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Corburn J, Curl S, Arredondo G. Health Equity in All Urban Policies: A Case Study of Richmond, California. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2025; 45:411-422. [PMID: 39136675 PMCID: PMC12059229 DOI: 10.1177/2752535x241273955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/10/2025]
Abstract
Local governments working in partnership with communities can institutionalize practices that promote health equity. We offer a case study of how one city in the US is implementing Health in All Policies (HiAP) with the explicit aim of promoting health equity. We use participant observations, original document reviews and interviews to describe how Richmond, California, is building new partnerships, programs and practices with community-based organizations and within government itself as part of the implementation of its HiAP Ordinance. We also report on indicators that were identified by community and government stakeholders for tracking progress toward improving place-based determinants of population health. We find that the responsibility for implementing Richmond's HiAP Ordinance rests on a new institution within local government and this entity is building new partnerships, promoting innovative policies and augmenting practices toward greater health equity. We also reveal how city governments and community partners can collaboratively track progress toward health equity using locally gathered data.
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Affiliation(s)
- Jason Corburn
- Deaprtment of Public Health, University of California Berkeley, Berkeley, CA, USA
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Mesa-Vieira C, Gonzalez-Jaramillo N, Díaz-Ríos C, Pano O, Meyer S, Menassa M, Minder B, Lin V, Franco OH, Frahsa A. Urban Governance, Multisectoral Action, and Civic Engagement for Population Health, Wellbeing, and Equity in Urban Settings: A Systematic Review. Int J Public Health 2023; 68:1605772. [PMID: 37719658 PMCID: PMC10500609 DOI: 10.3389/ijph.2023.1605772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 03/21/2023] [Indexed: 09/19/2023] Open
Abstract
Objectives: To identify the validated and reliable indicators and tools to assess good governance for population health, wellbeing, and equity in urban settings, and assess processes of multisectoral action and civic engagement as reported by peer-reviewed articles. Methods: We conducted a systematic review searching six databases for observational studies reporting strategies of either urban health, multisectoral action or civic engagement for wellbeing, health, or equity. Results: Out of 8,154 studies initially identified we included 17. From the included studies, 14 presented information about high-income countries. The general population was the main target in most studies. Multisectoral action was the most frequently reported strategy (14 studies). Three studies used Urban Health Equity Assessment and Response Tool (Urban HEART). Health indicators were the most frequently represented (6 studies). Barriers and facilitators for the implementation of participatory health governance strategies were reported in 12 studies. Conclusion: Data on the implementation of participatory health governance strategies has been mainly reported in high-income countries. Updated and reliable data, measured repeatedly, is needed to closely monitor these processes and further develop indicators to assess their impact on population health, wellbeing, and equity.
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Affiliation(s)
- Cristina Mesa-Vieira
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | | | - Catalina Díaz-Ríos
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Octavio Pano
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Sophie Meyer
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Marilyne Menassa
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Beatrice Minder
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Public Health and Primary Care Library, University Library of Bern, University of Bern, Bern, Switzerland
| | - Vivian Lin
- LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Oscar H. Franco
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- University Medical Center Utrecht, Utrecht, Netherlands
| | - Annika Frahsa
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
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Dam JL, Nagorka-Smith P, Waddell A, Wright A, Bos JJ, Bragge P. Research evidence use in local government-led public health interventions: a systematic review. Health Res Policy Syst 2023; 21:67. [PMID: 37400905 DOI: 10.1186/s12961-023-01009-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 05/13/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Local governments play an important role in improving public health outcomes globally, critical to this work is applying the best-available research evidence. Despite considerable exploration of research use in knowledge translation literature, how research is practically applied by local governments remains poorly understood. This systematic review examined research evidence use in local government-led public health interventions. It focused on how research was used and the type of intervention being actioned. METHODS Quantitative and qualitative literature published between 2000 and 2020 was searched for studies that described research evidence use by local governments in public health interventions. Studies reporting interventions developed outside of local government, including knowledge translation interventions, were excluded. Studies were categorised by intervention type and their level of description of research evidence use (where 'level 1' was the highest and 'level 3' was the lowest level of detail). FINDINGS The search identified 5922 articles for screening. A final 34 studies across ten countries were included. Experiences of research use varied across different types of interventions. However, common themes emerged including the demand for localised research evidence, the legitimising role of research in framing public health issues, and the need for integration of different evidence sources. CONCLUSIONS Differences in how research was used were observed across different local government public health interventions. Knowledge translation interventions aiming to increase research use in local government settings should consider known barriers and facilitators and consider contextual factors associated with different localities and interventions.
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Affiliation(s)
- Jennifer L Dam
- Monash Sustainable Development Institute, Monash University, 8 Scenic Boulevard, Clayton Campus, Clayton, VIC, 3800, Australia.
| | - Phoebe Nagorka-Smith
- School of Health and Social Development, Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
| | - Alex Waddell
- Action Lab, Monash University, 8 Scenic Boulevard, Clayton Campus, Clayton, VIC, 3800, Australia
| | - Annemarie Wright
- Victorian Department of Health and Human Services, 50 Lonsdale Street, Melbourne, VIC, 3000, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, VIC, 3053, Carlton, Australia
| | - Joannette J Bos
- Monash Sustainable Development Institute, Monash University, 8 Scenic Boulevard, Clayton Campus, Clayton, VIC, 3800, Australia
| | - Peter Bragge
- Monash Sustainable Development Institute, Monash University, 8 Scenic Boulevard, Clayton Campus, Clayton, VIC, 3800, Australia
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Vo A, Tao Y, Li Y, Albarrak A. The Association Between Social Determinants of Health and Population Health Outcomes: Ecological Analysis. JMIR Public Health Surveill 2023; 9:e44070. [PMID: 36989028 PMCID: PMC10131773 DOI: 10.2196/44070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/21/2022] [Accepted: 02/23/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND With the increased availability of data, a growing number of studies have been conducted to address the impact of social determinants of health (SDOH) factors on population health outcomes. However, such an impact is either examined at the county level or the state level in the United States. The results of analysis at lower administrative levels would be useful for local policy makers to make informed health policy decisions. OBJECTIVE This study aimed to investigate the ecological association between SDOH factors and population health outcomes at the census tract level and the city level. The findings of this study can be applied to support local policy makers in efforts to improve population health, enhance the quality of care, and reduce health inequity. METHODS This ecological analysis was conducted based on 29,126 census tracts in 499 cities across all 50 states in the United States. These cities were grouped into 5 categories based on their population density and political affiliation. Feature selection was applied to reduce the number of SDOH variables from 148 to 9. A linear mixed-effects model was then applied to account for the fixed effect and random effects of SDOH variables at both the census tract level and the city level. RESULTS The finding reveals that all 9 selected SDOH variables had a statistically significant impact on population health outcomes for ≥2 city groups classified by population density and political affiliation; however, the magnitude of the impact varied among the different groups. The results also show that 4 SDOH risk factors, namely, asthma, kidney disease, smoking, and food stamps, significantly affect population health outcomes in all groups (P<.01 or P<.001). The group differences in health outcomes for the 4 factors were further assessed using a predictive margin analysis. CONCLUSIONS The analysis reveals that population density and political affiliation are effective delineations for separating how the SDOH affects health outcomes. In addition, different SDOH risk factors have varied effects on health outcomes among different city groups but similar effects within city groups. Our study has 2 policy implications. First, cities in different groups should prioritize different resources for SDOH risk mitigation to maximize health outcomes. Second, cities in the same group can share knowledge and enable more effective SDOH-enabled policy transfers for population health.
