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Addressing Power in Local-Level Policies and Programs to Reduce Health Inequities - A Systematic Review.

Sally Schultz1, Anne Barrow1, Sharon Friel2

  • 1Deakin University, Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Geelong, Australia.

International Journal of Social Determinants of Health and Health Services
|December 1, 2025
PubMed
Summary
This summary is machine-generated.

Local interventions can address health inequities by rebalancing power dynamics. Strengthening community knowledge, leadership, and agency are key strategies for achieving health equity.

Keywords:
health equityhealth interventionspolicypower

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Area of Science:

  • Public Health
  • Health Equity Research
  • Community Health Interventions

Background:

  • Health inequities stem from unequal resource and power distribution.
  • Local actors can address power imbalances through health equity interventions.
  • Practical strategies for local health equity interventions remain unclear.

Purpose of the Study:

  • To systematically review how power is addressed in local health equity interventions.
  • To examine the design, implementation, and impacts of these interventions.
  • To provide practical guidance for equitable policymaking.

Main Methods:

  • Systematic review of five databases.
  • Analysis of 38 international studies using the Health Equity Power Framework and Four Expressions of Power typology.
  • Examination of intervention strategies and reported impacts.

Main Results:

  • Common interventions include community organizing, health education, advocacy, and funding.
  • Strengthening community knowledge, connectedness, and leadership enhances agency and rebalances power.
  • Activating multiple forms and spaces of power led to shifts in inequitable structures.

Conclusions:

  • Power-centered frameworks and principles aid in rebalancing power dynamics.
  • Entrenched structural and institutional power imbalances can moderate rebalancing efforts.
  • Local governments, institutions, and communities play a crucial role in addressing power imbalances for equitable policymaking.