Bridging the gap in health inequalities with the help of health trainers: a realistic task in hostile environments? A short report for debate.
BACKGROUND
From a public health theoretical perspective, there is acknowledgement that synchronized policies, which address both individual and area level risks to health, are important to reduce inequalities and improve health. Despite this, much research focuses on just one of these two approaches (often pitting them against each other) and much practice tends to focus on individual level interventions. Efforts to address health inequalities between rich and poor in the UK continue to focus on individual-based interventions, with the most recent initiative being health trainers.


METHODS
In this debate piece, we will use health trainers as a specific example, and focusing primarily on levels of physical activity, we will argue that neither individual level interventions nor environmental change alone are likely to improve levels of activity or reduce health inequalities.


CONCLUSIONS
We argue that synchronized policies that tackle both individual and neighbourhood environmental barriers to improving health behaviours are essential.
Trayers
Tanya
T
Academic Unit of Primary Health Care, Department of Community-Based Medicine, University of Bristol, Bristol BS8 2AA, UK.
Lawlor
Debbie A
DA
D004779:Environment Design; D015438:Health Behavior; D006266:Health Education; D006291:Health Policy; D006293:Health Promotion; D054624:Health Status Disparities; D006791:Hostility; D006801:Humans; D009043:Motor Activity; D011204:Poverty Areas; D012111:Residence Characteristics / Q000145:classification; D012931:Social Environment; D012935:Social Justice; D012959:Socioeconomic Factors; D006113:United Kingdom; D035862:Vulnerable Populations / Q000523:psychology*