Abstract:
:England was the first European country to pursue a systematic policy to reduce socio-economic inequalities in health. This paper assesses whether this strategy has worked, and what lessons can be learnt. A review of documents was conducted, as well as an analysis of entry-points chosen, specific policies chosen, implementation of these policies, changes in intermediate outcomes, and changes in final health outcomes. Despite some partial successes, the strategy failed to reach its own targets, that is, a 10% reduction in inequalities in life expectancy and infant mortality. This is due to the fact that it did not address the most relevant entry-points, did not use effective policies and was not delivered at a large enough scale for achieving population-wide impacts. Health inequalities can only be reduced substantially if governments have a democratic mandate to make the necessary policy changes, if demonstrably effective policies can be developed, and if these policies are implemented on the scale needed to reach the overall targets.
journal_name
J Epidemiol Community Healthjournal_title
Journal of epidemiology and community healthauthors
Mackenbach JPdoi
10.1136/jech.2010.128280subject
Has Abstractpub_date
2011-07-01 00:00:00pages
568-75issue
7eissn
0143-005Xissn
1470-2738pii
jech.2010.128280journal_volume
65pub_type
历史文章,杂志文章abstract:BACKGROUND:Polychlorinated biphenyls (PCBs) are complex mixtures of persistent contaminants that are widespread in the environment. Newborns are exposed across the placenta and through breast feeding. Experimental animal studies have indicated that PCBs are neurotoxic. The neurological effects of these compounds on chi...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,评审
doi:10.1136/jech.55.8.537
更新日期:2001-08-01 00:00:00
abstract:STUDY OBJECTIVE:The aim of this paper is to systematically review and analyse the validity and reliability of Antonovsky's life orientation questionnaire/sense of coherence scale (SOC). DESIGN:The study is descriptive and analytical with a systematic integration of the contemporary knowledge base on the salutogenic re...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,评审
doi:10.1136/jech.2003.018085
更新日期:2005-06-01 00:00:00
abstract:BACKGROUND:Injuries are an increasing child health concern and have become a leading cause of child mortality in the 1-4 years age group in many developing countries, including Bangladesh. METHODS:Household observations during 9 months of a community-based pilot of two supervision tools-a door barrier and a playpen-de...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2008.080903
更新日期:2010-07-01 00:00:00
abstract:STUDY OBJECTIVE:To test hypotheses about associations between area level exposures and the prevalence of the most common mental disorders (CMD) in Britain. A statistically significant urban-rural gradient was predicted, but not a socioeconomic gradient, in the prevalence of CMD after adjusting for characteristics of in...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.57.8.616
更新日期:2003-08-01 00:00:00
abstract:OBJECTIVE:To examine the effects of unfairness on incident coronary events and health functioning. DESIGN:Prospective cohort study. Unfairness, sociodemographics, established coronary risk factors (high serum cholesterol, hypertension, obesity, exercise, smoking and alcohol consumption) and other psychosocial work cha...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2006.052563
更新日期:2007-06-01 00:00:00
abstract::Medical students in Nottingham all complete an honours Bachelor of Medical Sciences course in one department including a research project. The honours programme in community health is described, with results from a survey of the 122 graduates since the medical school started. The 98 (80%) responses showed high levels ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.40.3.232
更新日期:1986-09-01 00:00:00
abstract:STUDY OBJECTIVE:The aim was to assess the interrelationship between alcohol intake, cigarette smoking, body weight, and blood lipid concentrations. DESIGN:This was the cross sectional (screening) phase of a prospective study. The main outcome measure was the blood lipids (serum total cholesterol, HDL cholesterol, and ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.46.3.197
更新日期:1992-06-01 00:00:00
abstract:STUDY OBJECTIVES:To assess the extent to which poorer self assessed health in men in whom an abdominal aortic aneurysm (AAA) is detected at screening is a consequence or a predictor of screening outcome. DESIGN:Prospective study. SETTING:Community based screening. PARTICIPANTS:23 654 men who attended for AAA screeni...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,多中心研究
doi:10.1136/jech.2003.019307
更新日期:2004-12-01 00:00:00
abstract::It has been claimed that the aggregation of information from several areas of life into a small set of global measures has certain advantages for describing disability. Global measures of disability were constructed from a modified version of an existing health survey instrument and the sickness impact profile (SIP) a...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.37.4.296
更新日期:1983-12-01 00:00:00
abstract:BACKGROUND:Financial strain is associated with earlier disability and mortality, but causal links are underexplored, partly because it is unethical to randomise people to financial stress. This study leverages naturally occurring random variation in days since monthly Social Security payment arrival among older adults ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2020-213807
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:There are few longitudinal data on physical activity patterns from mid-life into older age. The authors examined associations of self-reported physical activity, adiposity and socio-demographic factors in mid-life with objectively assessed measures of activity in older age. METHODS:Participants were 394 hea...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2011-200505
更新日期:2012-12-01 00:00:00
abstract:STUDY OBJECTIVE:Northern Ireland has the highest standardised mortality ratios for colon cancer in the United Kingdom and the Republic of Ireland has some of the highest mortality rates for cancer in the world. The aim of the study therefore was to investigate trends in colorectal cancer in the north and south of Irela...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.44.3.220
更新日期:1990-09-01 00:00:00
abstract:STUDY OBJECTIVE:In many countries, cancer registries cover only a small part of the national population. Cancer incidence for the rest of the country has therefore to be estimated. This can be done from mortality data using the relation between incidence and mortality observed in the cancer registry areas. Such an appr...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.53.9.558
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND:Efforts to end preventable newborn deaths will fail if the poor are not reached with effective interventions. To understand what works to reach vulnerable groups, we describe and explain the uptake of a highly effective community-based newborn health intervention across social strata in Asia and Africa. MET...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2014-204685
更新日期:2016-01-01 00:00:00
abstract:STUDY OBJECTIVE:The study aimed to examine the concurrence in the variation of monthly numbers of deaths in summer and winter from the four main underlying causes - respiratory, circulatory, neoplastic, and all others - in four countries. In particular, the hypothesis that most non-respiratory concurrent deaths are mis...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.49.4.373
更新日期:1995-08-01 00:00:00
abstract:BACKGROUND:Vitamin D has been suggested to have a role in infection defence and on the immune system. We therefore investigated the effect of serum 25-hydroxyvitamin D₃ (25(OH)D₃) on the risk of incident hospitalised pneumonia in an ageing general population in eastern Finland. METHODS:The study population included 72...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2012-202027
更新日期:2013-06-01 00:00:00
abstract:STUDY OBJECTIVE:To assess the representativeness of survey participants by systematically comparing volunteers in a national health and sexuality survey with the Australian population in terms of self reported health status (including the SF-36) and a wide range of demographic characteristics. DESIGN:A cross sectional...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.56.10.748
更新日期:2002-10-01 00:00:00
abstract::It is not a point of debate that the Stockholm Convention for the prevention of further accumulation of persistent organic pollutants (POPs) should be ratified and implemented by all countries. However, in their article, Schafer and Kegley present an unbalanced "worst case scenario". Approximately 20% of the food supp...
