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Health and Deprivation: Does Health Promotion Work?

The DoH committee looking at health and deprivation has a tough task. The unpalatable truth across the developed world is that people with lower socio-economic status face higher mortality rates. Social class V had twice the mortality rate of social class I in 1971; these findings of the Black report (1988) have been confirmed by other methods. The cause is less clear than the effect. Is health promotion a good buy for commissioners who want to rectify the imbalance?

Northern RHA commissioned a review of the effectiveness and cost-effectiveness of health promotion in deprived areas. The review shows the dearth of evaluations of health promotion. Most of the published work is from North America and may not transfer easily across culture. Four relatively successful types of health promotion emerged:
  • interventions that work with community support & participation
  • offering a service previously unavailable or with low uptake (e.g. screening programmes)
  • providing information not available previously (e.g. diet)
  • direct national or local policy to protect health (e.g. seatbelt legislation)


Of these the most effective were prevention measures (e.g. screening) and protection measures (e.g. seatbelts).

There is a strong case for demanding proper evaluation of any health promotion endeavours. This review will tell you where to start.

Reference:

Bunton R, Burrows R, Gillen K, Muncer S. Interventions to promote health in economically deprived areas: a critical review of the literature - 1994. Report to Northern RHA 1994.

Bandolier's attention was caught by a neat matrix (Feinstein, 1993).
Feinstein JS. The relationship between socioeconomic status and health: a review of the literature. The Millbank Memorial Fund Vol 71 No.2 1993.



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