Socioeconomic inequalities and the equity impact of population-level interventions for adolescent health : an overview of systematic reviews

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Macintyre, A.K. and Torrens, C. and Campbell, P. and Maxwell, M. and Pollock, A. and Biggs, H. and Woodhouse, A. and Williams, J.M. and McLean, J. (2020) Socioeconomic inequalities and the equity impact of population-level interventions for adolescent health : an overview of systematic reviews. Public Health, 180. pp. 154-162. ISSN 1476-5616 (https://doi.org/10.1016/j.puhe.2019.11.008)

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Abstract

Objectives: Despite robust evidence on health inequalities in adulthood, less attention has been paid to inequalities in adolescence. The aim of this overview was to examine systematic review (SR) evidence on the equity impact of population-level interventions intended to improve health, happiness and wellbeing for adolescents. Study Design: An overview (review of systematic reviews). Methods: Eleven electronic databases were systematically searched to identify SRs of population-level interventions for adolescent health. A secondary data analysis of socioeconomic inequality was conducted to identify whether SRs reported on primary studies in terms of disadvantage, by measures of socioeconomic status (SES) and by differential effects. Results: 35,310 review titles were screened; 566 full texts were retrieved and 140 SRs met the predefined selection criteria. Differential intervention effects were considered in 42/140 (30%) SRs, 18/140 (13%) reported primary studies using an SES measure and 16/140 (11%) explicitly reported differential effects. 15/140 SRs (11%) explicitly focused on socioeconomic inequalities; of these 4/15 reported differential intervention effects in more detail, 7/15 concluded there was insufficient primary evidence to identify the impact of interventions on socioeconomic inequalities and 4/15 planned to examine differential effects by SES, but this was not reported further.   Conclusions: Our overview identifies that there is limited SR evidence on the equity impact of population-level interventions for adolescent health. Strengthening the evidence on whether interventions narrow or widen inequalities for adolescents must be a priority for public health research.

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