Child Public Health Resources
Reading archive
Hot Reads for Child Public Health July 2006
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Fostering greater equity. Guest Editorial by Giovanna Prennushi, Francisco Ferreira, and Michael Walton. Development Outreach. Feb 2006. World Bank Group.
The authors wrote this editorial summarising the World Bank’s World Development Report 2006 : Equity and Development which was published in 2005. The report argues that greater equity is a key ingredient of long-term prosperity. In the report, equity is defined in terms of two principles: (i) equality of opportunities and (ii) the avoidance of extreme deprivation in outcomes. The report highlighted that opportunities are very unequally distributed; that the interaction between different kinds of inequality can create ‘inequality traps’, which hinder development and poverty reduction; and that well-designed policies can tackle these traps, leading to both greater equity and greater efficiency. The Development Report is available on line.
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The Scandinavian model and economic development. Moene and Wallerstein. Development Outreach. Feb 2006. World Bank Group.
This article is a follow on subsequent to the World Development Report. It summarises the Scandinavian model of low inequality and good economic performance, and how this can be applied in developing countries (or even here in Australia and New Zealand?). -
Applying clinical epidemiology methods to equity: the equity effectiveness loop. BMJ 2006;332:358-361 (11 February).
This framework estimates real effectiveness of interventions in least poor (or richest) and poorest subpopulations and highlights those areas that, if improved, could have the greatest impact on improving the effectiveness of interventions for the poor subpopulations. The authors also highlighted that priority funding of interventions with the best cost effectiveness ratios might increase differences between richest (or least poor) and poorest because the cost of reaching poor people may be higher and health benefits may be lower. One promising method to assess equity issues related to cost effectiveness is the development of an equity and quality adjusted life year (EQ-QALY), as a complement to established measures of the difference between rich and poor, such as the concentration index.
The framework proposed is a tool to reduce the gap in health between rich and poor, by adopting a strategic approach in designing and implementing interventions and policies that are effective in low income settings. The "equity effectiveness loop" provides a way of checking that the effects of interventions are examined across the gradients in wealth. By helping to determine which factors are likely to have the greatest impact on reducing health inequalities the framework should improve the targeting of interventions
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The Equity Oriented Tool Kit. W.H.O Collaborating Centre for Health Technology Assessment.
The equity oriented tool kit is a text and web-based summary of approaches to Needs-Based Health Technology Assessment. The aim of the tool kit is to facilitate knowledge brokering to communities and countries that do not have ready access to the existing range of researched options; to conserve scarce resources by not re-inventing the wheel; to promote a sound decision-making and policy process; and to be useful to donor agencies and countries in their discussions regarding community health development and resource allocation.
The kit contains 4 main sections: (1) Burden of illness (2) Community Effectiveness (3) Economic Evaluation and (4) Knowledge Translation & Implementation for Health Technology Assessment. Each section describes how to measure each of the components with an equity based approach, and provide tools on how to achieve this.
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Does IQ explain socioeconomic inequalities in health? BMJ March 2006;332: 580-584.
IQ may contribute to, but doesn't completely explain, socioeconomic gradients in health. In a prospective cohort study, Batty and colleagues assessed IQ, socioeconomic status, mortality, and morbidity of 1347 middle aged people from Scotland and found that indices of socioeconomic position were significantly associated with all the health outcomes they examined. After adjustment for IQ, all associations were weaker and one fifth was reduced to statistical non-significance. In half of the associations, however, the risk of ill health in the socioeconomically disadvantaged group was still twice that of the advantaged group.
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Social class inequalities in childhood mortality and morbidity in an English population. Paediatric & Perinatal Epidemiology. Jan 2006. Vol 20 pg 14.
The objective of this study was to examine the association between social class of the head of household at the time of birth and mortality and morbidity during the first 10 years of life in a cohort of all 117 212 children born to women who both lived, and delivered in hospital, in Oxfordshire or West Berkshire during the period 1 January 1979 to 31 December 1988. The study revealed a significant social class gradient in mortality during the first 10 years of life. Over the first 10 years of life, the mortality rate was lowest among children born into a social class II household (7.03 per 1000 births) and highest among children born into a social class V household (13.07 per 1000 births). The adjusted odds of mortality, for each decrement in social class category, during the first 10 years of life was estimated at 1.08 per category [95% CI 1.03, 1.14], which translates into a 40% increased odds of mortality, on average, for a child born into a social class V household compared with a child born into a social class I household. The study also revealed a significant adjusted social class gradient in hospital admission rates for 14 of the 16 groups of diseases during the first 10 years of life.