title: Addressing social determinants of health inequities through settings: a rapid review.
abstract: Changing settings to be more supportive of health and healthy choices is an optimum way to improve population health and health equity. This article uses the World Health Organisation's (1998) (WHO Health Promotion Glossary. WHO Collaborating Centre for Health Promotion, Department of Public Health and Community Medicine, University of Sydney, NSW) definition of settings approaches to health promotion as those focused on modifying settings' structure and nature. A rapid literature review was undertaken in the period June-August 2014, combining a systematically conducted search of two major databases with targeted searches. The review focused on identifying what works in settings approaches to address the social determinants of health inequities, using Fair Foundations: the VicHealth framework for health equity. This depicts the social determinants of health inequities as three layers of influence, and entry points for action to promote health equity. The evidence review identified work in 12 settings (cities; communities and neighbourhoods; educational; healthcare; online; faith-based; sports; workplaces; prisons; and nightlife, green and temporary settings), and work at the socioeconomic, political and cultural context layer of the Fair Foundations framework (governance, legislation, regulation and policy). It located a relatively small amount of evidence that settings themselves are being changed in ways which address the social determinants of health inequities. Rather, many initiatives focus on individual behaviour change within settings. There is considerable potential for health promotion professionals to focus settings work more upstream and so replace or integrate individual approaches with those addressing daily living conditions and higher level structures, and a significant need for programmes to be evaluated for differential equity impacts and published to provide a more solid evidence base.
authors.affiliation: Southgate Institute for Health Society & Equity, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia lareen.newman@flinders.edu.au.
authors.forename: Lareen
authors.initials: L
authors.lastname: Newman
authors.affiliation: Southgate Institute for Health Society & Equity, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.
authors.forename: Fran
authors.initials: F
authors.lastname: Baum
authors.affiliation: Southgate Institute for Health Society & Equity, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.
authors.forename: Sara
authors.initials: S
authors.lastname: Javanparast
authors.affiliation: Victorian Health Promotion Foundation (VicHealth), 15-31 Pelham Street, Carlton, VIC 3053, Australia.
authors.forename: Kerryn
authors.initials: K
authors.lastname: O'Rourke
authors.affiliation: Victorian Health Promotion Foundation (VicHealth), 15-31 Pelham Street, Carlton, VIC 3053, Australia.
authors.forename: Leanne
authors.initials: L
authors.lastname: Carlon
mesh_terms: D015438:Health Behavior; D006291:Health Policy; D006293:Health Promotion; D054624:Health Status Disparities; D006801:Humans; D064890:Social Determinants of Health; D012959:Socioeconomic Factors
keywords: equity; review; settings; social determinants