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BEDREHELSE-Bedre helse og livskvalitet

Evidence for action to reduce social inequalities in health

Alternative title: Kunnskapsbaserte tiltak for å redusere sosiale ulikheter i helse

Awarded: NOK 11.5 mill.

Reducing health inequalities is a major priority nationally and internationally. To succeed in this, the underlying structural conditions creating health inequalities must be targeted and sectors must coordinate their efforts. This project aims to develop sustainable, multi-sector interventions and policy input that contribute to reduce inequalities in health and promote health and health equity. Special attention is directed towards mental health in children, adolescents and their families. Based on qualitative research the project will identify barriers and enablers for user-involvement and coordinated work across sectors, as well as generate knowledge on users experienced impact of interventions. The project will also make use of quantitative population-based registry data to identify impact of interventions and potential causal pathways leading to positive health outcomes. Lastly, qualitative and quantitative data will be analyzed and synthesized into a summary of findings and model(s) of good practice. The project enables synergies across sectors that can improve efforts, knowledge and expertise about how to achieve better results in public health. Outcomes from the participating municipalities will be gathered systematically and compared to provide robust conclusions on the efficiency of measures and how to succeed with multi-sectorial cooperation and coordination. Implementation of multi-sectoral interventions will potentially result in significant health benefits for the end-user and lead to empowerment at individual and group levels and increased sense of ownership to efforts seeking social and political change. This can subsequently lead to improved social functioning, better performance in school, improved opportunities in the labor market, and improved quality of life. In the long term, reduced inequalities in health are expected. Trøndelag County Council and municipalities in the region are partners in the project and municipalities apply the Trøndelag Model for Public Health Work when developing and implementing their public health initiatives.

Mental illness are the leading cause of disability in children and youth, and account for a quarter of all years lived with disability globally. It has been emphasised that childhood and adolescence represent a critical stage of the life course where many behavioural patterns determining both current and later health outcomes are established. There is e.g. found a strong and bidirectional association between mental health problems and secondary school dropout. Non-completion of secondary school is one of the major risk factors for permanent exclusion from the labour market, and low education and adverse living conditions increase the risk. Together, these factors may result in a downward spiral, increasing socioeconomic inequalities in health during the life course. To improve the mental health among children and adolescents effectively and prevent social gaps from widening, the literature indicated that it is necessary to develop interventions targeting multiple domains. Multiple domain interventions do not only address the need of the individual child or adolescent, they do also involve important domains from their everyday support system. This is essential, since the relationship between social environments and the individual has been found to be interdependent, and different social levels can therefore form and influence mental health. However, a majority of interventions are not connected to multiple domains. They only addressed the needs in one domain, focusing on downstream factors such as individual behavioural change. Thus, this project aim tp develop coordinated multi-sector interventions and policies, reducing inequalities in health and promoting health and health equity in, for and with municipalities. Special attention is directed to; administrative transitions (from kindergarten to school; from school/studies to work) and social transitions (in the peer-groups) in children in general and vulnerable groups of children in particular.

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Funding scheme:

BEDREHELSE-Bedre helse og livskvalitet