This document summarizes research from the DRIVERS project aimed at understanding and developing effective advocacy strategies for health equity. The project conducted a literature review of advocacy practices, case studies of advocacy initiatives, and an expert workshop. Key findings include the importance of tailoring advocacy messages and evidence to different audiences, addressing both health and social determinants of health, and the value of qualitative research and evaluations of policies' effects on different social groups. Recommendations focus on building advocacy capacity, addressing barriers like blame of disadvantaged groups, and enabling cross-sector collaboration to promote health equity.

1. Advocacy for Health Equity
Claudia Marinetti - Research Manager
Linden Farrer, Caroline Costongs
7th European Public Health Conference, November 2014
In collaboration with:
DRIVERS is co-ordinated by EuroHealthNet and has received funding from the European
Union’s Seventh Framework Programme (FP7/2007-2013) under grant agreement n°278350

2. Advocacy
toolkit
Case
studies &
interviews
Discussion
paper &
workshop
Literature
review &
advocacy
mapping
Aims and activities
To understand, synthesise and
build upon existing knowledge
and develop practicable and
effective methodologies for
promoting health equity within
the DRIVERS project
and beyond

3. Definition & dimensions
Advocacy for health
equity: “a deliberate
attempt to influence
decision makers and other
stakeholders to support or
implement policies that
contribute to improving
health equity using
evidence”

4. Advocacy for health equity: a synthesis review
Aim: To bring together, for the first time, all evidence on
practices that can aid advocacy efforts
Methods: Qualitative synthesis methodology. Systematic
search of academic and grey literature.
– Academic: 21,425 papers > 137
– Grey: Google 248 > 59
Analysis of 196 pieces of evidence and synthesis
according to the ‘six dimensions of advocacy’

5. Experts workshop
Aim: To analyse initial findings and fill gaps with the help of
selected experts
Methods: The interactive workshop was attended by 20
experts from across Europe
– Brainstorming, open discussion and feedback sessions
– Label generation
– Sentence completion/categorisation
– Fixed-diagram exercises
Post hoc analysis of results

6. Grounding some of the findings
Case Studies: Health 2015 (Finland), Children health in
disadvantaged families (Netherlands), Think Family (England), Food
aid for deprived children (Greece), Mental Health First Aid (Wales)
Methods:
– Standardised reporting guidance
– Analysis of documentary materials
– Semi-structured interviews and coding, questionnaires
– Preparation of advocacy materials and events
Analysis focused on common and divergent findings

7. Conclusions and recommendations
 Evidence is unlikely to be the only conclusive factor in policy
decisions, and policy makers value a variety of different kinds
of evidence that do not necessarily accord with the ‘hierarchy
of evidence’
 Evidence should be translated for different audiences; it
needs to be easy to understand, contain key facts, avoid
jargon and present a balance of different kinds of evidence.
 Value of different kinds of advocacy message(s):
Importance of tailoring, context. Health/health equity or the
SDH? Health as a value, social justice, economic and human
rights arguments, sustainability and self-interest

8. Conclusions and recommendations
 Science and advocacy: Scientists can have a clear role to
play in advocacy, but some issues of compatibility exist.
Advocacy organisations can bridge evidence and policy
 Need for capacity : Individual and organisational capacities
including inclination, the valuable contribution of people
experiencing exclusion to advocacy
 Barriers: a pervasive zeitgeist that blames people for their
ill health, biomedical approaches and political short-termism
 Enablers: increased public understanding of SDH, greater
contact with disadvantage in syllabuses and training in
advocacy, enabling value of overlooked allies

9. Research to support advocacy efforts
 Evaluations of policies particularly their differential effects
across the social gradient, for discrete social groups.
ROI/cost-benefit
 Applied research to support policy strategies, particularly
examples of cross-sectoral collaboration, proportionate
universalism, the life-course approach, etc.
 Much more rigorous and large-scale qualitative research
on the SDH
 Research on tailoring messages in Europe
 Research and evaluation of advocacy efforts.

10. DRIVERS at the
European Parliament!
3 February 2015
For more information:
 Visit the website: www.health-gradient.eu
 Follow us on Twitter @DRIVERS4equity
 Contact info@health-gradient.eu
Coming soon!
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