Assessing the causal relationship between income inequality and mortality and self-rated health: protocol for systematic review and meta-analysis

Shimonovich, M. , Pearce, A. , Thomson, H. , McCartney, G. and Katikireddi, S. V. (2022) Assessing the causal relationship between income inequality and mortality and self-rated health: protocol for systematic review and meta-analysis. Systematic Reviews, 11, 20. (doi: 10.1186/s13643-022-01892-w) (PMID:35115055) (PMCID:PMC8815171)

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Abstract

Background: Income inequality has been linked to health and mortality. While there has been extensive research exploring the relationship, the evidence for whether the relationship is causal remains disputed. We describe the methods for a systematic review that will transparently assess whether a causal relationship exists between income inequality and mortality and self-rated health. Methods: We will identify relevant studies using search terms relating to income inequality, mortality, and self-rated health (SRH). Four databases will be searched: MEDLINE, ISI Web of Science, EMBASE, and the National Bureau of Economic Research. The inclusion criteria have been developed to identify the study designs best suited to assess causality: multilevel studies that have conditioned upon individual income (or a comparable measure, such as socioeconomic position) and natural experiment studies. Risk of bias assessment of included studies will be conducted using ROBINS-I. Where possible, we will convert all measures of income inequality into Gini coefficients and standardize the effect estimate of income inequality on mortality/SRH. We will conduct random-effects meta-analysis to estimate pooled effect estimates when possible. We will assess causality using modified Bradford Hill viewpoints and assess certainty using GRADE. Discussion: This systematic review protocol lays out the complexity of the relationship between income inequality and individual health, as well as our approach for assessing causality. Understanding whether income inequality impacts the health of individuals within a population has major policy implications. By setting out our methods and approach as transparently as we can, we hope this systematic review can provide clarity to an important topic for public policy and public health, as well as acting as an exemplar for other “causal reviews”.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Katikireddi, Professor Vittal and Thomson, Dr Hilary and McCartney, Professor Gerard and Pearce, Dr Anna and Shimonovich, Ms Michal
Authors: Shimonovich, M., Pearce, A., Thomson, H., McCartney, G., and Katikireddi, S. V.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Social Scientists working in Health and Wellbeing
College of Social Sciences > School of Social and Political Sciences > Sociology Anthropology and Applied Social Sciences
University Services > Learning and Teaching Services Division
Journal Name:Systematic Reviews
Publisher:BioMed Central
ISSN:2046-4053
ISSN (Online):2046-4053
Copyright Holders:Copyright © 2022 The Authors
First Published:First published in Systematic Reviews 11: 20
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
3048231Inequalities in healthAlastair LeylandChief Scientist Office (CSO)SPHSU17HW - MRC/CSO Social and Public Health Sciences Unit
3048231Inequalities in healthAlastair LeylandMedical Research Council (MRC)MC_UU_00022/2HW - MRC/CSO Social and Public Health Sciences Unit
174091Improving life chances & reducing child health inequalities: harnessing the untapped potential of existing dataAnna PearceWellcome Trust (WELLCOTR)205412/Z/16/ZHW - MRC/CSO Social and Public Health Sciences Unit
172690Understanding the impacts of welfare policy on health: A novel data linkage studySrinivasa KatikireddiOffice of the Chief Scientific Adviser (CSO)SCAF/15/02HW - Public Health