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Open Access Research article

A review of equity issues in quantitative studies on health inequalities: the case of asthma in adults

Heather L Greenwood12*, Nancy Edwards1234, Amandah Hoogbruin5, Eulalia K Kahwa6, Okeyo N Odhiambo7 and Jack A Buong8

Author Affiliations

1 Institute of Population and Public Health, Canadian Institutes for Health Research, 312-600 Peter Morand Crescent, Ottawa, K1G 5Z3, Canada

2 Institute of Population Health, University of Ottawa, 1 Stewart Street, Ottawa, K1N 6N5, Canada

3 School of Nursing, University of Ottawa, 451 Smyth Road, Ottawa, K1H 8M5, Canada

4 Department of Epidemiology and Community Medicine, University of Ottawa, 451 Smyth Road, Ottawa, K1H 8M5, Canada

5 Faculty of Community and Health Studies, Kwantlen Polytechnic University, 12666 72nd Avenue, Surrey, V3W 2M8, Canada

6 The UWI School of Nursing, Mona University of the West Indies, 9 Gibraltar Camp Way, Kingston 7, Jamaica

7 Department of Research and Knowledge Development, Great Lakes University of Kisumu, P.O. Box 2224, Kisumu, 40100, Kenya

8 Department of Community Health and Development, Great Lakes University of Kisumu, P.O. Box 2224, Kisumu, 40100, Kenya

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BMC Medical Research Methodology 2011, 11:104  doi:10.1186/1471-2288-11-104

Published: 12 July 2011

Abstract

Background

The term 'inequities' refers to avoidable differences rooted in injustice. This review examined whether or not, and how, quantitative studies identifying inequalities in risk factors and health service utilization for asthma explicitly addressed underlying inequities. Asthma was chosen because recent decades have seen strong increases in asthma prevalence in many international settings, and inequalities in risk factors and related outcomes.

Methods

A review was conducted of studies that identified social inequalities in asthma-related outcomes or health service use in adult populations. Data were extracted on use of equity terms (objective evidence), and discussion of equity issues without using the exact terms (subjective evidence).

Results

Of the 219 unique articles retrieved, 21 were eligible for inclusion. None used the terms equity/inequity. While all but one article traced at least partial pathways to inequity, only 52% proposed any intervention and 55% of these interventions focused exclusively on the more proximal, clinical level.

Conclusions

Without more in-depth and systematic examination of inequities underlying asthma prevalence, quantitative studies may fail to provide the evidence required to inform equity-oriented interventions to address underlying circumstances restricting opportunities for health.