Led by EuroHealthNet, this work aimed to consolidate existing knowledge of advocacy for health equity, which is dispersed widely across the academic and grey literature, across disciplines, and is contained in a variety of different kinds of publications. Advocates previously had no synthesis of this knowledge to draw upon to inform their efforts.

As a result, EuroHealthNet carried out a systematic review of the academic literature and fixed-length systematic search of the grey. The results of the search which were analysed and synthesised by using a heuristic representation of advocacy for health equity (the "Six Dimensions of Advocacy for Health Equity"), developed jointly with the European Anti-Poverty Network, Business in the Community and Eurochild.

The review shows that the policy world is complex and that scientific evidence is unlikely to be conclusive in the making of decisions policy. Timely qualitative, interdisciplinary, and mixed-methods research may be particularly valuable in advocacy efforts. The potential impact of evidence can be increased by “packaging” it using methods of knowledge transfer and translation. Increased contact between researchers and policy makers could improve the uptake of research in policy processes. Researchers can play a role in advocacy efforts, though health professionals and disadvantaged people, who have direct contact with - or experience of - hardship, can be particularly persuasive in advocacy efforts. Different types of advocacy messages can accompany evidence, but messages should be tailored to the target group. Advocates need to take advantage of “windows of opportunity”, which open and close quickly, and demonstrate expertise and credibility. For this reason, dedicated advocacy organisations that have the resources and experience required to advocate could play a leading role in advocacy efforts, bridging the ‘worlds’ of science, practice and policy.

One surprise finding was the emphasis on barriers that hamper advocacy efforts in the academic literature. The most frequently cited was the current political and economic zeitgeist (variously termed 'market fundamentalism', 'market justice', 'neo-classical economics' and 'neoliberalism') and related public opinion, which tends to blame disadvantaged people for their ill health. Other barriers identified included biomedical approaches to health, market-led reforms of higher education, academic difficulties or reluctance to advocate and political short-termism. Several papers suggested means of overcoming these barriers, including long-term actions to raise public awareness and understanding of the SDH, training health professionals in advocacy or human rights, and bringing students concerned with the determinants of health into closer contact with those experiencing hardship as part of their studies.

The review provided a useful building block for later research on advocacy within DRIVERS: five case studies on advocacy and development of the toolkit on advocacy for health equity. In addition, the findings helped inform the how the project disseminated and presented its results. The paper is available here, and appendices here. The case studies report is available here, and advocacy for health equity toolkit here.

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DRIVERS participated in several pre-conference sessions, during which project partners presented some key findings of the project and discussed the role of effective advocacy in realising health equity goals.

A session titled “How to tackle health inequalities? Results from four EU-funded projects” saw Prof Olle Lundberg (CHESS) illustrate the limitations of a welfare regime approach to studying social protection and health inequalities. It also saw Dr Hynek Pikhart (UCL) underline methodological and conceptual challenges in the harmonisation of inequality-relevant indicators across Europe.

Dr Claudia Marinetti (EuroHealthNet) gave an overview of the role of advocacy in reducing health inequalities. She emphasised the value of different kinds of evidence in advocacy efforts, in contrast to the well-known ‘hierarchy of evidence’, and the use of different types of advocacy messages.

In a poster walk dedicated to evidence-informed policy, Linden Farrer (EuroHealthNet) presented results from DRIVERS on improving the effectiveness of advocacy for health equity. He stated that it is important for evidence to find its way into policy processes, but doing so requires specific methods of knowledge transfer and translation. As scientists are not always willing or able to advocate, knowledge brokering organisations such as EuroHealthNet can play an extremely important role in facilitating this process.

One of DRIVERS’ aims is to identify solutions to reducing health inequalities through policy and practice in early childhood development. Joana Morrison (UCL) presented a review of early childhood interventions in several European countries conducted over the last two decades with the aim of addressing health and early development. One of the findings is that interventions with better outcomes appear to combine educational activities for both parents and children beginning in early pregnancy and include home visits by specialised staff.

DRIVERS also featured in a packed plenary session on tackling health inequalities organised by EuroHealthNet. The session included a discussion on presenting policy recommendations to policy makers from four EU-funded projects (DEMETRIQ, DRIVERS, SILNE, SOPHIE), all aiming to generate new evidence on the best ways of tackling health inequalities.

On behalf of the DRIVERS team, Prof Johannes Siegrist emphasised that public spending should strengthen sustainable employment and address health-adverse working conditions, particularly among lower socio-economic groups. Indeed, he noted that “DRIVERS has demonstrated a social gradient in risk of suffering from work stress, with lower occupational groups facing the greatest risks of psycho-social stress”.

All in all, the EPH conference was an excellent opportunity to disseminate new evidence arising from the DRIVERS project to public health researchers, policy makers, practitioners and health professionals.

If you missed DRIVERS at the EPH conference then please visit our Storify page (see below), which summarises the key events through the tweets that were produced throughout the course of the Pre-conference.

You can find the joint DRIVERS and EuroHealthNet news release issued at the start of the EPH Pre-Conference here.

You can also find the DRIVERS presentations and poster here.

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