Intersectoral action for health equity
The NCCDH is pleased to present an expedited rapid systematic review examining the effectiveness and impact of intersectoral action as a public health practice to advance health equity.
What we did
Using streamlined systematic review methods we sought out evidence on the impact of intersectoral action on health equity. Over a period of three months, we screened over 10,000 articles, selected articles that met our review criteria, critically appraised the included studies, and synthesized the findings.
What we found
The review includes 17 studies which met our criteria.
- Few of these studies reported on interventions which address structural determinants of health. Interventions which focused on access to care and service delivery were more common.
- The impact of intersectoral action is mixed, revealing a moderate effect to no effect on the social determinants of health. The evidence on the impact of intersectoral action on health equity is limited.
- A number of tools and strategies such as project committees, funding, dedicated staff, and clear expectations of outcomes for the population of interest supported the initiation and implementation of intersectoral initiatives.
What we learned
Our findings support what others have noted – much of the literature on the social determinants of health to advance health equity is descriptive and there is less of an emphasis on interventions. There are many examples of intersectoral initiatives from across Canada and around the world, yet outcomes related to health, the social determinants of health, or policy for health equity are often not reported. Applying the expedited systematic review method to the extremely complex and context-specific nature of social determinants of health interventions has emphasized the lack of available high quality, rigorously evaluated evidence.
This review has strengthened our understanding of the impact of intersectoral action on health equity and helps us to clarify how public health organizations work with other sectors.
The findings of this review were presented at the The Ontario Public Health Convention and Community Health Nurses of Canada 2012 conferences. The workshops provided an opportunity for practitioners and NCCDH staff to explore the intersection of research evidence and experience from practice.
To learn more about our findings, download the report!
Claire Betker leads the NCCDH team and St. Francis Xavier University colleagues in a discussion about expedited systematic review methods during a workshop hosted by Donna Fitzpatrick-Lewis from the Effective Public Health Practice Project.