Table 1. Study characteristics.
| First author, year and country | Aim | Study design | Data sources | Population | Inequality measures (eg, SES, gender) | Resulting recommendations for service delivery changes | Time between data collection |
|---|---|---|---|---|---|---|---|
| Badrick (2014), UK19 | The main aim of the study was to describe the development and implementation of practice equity audits, and an evaluation of changing inequalities over time for three project conditions in inner east London. | Sequential audits | Routine clinical and demographic data were collected from practice computer databases, using Morbidity Information Query and Export Syntax software and Web (Egton Medical Information Systems Ltd, 2010) from 148 of the 151 general practices in the three areas of London. | Three areas of London (Newham, City and Hackney and Tower Hamlets) with a combined GP-registered population of 829 710 in mid-2008. | Association between self-reported ethnicity, gender, age-band and four key indicators (cholesterol levels in CHD, blood pressure and haemoglobin A1c levels in diabetes and % smoking in COPD). | 38 practices in the intervention arm (Tower Hamlets) received two HEA and facilitated time with a cardiovascular nurse specialist to review their results. The study authors recommended prioritising monitoring inequalities by age, gender, and ethnic group; balancing rigorous, complete reports with simple, brief reports for reaching increased practice audiences; and implementation of HEA facilitation tailored to practice setting and needs to promote changes in clinical performance. | Cross-sectional data were extracted in April of every year between 2007 and 2010 for all patients on the CHD, diabetes and COPD registers. |
| Pringle (2013), UK17 | This HEA looks at the use and success of Lewisham’s Stop Smoking Service from April 2007 to March 2012 by age, gender, ethnicity, socioeconomic group and location. In addition, the views of a small number of service users and advisers were sought on factors that may affect the use and success of the service. | Sequential audits | Smoking prevalence data is available from the Integrated Household Survey which combines answers from a no of Office for National Statistics surveys containing questions about smoking. Interviews with 15 smokers and six advisers. Quits dates set from April first 2007 to March 31st 2012 were extracted from Quit Manager. Smoking data is self-reported. | Lewisham residents accessing Stop Smoking services. | Association between age, gender, ethnicity, socioeconomic group, and location and service access rates and successful smoking cessation rates. | The HEA recommended adjusting marketing messages, targeting specific underrepresented groups, collaborating with African American churches to implement Stop Smoking Services, exploring use of innovative technology especially with young smokers, reallocating level three advisers to the underrepresented groups who benefit most from their counselling, and undertaking further research on groups not examined in the HEA. | April 2007 to March 2012. |
| Roe. (2018), UK16Roe (2014), UK18 | The purpose of these reports is to assess whether the County Durham NHS Stop Smoking Service is having an impact on health inequalities. It aims to identify how services are delivered relative to the deprivation levels across County Durham and provide analysis by the two Clinical Commissioning Groups within its borders. The reports analyse the rate of access and rate of quitters. This HEA also provides a comparison with previous audits conducted in 2007 and 2014. | Sequential audits | Source of the data is Durham County Council Public Health Intelligence Team. The raw data for the 2014 and 2018 HEAs is taken from Quit manager; a Stop Smoking Service web-based patient data management system. The 2007 data was collated from five different reports from localities within Co. Durham and the source of the quit dates is not stated. | 2014–Durham residents accessing Stop Smoking services, 23 350 used records2018–Durham residents accessing Stop Smoking Services, 9240 used records | Deprivation was measured at small area level and the Relative Index of Inequality and the Slope Index of Inequality were used to compare inequalities over time. | The HEA recommended targeting specific groups of people including routine and manual workers, Gypsy, Roma and Travellers, pregnant women, people with a diagnosed mental illness, long term conditions and people who live in the 30% most deprived areas. | 2014–January 2011 to March 20132018–April 2015 to March 2017 |
CHD, coronary heart disease; COPD, chronic obstructive pulmonary disease; GP, general practitioner; HEAs, health equity audits; NHS, National Health Service; SES, socioeconomic status.