Connecting the dots on health inequalities--a systematic review on the social determinants of health in Portugal

Int J Equity Health. 2016 Feb 16:15:26. doi: 10.1186/s12939-016-0314-z.

Abstract

Introduction: Health inequalities are recognised as a public health issue worldwide, but only a few countries have developed national strategies to monitor and reduce them. Despite its considerable health inequalities, Portugal seems to lack a systematic strategy to tackle them, possibly due to the absence of organised evidence on the issue. We performed a systematic review that aimed to describe the available evidence on social inequalities in health in Portugal, in order to contribute towards a comprehensive and focused strategy to tackle them.

Methods: We followed the PRISMA guidelines and searched Scopus, Web of Science and PubMed for studies that looked at the association between a measure of socioeconomic status and a health outcome in the Portuguese resident population since the year 2000. We excluded health behaviours and healthcare use from our search. We performed a qualitative description of the results.

Results: Seventy-one publications were selected, all reporting observational analyses, most of them using cross-sectional data. These publications showed strong evidence for health inequalities related to education and gender, chiefly for obesity, self-rated health and mental health.

Conclusions: Analysis of the eligible publications showed that current research does not seem to have consistently covered the link between health and key Portuguese social problems. A strategy focusing on the monitoring of most prevalent diseases, most determining socioeconomic factors and vulnerable populations would be crucial to guide academic research in a country in which health inequalities are so ubiquitous and deeply rooted.

Registration: This systematic review is not registered.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Cross-Sectional Studies
  • Female
  • Health Promotion / standards
  • Humans
  • Male
  • Mental Health / standards
  • Obesity / epidemiology
  • Portugal / epidemiology
  • Public Health / standards*
  • Public Health / trends
  • Social Class
  • Social Determinants of Health*