Measurement and Analysis of Socio-economic Inequalities in Health

Health inequalities remain constant or are increasing and it is unclear how to reduce them. We work to improve methods for analysing routinely collected health data and population-based studies and to use novel linkages to social data, aiming to improve our understandings of inequalities in health and improve intervention strategies. The programme is organised into three themes: Health inequalities and linked data analysis; Natural experiments from observational data; and Enhancing cohort, survey and routine data sources. Our focus on existing data sources represents a cost-effective means of working, reflecting the MRC’s commitment to improve uses made of patient data and capitalising on substantial investment in surveys and cohorts as well as ‘big data’.

Background

Health inequalities in the UK were highlighted in the Black Report in 1980. Since then, and despite moving near the top of the health agenda, inequalities have in the main persisted or increased across Western Europe. There remains doubt as to how to reduce health inequalities; this reflects the uncertainty that still exists surrounding their causes. Routine data have great potential for health research as a largely untapped resource. Whilst some research groups– ours included– have considerable experience working with such data, recent developments in the UK have enabled health and social data to be linked. This has important implications for the study of inequalities in health. Until now many analyses using whole population data have been restricted to the assessment of inequalities using area-based deprivation; the ability to link social data makes it possible to use individual characteristics such as educational attainment or employment status. We will build on our experience using international data where such measures have been available for many years. Such data will provide further opportunities to inform interventions or policies and understand their impact on health and health inequalities.

Aims and Objectives

The aim of this programme is to improve the methodology for the measurement and analysis of health and inequalities in health using observational data with particular emphasis on improving our understanding of causes and informing strategies for intervention. Our objectives and associated research questions are:

1. To improve population health outcomes through conduct and translation of research based on the evaluation of policy or large-scale intervention.

• How do different policies and interventions impact on health and health inequalities?
• How can we improve the use made of observational data in general, and for the evaluation of natural experiments in particular?

2. To maximise the use of existing routine, linked and population-sampled data sources and, in so doing, enhance the return on the investment made in these resources.

• How do we combine data sources to increase their power (surveys and cohorts) and utility (routine data) to improve our understanding of population health?
• How do we harness the potential of these data to examine the influence of small clusters and to analyse rare outcomes?

3. To inform intervention strategy through research enhancing our understanding of health, inequalities in health and the determinants of health.

• How do the different levels of the socio-ecological framework contribute to health and health inequalities?
• How do health and health inequalities develop across the lifecourse and how influential are the different transitions?

4. To build capacity in the measurement and analysis of inequalities in health using observational data.