Health Systems, Health Services and Inequality in Population Health

This open access book shows the scientific and policy-added value of combining health systems, health services and population health research. In doing so the authors create awareness among researchers to look beyond the boundaries of their own discipline and promote cross-disciplinary collaboration. The book also gives an overview of what is known in the scientific literature about the relationships between the structure of health systems, health service provision and utilisation, and inequalities in population health.

Health inequalities are unjust and avoidable and, as a focus of health policy in many governments, are widely studied in public health research. But studies of health inequalities too often ignore the role that health systems and health services play in the production of inequalities in population health and, as a consequence, their potential to create or reduce inequalities in health. 

Studies of inequalities in health often incorporate the social determinants of health. The same societal structures that form the social determinants of health also determine the health system structure and their impact on access to and the provision of health services and the benefits of health service use to patients with different socioeconomic backgrounds. This means that attempts to reduce health inequalities by addressing the social determinants of health must also consider the potential pathway through the health system and the provision of health services.

In the final chapter the authors discuss ways of breaking down the barriers between the three approaches. After reading this compact volume, researchers will be more aware of the theoretical and methodological approaches in the three areas and more inclined to look beyond the boundaries of their own discipline.

Health Systems, Health Services and Inequality in Population Health is essential reading for researchers in health systems research, health services research and population health research. In addition, the brief is relevant for health policy researchers, health impact researchers, health economists, epidemiologists, public health practitioners and professionals in health services planning and management.

Peter P. Groenewegen is a sociologist. He is senior researcher ‘Health systems and governance’ and former director of the Netherlands Institute for Health Services Research Nivel. He was endowed professor at Utrecht University in the departments of sociology and human geography. His main research interests include international comparative studies of health systems, health policy and health care organisation.

Ilmo Keskimäki works as Research Professor at the Finnish Institute for Health and Welfare (THL) and is affiliated to the Tampere University as Professor of Health Services Research. His research has particularly focused on developing research methods for the use of register based longitudinal data in health services research and for evaluating health system performance, and equity and effectiveness of health services. He is a Past President of the European Public Health Association (EUPHA) and currently serves as a medical editor of the Finnish Medical Journal.  

Alastair H. Leyland is Professor of Population Health Statistics and Associate Director of the MRC/CSO Social and Public Health Sciences Unit at the University of Glasgow, Scotland. He has led a programme on Inequalities in Health since 1999 and is co-Director of the NIHR Global Health Research Unit on Social and Environmental Determinants of Health Inequalities. He was an editor of the European Journal of Public Health from 2009-2023 and was one of the editors of the 7th edition of the Oxford Textbook of Global Public Health.