Written by Gemma Spiers, Principal Research Associate

It is no longer sufficient to only ask ‘Does this intervention work?’. Critically, we must understand whether an intervention will offer equal benefits for everyone, regardless of whether they are rich or poor. The socioeconomic gap in healthy life expectancy is substantial and shows no signs of closing. Interventions and approaches to promote healthy ageing must therefore consider how to ensure that outcomes for the poorest in society are equivalent to, or greater than, their richest counterparts.

There are well established research methods to assess equitable access to and outcomes from health interventions. (In an equitable system, access would be related to need, and outcomes equal across the population, irrespective of baseline health status). Even so, progress at incorporating considerations of equity into evaluations remains slow, particularly within the field of healthy ageing. Within the Healthy Ageing Policy Research Unit, we are increasingly adopting the principles of Equity Focused Systematic Reviews (Welch et al., 2016), to allow us to draw conclusions about whether interventions offer equitable benefits across populations. A common challenge, however, is that primary studies (which we include within a review) rarely report the data we need to make a judgement about equity.

So where does this leave us? Typically, it means that whilst we can say whether an intervention will work, we cannot say whether it will work for everyone who might benefit from it. This is the sort of evidence-based conclusion that, going forward, is not helpful to equity-minded policy makers.

To address this, the team at HAPRU have been developing a supplementary method called Equity-Focused Workshops (EFW). The goal of this method is to gain preliminary insights into whether health interventions are likely to exclude populations experiencing material disadvantage. Using a workshop-based data collection protocol, the EFW method can be considered an ‘add-on’ to a systematic or rapid review of intervention effectiveness.

Of course, this approach should not replace existing, more established approaches to assessing equity in primary studies. However, it can be a useful tool when a review finds little evidence about whether interventions are similarly effective across the most and least advantaged groups. If you would like to read more about the method and how to apply it, the paper and the workshop protocol have been recently published in the Journal of Health Equity.

We are positive about applying EFWs in our future research in HAPRU. We hope that this method will help move us closer to being able to answer important policy questions about equity in healthy ageing.

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