Assessing Urban Health Inequities through a Multidimensional and Participatory Framework: Evidence from the EURO-HEALTHY Project

Freitas, Ângela; Rodrigues, T.; Santana, Paula

doi:10.1007/s11524-020-00471-5

Cited by 17 publications

(29 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These results were presented to the Lisbon Municipality, contributing to inform the Health Plan for Quality of Life and Wellbeing of the City of Lisbon 2019–2020 [ 76 ]. Additionally, they integrated the evidence base for conducting local workshops with a panel of stakeholders, including decision-makers, to identify critical situations and inform local policies aimed at reducing health inequities [ 77 ].…”

Section: Discussionmentioning

confidence: 99%

The Association between Material Deprivation and Avoidable Mortality in Lisbon, Portugal

Costa

Freitas

Almendra

et al. 2020

IJERPH

Self Cite

View full text Add to dashboard Cite

There is considerable evidence pointing to the existence of a socioeconomic gradient in mortality, which tends to be steeper in urban areas. Similar to other European cities, Lisbon is far from homogeneous since considerable geographical inequalities exist between the more advantaged and the more deprived neighborhoods. The main goals of this study are to describe the geographical pattern of premature deaths (before 65 years old), avoidable deaths (preventable and amenable to healthcare) and cause-specific mortality (HIV/AIDS and suicide) in Lisbon, at the lower administrative level (civil parish, in Portuguese: Freguesia), and analyze the statistical association between mortality risk and deprivation, before (1999–2003) and during the economic crisis (2008–2012). Smoothed Standardized Mortality Ratios (sSMR) and Relative Risk (RR) with 95% credible intervals were calculated to identify the association between mortality and deprivation. The analysis of the geographical distribution of cause-specific mortality reveals that civil parishes with high sSMR in the first period continued to present higher mortality rates in the second. Moreover, a significant statistical association was found between all the causes of death and deprivation, except suicide. These findings contribute to understanding how social conditions influence health outcomes and can offer insights about potential policy directions for local government.

show abstract

Section: Discussionmentioning

confidence: 99%

The Association between Material Deprivation and Avoidable Mortality in Lisbon, Portugal

Costa

Freitas

Almendra

et al. 2020

IJERPH

Self Cite

View full text Add to dashboard Cite

show abstract

“…The design of the conceptual and methodological framework follows previous studies of population health evaluation (Freitas et al, 2020;Santana, 2007Santana, , 2015Santana et al, 2017bSantana et al, , 2020 and is built upon the well-known "population health approach" with a geographic lens. This looks at how the population's health outcomes and health determinants are geographically distributed, as well as the extent to which policies and interventions from multiple sectors can address them (Kindig & Stoddart, 2003).…”

Section: Conceptual Frameworkmentioning

confidence: 99%

Putting Health at the Heart of Local Planning Through an Integrated Municipal Health Strategy

Freitas

Santana²

2022

Self Cite

View full text Add to dashboard Cite

As a cross-sectoral issue, the promotion of health needs to be addressed across all policies. In Portugal, as more competencies are being transferred to local governments, the integration of health considerations into municipal plans remains a challenge and guidance on how to develop an integrated municipal health strategy is absent. The aim of this study is to describe the conceptual and methodological approach that informed the development of an integrated and multisectoral municipal health strategy in the City of Coimbra. Its design followed a population health approach with a geographic lens, looking at how the population’s health outcomes and health determinants were geographically distributed across the municipality, as well as the extent to which policies from multiple sectors can address them. The planning cycle followed an iterative workflow of five actions: assessing, prioritizing, planning, implementing, and monitoring. Following a participatory planning approach, several participatory processes were conducted involving local stakeholders and citizens (e.g., population-based surveys, workshops, Delphi, collaborative sessions) to identify problems, establish priorities, and define measures and actions. The strategic framework for action integrates 94 actions across multisectoral domains of municipal intervention: sustainable mobility and public places, safe and adequate housing, accessible healthcare, social cohesion and participation, education and health literacy, and intersectoral and collaborative leadership. Findings shed light on important aspects that can inform other municipal strategies, such as the adoption of a place-based approach, focused on geographic inequalities, health determinants and stakeholder participation, and the application of a health in all policies framework.

show abstract

“…The CDF, AC, and indicators were developed through the survey instrument and dialogue/discussion with municipality mayors and parish council presidents. This was limited due to time and cost constraints, whereas further combined qualitative approaches are recommended with the participation of different community stakeholders [187,188]. In developing the CDF and AC, statistical associations between neighbourhood characteristics and mental health outcomes were used, but this should not be interpreted as if there is a direct causality, as some indirect causes may justify the relationship [189].…”

Section: Strengths Limitations and Future Researchmentioning

confidence: 99%

Strategic Assessment of Neighbourhood Environmental Impacts on Mental Health in the Lisbon Region (Portugal): A Strategic Focus and Assessment Framework at the Local Level

2022

Self Cite

View full text Add to dashboard Cite

Scientific evidence shows that each place/environment generates specific conditions with associated impacts on the mental health and well-being of the population. A holistic, multilevel and integrated environmental approach to mental health enhances the understanding of this phenomena, supporting the local decision-making processes to improve spatial planning of neighbourhood environments. The aim of this study is to develop a strategic assessment framework, based on four municipalities in the Lisbon Region (Portugal), that explores policy and planning initiatives capable of generating favourable neighbourhood environmental conditions for mental health while also detecting risks. Using baseline results of significant statistical associations between individuals’ perceptions of their neighbourhood environment and their mental health in the Lisbon Region, a Strategic Focus on Environmental and Mental Health Assessment framework (SEmHA) was built, by applying the methodology ‘Strategic Thinking for Sustainability’ in Strategic Environmental Assessment, developed by Partidário in 2012. Taking into account the promotion of the population’s mental health, four critical decision factors of neighbourhood environments were identified: (1) public space quality (e.g., improving sense of place), (2) physical environment quality (e.g., low levels of noise exposure), (3) professional qualification and creation of economic activities (e.g., attracting new economic activities), and (4) services and facilities (e.g., improving access to health and education services). The proposed strategic focus and assessment framework contributes to ensuring that interventions in neighbourhood environments truly achieve community mental health benefits and reduce inequalities, thus helping policy makers to assess impacts at the local level.

show abstract

Assessing Urban Health Inequities through a Multidimensional and Participatory Framework: Evidence from the EURO-HEALTHY Project

Cited by 17 publications

References 48 publications

The Association between Material Deprivation and Avoidable Mortality in Lisbon, Portugal

The Association between Material Deprivation and Avoidable Mortality in Lisbon, Portugal

Putting Health at the Heart of Local Planning Through an Integrated Municipal Health Strategy

Strategic Assessment of Neighbourhood Environmental Impacts on Mental Health in the Lisbon Region (Portugal): A Strategic Focus and Assessment Framework at the Local Level

Contact Info

Product

Resources

About