journal_title:Journal of epidemiology and community health
pub_type: 评论,杂志文章
doi:10.1136/jech.56.11.824
更新日期:2002-11-01 00:00:00
abstract:BACKGROUND:As the worldwide population has aged, the number of surgical procedures performed on older patients has increased. It is not known whether this increase has been proportional to growth in the elderly population. The aim of this study was to assess the population-adjusted incidence of acute and elective gener...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2019-212283
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Innovative strategies beyond the health system are required to reduce the prevalence of smoking. Early child development interventions are examples of interventions that can help set children on positive social and educational trajectories, which in turn may also reduce the prevalence of smoking. The aim of ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2009.101840
更新日期:2011-12-01 00:00:00
abstract:AIM:The hypothesis that patients with hyperglycaemia during admission, regardless of previous diagnosis of diabetes, have worse prognosis than those with normal glucose values is controversial. The objective was to assess the role of hyperglycaemia on short-term mortality after myocardial infarction (MI). METHODS AND ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.56.9.707
更新日期:2002-09-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate whether cognitive performance in childhood is an early determinant of adult illness. DESIGN:Prospective cohort study covering over 30 years. SETTING:Providence, Rhode Island, USA. PARTICIPANTS:633 people ages 30-39 followed up since birth as part of the Providence cohort of the national c...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2003.016444
更新日期:2004-08-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the ways in which institutions devoted to international development influence epidemiological studies. DESIGN:This article takes a descriptive epidemiological study of El Salvador, Epidemiological Profile, conducted in 1994 by the US Agency for International Development, as a case study. T...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.55.3.164
更新日期:2001-03-01 00:00:00
abstract:OBJECTIVES:To measure the effects of the civil unrest (the Troubles) on the mental health of the general population of Northern Ireland. DESIGN:A secondary analysis of a nationally representative population survey conducted in 1997. SETTING:Northern Ireland. METHODS:This is an analysis of the 1694 respondents (aged ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.57.7.488
更新日期:2003-07-01 00:00:00
abstract::The world is increasingly shaped by powerful global forces, many of which have consequences for human health and the social, economic, and environmental factors that influence health are increasingly determined at a supranational level. As a result, local or national level efforts to influence health determinants can ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2004.027854
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:This paper aims to assess whether 7-year-olds' physical activity is associated with family and area-level measures of the physical and socioeconomic environments. METHODS:We analysed the association of environments with physical activity in 6497 singleton children from the UK Millennium Cohort Study with re...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2014-204287
更新日期:2015-01-01 00:00:00
abstract:STUDY OBJECTIVE:The aim was to estimate health and economic consequences of interventions aimed at reducing the daily intake of salt (sodium chloride) by 6 g per person in the Norwegian population. Health promotion (information campaigns), development of new industry food recipes, declaration of salt content in food an...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.54.9.697
更新日期:2000-09-01 00:00:00
abstract:STUDY OBJECTIVE:To investigate the association of sexual problems with social, physical, and psychological problems. DESIGN:An anonymous postal questionnaire survey. SETTING:Four general practices in England. PARTICIPANTS:789 men and 979 women responding to a questionnaire sent to a stratified random sample of the a...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.53.3.144
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:Controversy remains on the relation between serum lipids levels and stroke risk. This paper investigated the association of total and HDL cholesterol level to fatal and non-fatal, and haemorrhagic and ischaemic stroke in four European cohorts participating in EUROSTROKE. METHODS:EUROSTROKE is a collaborativ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.56.suppl_1.i19
更新日期:2002-02-01 00:00:00
abstract:STUDY OBJECTIVE:The aim was to audit, against agreed standards, the control of bacterial meningitis, in particular completeness of notification and appropriateness of distribution of chemoprophylaxis to contacts; and to implement appropriate changes and monitor their impact. DESIGN:The first phase involved determinati...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.46.4.329
更新日期:1992-08-01 00:00:00