PI: Professor Amanda Sowden, Centre for Reviews and Dissemination, University of York
England’s public health policy aims to combine overall improvements in population health with greater improvements among disadvantaged groups and deprived communities. The most deprived areas of England have the lowest healthy life expectancy and there is a twenty year difference between people living in the most and least deprived parts of the country. Heart disease, stroke, cancer and respiratory illness are the top contributors to this difference.
Risk behaviours – physical inactivity, poor diet, smoking and alcohol misuse – are major contributors. Up to 80% of heart disease, stroke and type 2 diabetes and over a third of cancers could be prevented if these behaviours were eliminated. Physical inactivity and smoking are highest in more deprived areas while the proportion of people eating the recommended ‘5-a-day of fruits and vegetables’ is lowest.(6) Risk behaviours are prevalent among disadvantaged groups, with almost three times as many smokers amongst the lowest compared with the highest earners. Seventy per cent of homeless people and 50-80% of prisoners smoke. Interventions to support healthy lifestyles in disadvantaged groups are essential if improvements in their health are to match and outstrip those in the wider population.
There is a growing evidence base about the effectiveness of programmes to improve health behaviours in disadvantaged groups and a need to bring this evidence together to answer questions about what works to reduce inequalities. The overall aim of this project is therefore to identify, ‘map’, and synthesise evidence on interventions to reduce risk behaviours in disadvantaged groups and deprived communities. We will determine which interventions are likely to be effective (and ineffective) with which groups and identify barriers and facilitators to adopting healthy lifestyles. We will identify gaps in the evidence base and make recommendations for new research.