title: The effects of public health policies on population health and health inequalities in European welfare states: protocol for an umbrella review.
abstract: BACKGROUND
  The welfare state is potentially an important macro-level determinant of health that also moderates the extent, and impact, of socio-economic inequalities in exposure to the social determinants of health. The welfare state has three main policy domains: health care, social policy (e.g. social transfers and education) and public health policy. This is the protocol for an umbrella review to examine the latter; its aim is to assess how European welfare states influence the social determinants of health inequalities institutionally through public health policies.
  
  
  METHODS
  A systematic review methodology will be used to identify systematic reviews from high-income countries (including additional EU-28 members) that describe the health and health equity effects of upstream public health interventions. Interventions will focus on primary and secondary prevention policies including fiscal measures, regulation, education, preventative treatment and screening across ten public health domains (tobacco; alcohol; food and nutrition; reproductive health services; the control of infectious diseases; screening; mental health; road traffic injuries; air, land and water pollution; and workplace regulations). Twenty databases will be searched using a pre-determined search strategy to evaluate population-level public health interventions.
  
  
  CONCLUSIONS
  Understanding the impact of specific public health policy interventions will help to establish causality in terms of the effects of welfare states on population health and health inequalities. The review will document contextual information on how population-level public health interventions are organised, implemented and delivered. This information can be used to identify effective interventions that could be implemented to reduce health inequalities between and within European countries.
  
  
  BACKGROUND
  PROSPERO CRD42016025283.
authors.affiliation: Centre for Health and Inequalities Research, Department of Geography, Durham University, Lower Mountjoy, South Road, Durham, DH1 3LE, UK. k.h.thomson@durham.ac.uk.
authors.forename: Katie
authors.initials: K
authors.lastname: Thomson
authors.affiliation: Centre for Health and Inequalities Research, Department of Geography, Durham University, Lower Mountjoy, South Road, Durham, DH1 3LE, UK.
authors.forename: Clare
authors.initials: C
authors.lastname: Bambra
authors.affiliation: Department of Sociology and Political Science, Norwegian University of Science and Technology, Dragvoll, Building 9, Level 5, 7491, Trondheim, Norway.
authors.forename: Courtney
authors.initials: C
authors.lastname: McNamara
authors.affiliation: Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Yvonne Carter Building, 58 Turner Street, Whitechapel, London, E1 2AB, UK.
authors.forename: Tim
authors.initials: T
authors.lastname: Huijts
authors.affiliation: Centre for Health and Inequalities Research, Department of Geography, Durham University, Lower Mountjoy, South Road, Durham, DH1 3LE, UK.|Division of Pharmacy, School of Medicine, Pharmacy and Health, Durham University, Stockton-on-Tees, TS17 6BH, UK.
authors.forename: Adam
authors.initials: A
authors.lastname: Todd
mesh_terms: D005060:Europe; D006291:Health Policy; D054625:Healthcare Disparities; D006801:Humans; D011634:Public Health; D012107:Research Design; D000078202:Systematic Reviews as Topic
keywords: Europe; Health and health inequalities; Public health; Umbrella systematic review; Welfare states