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Affiliation(s)
- Ace Vo
- Information Systems and Business Analytics Department, Loyola Marymount University, Los Angeles, CA, United States
| | - Youyou Tao
- Information Systems and Business Analytics Department, Loyola Marymount University, Los Angeles, CA, United States
| | - Yan Li
- Center for Information Systems and Technology, Claremont Graduate University, Claremont, CA, United States
| | - Abdulaziz Albarrak
- Information Systems Department, King Faisal University, Al-Ahsa, Saudi Arabia
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Lilly K, Kean B, Hallett J, Robinson S, Selvey LA. Factors of the policy process influencing Health in All Policies in local government: A scoping review. Front Public Health 2023; 11:1010335. [PMID: 36844855 PMCID: PMC9949293 DOI: 10.3389/fpubh.2023.1010335] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 01/23/2023] [Indexed: 02/11/2023] Open
Abstract
Objectives This review aimed to identify factors in the policymaking environment that influence a Health in all Policies approach in local government, how these vary across different municipal contexts, and the extent that theories of the policy process are applied. Methods A scoping review was conducted to include sources published in English, between 2001 and 2021 in three databases, and assessed for inclusion by two blind reviewers. Results Sixty-four sources were included. Sixteen factors of the policy process were identified, expanding on previously reported literature to include understanding and framing of health, use of evidence, policy priority, and influence of political ideology. Eleven sources applied or referred to theories of the policy process and few reported findings based on different local government contexts. Conclusion There are a range of factors influencing a Health in All Policies approach in local government, although a limited understanding of how these differ across contexts. A theory-informed lens contributed to identifying a breadth of factors, although lack of explicit application of theories of the policy process in studies makes it difficult to ascertain meaningful synthesis of the interconnectedness of these factors.
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Affiliation(s)
- Kara Lilly
- School of Health, University of the Sunshine Coast, Maroochydore, QLD, Australia
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Bridie Kean
- School of Health, University of the Sunshine Coast, Maroochydore, QLD, Australia
| | - Jonathan Hallett
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Suzanne Robinson
- School of Population Health, Curtin University, Perth, WA, Australia
- Deakin Health Economics, Faculty of Health Sciences, Deakin University, Burwood, VIC, Australia
| | - Linda A. Selvey
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
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Yang Y, Tang J, Li Z, Wen J. How effective is the health promotion policy in Sichuan, China: based on the PMC-Index model and field evaluation. BMC Public Health 2022; 22:2391. [PMID: 36539758 PMCID: PMC9764584 DOI: 10.1186/s12889-022-14860-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Many countries around the world highlight the health in all policies (HiAP). However, most of the related research focused on the influential factors and implementation strategies, with less concern on the evaluation of HiAP. In response to HiAP's call, the Chinese government has proposed health promotion policies (HPPs) in counties or districts, the evaluation of HPPs in sample counties or districts of Sichuan province in China is an essential basis for optimizing policy content, improving policy implementation, and ensuring health promotion's continuous and efficient operation. METHODS This paper established an evaluation system for HPPs based on the PMC-Index model and then quantitatively analyzed 37 representative HPPs from the pilot areas in Sichuan province. In addition, a team of experts conducted a field assessment. RESULTS The results showed that the average PMC index of 37 HPPs was 7.091, and correlation analysis showed that there was a significant correlation between the PMC index and expert score. CONCLUSIONS This study indicates that the overall consistency of HPPs was good and proves a connection between the formulation and implementation of HPPs.
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Affiliation(s)
- Yanlin Yang
- grid.412901.f0000 0004 1770 1022Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, 610041 China
| | - Jing Tang
- grid.412901.f0000 0004 1770 1022Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, 610041 China
| | - Zhixin Li
- grid.419221.d0000 0004 7648 0872Sichuan Center for Disease Control and Prevention, Chengdu, 610041 China
| | - Jin Wen
- grid.412901.f0000 0004 1770 1022Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, 610041 China
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Porcherie M, Thomas MF, Quidu F, Héritage Z, Vaillant Z, Simos J, Rican S, Cantoreggi N, Faure E, Gall ARL. How to Evaluate Health in All Policies at the Local Level: Methodological Insights Within Municipalities From the WHO French Healthy Cities Network. Int J Health Policy Manag 2022; 11:3060-3070. [PMID: 35942970 PMCID: PMC10105196 DOI: 10.34172/ijhpm.2022.6584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 06/15/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND This article proposes a method for analysing the degree of maturity of Health in All Policies (HiAP) among World Health Organization-French Healthy Cities Network (WHO-FHCN) as part of the GoveRnance for Equity, EnviroNment and Health in the City (GREENH-City) project. We focused on the creation or enhancement of health-promoting environments, and more specifically, public green spaces. METHODS We conducted a cross-sectional quantitative study guided by the evaluative framework of the HiAP maturity level developed by Storm et al mixed with a qualitative interpretation. A self-administered questionnaire was sent to elected officials and health department officers in the 85 member cities of the WHO-FHCN in 2017. Subsequently 58 cities were included in the analysis, which was based on a multiple correspondence analysis (MCA) and a hierarchical ascending classification (HAC). RESULTS Thirty-two criteria among a total of 100 were identified and were used to organize the cities into 8 groups which was then reduced to three profiles among the cities: a less advanced HiAP profile, an established HiAP profile and an advanced HiAP profile. This process allows us to identify 4 dimensions that make it possible to evaluate the level of maturity of cities in the HiAP process, namely: (1) the consideration of social inequalities in health and/or health issues in the policies/actions of the sector studied, (2) occasional intersectoral collaboration, ie, one-off initiatives between the health department and others sectors, (3) the existence of joint projects, ie, common projects between two or more sectors, (4) the existence of intersectoral bodies, in this case on the theme of urban green spaces including an intersectoral committee and/or working groups. CONCLUSION Four dimensions which allow to the measurement of the degree of progress in implementing health-all-policies are proposed. With a view to integrating knowledge into public action, this study carried out under real conditions offers a realistic method to evaluate HiAP.
