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The effects of public health policies on population health and health inequalities in European welfare states: protocol for an umbrella review

Lookup NU author(s): Dr Katie ThomsonORCiD, Professor Clare Bambra, Professor Adam ToddORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Background: The welfare state is potentially an important macro-level determinant of health that also moderates the extent, and impact, of socio-economic inequalities in exposure to the social determinants of health. The welfare state has three main policy domains: health care, social policy (e.g. social transfers and education) and public health policy. This is the protocol for an umbrella review to examine the latter; its aim is to assess how European welfare states influence the social determinants of health inequalities institutionally through public health policies. Methods/design: A systematic review methodology will be used to identify systematic reviews from high-income countries (including additional EU-28 members) that describe the health and health equity effects of upstream public health interventions. Interventions will focus on primary and secondary prevention policies including fiscal measures, regulation, education, preventative treatment and screening across ten public health domains (tobacco; alcohol; food and nutrition; reproductive health services; the control of infectious diseases; screening; mental health; road traffic injuries; air, land and water pollution; and workplace regulations). Twenty databases will be searched using a pre-determined search strategy to evaluate population-level public health interventions. Discussion: Understanding the impact of specific public health policy interventions will help to establish causality in terms of the effects of welfare states on population health and health inequalities. The review will document contextual information on how population-level public health interventions are organised, implemented and delivered. This information can be used to identify effective interventions that could be implemented to reduce health inequalities between and within European countries.

Publication metadata

Author(s): Thomson K, Bambra C, McNamara C, Huijits T, Todd A

Publication type: Article

Publication status: Published

Journal: Systematic Reviews

Year: 2016

Volume: 5

Online publication date: 08/04/2016

Acceptance date: 04/04/2016

Date deposited: 05/02/2017

ISSN (electronic): 2046-4053

Publisher: BioMed Central Ltd


DOI: 10.1186/s13643-016-0235-3


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