Employmentweb_low

the process oF Knowledge generation
The third and final shortcoming is that, while it is important to
examine the best practices and examples of policy successes in
lessening health inequalities, knowledge in this area is still very
limited. To identify what works and what has worked across different
historical and political contexts is a matter of utmost urgency, as
policy-makers face difficult political choices in addressing enduring
health inequalities.
Systematic review approach: features and limitations
Having identified the major objectives we want to accomplish in this
study and the primary obstacles we face, we now describe our
approach to tackling this complicated question. Common scientific
wisdom holds that the best way to study a complex reality is by
"systematic reviews" of published scientific literature combined with
the collection of empirical data. The systematic review approach
differs from traditional reviews and commentaries produced by
"content experts" in that it uses a replicable, and transparent
approach designed to minimise bias (Glanville & Sowden, 2001). By
identifying, critically appraising, and summarising the results of
otherwise unmanageable quantities of research, a systematic review
would -at least in theory- cover the research objectives of this book.
Despite this, mainstream systematic reviews have a number of
potential limitations that can lead to anomalous results (Glasziou,
Vandenbrouke, & Chalmers, 2004; Asthana & Halliday, 2006;
Killoran, Swann, & Kelly, 2006). First, this approach creates a strong
tendency to select studies on the basis of the quality of the methods
rather than the theories and concepts used. Second, this approach
typically privileges particular types of research design, such as
randomized controlled trials, undermining other qualitative or "soft"
studies. Third, the importance of context is usually not sufficiently
appreciated. This is of central importance when considering the
social roots of many health issues. In the case of interventions, for
example, "a fundamental problem lies in the notion that methods
found to be effective in one setting could be assumed to be effective
in another… In answering the question 'does this intervention work'
it is always necessary to consider not only the intervention, the
outcome and the link between the two but also the context" (Kemm,
2006). Finally, the lack of studies covering a particular subject will
also create bias. In this study we treat employment-related health
inequalities as a global social affliction, and this is a situation in
which an approach based on mainstream systematic reviews and
standard evidence gathering is of limited utility.
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