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Affiliation(s)
- Marion Porcherie
- Department of Social Sciences, Ecole des Hautes Etudes en Santé Publique, Laboratoire Arènes URM CNRS 6051, Université Rennes 1, Rennes, France
| | - Marie-Florence Thomas
- Ecole des Hautes Etudes en Santé Publique, Leres, Irset UMR- Inserm S 1085, Rennes, France
| | - Frédérique Quidu
- Department of Social Sciences, Ecole des Hautes Etudes en Santé Publique, Laboratoire Arènes URM CNRS 6051, Université Rennes 1, Rennes, France
| | - Zoé Héritage
- Santé Publique France, Saint-Maurice, Paris, France
| | - Zoé Vaillant
- LADYSS, Université Paris-Nanterre, Nanterre, France
| | - Jean Simos
- Institut de Santé Globale, Université de Genève, Genève, Switzerland
| | | | - Nicola Cantoreggi
- Institut de Santé Globale, Université de Genève, Genève, Switzerland
| | | | - Anne Roué Le Gall
- Department of Health and Environment, Ecole des Hautes Etudes en Santé Publique, Laboratoire Arènes URM CNRS 6051, Université Rennes 1, Rennes, France
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Brinkley C, Wagner J. Who is Planning for Environmental Justice, And How. JOURNAL OF THE AMERICAN PLANNING ASSOCIATION. AMERICAN PLANNING ASSOCIATION 2022; 90:63-76. [PMID: 39228964 PMCID: PMC11370866 DOI: 10.1080/01944363.2022.2118155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2024]
Abstract
Problem research strategy and findings Environmental justice (EJ) seeks to correct legacies of disproportionately burdening low-income and Black, Indigenous, and people of color (BIPOC) communities with environmental hazards that contribute to health inequalities. Federal and state policies increasingly require plans to assess and incorporate EJ principles. The current lack of accessible data and plan evaluation on EJ has been a barrier to policy setting and benchmarking. We created a framework for analyzing content across a large corpus of plans by using quantitative text analysis on 461 California city general plans, also known as comprehensive plans. To verify results and identify specific policies, we conducted content analysis on a subset of seven plans. Demonstrating the broad applicability of EJ principles in planning, policies spanned all required elements of general plans: housing, circulation, land use, health, safety, open space, air quality, and noise. We found that the most headway in EJ planning has been made in cities with a majority population of color and well before the 2018 California state mandate to address EJ. Policies were primarily focused on preventing adverse exposures as opposed to correcting for legacies of inequality. Further, although all policies address vulnerable populations and places, very few specifically addressed race or racism. Thus, EJ has been largely operationalized as health equity. Takeaway for practice We identified 628 EJ policies focused on vulnerable populations across the seven city plans included in content analysis. The smorgasbord of policy approaches provided fodder for cities across the United States to incorporate an EJ approach to planning. Gaps in focus areas reveal room for policy innovation (e.g., emphasis on language justice, formerly incarcerated individuals, and noise ordinance policing). We invite planners and community advocates to search across California's plans for EJ policy inspiration, and to use the appendix of EJ policies cataloged in this research as a benchmark of city-level innovation.
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Affiliation(s)
- Catherine Brinkley
- University of California, Davis, Human Ecology, Community and Regional Development, 1 Shields Ave, Davis, United States
| | - Jenny Wagner
- University of California, Davis, Public Health, 1 Shields Ave, Davis, United States
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Bai Y, Zhang Y, Zotova O, Pineo H, Siri J, Liang L, Luo X, Kwan MP, Ji J, Jiang X, Chu C, Cong N, Lin V, Summerskill W, Luo Y, Yu H, Wu T, Yang C, Li J, Xiao Y, Zhou J, Dou D, Xiong H, Zhang LL, Wang L, Tao S, Fu B, Zhang Y, Xu B, Yang J, Gong P. Healthy cities initiative in China: Progress, challenges, and the way forward. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 27:100539. [PMID: 35854811 PMCID: PMC9286727 DOI: 10.1016/j.lanwpc.2022.100539] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
UNLABELLED China implemented the first phase of its National Healthy Cities pilot program from 2016-20. Along with related urban health governmental initiatives, the program has helped put health on the agenda of local governments while raising public awareness. Healthy City actions taken at the municipal scale also prepared cities to deal with the COVID-19 pandemic. However, after intermittent trials spanning the past two decades, the Healthy Cities initiative in China has reached a crucial juncture. It risks becoming inconsequential given its overlap with other health promotion efforts, changing public health priorities in response to the pandemic, and the partial adoption of the Healthy Cities approach advanced by the World Health Organization (WHO). We recommend aligning the Healthy Cities initiative in China with strategic national and global level agendas such as Healthy China 2030 and the Sustainable Development Goals (SDGs) by providing an integrative governance framework to facilitate a coherent intersectoral program to systemically improve population health. Achieving this alignment will require leveraging the full spectrum of best practices in Healthy Cities actions and expanding assessment efforts. FUNDING Tsinghua-Toyota Joint Research Fund "Healthy city systems for smart cities" program.
