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Reducing health inequalities with interventions targeting behavioral factors among individuals with low levels of education - A rapid review

Vilhelmsson, Andreas LU and Östergren, Per Olof LU (2018) In PLoS ONE 13(4).
Abstract

Individuals with low levels of education systematically have worse health than those with medium or high levels of education. Yet there are few examples of attempts to summarize the evidence supporting the efficacy of interventions targeting health-related behavior among individuals with low education levels, and a large part of the literature is descriptive rather than analytical. A rapid review was carried out to examine the impact of such interventions. Special attention was given to the relative impact of the interventions among individuals with low education levels and their potential to reduce health inequality. Of 1,365 articles initially identified, only 31 were deemed relevant for the review, and of those, nine met the... (More)

Individuals with low levels of education systematically have worse health than those with medium or high levels of education. Yet there are few examples of attempts to summarize the evidence supporting the efficacy of interventions targeting health-related behavior among individuals with low education levels, and a large part of the literature is descriptive rather than analytical. A rapid review was carried out to examine the impact of such interventions. Special attention was given to the relative impact of the interventions among individuals with low education levels and their potential to reduce health inequality. Of 1,365 articles initially identified, only 31 were deemed relevant for the review, and of those, nine met the inclusion and quality criteria. The comparability of included studies was limited due to differences in study design, sample characteristics, and definitions of exposure and outcome variables. Therefore, instead of performing a formal meta-analysis, an overall assessment of the available evidence was made and summarized into some general conclusions. We found no support for the notion that the methods used to reduce smoking decrease inequalities in health between educational groups. Evidence was also limited for decreasing inequality through interventions regarding dietary intake, physical activity and mental health. Only one study was found using an intervention designed to decrease socioeconomic inequalities by increasing the use of breast cancer screening. Thus, we concluded that there is a lack of support regarding this type of intervention as well. Therefore, the main conclusion is that solid evidence is lacking for interventions aimed at individual determinants of health and that more research is needed to fill this gap in knowledge.

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author
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publication status
published
subject
in
PLoS ONE
volume
13
issue
4
publisher
Public Library of Science
external identifiers
  • scopus:85045508289
ISSN
1932-6203
DOI
10.1371/journal.pone.0195774
language
English
LU publication?
yes
id
351d291c-f4bc-4c7e-b228-f7f4e3f7181e
date added to LUP
2018-04-27 11:33:23
date last changed
2018-07-28 03:00:15
@article{351d291c-f4bc-4c7e-b228-f7f4e3f7181e,
  abstract     = {<p>Individuals with low levels of education systematically have worse health than those with medium or high levels of education. Yet there are few examples of attempts to summarize the evidence supporting the efficacy of interventions targeting health-related behavior among individuals with low education levels, and a large part of the literature is descriptive rather than analytical. A rapid review was carried out to examine the impact of such interventions. Special attention was given to the relative impact of the interventions among individuals with low education levels and their potential to reduce health inequality. Of 1,365 articles initially identified, only 31 were deemed relevant for the review, and of those, nine met the inclusion and quality criteria. The comparability of included studies was limited due to differences in study design, sample characteristics, and definitions of exposure and outcome variables. Therefore, instead of performing a formal meta-analysis, an overall assessment of the available evidence was made and summarized into some general conclusions. We found no support for the notion that the methods used to reduce smoking decrease inequalities in health between educational groups. Evidence was also limited for decreasing inequality through interventions regarding dietary intake, physical activity and mental health. Only one study was found using an intervention designed to decrease socioeconomic inequalities by increasing the use of breast cancer screening. Thus, we concluded that there is a lack of support regarding this type of intervention as well. Therefore, the main conclusion is that solid evidence is lacking for interventions aimed at individual determinants of health and that more research is needed to fill this gap in knowledge.</p>},
  articleno    = {e0195774},
  author       = {Vilhelmsson, Andreas and Östergren, Per Olof},
  issn         = {1932-6203},
  language     = {eng},
  month        = {04},
  number       = {4},
  publisher    = {Public Library of Science},
  series       = {PLoS ONE},
  title        = {Reducing health inequalities with interventions targeting behavioral factors among individuals with low levels of education - A rapid review},
  url          = {http://dx.doi.org/10.1371/journal.pone.0195774},
  volume       = {13},
  year         = {2018},
}