An Iterative, Participatory Approach to Developing a Neighborhood-Level Indicator System of Health and Wellbeing

Abstract

Despite increased awareness of the essential role of neighborhood characteristics for residents’ health and wellbeing, the development of neighborhood-level indicator systems has received relatively little attention to date. To address this gap, we describe the participatory development process of a small-area indicator system that includes information on local health needs in a pilot neighborhood in the German city of Mannheim. To identify relevant indicators, we partnered with representatives of the city’s public health department and used an iterative approach that included multiple Plan-Do-Check-Act cycles with ongoing feedback from local key stakeholders. The described process resulted in a web-based indicator system with a total of 86 indicators. Additionally, 123 indicators were perceived as relevant by stakeholders but could not be included due to data unavailability. Overall, stakeholders evaluated the participatory approach as useful. Even though the onset of the COVID-19 pandemic and the lack of some data elements hindered instrument development, close collaboration with public health partners facilitated the process. To identify and target sub-national health inequalities, we encourage local public health stakeholders to develop meaningful and useful neighborhood-level indicator systems, building on our experiences from the applied development process and considering identified barriers and facilitators.

A Co-Created Assessment Framework to Measure Inclusive Health and Wellbeing in a Vulnerable Context in the South of Europe

“…While top-down approaches are essential for establishing overarching guidelines and regulatory frameworks, they may overlook diverse urban communities' nuanced realities and lived experiences. In contrast, bottom-up approaches, driven by community engagement, participatory research, and grassroots knowledge, provide valuable insights into the challenges and priorities shaping health and wellbeing at the neighbourhood level [29]. By actively involving community members, local organisations, and marginalised groups in designing and implementing assessment frameworks, we gained a deeper understanding of the contextual nuances and social determinants influencing health and wellbeing outcomes in Las Palmeras.…”

“…Analysing health and wellbeing requires comprehensive frameworks that consider many components and how their interrelations shape people's lives [27]. This approach encompasses the complex interrelationships among economic, psychological, social, and relational dimensions of health and wellbeing within this specific context and combines expert knowledge and local perspectives [29]. The framework is based on combining top-down dimensions and subdimensions influencing citizens' health and wellbeing with the bottom-up perspectives of local inhabitants.…”

“…While ref. [29] proposed the development of indicators at a neighbourhood level, the authors' emphasis was not specifically on vulnerable neighbourhoods. Additionally, their work primarily involved health authorities and concentrated more on physical health indicators.…”