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Affiliation(s)
- Yuqi Bai
- Department of Earth System Science, Institute for Global Change Studies, Ministry of Education Key Laboratory for Earth System Modelling, Tsinghua University, Beijing, China
| | - Yutong Zhang
- Department of Earth System Science, Institute for Global Change Studies, Ministry of Education Key Laboratory for Earth System Modelling, Tsinghua University, Beijing, China
| | - Olena Zotova
- Faculty of Health and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Helen Pineo
- Institute for Environmental Design and Engineering, University College London, WC1H 0NN London, UK
| | - José Siri
- Independent Consultant, Urban Health, Philadelphia, PA 19103, United States of America
| | - Lu Liang
- Department of Geography and the Environment, University of North Texas, 1155 Union Circle, Denton, TX 76203, United States of America
| | - Xiangyu Luo
- Department of Earth System Science, Institute for Global Change Studies, Ministry of Education Key Laboratory for Earth System Modelling, Tsinghua University, Beijing, China
| | - Mei-Po Kwan
- Department of Geography and Resource Management and Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - John Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Xiaopeng Jiang
- Office of the WHO Representative in People's Republic of China, WHO, Beijing, China
| | - Cordia Chu
- Centre for Environment and Population Health, School of Medicine and Dentistry, Griffith University, Nathan, QLD 4111, Australia
| | - Na Cong
- Department of Earth System Science, Institute for Global Change Studies, Ministry of Education Key Laboratory for Earth System Modelling, Tsinghua University, Beijing, China
| | - Vivian Lin
- LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, China
| | - William Summerskill
- Consulting Editor, The Lancet, 125 London Wall, London EC2Y 5AS, United Kingdom
| | - Yong Luo
- Department of Earth System Science, Institute for Global Change Studies, Ministry of Education Key Laboratory for Earth System Modelling, Tsinghua University, Beijing, China
| | - Hongjun Yu
- Department of Physical Education, Tsinghua University, Beijing, China
| | - Tinghai Wu
- School of Architecture, Tsinghua University, Beijing, China
| | - Changhong Yang
- Division for Business Management and Quality Control of Sichuan Centre for Diseases Control and Prevention, Chengdu 610041, China
| | - Jing Li
- Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen; National Clinical Research Centre for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Centre for Cardiovascular Diseases, Beijing, China
| | - Yixiong Xiao
- Business Intelligence Lab, Baidu Research, Beijing, China
| | - Jingbo Zhou
- Business Intelligence Lab, Baidu Research, Beijing, China
| | - Dejing Dou
- Business Intelligence Lab, Baidu Research, Beijing, China
| | - Hui Xiong
- Artificial Intelligence Thrust, The Hong Kong University of Science and Technology (Guangzhou), Guangzhou, China and The Department of Computer Science and Engineering, The Hong Kong University of Science and Technology, Hong Kong SAR, China
| | | | - Lan Wang
- College of Architecture and Urban Planning, Tongji University, Shanghai, China
| | - Shu Tao
- School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen, China
| | - Bojie Fu
- State Key Laboratory of Urban and Regional Ecology, Research Centre for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, China
| | - Yong Zhang
- Cancer Hospital Chinese Academy of Medical Science, Beijing, China
| | - Bing Xu
- Department of Earth System Science, Institute for Global Change Studies, Ministry of Education Key Laboratory for Earth System Modelling, Tsinghua University, Beijing, China
| | - Jun Yang
- Department of Earth System Science, Institute for Global Change Studies, Ministry of Education Key Laboratory for Earth System Modelling, Tsinghua University, Beijing, China
| | - Peng Gong
- Department of Earth Sciences and Geography, University of Hong Kong, Hong Kong Special Administrative Region, China
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Pineo H, Moore G, Braithwaite I. Incorporating practitioner knowledge to test and improve a new conceptual framework for healthy urban design and planning. CITIES & HEALTH 2022; 6:906-921. [PMID: 39430873 PMCID: PMC7616717 DOI: 10.1080/23748834.2020.1773035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 05/05/2020] [Indexed: 10/22/2024]
Abstract
There are increasing arguments for bridging diverse knowledges and co-producing new knowledge between researchers, professional communities and citizens to create health-promoting built environments. The new THRIVES Framework (Towards Healthy uRbanism: InclusiVe, Equitable, Sustainable) echoes the call that healthy urbanism processes should be participatory and this principle informed the development of the Framework itself, which involved several stages of informal and formal testing with stakeholders, through a process of action research and 'extended peer review'. Formal feedback about the design of the preliminary Framework and its implementation in built environment practice was gathered through a participatory workshop with 26 built environment and public health professionals in January 2020. Participants were encouraged to share their knowledge, ask questions, critique and provide recommendations. Overall, participants were supportive of the conceptual messages of the THRIVES Framework and more critical of the visual design of the preliminary version. They also questioned whether further resources would be required to implement the Framework. This research created a forum for stakeholders, who may typically be outside the research process, to shape the development of a conceptual framework for healthy urbanism. Further research and collaboration will create resources to bridge the gap between this new conceptualisation and practice.
