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Journal of Urban Health

, Volume 89, Issue 6, pp 881–893 | Cite as

Are We Producing the Right Kind of Actionable Evidence for the Social Determinants of Health?

  • Patricia O’CampoEmail author
Article

Abstract

Globally, health and social inequities are growing and are created, actively maintained, and aggravated by existing policies and practices. The call for evidence-based policy making to address this injustice seems a promising strategy to facilitate a reversal of existing strategies and the design of new effective programming. Acting on evidence to address inequities requires congruence between identifying the major drivers of disparities and the study of their causes and solutions. Yet, current research on inequities tends to focus on documenting disparities among individuals or subpopulations with little focus on identifying the macro-social causes of adverse population health. Moreover, the research base falls far short of a focus on the solutions to the complex multilevel drivers of disparities. This paper focuses upon recommendations to refocus and improve the public health research evidence generated to inform and create strong evidence-based recommendations for improving population health.

Keywords

Social determinants of health Health inequalities Evidence Social epidemiology 

Notes

Acknowledgments

This work has been funded in part by the Canadian Institutes of Health Research under grant #101693, entitled “Power, Politics, and the Use of Health Equity Research.”

References

  1. 1.
    Commission on Social Determinants of Health. Closing the Gap in a Generation: Health Equity Through Action on the Social Determinants of Health. Geneva: World Health Organization; 2008.Google Scholar
  2. 2.
    Wilkinson R, Pickett K. Spirit Level: Why More Equal Societies Almost Always Do Better. London: Allen Lane; 2009.Google Scholar
  3. 3.
    Szanton P. Not Well Advised: The City as Client—an Illuminating Analysis of Urban Governments and Their Consultants. San Jose: Authors Choice; 2001.Google Scholar
  4. 4.
    Brownson R, Royer C, Ewing R, McBride T. Researchers and policymakers: travelers in parallel universes. Am J Prev Med. 2006;30(2):164–172.PubMedCrossRefGoogle Scholar
  5. 5.
    Choi B, Gupta A, Ward B. Good thinking: six ways to bridge the gap between scientists and policy makers. J Epidemiol Community Health. 2009;63:179–180.PubMedCrossRefGoogle Scholar
  6. 6.
    Exworthy M. Policy to tackle the social determinants of health: using conceptual models to understand the policy process. Health Policy Plan. 2008;23:318–327.PubMedCrossRefGoogle Scholar
  7. 7.
    Jansen M, van Oers H, Kok G, de Vries N. Public health: disconnections between policy, practice and research. Health Res Policy Syst. 2010;8(37).Google Scholar
  8. 8.
    Murphy K, Fafard P. Knowledge translation and social epidemiology: taking power, politics, and values seriously. In: O’Campo P, Dunn J, eds. Rethinking Social Epidemiology: Toward a Science of Change. New York: Springer; 2011.Google Scholar
  9. 9.
    Ogilvie D, Craig P, Griffin S, Macintyre S, Wareham N. A translational framework for public health research. BMC Public Health. 2009;9(116).Google Scholar
  10. 10.
    Petticrew M. When are complex interventions ‘complex’? When are simple interventions ‘simple’? Eur J Public Health. 2011;21(4):397–398.PubMedCrossRefGoogle Scholar
  11. 11.
    Petticrew M, Whitehead M, Macintyre S, Graham H, Egan M. Evidence for public health policy on inequalities: 1: the reality according to policymakers. J Epidemiol Community Health. 2004;58:811–816.PubMedCrossRefGoogle Scholar
  12. 12.
    Best A, Hiatt R, Norman C. Knowledge integration: conceptualizing communications in cancer control systems. Patient Educ Couns. 2008;71(3):313–327.CrossRefGoogle Scholar
  13. 13.
    Graham I, Logan J, Harrison M, et al. Lost in knowledge translation: time for a map? J Contin Educ Heal Prof. 2006;26:13–24.CrossRefGoogle Scholar
  14. 14.
    Mitton C, Adair C, McKenzie E, Patten S, Perry B, Adair E. Knowledge transfer and exchange: review and synthesis of the literature. Milbank Q. 2007;85(4):729–768.PubMedCrossRefGoogle Scholar
