2023-09-28 14:46:10 +00:00
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abstract: 'Background: The social determinants of health have been widely
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recognised yet there remains a lack of clarity regarding what constitute
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the macro-economic determinants of health and what can be done to
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address them. An umbrella review of systematic reviews was conducted to
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identify the evidence for the health and health inequalities impact of
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population level macroeconomic factors, strategies, policies and
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interventions.
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Methods: Nine databases were searched for systematic reviews meeting the
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Database of Abstracts of Reviews of Effects (DARE) criteria using a
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novel conceptual framework. Studies were assessed for quality using a
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standardised instrument and a narrative overview of the findings is
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presented.
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Results: The review found a large (n = 62) but low quality systematic
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review-level evidence base. The results indicated that action to promote
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employment and improve working conditions can help improve health and
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reduce gender-based health inequalities. Evidence suggests that market
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regulation of tobacco, alcohol and food is likely to be effective at
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improving health and reducing inequalities in health including strong
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taxation, or restriction of advertising and availability. Privatisation
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of utilities and alcohol sectors, income inequality, and economic crises
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are likely to increase health inequalities. Left of centre governments
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and welfare state generosity may have a positive health impact, but
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evidence on specific welfare interventions is mixed. Trade and trade
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policies were found to have a mixed effect. There were no systematic
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reviews of the health impact of monetary policy or of large economic
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institutions such as central banks and regulatory organisations.
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Conclusions: The results of this study provide a simple yet
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comprehensive framework to support policy-makers and practitioners in
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addressing the macroeconomic determinants of health. Further research is
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needed in low and middle income countries and further reviews are needed
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to summarise evidence in key gaps identified by this review.'
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affiliation: 'Naik, Y (Corresponding Author), Leeds Teaching Hosp NHS Trust, Beckett
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St, Leeds LS9 7TF, W Yorkshire, England.
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Naik, Y (Corresponding Author), Univ Liverpool, Dept Publ Hlth \& Policy, 3rd Floor,Whelan
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Bldg,Brownlow Hill, Liverpool L69 3GB, Merseyside, England.
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Naik, Yannish; Kelly, Gill; Roderick, Peter, Leeds Teaching Hosp NHS Trust, Beckett
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St, Leeds LS9 7TF, W Yorkshire, England.
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Naik, Yannish; Barr, Ben, Univ Liverpool, Dept Publ Hlth \& Policy, 3rd Floor,Whelan
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Bldg,Brownlow Hill, Liverpool L69 3GB, Merseyside, England.
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Baker, Peter, Imperial Coll London, Global Hlth \& Dev Grp, Sch Publ Hlth, St Marys
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Campus,Norfolk Pl, London W2 1PG, England.
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Ismail, Sharif A., London Sch Hyg \& Trop Med, Dept Global Hlth \& Dev, 15-17 Tavistock
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Pl, London WC1H 9SH, England.
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Ismail, Sharif A., Imperial Coll London, Dept Primary Care \& Publ Hlth, Reynolds
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Bldg,St Dunstans Rd, London W6 8RP, England.
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Tillmann, Taavi, UCL, Inst Global Hlth, Ctr Global Noncommunicable Dis, 30 Guilford
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St, London WC1N 1EH, England.
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Bash, Kristin; Black, Michelle, Univ Sheffield, Sch Hlth \& Related Res ScHARR,
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30 Regent St, Sheffield S1 4DA, S Yorkshire, England.
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Quantz, Darryl, Hlth Educ England North West, NW Sch Publ Hlth, First Floor Regatta
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Pl,Business Pk,Summers Rd, Liverpool L3 4BL, Merseyside, England.
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Hillier-Brown, Frances, Univ Durham, Dept Sport \& Exercise Sci, 42 Old Elvet, Durham
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DH1 3HN, England.
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Jayatunga, Wikum, UCL, Inst Hlth Informat, 222 Euston Rd, London NW1 2DA, England.
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Bambra, Clare, Newcastle Univ, Fac Med Sci, Royal Victoria Infirm, Sir James Spence
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Bldg, Newcastle Upon Tyne NE1 4LP, Tyne \& Wear, England.'
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article-number: '1678'
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author: Naik, Yannish and Baker, Peter and Ismail, Sharif A. and Tillmann, Taavi and
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Bash, Kristin and Quantz, Darryl and Hillier-Brown, Frances and Jayatunga, Wikum
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and Kelly, Gill and Black, Michelle and Gopfert, Anya and Roderick, Peter and Barr,
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Ben and Bambra, Clare
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author-email: yannishnaik@nhs.net
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author_list:
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- family: Naik
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given: Yannish
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- family: Baker
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given: Peter
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- family: Ismail
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given: Sharif A.
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- family: Tillmann
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given: Taavi
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- family: Bash
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given: Kristin
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- family: Quantz
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given: Darryl
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- family: Hillier-Brown
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given: Frances
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- family: Jayatunga
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given: Wikum
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- family: Kelly
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given: Gill
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- family: Black
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given: Michelle
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- family: Gopfert
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given: Anya
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- family: Roderick
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given: Peter
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- family: Barr
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given: Ben
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- family: Bambra
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given: Clare
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da: '2023-09-28'
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doi: 10.1186/s12889-019-7895-6
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eissn: 1471-2458
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files: []
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journal: BMC PUBLIC HEALTH
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keywords: 'Economy; Social determinants of health; Population health; Economic
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policy; Health inequalities; Macroeconomy; Public health; Regulation'
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keywords-plus: 'POPULATION-LEVEL INTERVENTIONS; EXCESSIVE ALCOHOL-CONSUMPTION; INCOME
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INEQUALITY; ECONOMIC CRISES; WELFARE REGIMES; CHILD HEALTH; MORTALITY;
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POLICIES; OUTCOMES; POVERTY'
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language: English
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month: DEC 17
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number: '1'
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number-of-cited-references: '99'
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orcid-numbers: 'Ismail, Sharif/0000-0001-7246-7337
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Tillmann, Taavi/0000-0002-8428-3719
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Bambra, Clare l/0000-0002-1294-6851
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Black, Michelle/0000-0002-8358-9150
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Barr, Ben R/0000-0002-4208-9475
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Jayatunga, Wikum/0000-0002-3063-8975
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Hillier-Brown, Frances/0000-0001-9031-4801
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Bash, Kristin/0000-0003-3839-3308
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Gopfert, Anya/0000-0002-1678-4773'
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papis_id: ca42c5c613ce8096f76216dba25827ca
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ref: Naik2019goingupstream
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researcherid-numbers: 'Ismail, Sharif/ABD-5364-2021
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Tillmann, Taavi/R-6026-2016
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Bambra, Clare l/C-1392-2010
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Black, Michelle/IUL-1582-2023
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Barr, Ben R/W-9989-2018
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'
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tags:
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- review
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times-cited: '33'
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title: Going upstream - an umbrella review of the macroeconomic determinants of health
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and health inequalities
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000511639000001
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usage-count-last-180-days: '1'
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usage-count-since-2013: '24'
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volume: '19'
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web-of-science-categories: Public, Environmental \& Occupational Health
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year: '2019'
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