might have been involved in generating this specific research capacity over time.
We conducted a realist explanatory case study, which included 12 semi-structured interviews, to test six theoretical mechanisms that we proposed might have been involved in this process. Data from the interviews and grey and scientific literature were triangulated to inform our findings.
We found evidence to suggest that at least four of our proposed mechanisms have been activated by certain conditions and have contributed to the health inequalities research production process in the United Kingdom over the past 50 years. Limited evidence suggests that two new mechanisms might have potentially also been at play.
Valuable learning can be established from this case study, which explores the United Kingdom's experience in developing a strong national health inequalities research tradition, and the potential mechanisms involved in this process. More research is needed to explore additional facilitating and inhibiting mechanisms and other factors involved in this process in this context, as well as in other settings where less health inequalities research has been produced. This type of in-depth knowledge could be used to guide the development of new health inequalities research capacity-strengthening strategies and support the development of novel approaches and solutions aiming to tackle health inequalities.
过去几十年里，有关健康不平等的证据不断增加，但全球各国在开展健康不平等研究方面的能力存在差异，需要加以加强。需要更深入地了解使这种类型的研究和相关研究能力在不同背景下产生的社会历史、政治和制度进程。最近对健康不平等研究领域的文献计量分析发现，这种类型的研究在全球的产出存在不平等现象。该分析还发现，英国是仅次于美国的全球第二大此类研究领域贡献者。本研究旨在了解英国作为健康不平等研究的“高产国”之一，为何以及如何在过去五十年中产生如此多的健康不平等研究，以及哪些主要机制可能随着时间的推移而产生了这种特定的研究能力。
我们进行了一项真实的解释性案例研究，其中包括 12 次半结构化访谈，以检验我们提出的可能涉及这一过程的六个理论机制。访谈和灰色及科学文献中的数据进行了三角验证，以提供我们的研究结果。
我们有证据表明，在过去 50 年中，我们提出的至少四个机制在某些条件下已经被激活，并为英国的健康不平等研究产出做出了贡献。有限的证据表明，两个新的机制也可能发挥了作用。
本案例研究探讨了英国发展强大的国家健康不平等研究传统的经验以及这一过程中涉及的潜在机制，可以从中获得宝贵的经验教训。需要进一步研究来探索这一过程中涉及的其他促进和抑制机制以及其他因素，以及在其他产出较少健康不平等研究的环境中。这种深入的知识可以用于指导新的健康不平等研究能力建设战略的制定，并支持旨在解决健康不平等问题的新方法和解决方案的开发。
