Research Recap. Vol 4

I’m in the process of switching from Endnote to Papers as my reference management/citation software of choice. It’s never an easy choice or a short task to switch reference software. I’m sure I will still use both Endnote and Papers for the next while. Anyway, Recently went through about 60 unread articles in the stack. Here are some highlights:
Extensive medical, public health, and social science research has focused on cataloguing male- female differences in human health. Unfortunately, much of this research unscientifically and unquestionably attributes these differences to biological causes – as exemplified in the Institute of Medicine’s conclusion that “every cell has a sex.” In this manuscript we theorize the entanglement of sex and gender in human health research and articulate good practice guidelines for assessing the role of biological processes – along with social and biosocial processes – in the production of non-reproductive health differences between and among men and women. There are two basic tenets underlying this project. The first is that sex itself is not a biological mechanism and the second is that “sex” and “gender” are entangled, and analyses should proceed by assuming that measures of sex are not “pristine,” but include effects of gender. Building from these tenets – and using cardiovascular disease as a consistent example – we articulate a process that scientists and researchers can use to seriously and systematically assess the role of biology and social environment in the production of health among men and women. We hope that this intervention will be one further step toward understanding the complexity and nuance of health outcomes, and that this increased knowledge can be used to improve human health.
2) Second a set of papers discussing the merits of and alternatives to randomized controlled trials for evaluating public health interventions. I’ve been very interested in the relationship between randomization (and it’s assumptions) and causality lately. If you need a primer on this research area I definitely recommend starting here (Holland, P. W. (1986). Statistics and causal inference. Journal of the American Statistical Association, 81(396), 945–960.)
Sally Macintyre makes a strong case for the need for randomized controlled trials of public health interventions. I agree.
In their reply to Macintyre, Cousens, Bonell et al.,  make a strong case for the need for alternative designs and analysis methods of public health interventions. I agree.
England was the first European country to pursue a systematic policy to reduce socio-economic inequalities in health. This paper assesses whether this strategy has worked, and what lessons can be learnt. A review of documents was conducted, as well as an analysis of entry-points chosen, specific policies chosen, implementation of these policies, changes in intermediate outcomes, and changes in final health outcomes. Despite some partial successes, the strategy failed to reach its own targets, that is, a 10% reduction in inequalities in life expectancy and infant mortality. This is due to the fact that it did not address the most relevant entry-points, did not use effective policies and was not delivered at a large enough scale for achieving populationwide impacts. Health inequalities can only be reduced substantially if governments have a democratic mandate to make the necessary policy changes, if demonstrably effective policies can be developed, and if these policies are implemented on the scale needed to reach the overall targets.

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