  15. 15.
    Canadian Center for Policy Alternatives. Alternative Federal Budget 2011: Rethink, Rebuild, Renew: A Post-Recession Recovery Plan. Ottawa: Canadian Center for Policy Alternatives; 2011.Google Scholar
  16. 16.
    Mishel L, Shierholz H. Sustained, High Joblessness Causes Lasting Damage to Wages, Benefits, Income and Wealth. Washington, DC: Economic Policy Institute; 2011.Google Scholar
  17. 17.
    O’Campo P, Dunn J, eds. Rethinking Social Epidemiology: Toward a Science of Change. New York: Springer; 2011.Google Scholar
  18. 18.
    Cox J. US Housing Crisis Is Now Worse Than the Great Depression. www.cnbc.com; 2011.
  19. 19.
    Hough A. More middle class families ‘will become homeless’ due to recession. The Telegraph, 2011.Google Scholar
  20. 20.
    Rampell C. Length of unemployment continues to break records. The New York Times. August 5, 2011.Google Scholar
  21. 21.
    Shah A. Today, over 22,000 children died around the world. Global Issues: Social, Political, Economic and Environmental Issues That Affect Us All. Available at: http://www.globalissues.org/article/715/today-over-22000-children-died-around-the-world.
  22. 22.
    Fieldhouse A, Shapiro I. The Facts Support Raising Revenues from the Highest-Income Households. Washington, DC: Economic Policy Institute & The Century Foundation; 2011.Google Scholar
  23. 23.
    Krugman P. The Hijacked Crisis. New York Times. August 11, 2011.Google Scholar
  24. 24.
    Stiglitz J. Of the 1%, by the 1%, for the 1%. Vanity Fair; May 2011.Google Scholar
  25. 25.
    Yalnizyan A. The Rise of Canada’s Richest 1%. Ottawa: Centre for Policy Alternatives; 2010.Google Scholar
  26. 26.
    Berkman LF. Seeing the forest and the trees: new visions in social epidemiology. Am J Epidemiol. 2004;160:1–2.PubMedCrossRefGoogle Scholar
  27. 27.
    House JS. Understanding social factors and inequalities in health: 20th century progress and 21st century prospects. J Heal Soc Behav. 2002;43(2):125–142.CrossRefGoogle Scholar
  28. 28.
    Putnam S, Galea S. Epidemiology and the macrosocial determinants of health. J Public Health Policy. 2008;29(3):275–289.PubMedCrossRefGoogle Scholar
  29. 29.
    Schwartz SD, Carpenter KM. The right answer for the wrong question: consequences of type iii error for public health research. Am J Public Health. 1999;89(8).Google Scholar
  30. 30.
    Bonneux L. From evidence based bioethics to evidence based social policies. Eur J Epidemiol. 2007;22:483–485.PubMedCrossRefGoogle Scholar
  31. 31.
    Braveman P, Barclay C. Health disparities beginning in childhood: a life-course perspective. Pediatrics. 2009;124(Suppl 3):S163–S175.PubMedCrossRefGoogle Scholar
  32. 32.
    Muntaner C, Sridharan S, Chung H, et al. The solution space: developing research and policy agendas to eliminate employment-related health inequalities. Int J Heal Serv. 2010;40(2):309–314.CrossRefGoogle Scholar
  33. 33.
    Armstrong R, Doyle J, Lamb C, Waters E. Multi-sectoral health promotion and public health: the role of evidence. J Public Health. 2006;28(2):168–172.CrossRefGoogle Scholar
  34. 34.
    Ministerial Summit on Health Research. The Mexico statement on health research: knowledge for better health: strengthening health systems Available at: http://www.who.int/rpc/summit/agenda/Mexico_Statement-English.pdf
  35. 35.
    Whitehead M, Petticrew M, Graham H, Macintyre SJ, Bambra C, Egan M. Evidence for public health policy on inequalities: 2: assembling the evidence jigsaw. J Epidemiol Community Health. 2004;58(10):817–821.PubMedCrossRefGoogle Scholar
  36. 36.
    Rosenfield P. The potential for transdisciplinary research for sustaining and extending linkages between the health and social sciences. Soc Sci Med. 1992;35(11):1343–1357.PubMedCrossRefGoogle Scholar
  37. 37.
    Kirst M, Schafer-McDaniel N, Hwang S, O’Campo P. Converging Disciplines: A Transdisciplinary Research Approach to Urban Health Problems. Berlin: Springer; 2010.Google Scholar
  38. 38.
    Kirst M, O’Campo P. Realist review methods for complex health problems. In: O’Campo P, Dunn J, eds. Rethinking Social Epidemiology: Toward a Science of Change. New York: Springer; 2011.Google Scholar