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Affiliation(s)
- Helen Pineo
- Institute for Environmental Design and Engineering, Bartlett School of Environment, Energy and Resources, University College London, London, UK
| | - Gemma Moore
- Institute for Environmental Design and Engineering, Bartlett School of Environment, Energy and Resources, University College London, London, UK
| | - Isobel Braithwaite
- UCL Institute for Health Informatics, University College London, London, UK
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Cairney P, Kippin S. The future of education equity policy in a COVID-19 world: a qualitative systematic review of lessons from education policymaking. OPEN RESEARCH EUROPE 2022; 1:78. [PMID: 37645089 PMCID: PMC10445953 DOI: 10.12688/openreseurope.13834.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/04/2022] [Indexed: 08/31/2023]
Abstract
Background: COVID-19 had a major global impact on education, prompting concerns about its unequal effects and some impetus to reboot equity strategies. Yet, policy processes exhibit major gaps between such expectations and outcomes, and similar inequalities endured for decades before the pandemic. Our objective is to establish how education researchers, drawing on policy concepts and theories, explain and seek to address this problem. Methods: A qualitative systematic review (2020-21), to identify peer reviewed research and commentary articles on education, equity, and policymaking, in specialist and general databases (ERIC, Web of Science, Scopus, Cochrane/ Social Systems Evidence). We did not apply additional quality measures. We used an immersive and inductive approach to identify key themes. We use these texts to produce a general narrative and explore how policy theory articles inform it. Results: 140 texts (109 articles included; 31 texts snowballed) provide a non-trivial reference to policymaking. Limiting inclusion to English-language produced a bias towards Global North articles. Our comparison with a review of health equity research highlights distinctive elements in education. First, education equity is ambiguous and contested, with no settled global definition or agenda (although some countries and international organisations have disproportionate influence). Second, researchers critique 'neoliberal' approaches that dominate policymaking at the expense of 'social justice'. Third, more studies provide 'bottom-up' analysis of 'implementation gaps'. Fourth, more studies relate inequity to ineffective policymaking to address marginalised groups. Conclusions: Few studies use policy theories to explain policymaking, but there is an education-specific literature performing a similar role. Compared to health research, there is more use of critical policy analysis to reflect on power and less focus on technical design issues. There is high certainty that current neoliberal policies are failing, but low certainty about how to challenge them successfully.
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Affiliation(s)
- Paul Cairney
- History, Heritage, and Politics, University of Stirling, Stirling, Stirling, FK94LA, UK
| | - Sean Kippin
- History, Heritage, and Politics, University of Stirling, Stirling, Stirling, FK94LA, UK
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12
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Cairney P, Kippin S. The future of education equity policy in a COVID-19 world: a qualitative systematic review of lessons from education policymaking. OPEN RESEARCH EUROPE 2022; 1:78. [PMID: 37645089 PMCID: PMC10445953 DOI: 10.12688/openreseurope.13834.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/04/2022] [Indexed: 08/31/2023]
Abstract
Background: COVID-19 had a major global impact on education, prompting concerns about its unequal effects and some impetus to reboot equity strategies. Yet, policy processes exhibit major gaps between such expectations and outcomes, and similar inequalities endured for decades before the pandemic. Our objective is to establish how education researchers, drawing on policy concepts and theories, explain and seek to address this problem. Methods: A qualitative systematic review (2020-21), to identify peer reviewed research and commentary articles on education, equity, and policymaking, in specialist and general databases (ERIC, Web of Science, Scopus, Cochrane/ Social Systems Evidence). We did not apply additional quality measures. We used an immersive and inductive approach to identify key themes. We use these texts to produce a general narrative and explore how policy theory articles inform it. Results: 140 texts (109 articles included; 31 texts snowballed) provide a non-trivial reference to policymaking. Limiting inclusion to English-language produced a bias towards Global North articles. Our comparison with a review of health equity research highlights distinctive elements in education. First, education equity is ambiguous and contested, with no settled global definition or agenda (although some countries and international organisations have disproportionate influence). Second, researchers critique 'neoliberal' approaches that dominate policymaking at the expense of 'social justice'. Third, more studies provide 'bottom-up' analysis of 'implementation gaps'. Fourth, more studies relate inequity to ineffective policymaking to address marginalised groups. Conclusions: Few studies use policy theories to explain policymaking, but there is an education-specific literature performing a similar role. Compared to health research, there is more use of critical policy analysis to reflect on power and less focus on technical design issues. There is high certainty that current neoliberal policies are failing, but low certainty about how to challenge them successfully.
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Affiliation(s)
- Paul Cairney
- History, Heritage, and Politics, University of Stirling, Stirling, Stirling, FK94LA, UK
| | - Sean Kippin
- History, Heritage, and Politics, University of Stirling, Stirling, Stirling, FK94LA, UK
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13
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Francis-Oliviero F, Cambon L, Wittwer J, Marmot M, Alla F. [Theoretical and practical challenges of proportionate universalism: a reviewAnálise dos desafios teóricos e práticos de universalismo proporcional]. Rev Panam Salud Publica 2021; 45:e102. [PMID: 34703455 PMCID: PMC8529998 DOI: 10.26633/rpsp.2021.102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 07/23/2020] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE In 2010, the principle of proportionate universalism (PU) has been proposed as a solution to reduce health inequalities. It had a great resonance but does not seem to have been widely applied and no guidelines exist on how to implement it. The two specific objectives of this scoping review were: (1) to describe the theoretical context in which PU was established, (2) to describe how researchers apply PU and related methodological issues. METHODS We searched for all articles published until 6th of February 2020, mentioning "Proportionate Universalism" or its synonyms "Targeted universalism" OR "Progressive Universalism" as a topic in all Web of Science databases. RESULTS This review of 55 articles allowed us a global vision around the question of PU regarding its theoretical foundations and practical implementation. PU principle is rooted in the social theories of universalism and targeting. It proposes to link these two aspects in order to achieve an effective reduction of health inequalities. Regarding practical implementation, PU interventions were rare and led to different interpretations. There are still many methodological and ethical challenges regarding conception and evaluation of PU interventions, including how to apply proportionality, and identification of needs. CONCLUSION This review mapped available scientific literature on PU and its related concepts. PU principle originates from social theories. As highlighted by authors who implemented PU interventions, application raises many challenges from design to evaluation. Analysis of PU applications provided in this review answered to some of them but remaining methodological challenges could be addressed in further research.
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Affiliation(s)
| | - Linda Cambon
- University of BordeauxBordeauxFranciaUniversity of Bordeaux, Bordeaux, Francia.
| | - Jérôme Wittwer
- University of BordeauxBordeauxFranciaUniversity of Bordeaux, Bordeaux, Francia.
| | - Michael Marmot
- Institute of Health Equity at the University College LondonLondresReino UnidoInstitute of Health Equity at the University College London, Londres, Reino Unido.
| | - François Alla
- University of BordeauxBordeauxFranciaUniversity of Bordeaux, Bordeaux, Francia.
