The effects of social protection policies on health inequalities: Evidence from systematic reviews. Issue 6 (August 2019)

• Record Type: Journal Article
• Authors: Hillier-Brown, Frances; Thomson, Katie; Mcgowan, Victoria; Cairns, Joanne; Eikemo, Terje A.; Gil-Gonzále, Diana; Bambra, Clare
• Is Part Of: Scandinavian journal of public health. Volume 47:Issue 6(2019:Aug.)
• Page Start: 655
• Page End: 665
• Publication Date: 2019-08
• Subjects: Social policy -- gender -- labour market -- health equity -- review -- evidence; Public health -- Periodicals; Social medicine -- Periodicals; 614
• DOI: 10.1177/1403494819848276
• Languages: English
• ISSNs: 1403-4948

Abstract

Background: The welfare state distributes financial resources to its citizens – protecting them in times of adversity. Variations in how such social protection policies are administered have been attributed to important differences in population health. The aim of this systematic review of reviews is to update and appraise the evidence base of the effects of social protection policies on health inequalities. Methods/design : Systematic review methodology was used. Nine databases were searched from 2007 to 2017 for reviews of social policy interventions in high-income countries. Quality was assessed using the Assessment of Multiple Systematic Reviews 2 tool. Results : Six systematic reviews were included in our review, reporting 50 unique primary studies. Two reviews explored income maintenance and poverty relief policies and found some, low quality, evidence that increased unemployment benefit generosity may improve population mental health. Four reviews explored active labour-market policies and found some, low-quality evidence, that return to work initiatives may lead to short-term health improvements, but that in the longer term, they can lead to declines in mental health. The more rigorously conducted reviews found no significant health effects of any of social protection policy under investigation. No reviews of family policies were located. Conclusions : The systematic review evidence base of the effects of social protection policy interventions remains sparse, of low quality, of limited generalizability (as the evidence base is concentrated in the Anglo-Saxon welfare state type), and relatively inconclusive. There is a clear need for evaluations in more diverse welfare state settings and particularly of family policies.