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Durham University

Wolfson Research Institute for Health and Wellbeing

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Tuesday 2 May 2017

Evaluating Population Health and Health Policy: A counterfactual approach to natural experiments

1:00pm to 2:30pm, F009, Wolfson Building, Durham University, Queen's Campus, Stockton-on-Tees, Dr Vittal Katikireddi, NRS Senior Clinical Research Fellow, University of Glasgow

Over much of the last two decades, health research has been dominated by randomised controlled trials (RCTs). However, many interventions which target the social determinants of health are often difficult or even impossible to randomise, for political, ethical and pragmatic reasons. Critics have therefore expressed concern that privileging the RCT as the study design of choice may mean that the social determinants of health are side-lined within research.

This talk will introduce a counterfactual way of thinking about natural experiments, describe the range of methods to evaluating natural policy experiments and discuss the strengths and weaknesses of this perspective. The natural experiment approach will be illustrated by drawing on a range of examples, including evaluations of welfare reforms (such as lone parent obligations and reductions to pension credits), changes to the English NHS (the Health & Social Care Act 2012) and the planned evaluation of minimum unit pricing of alcohol. A debate about the role of different evaluation perspectives (such as realist or complex systems) is welcomed.

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