SPHIP Support Team - Equity Research in the SPHIP Programme

The Support to Public Health Institutes Programme (SPHIP), financed by the European Union, aims to build capacities of researchers and research institutes to perform health research and to contribute to policy development(see box). In the SPHIP country projects, health equity research is being conducted and engagement with policy makers is yielding positive results. This newsletter highlights four examples taken from EU-supported SPHIP projects.

Health equity research describes research that contributes to achieving more equity in societies and in the world. Where in previous decades there was a great deal of research about disparities in health, or into features of inequities, now there is more research concerning root causes and solutions for inequities.[1]

The WHO report, Closing the Gap in One Generation (Marmot Commission)^[2], recommends empowering all groups in society through fair representation in decision-making, particularly in relation to health equity. The commission suggests enabling civil society to organise and act in a manner that promotes and realises the political and social rights affecting health equity.

Equity research assesses determinants of health at population level, linking findings to the bigger picture of interacting factors influencing health, often beyond the medical domain. It examines the following areas: (1) global factors and processes that affect health equity; (2) structures and processes that differentially affect people's chances to be healthy within a given society; (3) health system factors that affect health equity; and (4) policies and interventions to reduce health inequity.[3]

Lessons learned from health equity research in the SPHIP programme are:

• Opportunities to promote better health equity develop during the course of research projects, and grow organically . These opportunities can be created, but cannot be planned ahead of the research project. Flexibility in planning and implementation of action research is therefore required.
• Engagement and collaboration between researchers and communities is a long-term process of building trust, developing a common language, and formulating a common goal. It requires patience and commitment.
• Health equity research requires champions at both sides, people who do not aim for quick wins or instant success. Changing policies and practices is a tedious transformation process, and requires people who commit themselves for longer period of time.
• Community groups can become strong advocates of evidence-based policy development when they are engaged in health equity research activities.

[1] Srinivasan S and Williams SD. Transitioning from Health Disparities to a Health Equity Research Agenda: The Time Is Now Public Health Rep. 2014 Jan-Feb; 129 (Suppl 2): 71–76.

[2] CSDH (2008). Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. Geneva, World Health Organization.

[3] Östlin P, Schrecker T, Sadana R, Bonnefoy J, Gilson L, Hertzman C, et al. (2011) Priorities for Research on Equity and Health: Towards an Equity-Focused Health Research Agenda. PLoS Med 8(11): e1001115.