National monitoring systems for health inequalities by socioeconomic status - an OECD snapshot

We assess the extent and quality of High-Income Countries' (HIC) practices in monitoring Socioeconomic Inequalities in Health (SIH) through routine data collection/collation and analysis systems. Official websites of government authorities of eligible countries were examined for any reports containing data on SIH, which were assessed for quality from an epidemiological perspective, using published guidelines for monitoring of socioeconomic inequalities in health status.Despite the global commitment to Sustainable Development Goal 10, and recommendations of the WHO 2008 Commission of Social Determinants of Health, most of the thirty-six HIC whose websites were searched appear not to be routinely monitoring SIHs. Only seven HIC websites were found to have SIH monitoring reports that were readily discoverable on their official websites. Only two countries (England and Scotland) have been publishing such trends in detail for more than a half-decade. Although an SIH monitoring system is not itself a sufficient condition for reducing SIH, it is likely a necessary one. For countries that are planning to establish a system, lessons from others who have established such systems include the value of routinely and automatically post-coding of major health outcomes, with robust assignment of average socio-economic status to each local area.