![]() Similarly, involuntary unemployment and its related income loss are associated with negative health outcomes. For example, the links between poverty and poor health are wide-ranging and well-documented with lower income being associated with both behavioural risk factors, such as smoking, and a range of negative health outcomes. To date, public health researchers have begun to map out the interconnected pathways and linkages between economic conditions/policies and health outcomes. Berkman notes that ‘understanding the ways in which social and economic policies impact population health is one of the most critical areas for public health today’. In response, there are calls to consider economic policies as health policies with research and evaluation that would more clearly identify the mechanisms through which economic factors/policies affect health. This is particularly pertinent in light of policy debates around Health in All Policies-a move to consider the impact on health and health inequalities in all aspects of government policy. This lack of action has been attributed to the challenge of understanding the multifaceted impacts of social and economic factors, as well as the need for long-term outlooks to address policy problems. In spite of this evidence and formal calls for action dating back to the Ottawa Charter, there continues to be frustration over the lack of practical policy interventions around social and economic determinants. In line with ongoing advocacy for investment in the wider determinants, the results indicate that social and economic factors are the largest influences on population health. Building on these frameworks, there have been several efforts to quantify the impact of the social determinants relative to other influences such as healthcare services. These economic factors are consistently identified in local, national and international population health frameworks as both influences on health and levers to improve health and reduce health inequalities. There has been long-standing recognition of the role of economic factors on health and well-being. This umbrella review protocol has been registered with PROSPERO CRD42017068357. It will also help set the future research agenda in this field and guide the development of interventions. This will yield important information for policymakers, practitioners and researchers at the local, national and international level. Our umbrella review protocol provides a robust method to systematically appraise the evidence in this field, using new conceptual models derived specifically to address the study question. Data will be extracted using a standardized pro forma, and the findings will be synthesized into a conceptual framework to address our review aim. Six databases will be searched using tailored versions of our piloted search strategy to locate relevant reviews. ![]() Secondary outcomes will include health inequalities by gender, ethnicity or socio-economic status. Primary outcomes will include but are not limited to morbidity, mortality, prevalence and incidence of conditions and life expectancy. Reviews of studies with and without controls will be included both association and intervention studies will be included. Reviews will be included if they meet the Database of Abstracts and Reviews of Effects criteria for systematic reviews. We will identify relevant systematic reviews using search terms derived from the Journal of Economic Literature classification. This protocol details the methods for an umbrella review to explore the macro-economic factors, strategies, policies and interventions that affect health outcomes and health inequalities. We conceptualise the economy as a complex system made up of underlying approaches, regulation from institutions, markets, finance, labour, the public-private balance as well as production and distributional effects, which collectively impact on health through the effect of moderators. The economic determinants of health have been widely recognised as crucial factors affecting health however, to date, no comprehensive review has been undertaken to summarise these factors and the ways in which they can influence health.
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