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14
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Cairney P, St Denny E, Mitchell H. The future of public health policymaking after COVID-19: a qualitative systematic review of lessons from Health in All Policies. OPEN RESEARCH EUROPE 2021; 1:23. [PMID: 37645203 PMCID: PMC10445916 DOI: 10.12688/openreseurope.13178.2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/07/2021] [Indexed: 08/31/2023]
Abstract
Background: 'Health in All Policies' (HiAP) describes the pursuit of health equity. It has five main elements: treat health as a human right; identify evidence of the 'social determinants' of health inequalities, recognise that most powers to affect health are not held by health departments, promote intersectoral policymaking and collaboration inside and outside of government, and generate political will. Studies describe its potential but bemoan a major implementation gap. Some HiAP scholars learn from policymaking research how to understand this gap, but the use of policy theories is patchy. In that context, our guiding research question is: How does HiAP research use policy theory to understand policymaking? It allows us to zoom-out to survey the field and zoom-in to identify: the assumed and actual causes of policy change, and transferable lessons to HiAP scholars and advocates. Methods: Our qualitative systematic review (two phases, 2018 and 2020) identified 4972 HiAP articles. Of these, 113 journal articles (research and commentary) provide a non-trivial reference to policymaking (at least one reference to a policymaking concept). We use the 113 articles to produce a general HiAP narrative and explore how the relatively theory-informed articles enhance it. Results: Most articles focus on policy analysis (identifying policy problems and solutions) rather than policy theory (explaining policymaking dynamics). They report a disappointing gap between HiAP expectations and policy outcomes. Theory-informed articles contribute to a HiAP playbook to close that gap or a programme theory to design and evaluate HiAP in new ways. Conclusions: Few HiAP articles use policy theories for their intended purpose. Policy theories provide lessons to aid critical reflection on power, political dilemmas, and policymaking context. HiAP scholars seek more instrumental lessons, potentially at the cost of effective advocacy and research.
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Affiliation(s)
- Paul Cairney
- History, Heritage, and Politics, University of Stirling, Stirling, FK94LA, UK
| | - Emily St Denny
- Department of Political Science, University of Copenhagen, Copenhagen, DK-1353, Denmark
| | - Heather Mitchell
- History, Heritage, and Politics, University of Stirling, Stirling, FK94LA, UK
- Faculty of Health Sciences, University of Stirling, Stirling, FK94LA, UK
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15
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Cairney P, St Denny E, Mitchell H. The future of public health policymaking after COVID-19: a qualitative systematic review of lessons from Health in All Policies. OPEN RESEARCH EUROPE 2021; 1:23. [PMID: 37645203 PMCID: PMC10445916 DOI: 10.12688/openreseurope.13178.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/07/2021] [Indexed: 08/31/2023]
Abstract
Background: 'Health in All Policies' (HiAP) describes the pursuit of health equity. It has five main elements: treat health as a human right; identify evidence of the 'social determinants' of health inequalities, recognise that most powers to affect health are not held by health departments, promote intersectoral policymaking and collaboration inside and outside of government, and generate political will. Studies describe its potential but bemoan a major implementation gap. Some HiAP scholars learn from policymaking research how to understand this gap, but the use of policy theories is patchy. In that context, our guiding research question is: How does HiAP research use policy theory to understand policymaking? It allows us to zoom-out to survey the field and zoom-in to identify: the assumed and actual causes of policy change, and transferable lessons to HiAP scholars and advocates. Methods: Our qualitative systematic review (two phases, 2018 and 2020) identified 4972 HiAP articles. Of these, 113 journal articles (research and commentary) provide a non-trivial reference to policymaking (at least one reference to a policymaking concept). We use the 113 articles to produce a general HiAP narrative and explore how the relatively theory-informed articles enhance it. Results: Most articles focus on policy analysis (identifying policy problems and solutions) rather than policy theory (explaining policymaking dynamics). They report a disappointing gap between HiAP expectations and policy outcomes. Theory-informed articles contribute to a HiAP playbook to close that gap or a programme theory to design and evaluate HiAP in new ways. Conclusions: Few HiAP articles use policy theories for their intended purpose. Policy theories provide lessons to aid critical reflection on power, political dilemmas, and policymaking context. HiAP scholars seek more instrumental lessons, potentially at the cost of effective advocacy and research.
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Affiliation(s)
- Paul Cairney
- History, Heritage, and Politics, University of Stirling, Stirling, FK94LA, UK
| | - Emily St Denny
- Department of Political Science, University of Copenhagen, Copenhagen, DK-1353, Denmark
| | - Heather Mitchell
- History, Heritage, and Politics, University of Stirling, Stirling, FK94LA, UK
- Faculty of Health Sciences, University of Stirling, Stirling, FK94LA, UK
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16
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Buttazzoni A, Doherty S, Minaker L. How Do Urban Environments Affect Young People's Mental Health? A Novel Conceptual Framework to Bridge Public Health, Planning, and Neurourbanism. Public Health Rep 2021; 137:48-61. [PMID: 33563094 PMCID: PMC8721758 DOI: 10.1177/0033354920982088] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Childhood and adolescence are crucial periods for mental and social development. Currently, mental illness among young people is a global epidemic, and rates of disorders such as depression and anxiety are rising. Urban living, compared with rural living, is linked with a higher risk of serious mental illness, which is important because the world is urbanizing faster than ever before. Urban environments and their landscapes, designs, and features influence mental health and well-being. However, no conceptual frameworks to date have detailed the effect of urban environments on young people's mental health, and few studies have considered the growing role of digital and social media in this relationship, leading to calls for the development of holistic approaches to describe this relationship. This article synthesizes existing knowledge on urban places (both built and natural environments) and mental health in the public health and urban planning literature and examines the emerging field of neurourbanism (a multidisciplinary study of the effect of urban environments on mental health and brain activity) to enhance current practice and research. We developed 2 novel conceptual frameworks (1 research-oriented, 1 practice-oriented), adapted from Bronfenbrenner's socioecological model, that focus on the relationship between urban environments and young people's mental health. We added a digital and social media contextual level to the socioecological model, and we applied a multilayer concept to highlight potential cross-field interactions and collaborations. The proposed frameworks can help to guide future practice and research in this area.