  39. 39.
    Murphy K, Wolfus B, Lofters A. From complex problems to complex problem-solving: transdisciplinary practice as knowledge translation. In: Kirst M, Schafer-McDaniel N, Hwang S, O’Campo P, eds. Converging Disciplines: A Transdisciplinary Research Approach to Urban Health Problems. Berlin: Springer; 2010.Google Scholar
  40. 40.
    Noonan E, Bjorndal A. The Campbell Collaboration. Available at: http://www.thecochranelibrary.com/details/editorial/839335/The-Campbell-Collaboration.html. Accessed August 15, 2011.
  41. 41.
    Aronson R, Wallis AB, O’Campo P, Whitehead T, Schafer P. Ethnographically informed community evaluation: a framework and approach for evaluating community based initiatives. Matern Child Healt J. 2007;11(2):97–109.CrossRefGoogle Scholar
  42. 42.
    McKey R, Condelli L, Ganson H, Barrett B, McConkey C, Plantz M. The Impact of Head Start on Children, Families and Communities. Final Report of the Head Start Evaluation, Synthesis and Utilization Project. Washington, DC: Superintendent of Documents, U.S. Government Printing Office; 1985.Google Scholar
  43. 43.
    Saari E, Kallio K. Developmental impact evaluation for facilitating learning in innovation networks. Am J Eval. 2011;32:227–245.CrossRefGoogle Scholar
  44. 44.
    Chen H-T. Theory-Driven Evaluations. Newbury Park: Sage; 1990.Google Scholar
  45. 45.
    Coryn C, Noakes L, Westine C, Schroter D. A systematic review of theory-drive evaluation practice from 1990–2009. Am J Eval. 2011;32(3):199–226.CrossRefGoogle Scholar
  46. 46.
    Greenhalgh T, Wong G, Westhorp G, Pawson R. Protocol—realist and meta-narrative evidence synthesis: evolving standards (RAMESES). BMC Med Res Methodology. 2011;11(1):115.CrossRefGoogle Scholar
  47. 47.
    Ranmuthugala G, Cunningham FC, Plumb JJ, et al. A realist evaluation of the role of communities of practice in changing healthcare practice. Implementation Sci. 2011;6(49).Google Scholar
  48. 48.
    Wong G, Greenhalgh T, Pawson R. Internet-based medical education: a realist review of what works, for whom and in what circumstances. BMC Med Education. 2010;10(12).Google Scholar
  49. 49.
    O’Campo P, Kirst M, Schaefer-McDaniel N, Firestone M, Scott A, McShane K. Community-based services for homeless adults experiencing concurrent mental health and substance use disorders: a realist approach to synthesizing evidence. J Urban Health. 2009;86(6):965–989.PubMedCrossRefGoogle Scholar
  50. 50.
    O’Campo P, Kirst M, Tsamis C, Chambers C, Ahmad F. Implementing successful intimate partner violence screening programs in health care settings: evidence generated from a realist-informed systematic review. Soc Sci Med. 2011;72(6):855–866.PubMedCrossRefGoogle Scholar
  51. 51.
    Preventive Services US. Task force. Recommendation statement: screening for family and intimate partner violence. Ann Intern Med. 2004;140(5):382–386.Google Scholar
  52. 52.
    Durlak JA, DuPre EP. Implementation matters: a review of research on the influence of implementation on program outcomes and the factors affecting implementation. Am J Community Psychol. 2008;41:327–350.PubMedCrossRefGoogle Scholar
  53. 53.
    Wandersman A, Duffy J, Flaspohler P, et al. Bridging the gap between prevention research and practice: the interactive systems framework for dissemination and implementation. Am J Community Psychol. 2008;41:171–181.PubMedCrossRefGoogle Scholar
  54. 54.
    Gamble JAA. A Developmental Evaluation Primer. Montréal: JW McConnell Family Foundation; 2008.Google Scholar
  55. 55.
    Patton MQ. Developmental evaluation. Eval Pract. 1994;15(3):311–319.CrossRefGoogle Scholar
  56. 56.
    Keller C, Goering P, Hume C, et al. Initial implementation of Housing First in five Canadian cities: how do you make the shoe fit, when one size does not fit all? Psychiatric Rehabilitation Journal. 2012; in press.Google Scholar
  57. 57.
    Macnaughton EGP, Nelson G. Using mixed methods within the At Home/Chez Soi Housing First project: a strategy to evaluate the implementation of a complex population health intervention for people with lived experience of homelessness and mental illness. Canadian Journal of Public Health. 2012; in press.Google Scholar
