Trial lesson given as part of the habilitation procedure in epidemiology.

Summary: Health inequalities — socially produced, patterned, and avoidable differences in health outcomes — remain substantial across high-income countries. A central challenge for public health policy is that improving the health of the overall population does not automatically reduce health inequalities, and some interventions may even widen them. Understanding which policies reduce health inequalities therefore requires both a coherent theoretical framework and a robust synthesis of empirical evidence.

This lecture draws on Geoffrey Rose's population approach to classify interventions along two key dimensions: their target population, from narrowly targeted to fully universal, and their expected distributional impact across socioeconomic groups. Building on this foundation, evidence from systematic reviews evaluates the equity effects of public health policies across multiple domains, including fiscal measures, regulation, education, housing, and health system interventions.
A key organising concept is the distinction between low- and high-agentic demand interventions, with the latter risking the generation of new inequalities when not carefully tailored to socioeconomically disadvantaged groups.

By the end of this session, students will be able to classify public health policies by type, anticipate their likely distributional impact, and critically appraise the conditions under which policies succeed or fail in reducing health inequalities.