Scottish Longitudinal Study
Development & Support Unit
DEMETRIQ – DEVELOPING METHODOLOGIES TO REDUCE INEQUALITIES IN THE DETERMINANTS OF HEALTH
Gwen Menvielle (Inserm)
Johan Mackenbach (Erasmus MC)
Frank van Lenthe (Erasmus MC)
Rianne de Gelder (Erasmus MC)
Yannan Hu (Erasmus MC)
Rasmus Hoffman (Erasmus MC)
Caspar Looman (Erasmus MC)
17 April 2013
Social inequalities in health are a major challenge to public health in Europe and hence a priority topic for the EU. While the average level of health in EU countries has continued to improve over the last decades, differences in health between advantaged and disadvantaged sections of the population within each country remain substantial. A broad spectrum of policies influences the determinants of health inequalities. Such interventions are seldom evaluated for their impact on population health in general and even more rarely for their differential impact on different socioeconomic groups. There is an urgent need to extend and strengthen the evidence base on differential policy impact, to help identify the most effective ways to reduce health inequalities in different EU countries. Methodologically, this is a highly challenging task for which traditional experimental evaluation designs are neither adequate nor feasible.
Within DEMETRIQ project, new methods of policy analysis and evaluation of natural experiments will be combined with a unique longitudinal dataset of health determinants and health outcomes by socioeconomic group in more than 20 European countries covering several decades, in order to generate new knowledge on differential effects of policies targeting the strategic drivers of health inequalities.
In the evaluation of natural policy experiments, logic models will be developed which describe the potential pathways trough which policies may ultimately affect socioeconomic inequalities in health. Quantitative techniques will also be applied to assess the impact of natural policy experiments (for example, regression adjustment, matching, instrumental variables, a regression discontinuity design, interrupted time-series, difference-in-differences, and fixed effect models). Those methods have been widely used for general policy evaluation, but rarely for the effect on health inequality. The longitudinal dataset to be constructed allows trend analysis of socioeconomic inequalities in health, and as such contribute to the evaluation of the policies.
- Develop, evaluate and refine methodologies for assessing the effects of social, economic and health policies on the pattern and magnitude of health inequalities among socioeconomic groups.
- Assess the differential health effects by socioeconomic group of ‘natural policy experiments’ in the fields of unemployment and poverty reduction; tobacco and alcohol control; and access to education and preventive health care.
- Synthesise the evidence from the findings of objectives 1-2, and to actively engage users in the research to promote effective exchange of knowledge for policy and practice.