GRADIENT: Assessing public health policy approaches to level-up the gradient in health inequalities

The Gradient Project is a collaborative research project involving 12 institutions (universities, research institutes and public health institutes) from all over Europe. The project is coordinated by EuroHealthNet and has received funding from the European Community’s Seventh Framework Programme.

As a core part of the project, the Gradient Evaluation Framework (GEF) has been developed as a European action-oriented policy tool to guide and inform technical experts in (modern) public health1 working at the Member State level. Linked directly to the policy cycle, GEF is designed to assist those involved in the development, implementation, and evaluation of policies that aim to reduce health inequalities and level-up the gradient in health and its social determinants among children, young people and their families.

Specifically, it is intended to facilitate the evaluation of policy actions2 for their current or future use in terms of their ‘gradient friendliness’ i.e. their potential to level-up the gradient.

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Project objectives

Funded by the EC FP7 framework (2009-2012), this project aimed to evaluate and recommend public health policy options that tackle health inequalities and address the gradients in health determinants among families and children. Specific objectives of the project were:

To develop a consensus-based European Framework to monitor and evaluate public health policies and their impact on the gradients that exists in the social determinants that generate health inequalities.
To investigate if and why children and families from different socio-economic groups respond and act differently to public health policy interventions
To identify protective factors for the health of children and young people and their families focusing on social relations and social networks, in order to explore alternative policy options that moderate social inequities in health.
To analyse and compare general policies for families and children with policies targeted at 'at risk' families and children.
To formulate policy recommendations at European, national, regional and local level and to disseminate the findings across the European Union.

Project outcomes

Completed in March 2012, as a core part of the project, The Gradient Evaluation Framework (GEF) has been developed by Professor John Kenneth Davies and Dr Nigel Sherriff as a European action-oriented policy tool to guide and inform technical experts in public health working at the Member State level. Linked directly to the policy cycle, GEF is designed to assist those involved in the development, implementation, and evaluation of policies that aim to reduce health inequalities and level-up the gradient in health and its social determinants among children, young people and their families.

Download the GRADIENT report here.

Research team

Dr Nigel Sherriff

Professor John Kenneth Davies

Outputs

Davies, J.K. and Sherriff, N.S. (2014). Assessing public health policy approaches to level-up the gradient in health inequalities using a consensus-building process: The Gradient Evaluation Framework (GEF). Public Health, 128, 246-253

Davies, J.K., and Sherriff, N.S. (2012). The Gradient Evaluation Framework (GEF): A European framework for designing and evaluating policies and actions to level-up the gradient in health inequalities among children, young people, and their families. Brighton: University of Brighton.

Davies, J.K. and Sherriff, N.S. (2011). The gradient in health inequalities among families and children: a review of evaluation frameworks. Health Policy, 101(1), 1-10.

Davies, J.K., Sherriff, N.S., and Ieven, A. (2010). A review of evaluation frameworks part one. GRADIENT project Work Package Two working document www.health-gradient.eu; Brighton; University of Brighton.

All outputs can be viewed on the Gradient project website

Presentations

Sherriff, N.S and Davies, J.K. (2013). Health inequalities and the health gradient. Presentation at the ACTION-FOR-HEALTH Summer School Conference, Murska Sobota, Slovenia, 23rd -25th September. 2013.

Davies, J.K. and Sherriff, N.S. (2012) Assessing Policy Actions to level Health Inequalities using the Gradient Evaluation Framework (GEF), (Keynote), 2nd Asia Pacific Conference on Health Promotion & Education, 4-6 May 2012, Taipei, China

Davies, J.K. and Sherriff, N.S. (2011). The Gradient Evaluation Framework (GEF) in Action. Paper presented at the symposium on “Tackling the gradient in health amongst children and families: analysis of evidence and policies”, European Public Health Association Annual Conference, Public Health and Welfare: Welfare development and health, 9-12th November 2011, Copenhagen, Denmark.

Davies, J.K. and Sherriff, N.S. (2010). Tackling the gradient: a review of health policy evaluation frameworks. Paper presented at the symposium on “Tackling the gradient in health amongst children and families: analysis of evidence and policies”, 20th IUHPE World Conference on Health Promotion, 11-15 July 2010, Geneva, Switzerland.

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