How do Contextual Effects Contribute to the Production of Health Inequalities?
Date: 6 – 8 June 2016
Convenors: Odile Sauzet (Bielefeld, GER), Reinhard Schunck (Köln, GER), Basile Chaix (Paris, FRA), Margit Fauser (Bielefeld, GER), Oliver Razum (Bielefeld, GER)
Contextual effects (e.g. the neighbourhood) on health inequalities are empirically well documented. A lot remains to be done, however, to obtain a comprehensive model of causal pathways connecting contextual conditions and individual outcomes. The effects of neighbourhoods on human activities related to health are studied by epidemiologists, sociologists, geographers and statisticians, and challenges to move the subject forward have been set in these fields. There are few opportunities for researchers of these different fields to share their findings and methods. We organised a workshop gathering scientists from the above mentioned disciplines to discuss three topical aspects of research on contextual effects: 1) How can causal mechanisms which have been theoretically identified as being part of a causal chain, but for which little empirical evidence exits, be operationalised?, 2) Which quantitative methods can be used to obtain evidence on the role of a given mechanism within a causal chain?, 3) How do the different disciplines conceptualize causality and causal thinking/mechanisms?
The workshop gathered 23 participants from five European countries covering seven disciplines. A variety of thematic was covered by the speakers which included statistical and modelling approaches to the evaluation of mechanism, the conceptualisation of mechanism in quantitative studies, health care provision. The opening talk offered an overview of the challenges in trying to conceptualise mechanism in neighbourhood effect focussed on the example of people moving addresses while the final talk provided a review of concepts in sociological causal thinking.
The first discussion was concerned with the operationalisation of mechanisms. The need to turn results of empirical studies into interventions was also discussed and there the need to develop methods to evaluate these interventions was identified. The second day, methods for life course studies were discussed and the need to be more creative with existing data was raised due to the cost and general difficulties of running life course cohorts. The third day, plans were made for a collective publication to disseminate the results of our discussions about the challenges and measurements of neighbourhood effects of health inequalities.