Socio-economic inequalities in health and behaviour

Socio-economic inequalities in health and behaviour: application of novel approaches to identify health inequalities in Scotland and England to inform policy

Reducing health inequalities is a major focus of the Scottish Government. Understanding the mechanisms that generate health inequalities requires an in-depth understanding of the underlying determinants. Health behaviours and their associated socio-economic inequalities were viewed here as health inequality determinants. The project aimed to understand how and to what extent health behaviours and income-related inequalities (IRIs) in health behaviours are a mediating factor in health inequalities.

The main factors contributing to IRIs were income itself, employment status, particularly economic inactivity, and no educational qualifications. However, health behaviours as health and health behaviour determinants were also found to make significant contributions to health and health behaviour inequalities. We further found that changes in IRIs are largely driven by changes in the responsiveness of health and health behaviours to indicators of socio-economic status rather than changes in the IRI in these indicators.

Outcome and Translation

The relative scale of the impact of health determinants on health and health behaviours, compared with the effect of inequalities in the health determinants, suggests that, in the short term, reducing the impact of disadvantage on health and health behaviours has more effect on IRIs than changes in the underlying distribution of income, economic activity and education. This implies that health improvement interventions which reduce the impact of disadvantage on health have the potential to reduce IRIs in health more effectively, in the short term, than interventions which seek to reduce IRIs in education and economic circumstances, which would be longer-term and implemented largely outwith the NHS.

HERU researchers involved in this research project: Anne Ludbrook, Rodolfo Hernández and Barbara Eberth

External collaborators: U-G Gerdtham (Lund University)

Publications

Eberth, B., Ludbrook, A., Hernández, R. and Gertham, U-G. (2014) Socio-economic inequalities in health and behaviour: application of novel approaches to identify health inequalities in Scotland and England to inform policy. Final report, Edinburgh: Scottish Government Chief Scientist Office.

Eberth, B., Ludbrook, A., Gerdtham, U.-G. and Hernández, R. (2014) Socioeconomic inequalities in health and behaviour: application of novel approaches to identify health inequality in Scotland and England to inform policy. CSO Focus on Research, Edinburgh: Chief Scientist Office.

Eberth, B., Ludbrook, A., Hernández, R. and Gerdtham, U.-G. (2014) Identifying underlying causes of health inequality to inform policy, HERU Briefing Paper, University of Aberdeen, September 2014.

Presentations

Eberth, B. (2011) 'Novel approaches to identifying determinants of health inequality and effective policy responses', Chief Scientist Office workshop on: measuring, understanding and tackling health inequalities: new insights from Scottish research., Edinburgh, 21st February 2011.

Eberth, B. (2013) 'An Evaluation of Health Inequalities in Scotland Using repeated Cross-Sectional Survey Data', Scottish Faculty of Public Health Conference, Dunblane, Scotland, November 2013.

Eberth, B. (2014) 'Health behaviours and health inequalities in Scotland', Scottish Institute for Research in Economics (SIRE) Policy Forum on Health Inequalities, Edinburgh, 19 June 2014.

Eberth, B. and Ludbrook, A. (2015) 'Socioeconomic inequalities in health and behaviour: application of novel approaches to identify health inequality in Scotland and England to inform policy', HERU Policy Workshop, Edinburgh, January 2015.