title: Connecting the dots on health inequalities--a systematic review on the social determinants of health in Portugal.
abstract: BACKGROUND
  Health inequalities are recognised as a public health issue worldwide, but only a few countries have developed national strategies to monitor and reduce them. Despite its considerable health inequalities, Portugal seems to lack a systematic strategy to tackle them, possibly due to the absence of organised evidence on the issue. We performed a systematic review that aimed to describe the available evidence on social inequalities in health in Portugal, in order to contribute towards a comprehensive and focused strategy to tackle them.
  
  
  METHODS
  We followed the PRISMA guidelines and searched Scopus, Web of Science and PubMed for studies that looked at the association between a measure of socioeconomic status and a health outcome in the Portuguese resident population since the year 2000. We excluded health behaviours and healthcare use from our search. We performed a qualitative description of the results.
  
  
  RESULTS
  Seventy-one publications were selected, all reporting observational analyses, most of them using cross-sectional data. These publications showed strong evidence for health inequalities related to education and gender, chiefly for obesity, self-rated health and mental health.
  
  
  CONCLUSIONS
  Analysis of the eligible publications showed that current research does not seem to have consistently covered the link between health and key Portuguese social problems. A strategy focusing on the monitoring of most prevalent diseases, most determining socioeconomic factors and vulnerable populations would be crucial to guide academic research in a country in which health inequalities are so ubiquitous and deeply rooted.
  
  
  BACKGROUND
  This systematic review is not registered.
authors.affiliation: Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisbon, Portugal. ines.matos@ihmt.unl.pt.|Centro de Investigação em Saúde Pública, Lisbon, Portugal. ines.matos@ihmt.unl.pt.
authors.forename: Inês
authors.initials: I
authors.lastname: Campos-Matos
authors.affiliation: Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisbon, Portugal.|Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, NOVA University of Lisbon, Lisbon, Portugal.
authors.forename: Giuliano
authors.initials: G
authors.lastname: Russo
authors.affiliation: Centro de Investigação em Saúde Pública, Lisbon, Portugal.|Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal.
authors.forename: Julian
authors.initials: J
authors.lastname: Perelman
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006293:Health Promotion / Q000592:standards; D006801:Humans; D008297:Male; D008603:Mental Health / Q000592:standards; D009765:Obesity / Q000453:epidemiology; D011174:Portugal / Q000453:epidemiology; D011634:Public Health / Q000592:standards* / Q000639:trends; D012923:Social Class; D064890:Social Determinants of Health