Evaluating the health equity impact of policies
About this research and why it is a public health priority
Health inequalities in England have widened since 2010. By 2019, for the first time in over a century, life expectancy amongst women living in disadvantaged areas had fallen and inequalities in children’s and young people’s health were deteriorating. In this context, it is important to evaluate the impact on health equity of diverse national and local policies outside the health field and of interventions that specifically aim to improve aspects of population health. LiLaC members are undertaking a wide range of studies in this field.
Research Highlights and selected impacts
- An evaluation of the ten-year NHS health inequalities resource allocation policy by the Liverpool Health Inequalities Policy Research Group (https://www.liverpool.ac.uk/population-health-sciences/departments/public-health-and-policy/research-themes/social-determinants-and-health-inequalities/) highlighted the positive health equity impact of this policy The group’s evaluation of the English Work Capability Assessment produced the first empirical evidence on the damage to mental health, influencing changes in disability benefit assessment.
- An evaluation of the health inequalities impact of the major two billion pound regeneration initiative New Deal for Communities by LiLaC members assessed the role of community engagement in producing programme impacts. https://www.journalslibrary.nihr.ac.uk/phr/phr03120/#/abstract
- A collaborative study led by LiLaC researchers funded by the NIHR SPHR Public Health Practice Evaluation Scheme investigated the differential impact on use of concessionary prices or free access for leisure facilities across several local authorities in North West England. https://sphr.nihr.ac.uk/research/the-health-inequalities-impact-of-reducing-the-cost-of-local-authority-leisure-facilities/
- Modelling research by member of Liverpool’s NDC prevention and food policy research group (https://www.liverpool.ac.uk/population-health-sciences/departments/public-health-and-policy/research-themes/ncd-prevention-and-food-policy/food-policy-research/) showed that legal and fiscal food policies consistently reduce mortality from coronary heart disease contributing to the 2016 UK sugary drinks tax and informing the 2019 Prevention Green Paper salt target.
- Research by Lancaster’s Data Science Institute Infectious disease modelling sub-group (https://www.lancaster.ac.uk/dsi/research/health/) on the transmission of infectious diseases with a particular interest in social networks has informed SAGE decision making around physical distancing in the context of the COVID19 pandemic
- Research led by the Health Economics @Lancaster group (https://www.lancaster.ac.uk/health-and-medicine/research/heal/) showing that heavy drinkers are less responsive to alcohol price changes than moderate drinkers has highlighted the importance of targeting policy beyond minimum pricing.
- The Communities in Control study, led by LiLaC researchers, is a longitudinal evaluation of the impact on health equity impacts of a community empowerment initiative involving 150 English communities. https://communitiesincontrol.uk
- As collaborators in the Arthritis Research UK/MRC National Centre of Excellence for Musculoskeletal Health and Work (https://www.mrc.soton.ac.uk/cmhw/ LiLaC researchers are developing and evaluating cost-effective ways to reduce work disability among individuals with musculoskeletal disorders.
Barr, B; Higgerson, J. Whitehead. M (2017) ‘Investigating the Impact of the English Health Inequalities Strategy: Time Trend Analysis’. BMJ 358: j3310. https://doi.org/10.1136/bmj.j3310
Wickham S, Bentley L, Rose T, Whitehead M, Taylor-Robinson D, Barr B (2020) Effects on mental health of a UK welfare reform – Universal Credit: A longitudinal controlled study. Lancet Public Health. 5(3):e157-e164. doi:10.1016/S2468-2667(20)30026-8 https://doi.org/10.1016/S2468-2667(20)30026-8
Popay J, Whitehead M, Carr-Hill R, Dibben C, Dixon P, Halliday E, et al. The impact on health inequalities of approaches to community engagement in the New Deal for Communities regeneration initiative: a mixed-methods evaluation. Public Health Res 2015;3(12) https://europepmc.org/article/nbk/nbk321028
Halliday, E., Barr, B., Higgerson, J., Holt, V., Ortiz-Nunez, A. and Ward, F., 2018. Using local authority entrance charges to tackle inequalities in physical activity? A qualitative study of leisure and public health perspectives. Journal of Public Health, 40(3), pp.567-572. https://doi.org/10.1093/pubmed/fdx124
Higgerson, J., Halliday, E., Ortiz-Nunez, A., Brown, R. and Barr, B Impact of free access to leisure facilities and community outreach on inequalities in physical activity: a quasi-experimental study. Journal of Epidemiology and Community Health. 2018 Feb 12; 72(3): 252-258 http://dx.doi.org/10.1136/jech-2017-209882
Ponsford, R. Collins, M. Egan, M. Halliday, E. Lewis, S. Orton L. Powell, K. Barnes, A. Salway, S. Townsend, A; Whitehead, M. Popay, J. (2020) Power, Control, Communities and Health Inequalities Part II: Measuring Shifts in Power. Health Promotion International https://academic.oup.com/heapro/advance-article/doi/10.1093/heapro/daaa019/6056665