  58. 58.
    Devaney B, Howell E, McCormick M, Moreno L. Reducing Infant Mortality: Lessons Learned from Healthy Start. Princeton: Mathematica Policy Research; 2000.Google Scholar
  59. 59.
    Sherk J. How Congress Can Support, Not Hinder, Labor Market Recovery. Washington, DC: Heritage Foundation; 2011.Google Scholar
  60. 60.
    Health Canada. Tobacco Control Programme, Health Canada Supplementary Tables, Youth Smoking Survey 2006–07. Table 4a. Smoking status by province, grades 5–9, Canada, 2006-07. 2008-12-22. Available at: http://www.hc-sc.gc.ca/hc-ps/tobac-tabac/research-recherche/stat/_survey-sondage_2006-2007/table-04-eng.php.
  61. 61.
    Brinn MP, Carson KV, Esterman AJ, Chang AB, Smith BJ. Mass media interventions for preventing smoking in young people. Cochrane Database of Systematic Reviews. 2010;(11):CD001006.Google Scholar
  62. 62.
    Carson KV, Brinn MP, Labiszewski NA, Esterman AJ, Chang AB, Smith BJ. Community interventions for preventing smoking in young people. Cochrane Database of Systematic Reviews. 2011;(7):CD001291.Google Scholar
  63. 63.
    Lantz PM. Youth Smoking Prevention Policy: Lessons Learned and Continuing Challenges. Washington, DC: The National Academies; 2004.Google Scholar
  64. 64.
    Lovato C, Linn G, Stead LF, Best A. Impact of tobacco advertising and promotion on increasing adolescent smoking behaviours. Cochrane Database of Systematic Reviews. 2003;(4):CD003439.Google Scholar
  65. 65.
    Priest N, Armstrong R, Doyle J, Waters E. Policy interventions implemented through sporting organisations for promoting healthy behaviour change. Cochrane Database Syst Rev. 2008;3:CD004809.Google Scholar
  66. 66.
    Stead LF, Lancaster T. Interventions for preventing tobacco sales to minors. Cochrane Database of Systematic Reviews. 2005;(1):CD001497.Google Scholar
  67. 67.
    Thomas RE, Baker PRA, Lorenzetti D. Family-based programmes for preventing smoking by children and adolescents. Cochrane Database of Systematic Reviews. 2007;(1):CD004493.Google Scholar
  68. 68.
    McCall L, Kenworthy L. Americans’ social policy preference in the era of rising inequality. Perspectives on Politics. 2009;7(3):459–484.CrossRefGoogle Scholar
  69. 69.
    Russell E, Dufour M. Rising Profit Shares, Falling Wage Shares. Toronto: Centre for Policy Alternatives; 2007.Google Scholar
  70. 70.
    Leischow S, Best A, Trochim W, et al. Systems thinking to improve the public’s health. Am J Prev Med. 2008;35(2S):S196–S203.PubMedCrossRefGoogle Scholar
  71. 71.
    Schulz A, Northridge M. Social determinants of health: implications for environmental health promotion. Health Educ Behav. 2004;31(3):455–471.PubMedCrossRefGoogle Scholar
  72. 72.
    Chapman J, Thompson J. The Economic Impact of Local Living Wages. Washington, DC: Economic Policy Institute; 2006.Google Scholar
  73. 73.
    Zabin C, Martin I. Living Wage Campaigns in the Economic Policy Arena: Four Case Studies from California. Berkeley: Center for Labor Research and Education, Institute of Industrial Relations, University of California; 1999.Google Scholar
  74. 74.
    Luce S. The role of community involvement in living wage ordinances. Ind Relat. 2005;44(1):32–58.CrossRefGoogle Scholar
  75. 75.
    Pollin R. Evaluating living wage laws in the United States: good intentions and economic reality in conflict? Econ Dev Q. 2005;19(1):3–24.CrossRefGoogle Scholar
  76. 76.
    Oxman A, Lavis J, Lewin S, Fretheim A. SUPPORT tools for evidence-informed health Policymaking (STP) 10: taking equity into consideration when assessing the findings of a systematic review. Health Res Policy Syst. 2009;7(Suppl 1):S10.PubMedCrossRefGoogle Scholar

Copyright information

© The New York Academy of Medicine 2012

Authors and Affiliations

  1. 1.Centre for Research on Inner City HealthTorontoCanada
  2. 2.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
  3. 3.Johns Hopkins Bloomberg School of Public HealthBaltimoreUSA

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