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Affiliation(s)
- Adrian Buttazzoni
- School of Planning, Faculty of Environment, University of Waterloo, Waterloo, Ontario, Canada,Geographies of Health in Place, Planning, and Public Health Lab, Faculty of Environment, University of Waterloo, Waterloo, Ontario, Canada,Adrian Buttazzoni, MSc, University of Waterloo, School of Planning, Faculty of Environment, 200 University Ave W, Environment Building 3, Waterloo, Ontario N2L 3G1, Canada.
| | - Sean Doherty
- Department of Geography and Environmental Studies, Faculty of Arts, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Leia Minaker
- School of Planning, Faculty of Environment, University of Waterloo, Waterloo, Ontario, Canada,Geographies of Health in Place, Planning, and Public Health Lab, Faculty of Environment, University of Waterloo, Waterloo, Ontario, Canada,School of Public Health and Health Systems, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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Ron S, Dimitri N, Ginzburg SL, Reisner E, Martinez PB, Zamore W, Echevarria B, Brugge D, Martinez LS. Health Lens Analysis: A Strategy to Engage Community in Environmental Health Research in Action. SUSTAINABILITY 2021; 13. [PMID: 33981451 DOI: 10.3390/su13041748] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Health Lens Analysis is a tool to facilitate collaboration among diverse community stakeholders. We employed HLA as part of a community based participatory research (CBPR) and action study to mitigate the negative health effects of TRAP and ultrafine particles (UFPs) in Somerville, MA. HLA is a Health in All Policies tool with previously limited implementation in a North American context. As part of the HLA, community and academic partners engaged residents from across near-highway neighborhoods in a series of activities designed to identify health concerns and generate recommendations for policies and projects to improve health over an 18-month planning period. Noise barriers, which may reduce TRAP exposure among residents in addition to reducing traffic noise, were seen as an acceptable solution by community stakeholders. We found HLA to be an effective means to engage stakeholders from across sectors and diverse community residents in critical discourse about the health impacts of near-roadway exposures. The iterative process allowed the project team to fully explore the arguments for noise barriers and preferred health interventions, while building a stakeholder base interested in the mitigation of TRAP, thus, creating a shared language and understanding of the issue.
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Affiliation(s)
- Sharon Ron
- Metropolitan Area Planning Council 60 Temple Place, Boston, MA, 02111, USA
| | - Noelle Dimitri
- Boston University School of Social Work 264 Bay State Rd., Boston, MA 02215, USA
| | - Shir Lerman Ginzburg
- UConn Health, Department of Public Health Sciences 263 Farmington Ave., Farmington, CT 06032, USA
| | - Ellin Reisner
- Somerville Transportation Equity Partnership, Somerville, MA 02145, USA
| | - Pilar Botana Martinez
- Department of Environmental Health, Boston University School of Public Health, 715 Albany Ave., Boston, MA 02118, USA
| | - Wig Zamore
- Somerville Transportation Equity Partnership, Somerville, MA 02145, USA
| | - Ben Echevarria
- The Welcome Project, 530 Mystic Ave., Somerville, MA, 02145, USA
| | - Doug Brugge
- Department of Public Health Sciences, University of Connecticut School of Medicine 263 Farmington Ave., Farmington, CT 06030, USA
| | - Linda Sprague Martinez
- Macro Department, Boston University School of Social Work, 264 Bay State Rd., Boston, MA 02215, USA
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18
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19
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Freitas Â, Rodrigues TC, Santana P. Assessing Urban Health Inequities through a Multidimensional and Participatory Framework: Evidence from the EURO-HEALTHY Project. J Urban Health 2020; 97:857-875. [PMID: 32860097 PMCID: PMC7454139 DOI: 10.1007/s11524-020-00471-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Urban health inequities often reflect and follow the geographic patterns of inequality in the social, economic and environmental conditions within a city-the so-called determinants of health. Evidence of patterns within these conditions can support decision-making by identifying where action is urgent and which policies and interventions are needed to mitigate negative impacts and enhance positive impacts. Within the scope of the EU-funded project EURO-HEALTHY (Shaping EUROpean policies to promote HEALTH equitY), the City of Lisbon was selected as a case study to apply a multidimensional and participatory assessment approach of urban health whose purpose was to inform the evaluation of policies and interventions with potential to address local health gaps. In this paper, we present the set of indicators identified as drivers of urban health inequities within the City of Lisbon, exploring the added value of using a spatial indicator framework together with a participation process to orient a place-based assessment and to inform policies aimed at reducing health inequities. Two workshops with a panel of local stakeholders from health and social care services, municipal departments (e.g. urban planning, environment, social rights and education) and non-governmental and community-based organizations were organized. The aim was to engage local stakeholders to identify locally critical situations and select indicators of health determinants from a spatial equity perspective. To support the analysis, a matrix of 46 indicators of health determinants, with data disaggregated at the city neighbourhood scale, was constructed and was complemented with maps. The panel identified critical situations for urban health equity in 28 indicators across eight intervention axes: economic conditions, social protection and security; education; demographic change; lifestyles and behaviours; physical environment; built environment; road safety and healthcare resources and performance. The geographical distribution of identified critical situations showed that all 24 city neighbourhoods presented one or more problems. A group of neighbourhoods systematically perform worse in most indicators from different intervention axes, requiring not only priority action but mainly a multi- and intersectoral policy response. The indicator matrices and maps have provided a snapshot of urban inequities across different intervention axes, making a compelling argument for boosting intersectoral work across municipal departments and local stakeholders in the City of Lisbon. This study, by integrating local evidence in combination with social elements, pinpoints the importance of a place-based approach for assessing urban health equity.
