Table 3 Data extraction criteria
From: Intersectoral action for health equity: a rapid systematic review
Item | Description |
|---|---|
Location | Country |
Setting | Rural, urban, organizational, local, regional, national |
Population | Description of population if specified |
Population health approach to addressing health equity | Interventions may be defined by their approach to reducing health inequities, with universal interventions addressing the entire population [5, 16, 27], targeted interventions selectively providing interventions to disadvantaged groups [5, 16, 27], and mixed approaches (“targeting within universalism”) directing extra benefits to disadvantaged groups within the context of a universal policy design [28]. |
Level of intervention | Interventions to advance health equity may be categorized by their approach to addressing the “upstream,” “midstream,” or “downstream” determinants of health [16, 29, 30]. |
Interventions are classified as upstream interventions if they include reform of fundamental social and economic structures and involve mechanisms for the redistribution of wealth, power, opportunities, and decision-making capacities. Upstream interventions typically involve structural and system-level changes. | |
Midstream interventions seek to reduce risky behaviours or exposures to hazards by influencing health behaviours or psychosocial factors and/or by improving material working and living conditions. Midstream interventions generally occur at the community or organizational level. | |
Downstream interventions occur at the micro and/or individual level and mitigate the inequitable impacts of upstream and midstream determinants through efforts to increase equitable access to health care services. | |
Sectors | Description of sectors involved |
Relationship between sectors | Based on four patterns of relationships in intersectoral action: information-sharing, cooperation, coordination, and integration [5]. An informative relationship is based on information sharing and exchange between sectors; cooperation refers to the achievement of greater efficiency through optimization of resources for the enforcement or implementation of policies or programs; coordination involves joint work among sectors for greater efficiency and effectiveness, generally the creation and integration of synergistic relationships and shared financing; and integration refers to approaching a new policy or program in conjunction with multiple sectors and requires the synthesis of objectives, administrative processes, resources, responsibilities, and actions; |
Role of public health | Four roles for public health action on the social determinants of health to advance health equity include [31, 32]: |
◦ “Reporting/ assessing on the health of populations and describing health inequalities and inequities and effective strategies to address those inequalities and inequities. | |
◦ Modifying and orienting interventions to reduce health inequities including the unique needs and capacities of priority populations. | |
◦ Engaging in community and multi-sectoral collaboration to address the health needs of priority populations through services and programs. | |
◦ Leading/participating and supporting other stakeholders in policy analysis, development and advocacy for improvements in the health determinants/inequities” | |
Tools, strategies, and mechanisms | Tools may be described as catalysts that facilitate intersectoral action; mechanisms as institutional structures and arrangements; and strategies as a broader combination of planned actions or initiatives [8] |
Social determinant of health | Description of social determinant of health addressed in intervention |