A scoping review of equity stratifier definitions used in Irish health inequality reporting 2015-25

Equity stratifiers (ES) are social and demographic variables used to examine health inequalities across populations. This scoping review aimed to identify how ES have been defined within health inequality reporting in Ireland over the past ten years and assess the compatibility of definitions with existing national data standards across six dimensions. Findings have informed formal consultation within the Health Service Executive (HSE), led by HSE Public Health, to develop recommendations for routine inclusion of ES across health datasets. The review followed the Joanna Briggs Institute framework and PRISMA ScR guidance. The Cochrane Database, PubMed, PsycInfo, Lenus and Health Research Board databases were searched for publications from 2015–2025. Grey literature was identified via Google Scholar and reference trawling. Eligible sources included peer reviewed studies, reports and policy documents reporting outcomes stratified by equity related variables in Ireland. Database searches identified 444 records, and 35 met inclusion criteria. Thirteen additional sources were identified through grey literature, resulting in 48 included studies. The most frequently defined ES was socioeconomic status (n = 30), followed by ethnicity (n = 17), gender/sex (n = 10), residence (n = 8), disability (n = 7) and sexual orientation (n = 6). Sixty-seven unique definitions were described, with multiple ES often applied simultaneously enabling intersectional analyses. However, substantial heterogeneity in definitions and categorisations limited comparability. A key barrier to understanding and addressing health inequalities in Ireland is the lack of standardised, policy aligned ES definitions that can be consistently applied and linked across datasets. Strengthening equity surveillance requires agreed definitions embedded in routine data collection and reporting. This review will inform national guidance to establish standardised ES definitions aligned with policy and best practice standards.

Key messages

• Establishing consistent, policy‑aligned equity stratifier definitions is essential to strengthen equity monitoring and routine reporting in Irish health data.

• While this is Irish data, this review reflects a global pattern - inconsistent equity stratifier definitions impede robust comparison of health inequalities.