Combining health and social protection measures to reach the ultra ...

Introduction
Living and working
conditions
General socioeconomic, cultural and environmental conditions
Work
environment
Unemployment
Social and community networks
Water and
sanitation
Education
Individual lifestyle factors
Agriculture
and food
production
Age, sex and
constitutional
factors
Health
care
services
Housing
Figure 1: Factors affecting health 4
global movement for action on social inequities, human
rights, and the other broad social determinants necessary to
achieve health equity. The Knowledge Networks are building
a detailed picture of the linkages between health and the
social determinants, and their work should uncover an
extensive research agenda that will need to be addressed to
accomplish the Commission’s overall goals.
Margaret Whitehead 6 has set out a typology of actions to
tackle social inequalities in health, which helps to generate a
useful framework for a research agenda to support practical
and effective policies and programmes. Whitehead’s
approach begins with identifying the theory underlying
interventions: recognizing the logical reasoning that connects
intervention programme inputs to intended outcomes (Figure
1) provides a basis for assessing whether there is any
reasonable likelihood that programme goals could be
achieved and enables the development of appropriate criteria
for evaluating success.
Whitehead’s typology of actions to reduce health
inequalities includes four categories:
✜ strengthening individuals;
✜ strengthening communities;
✜ improving living and working conditions;
✜ promoting healthy macro-policies.
This framework may also be useful for analyzing and
planning research in the field of health inequalities and
equitable access.
Problem
of
health
inequality
Perceived
causes
of
problem
Policy goals
to address
causes
Theories
about how
and why
interventions
might work to
bring
about change
Design of
intervention
programme
Outcome of
programme
Figure 2: The logic of health inequalities interventions 8
Global Forum Update on Research for Health Volume 4 ✜ 013