The effects of an urban renewal project on health and health inequalities: a quasi-experimental study in Barcelona

Mehdipanah, Roshanak; Rodríguez-Sanz, Maica; Malmusi, Davide; Muntañer, Carles; Díez, Èlia; Bartoll, Xavier; Borrell, Carme

doi:10.1136/jech-2013-203434

Cited by 53 publications

(31 citation statements)

References 33 publications

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“…In this line, and using census data, we have also identified an increase in the percentage of young people achieving compulsory education in the intervened areas between 2001 and 2011 (see online supplementary material). Therefore, our findings are in line with previous research showing the positive impact of urban regeneration on health and its social determinants,14 15 34–40 yet introducing a specific analytical link in order to explain this impact (ie, improvement of ‘access to means’ and the reduction of preventable mortality).…”

Section: Discussionsupporting

confidence: 91%

Impact of area regeneration policies: performing integral interventions, changing opportunity structures and reducing health inequalities

Moya

Navarro

2016

J Epidemiol Community Health

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BackgroundUrban regeneration policies are area-based interventions addressing multidimensional problems. In this study, we analyse the impact of urban regeneration processes on the evolution of inequalities in mortality from certain causes. On the basis of Fundamental Cause Theory (FCT), our main hypothesis is that the impact of urban regeneration programmes will be more clearly observed on the causes of preventable deaths, as these programmes imply a direct or indirect improvement to a whole range of ‘flexible resources’ that residents in relevant areas have access to, and which ultimately may influence the inverse relationship between socioeconomic status and health.MethodsUsing a quasi-experimental design and data from Longitudinal Statistics on Survival and Longevity of Andalusia (Spain), we analyse differences in the evolution of standard mortality ratios for preventable and less-preventable causes of premature death. This encompasses 59 neighbourhoods in 37 municipalities where urban regeneration projects were implemented in the last decade within the framework of three different programmes and in 59 counterparts where these policies were not implemented.ResultsAs expected in line with FCT, there are no significant patterns in the evolution of internal differences in terms of less-preventable mortality. However, excessive preventable mortality strongly decreases in the neighbourhoods with intervention programmes, specifically in those where two or more projects were in force. This is even more apparent for women.ConclusionsThe urban regeneration policies studied seem to contribute to reducing health inequity when the interventions are more integral in nature.

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Section: Discussionsupporting

confidence: 91%

Impact of area regeneration policies: performing integral interventions, changing opportunity structures and reducing health inequalities

Moya

Navarro

2016

J Epidemiol Community Health

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“…However, this seems unlikely given the weak evidence from other urban regeneration studies with longer durations of follow-up. 16 17 26 27 While further follow-up of the cohort might be informative in ascertaining longer term effects, this might be adversely affected by the continued development of East Village; high-rise accommodation blocks (with 30+ storey accommodation being built among the existing 10–12 storey accommodation), reductions in green space 14 and the high turnover of residents with rental tenancies could weaken social bonds and cohesion contributing to worse mental health and well-being. 35 Unfortunately, the high mobility of residents also means that we have lost contact with many who took part in the study, making further follow-up of sufficient numbers infeasible.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the effect of change in the built environment on mental health and subjective well-being: a natural experiment

Ram

Limb

Shankar

et al. 2020

J Epidemiol Community Health

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BackgroundNeighbourhood characteristics may affect mental health and well-being, but longitudinal evidence is limited. We examined the effect of relocating to East Village (the former London 2012 Olympic Athletes’ Village), repurposed to encourage healthy active living, on mental health and well-being.Methods1278 adults seeking different housing tenures in East village were recruited and examined during 2013–2015. 877 (69%) were followed-up after 2 years; 50% had moved to East Village. Analysis examined change in objective measures of the built environment, neighbourhood perceptions (scored from low to high; quality −12 to 12, safety −10 to 10 units), self-reported mental health (depression and anxiety) and well-being (life satisfaction, life being worthwhile and happiness) among East Village participants compared with controls who did not move to East Village. Follow-up measures were regressed on baseline for each outcome with group status as a binary variable, adjusted for age, sex, ethnicity, housing tenure and household clustering (random effect).ResultsParticipants who moved to East Village lived closer to their nearest park (528 m, 95% CI 482 to 575 m), in more walkable areas, and had better access to public transport, compared with controls. Living in East Village was associated with marked improvements in neighbourhood perceptions (quality 5.0, 95% CI 4.5 to 5.4 units; safety 3.4, 95% CI 2.9 to 3.9 units), but there was no overall effect on mental health and well-being outcomes.ConclusionDespite large improvements in the built environment, there was no evidence that moving to East Village improved mental health and well-being. Changes in the built environment alone are insufficient to improve mental health and well-being.

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“…There are successful examples of third sector involvement in addressing health inequalities in different cities throughout Europe [ 5 ]. The Neighbourhood’s Law in Barcelona [ 40 , 41 ], aimed at reducing social inequalities although not specifically in health, established a partnership between different sectors in the city council and community agents to renew deprived neighbourhoods.…”

Section: Discussionmentioning

confidence: 99%

Perceptions and beliefs of public policymakers in a Southern European city

Morrison

Pons‐Vigués

Díez

et al. 2015

Int J Equity Health

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IntroductionSocio-economic inequalities in health are large in urban areas; however, local municipal governments may plan, manage and provide services and policies which can reduce these. The objective of this study was to describe the beliefs and perceptions of public policymakers in a European city, Barcelona. They are the key actors in designing and implementing urban public policies.MethodsA qualitative research study describing policymakers’ beliefs on health inequalities. The study population were twelve policymakers. These were politicians or officers from the city council. Informant profiles were selected using a theoretical sample. Semi-structured individual interviews were performed to collect the data and a thematic content analysis was carried out.ResultsPoliticians were aware of health inequalities in their city and identified diverse social causes. They viewed reducing inequalities as a priority for the city’s government. Officers were less knowledgeable and described less efforts in addressing health inequalities. It was stated by some that reducing inequalities in non-health sectors helped to reduce health inequalities indirectly and there was some collaboration between two sectors. The most frequent barriers encountered when implementing policies were funding and the cities’ limited authority.ConclusionsOfficers and policymakers had different levels of awareness and access to information on health and its socials determinants. Officers referred to specific causes of health inequalities and policies which related to their sectors and politicians were more familiar with upstream determinants and policies. Some participants explained that policies and programmes needed to be evaluated and very little intersectoral action was said to be carried out. More efforts should be made to provide all policymakers with information on the social determinants of health inequalities. Research on health inequalities and policy should engage with policymakers and promote health as a cross cutting issue in the city council in liaison with the third sector.

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The effects of an urban renewal project on health and health inequalities: a quasi-experimental study in Barcelona

Abstract: The Neighbourhoods Law had a positive effect on self-rated health and seems to prevent poor mental health increases in both sexes and especially among manual social classes.

Cited by 53 publications

References 33 publications

Impact of area regeneration policies: performing integral interventions, changing opportunity structures and reducing health inequalities

Impact of area regeneration policies: performing integral interventions, changing opportunity structures and reducing health inequalities

Evaluating the effect of change in the built environment on mental health and subjective well-being: a natural experiment

Perceptions and beliefs of public policymakers in a Southern European city

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