ArticleJournal of public health (Oxford, England)2018
Moving beyond individual choice in policies to reduce health inequalities: the integration of dynamic with individual explanations.
Article in Journal of public health (Oxford, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Shaping Pathways to Child Health: A Systematic Review of Street-Scale Interventions in City Streets.International journal of environmental research and public health · 2022Pooled it
- Health literacy reductionism: when individual deficits become the default explanation.Health promotion international · 2026Article
- What are we missing? Reflections on the 'problem' of missed appointments in the UK.NIHR open research · 2026Article
- Lifestyle psychiatry: a conceptual framework for application in mental healthcare and support.BMJ mental health · 2025Review
- Article
- Overcoming barriers to gut microbiome development through nutritional factors in the first 1,000 days of life: strategies and implications for preventing non-communicable diseases.Gut microbiome (Cambridge, England) · 2025Review
- Infant mortality and social causality: Lessons from the history of Britain's public health movement, c. 1834-1914.The British journal of sociology · 2024Article
- Modifying urban planning to promote child health: A scoping review of reviews.Health promotion perspectives · 2024Review
- Has the pandemic resulted in a renewed and improved focus on heath inequalities in England? A discourse analysis of the framing of health inequalities in national policy.Public health in practice (Oxford, England) · 2023Article
- Women Consumers' Views on Legislation to Restrict Prominent Placement and Multibuy Promotions of High Fat, Sugar, and Salt Products in England: A Qualitative Perspective.International journal of health policy and management · 2023Article
- An analysis of English national policy approaches to health inequalities: 'transforming children and young people's mental health provision' and its consultation process.BMC public health · 2022Review
- Patient and practitioner views on cancer risk discussions in primary care: a qualitative study.BJGP open · 2022Article
- A critique of the English national policy from a social determinants of health perspective using a realist and problem representation approach: the 'Childhood Obesity: a plan for action' (2016, 2018, 2019).BMC public health · 2021Article
- Noncommunicable diseases, climate change and iniquities: What COVID-19 has taught us about syndemic.European journal of clinical investigation · 2021Review
- The relation between the social and the biological and COVID-19.Public health · 2021Article
- Women's perceptions of factors influencing their food shopping choices and how supermarkets can support them to make healthier choices.BMC public health · 2021Article
- Exemplary medical care or Trojan horse? An analysis of the 'lifestyle medicine' movement.The British journal of general practice : the journal of the Royal College of General Practitioners · 2021Article
- The Challenges of Putting Systems Thinking into Practice Comment on "What Can Policy-Makers Get Out of Systems Thinking? Policy Partners' Experiences of a Systems-Focused Research Collaboration in Preventive Health".International journal of health policy and management · 2021Article
- Changing behaviour: an essential component of tackling health inequalities.BMJ (Clinical research ed.) · 2021Article
- Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
Background: A strong focus on individual choice and behaviour informs interventions designed to reduce health inequalities in the UK. We review evidence for wider mechanisms from a range of disciplines, demonstrate that they are not yet impacting on programmes, and argue for their systematic inclusion in policy and research. Methods: We identified potential mechanisms relevant to health inequalities and their amelioration from different disciplines and analysed six policy documents published between 1976 and 2010 using Bacchi's 'What's the problem represented to be?' framework for policy analysis. Results: We found substantial evidence of supra-individualistic and relational mechanisms relevant to health inequalities from sociology, history, biology, neuroscience, philosophy and psychology. Policy documents sometimes expressed these mechanisms in policy rhetoric but rarely in policy recommendations, which continue to focus on individual behaviour. Discussion: Current evidence points to the potential of systematically applying broader thinking about causal mechanisms, beyond individual choice and responsibility, to the design, implementation and evaluation of policies to reduce health inequalities. We provide a set of questions designed to enable critique of policy discussions and programmes to ensure that these wider mechanisms are considered.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.