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Based on extensive review of global evidence, the recommendations of the WHO Commission on Social Determinants of Health highlight the need for strengthening research on health equity with a focus on social determinants of health. To do so requires a paradigm shift that explicitly addresses social, political, and economic processes that influence population health; this shift is under way and complements existing research in medicine, the life sciences, and public health. Reflecting further synthesis and stakeholder consultations, an agenda for future research on health equity is outlined in four distinct yet interrelated areas: (1) global factors and processes that affect health equity; (2) structures and processes that differentially affect people's chances to be healthy within a given society; (3) health system factors that affect health equity; and (4) policies and interventions to reduce health inequity. Influencing regional and national research priorities on equity and health and their implementation requires joint efforts towards creating a critical mass of researchers, expanding collaborations and networks, and refining norms and standards, with WHO having an important role given recent mandates.

Community engagement is central to national strategies for promoting health, yet there have been few attempts to systematically review the evidence on the impact of initiatives that aim to engage communities. This rapid review fills this gap by exploring the population impact of initiatives which sought to address social determinants of health. It took a novel approach to synthesizing a sample of the enormous UK literature on community engagement. The synthesis found no evidence of positive impacts on population health or the quality of services, but initiatives did have positive impacts on housing, crime, social capital and community empowerment. Methodological developments are needed to enable studies of complex social interventions to provide robust evidence of population impact in relation to community engagement.

Past research has suggested that there are significant differences in the prevalence and progress of anxiety and depression in different ethnic groups in England and that patterns of help seeking also differ. In parallel, research has also reported distinctive differences in the language and representations of mental distress across different ethnic groups. Differences both in the expression of depression and underlying conceptual models of mental health and illness may be part of the explanation for different patterns of help seeking, as the accounts people give of their experience of health and illness, including the meaning they attach to symptoms and signs for example, have been shown to be an important mediator of the action they take to protect their health or to respond to ill health. In this paper we will use evidence from recent mixed-method research with people of Pakistani origin and white people living in a locality in northwest England to explore the constructions and representations of mental distress, and in particular the physical imagery and ‘somatic metaphors’ of narratives used by our respondents, and consider how these data might illuminate debates about the experience of mental ill health and help-seeking practices.

Objectives: This study aimed to describe social problems presented to general practitioners (GPs) in UK inner cities and GPs’ responses; describe patients help-seeking pathways; and consider how these pathways can be improved. Methods: The study involved a pilot survey and follow-up qualitative interviews with patients in two inner city areas in London and Salford in 2001–2. The pilot survey involved five practices in each locality. GPs completed questionnaires on 57 people presenting with social problems. A diversity sample of 12 patients was followed up for interview. Results: Study results are presented in two parts. Here (Part II) qualitative research results are reported highlighting four themes: the complex and enduring nature of social problems; the persistence people display seeking help; the fragmented and problematic pathways available; and the roles GPs play as: primary medical adviser; formal gateway to another service; advocates or facilitators to another service; and sources of support and advice during a process of recovery. Commonly, GPs occupied more than one role. Conclusions: GPs do help people deal with social problems, but their responses are limited. More integrated pathways to help and advice for social problems are needed. Existing pathways could be more visible and accessible, and new pathways developed through commissioning and extending social prescribing. More partnerships across sectors may create more co-ordinated provision, but these are notoriously difficult, and other trends such as the focus on lifestyle issues and long-standing conditions may make it more difficult for people with social needs to access support. -------------------------------------------------------------------------------- Abbreviations: GP, general practitioner; LAA, Local Area Agreement; RSI, repetitive strain injury

The qualitative research described in this article aims to explore the dynamics of routine public health practice and policy within two local health systems. Using a theoretical framework drawn from social science and management literatures on 'communities of practice' (Wenger, 1998), we seek to illuminate the values and ideas that shape the way in which public health practice and policy making is 'done' on a routine basis. In particular, we suggest that people's narratives about their daily work resonate with the concepts of engagement, peripheral participation and marginalisation used in the communities of practice literature.

Objective: To explore data on factors affecting implementation processes in papers contributing to a Cochrane systematic review (SR) of smoke alarm interventions, supplemented by further papers not included in the review. Design: Screening for data on implementation on the basis of: (1) primary studies included in a Cochrane SR, (2) further papers relating to these and similar studies, and (3) approaches to authors of these and other relevant studies and reports. Results: Relatively few data were found to help people seeking to implement smoke alarm promotion interventions. Conclusions: For practitioners and policymakers to be able to build on research evidence, researchers and journal editors need to ensure that sufficient data are published, or are otherwise available to interested parties to move from understanding the evidence to using it.

This paper takes as its starting point the assumption that the 'Epidemiological Imagination' has a central role to play in the future development of policies and practice to improve population health and reduce health inequalities within and between states but suggests that by neglecting the contribution that qualitative research can make epidemiology is failing to deliver this potential. The paper briefly considers what qualitative research is, touching on epistemological questions--what type of "knowledge" is generated--and questions of methods--what approaches to data collection, analysis and interpretation are involved). Following this the paper presents two different models of the relationship between qualitative and quantitative research. The enhancement model (which assumes that qualitative research findings add something extra to the findings of quantitative research) suggests three related "roles" for qualitative research: generating hypothesis to be tested by quantitative research, helping to construct more sophisticated measures of social phenomena and explaining unexpected research from quantitative research. In contrast, the Epistemological Model suggests that qualitative research is equal but different from quantitative research making a unique contribution through: researching parts other research approaches can't reach, increasing understanding by adding conceptual and theoretical depth to knowledge, shifting the balance of power between researchers and researched and challenging traditional epidemiological ways of "knowing" the social world. The paper illustrates these different types of contributions with examples of qualitative research and finally discusses ways in which the "trustworthiness" of qualitative research can be assessed.

This paper takes as its starting point the assumption that the 'Epidemiological Imagination' has a central role to play in the future development of policies and practice to improve population health and reduce health inequalities within and between states but suggests that by neglecting the contribution that qualitative research can make epidemiology is failing to deliver this potential. The paper briefly considers what qualitative research is, touching on epistemological questions--what type of "knowledge" is generated--and questions of methods--what approaches to data collection, analysis and interpretation are involved). Following this the paper presents two different models of the relationship between qualitative and quantitative research. The enhancement model (which assumes that qualitative research findings add something extra to the findings of quantitative research) suggests three related "roles" for qualitative research: generating hypothesis to be tested by quantitative research, helping to construct more sophisticated measures of social phenomena and explaining unexpected research from quantitative research. In contrast, the Epistemological Model suggests that qualitative research is equal but different from quantitative research making a unique contribution through: researching parts other research approaches can't reach, increasing understanding by adding conceptual and theoretical depth to knowledge, shifting the balance of power between researchers and researched and challenging traditional epidemiological ways of "knowing" the social world. The paper illustrates these different types of contributions with examples of qualitative research and finally discusses ways in which the "trustworthiness" of qualitative research can be assessed.