TY - JOUR
T1 - Municipal interventions against inequalities in health
T2 - The view of their managers
AU - Diez, Elia
AU - Camprubí, Lluís
AU - Morrison, Joana
AU - Pons Vigués, Mariona
AU - Borrell, Carme
AU - Corman, Diana
AU - Burström, Bo
AU - Dominguez Berjón, Felicitas
AU - Gandarillas, Ana
AU - Hoffmann, Rasmus
AU - Santana, Paula
N1 - Funding Information:
This article has been partially funded by the project ‘INEQ-Cities, Socioeconomic inequalities in mortality: evidence and policies of cities of Europe’, funded by the Executive Agency for Health and Consumers (Commission of the European Union), project 2008 12 13
PY - 2014/8
Y1 - 2014/8
N2 - Background: European city councils are increasingly developing interventions against health inequalities. There is little knowledge about how they are perceived. This study describes and analyses good practices and challenges for local interventions on inequalities in health through the narratives of European city managers. Methods: A qualitative study was conducted. Each participating city (Amsterdam, Barcelona, Cluj-Napoca, Helsinki, Lisbon, London, Madrid, Rotterdam) selected interventions following these criteria: at least 6 months of implementation; an evaluation performed or foreseen; the reduction of health inequalities among their objectives, and only one of the interventions selected could be based on health care. Managers of these local interventions were interviewed following an outline. Eleven individual in-depth interviews describing nine local interventions were obtained. A thematic content analysis was performed. Results: One or more local interventions against health inequalities were identified in each city. Most relied on quantitative data and were linked to national strategies. Few interventions addressed socio-economic determinants. Health care, employment and education were the main determinants addressed. With variable depth, evidence-base, participation and intersectorality were regular components of the interventions. Half of them targeted the city and half some deprived neighbourhoods. Few interventions had been evaluated. Scarcity of funding and sustainability of the projects were the main perceived barriers by the managers. Conclusions: City intervention managers were familiar with health inequalities and concepts as intersectorality, participation and evidence-based action, but others such as socioeconomic aims, gradient approach, evaluation and sustainability were not so widely applied. Managers' capacities and political leadership in governance for health should be reinforced.
AB - Background: European city councils are increasingly developing interventions against health inequalities. There is little knowledge about how they are perceived. This study describes and analyses good practices and challenges for local interventions on inequalities in health through the narratives of European city managers. Methods: A qualitative study was conducted. Each participating city (Amsterdam, Barcelona, Cluj-Napoca, Helsinki, Lisbon, London, Madrid, Rotterdam) selected interventions following these criteria: at least 6 months of implementation; an evaluation performed or foreseen; the reduction of health inequalities among their objectives, and only one of the interventions selected could be based on health care. Managers of these local interventions were interviewed following an outline. Eleven individual in-depth interviews describing nine local interventions were obtained. A thematic content analysis was performed. Results: One or more local interventions against health inequalities were identified in each city. Most relied on quantitative data and were linked to national strategies. Few interventions addressed socio-economic determinants. Health care, employment and education were the main determinants addressed. With variable depth, evidence-base, participation and intersectorality were regular components of the interventions. Half of them targeted the city and half some deprived neighbourhoods. Few interventions had been evaluated. Scarcity of funding and sustainability of the projects were the main perceived barriers by the managers. Conclusions: City intervention managers were familiar with health inequalities and concepts as intersectorality, participation and evidence-based action, but others such as socioeconomic aims, gradient approach, evaluation and sustainability were not so widely applied. Managers' capacities and political leadership in governance for health should be reinforced.
KW - Health inequalities
KW - cities
KW - public policies
KW - qualitative research
KW - urban health
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U2 - 10.1177/1403494814529850
DO - 10.1177/1403494814529850
M3 - Article
C2 - 24756877
AN - SCOPUS:84904694781
SN - 1403-4948
VL - 42
SP - 476
EP - 487
JO - Scandinavian journal of public health
JF - Scandinavian journal of public health
IS - 6
ER -