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

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  • Andreas Vilhelmsson
  • Per-Olof Östergren

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 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.

Suggested Citation

  • Andreas Vilhelmsson & Per-Olof Östergren, 2018. "Reducing health inequalities with interventions targeting behavioral factors among individuals with low levels of education - A rapid review," PLOS ONE, Public Library of Science, vol. 13(4), pages 1-14, April.
  • Handle: RePEc:plo:pone00:0195774
    DOI: 10.1371/journal.pone.0195774
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    References listed on IDEAS

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    Cited by:

    1. Pietrzyk, Irena & Erdmann, Melinda, 2020. "Investigating the impact of interventions on educational disparities: Estimating average treatment effects (ATEs) is not sufficient," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 65, pages 1-1.
    2. Guldbrandsson, Karin & Bremberg, Sven, 2020. "Cross-sectoral cooperation at the ministerial level in three Nordic countries - With a focus on health inequalities," Social Science & Medicine, Elsevier, vol. 256(C).
    3. Lisa Wilderink & Ingrid Bakker & Albertine J. Schuit & Jacob C. Seidell & Ioana A. Pop & Carry M. Renders, 2022. "A Theoretical Perspective on Why Socioeconomic Health Inequalities Are Persistent: Building the Case for an Effective Approach," IJERPH, MDPI, vol. 19(14), pages 1-17, July.

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