Background

This systematic review aimed to critically review and analyse evidence synthesis articles using health inequality/inequity guidance to support their review.

Methods

A comprehensive, systematic search of six social science databases (1990 to May 2022) and grey literature sources was undertaken.

A narrative approach to synthesis was adopted, describing and categorizing the characteristics of included articles. A comparison of the existing methodological guides was also conducted, discussing the similarities and differences between them.

Results

From 205 identified reviews published between 2008 and 2022, 62 (30%) focusing on health inequality/inequity, met the criteria. The reviews were diverse in terms of methodology, populations, intervention level, and clinical areas. Only 19 (31%) reviews discussed the definition of inequality/inequity.

Two methodological guides were identified: (i) the PROGRESS/Plus framework and (ii) the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Equity checklist.

Conclusion

A critique on the methodological guides reaffirms a lack of clarity or guidance on how health inequality/inequity should be considered.

The PROGRESS/Plus framework narrowly focuses on dimensions of health inequality/inequity but rarely considers the pathways and interactions of these dimensions and their effect on outcomes.

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses–Equity checklist, on the other hand, provides guidance on report.

A conceptual framework is needed to show the pathways and interactions of dimensions of health inequality/inequity.

Full publication

A systematic review finds a lack of consensus in methodological approaches in health inequality/inequity focused reviews (Journal of Clinical Epidemiology)

Date

March 2023

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