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Improving health equity through theory-informed evaluations: A look at housing first strategies, cross-sectoral health programs, and prostitution policy

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  • Dunn, James R.
  • van der Meulen, Emily
  • O’Campo, Patricia
  • Muntaner, Carles

Abstract

The emergent realist perspective on evaluation is instructive in the quest to use theory-informed evaluations to reduce health inequities. This perspective suggests that in addition to knowing whether a program works, it is imperative to know ‘what works for whom in what circumstances and in what respects, and how?’ (Pawson & Tilley, 1997). This addresses the important issue of heterogeneity of effect, in other words, that programs have different effects for different people, potentially even exacerbating inequities and worsening the situation of marginalized groups. But in addition, the realist perspective implies that a program may not only have a greater or lesser effect, but even for the same effect, it may work by way of a different mechanism, about which we must theorize, for different groups. For this reason, theory, and theory-based evaluations are critical to health equity.

Suggested Citation

  • Dunn, James R. & van der Meulen, Emily & O’Campo, Patricia & Muntaner, Carles, 2013. "Improving health equity through theory-informed evaluations: A look at housing first strategies, cross-sectoral health programs, and prostitution policy," Evaluation and Program Planning, Elsevier, vol. 36(1), pages 184-190.
    • Handle: RePEc:eee:epplan:v:36:y:2013:i:1:p:184-190
    DOI: 10.1016/j.evalprogplan.2012.03.006
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    1. Bernard, Paul & Charafeddine, Rana & Frohlich, Katherine L. & Daniel, Mark & Kestens, Yan & Potvin, Louise, 2007. "Health inequalities and place: A theoretical conception of neighbourhood," Social Science & Medicine, Elsevier, vol. 65(9), pages 1839-1852, November.
    2. Graham, Hilary, 2002. "Building an inter-disciplinary science of health inequalities: the example of lifecourse research," Social Science & Medicine, Elsevier, vol. 55(11), pages 2005-2016, December.
    3. Tsemberis, S. & Gulcur, L. & Nakae, M., 2004. "Housing First, Consumer Choice, and Harm Reduction for Homeless Individuals with a Dual Diagnosis," American Journal of Public Health, American Public Health Association, vol. 94(4), pages 651-656.
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    Cited by:

    1. Thomson, Hilary & Thomas, Sian, 2015. "Developing empirically supported theories of change for housing investment and health," Social Science & Medicine, Elsevier, vol. 124(C), pages 205-214.
    2. Mehdipanah, Roshanak & Manzano, Ana & Borrell, Carme & Malmusi, Davide & Rodriguez-Sanz, Maica & Greenhalgh, Joanne & Muntaner, Carles & Pawson, Ray, 2015. "Exploring complex causal pathways between urban renewal, health and health inequality using a theory-driven realist approach," Social Science & Medicine, Elsevier, vol. 124(C), pages 266-274.

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