Writing about health inequality: recommendations for accurate and impactful presentation of evidence

Health and development agendas and programmes often prioritize the reduction of unfair and remediable health inequalities. There is a growing amount of data pertaining to health inequalities. Written outputs, including academic research papers, are key tools for describing health inequalities. Epidemiologists, data analysts, policy advisors and health equity scholars can have greater impact through accurate, concise and compelling presentation of this evidence and so assist those advocating for action to close health gaps. We make recommendations to improve the accuracy and impact of written evidence on health inequality. Focusing on the micro, macro and meta aspects of developing written reports, we drew from our varied experiences promoting health inequality monitoring to identify key strategies specific to this field, which were further expanded and explored through literature searches and consultation with experts. We recommend four general strategies: (i) using terminology deliberately and consistently; (ii) presenting statistical content accurately and with sufficient detail; (iii) adhering to guidelines and best practices for reporting; and (iv) respecting and upholding the interests of affected communities. Specifically, we address the use of terminology related to health inequality and health inequity, dimensions of inequality and determinants of health, economic inequality and economic-related inequality, sex and gender, and race and ethnicity. We present common pitfalls related to reporting statistical content, underscoring the importance of clarity when reporting association and causation. We advocate for engaged and inclusive writing processes that use affirming language and adopt strength-based messaging. This guidance is intended to increase the impact of written evidence on efforts to tackle avoidable health inequalities.