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Affiliation(s)
- Ângela Freitas
- CEGOT-UC, Centre of Studies in Geography and Spatial Planning, University of Coimbra, Coimbra, Portugal.
| | - Teresa C Rodrigues
- CEG-IST, Centre for Management Studies of Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Paula Santana
- CEGOT-UC, Centre of Studies in Geography and Spatial Planning, Department of Geography and Tourism, University of Coimbra, Coimbra, Portugal
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20
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Francis-Oliviero F, Cambon L, Wittwer J, Marmot M, Alla F. Theoretical and practical challenges of proportionate universalism: a review. Rev Panam Salud Publica 2020; 44:e110. [PMID: 33088291 PMCID: PMC7556407 DOI: 10.26633/rpsp.2020.110] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 07/23/2020] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE In 2010, the principle of proportionate universalism (PU) has been proposed as a solution to reduce health inequalities. It had a great resonance but does not seem to have been widely applied and no guidelines exist on how to implement it.The two specific objectives of this scoping review were: (1) to describe the theoretical context in which PU was established, (2) to describe how researchers apply PU and related methodological issues. METHODS We searched for all articles published until 6th of February 2020, mentioning "Proportionate Universalism" or its synonyms "Targeted universalism" OR "Progressive Universalism" as a topic in all Web of Science databases. RESULTS This review of 55 articles allowed us a global vision around the question of PU regarding its theoretical foundations and practical implementation. PU principle is rooted in the social theories of universalism and targeting. It proposes to link these two aspects in order to achieve an effective reduction of health inequalities. Regarding practical implementation, PU interventions were rare and led to different interpretations. There are still many methodological and ethical challenges regarding conception and evaluation of PU interventions, including how to apply proportionality, and identification of needs. CONCLUSION This review mapped available scientific literature on PU and its related concepts. PU principle originates from social theories. As highlighted by authors who implemented PU interventions, application raises many challenges from design to evaluation. Analysis of PU applications provided in this review answered to some of them but remaining methodological challenges could be addressed in further research.
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Affiliation(s)
| | - Linda Cambon
- University of BordeauxBordeauxFranceUniversity of Bordeaux, Bordeaux, France
| | - Jérôme Wittwer
- University of BordeauxBordeauxFranceUniversity of Bordeaux, Bordeaux, France
| | - Michael Marmot
- Institute of Health Equity at the University College LondonLondonUnited KingdomInstitute of Health Equity at the University College London, London, United Kingdom
| | - François Alla
- University of BordeauxBordeauxFranceUniversity of Bordeaux, Bordeaux, France
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21
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Lilly K, Hallett J, Robinson S, Selvey LA. Insights into local health and wellbeing policy process in Australia. Health Promot Int 2020; 35:925-934. [PMID: 31504496 DOI: 10.1093/heapro/daz082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
To investigate factors that enable or challenge the initiation and actioning of health and wellbeing policy in Australian local governments using political science frameworks. An online survey was distributed to staff and elected members of Australian local governments. The survey sought responses to a range of variables as informed by political science frameworks. Data were analysed using descriptive statistics and results were compared between local governments of different geographical sizes and locations using Kruskal-Wallis non-parametric testing. There were 1825 survey responses, including 243 CEOs, representing 45% of Australian local governments. Enablers for local government policy initiation and action included the high priority given to health and wellbeing (44%), local leadership (56%) and an organizational (70%) and personal obligation (68%) to the community to act. Less true is a favourable legislative environment (33%), leadership from higher levels of government (29%) and sufficient financial capacity (22%). Cities are better positioned to initiate and action health policy, regardless of the broader legislative environment. Health and wellbeing is a high priority for Australian local governments, despite lack of funding and limited lobbying and support from other sectors and higher levels of government. The insights from political science frameworks assist to understand the policy process, including the interrelatedness of enablers and challenges to initiating and actioning health and wellbeing policy. Further understanding the policy drivers would support practitioners and researchers advocating to influence local health and wellbeing policy.
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Affiliation(s)
- Kara Lilly
- School of Health and Sport Science, University of the Sunshine Coast, Sunshine Coast, Australia.,School of Public Health, Curtin University, Perth, Australia
| | | | | | - Linda A Selvey
- School of Public Health, University of Queensland, Brisbane, Australia
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22
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Berkowitz RL, Gao X, Michaels EK, Mujahid MS. Structurally vulnerable neighbourhood environments and racial/ethnic COVID-19 inequities. ACTA ACUST UNITED AC 2020; 5:S59-S62. [DOI: 10.1080/23748834.2020.1792069] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Rachel L. Berkowitz
- Division of Health Policy and Management, School of Public Health, University of California, Berkeley
- Sutter Health Center for Health Systems Research
| | - Xing Gao
- Division of Epidemiology, School of Public Health, University of California, Berkeley
| | - Eli K. Michaels
- Division of Epidemiology, School of Public Health, University of California, Berkeley
| | - Mahasin S. Mujahid
- Division of Epidemiology, School of Public Health, University of California, Berkeley
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23
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Pineo H, Glonti K, Rutter H, Zimmermann N, Wilkinson P, Davies M. Use of Urban Health Indicator Tools by Built Environment Policy- and Decision-Makers: a Systematic Review and Narrative Synthesis. J Urban Health 2020; 97:418-435. [PMID: 31482385 PMCID: PMC7305281 DOI: 10.1007/s11524-019-00378-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Global initiatives have raised awareness of the need for cross-departmental and cross-sectoral activities to support urban health, sustainability, and equity, with respective indicators routinely used as a way to catalyze and monitor action toward pre-defined goals. Despite the existence of at least 145 urban health indicator (UHI) tools globally, there has been very little research on the use of indicators by policy- and decision-makers; more attention has been devoted to their development and validation. This paper describes the second part of a two-part systematic review of the characteristics (part A) and use (part B, this part) of UHI tools by municipal built environment policy- and decision-makers. Part B is a narrative synthesis of studies on the use of UHI tools. This PRISMA-P compliant review follows a mixed methods sequential explanatory design. The search was conducted using seven bibliographic databases, grey literature searches, and key journal hand searches. Ten studies describing the use of ten UHI tools in seven countries were included in the narrative synthesis, resulting in development of a theory of change (ToC). We found that both expert-led and participatory indicator projects can be underpinned by research evidence and residents' knowledge. Our findings contradict the dominant view of indicator use in policy-making as a linear process, highlighting a number of technical, organizational, political, knowledge, and contextual factors that affect their use. Participatory UHI tools with community involvement were generally more effective at supporting "health in all policies" and "whole-of-society" approaches to governing healthy cities than expert-led processes. UHI tool producers proposed a range of techniques to address urban health complexity characteristics. Finally, in combining data from both parts of the review, we found that potentially important UHI tool features, such as neighbourhood-scale data, were influential in the use of indicators by built environment policy- and decision-makers.
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Affiliation(s)
- Helen Pineo
- Institute for Environmental Design and Engineering, Bartlett School of Environment, Energy and Resources, University College London, Central House, 14 Upper Woburn Place, London, WC1H 0NN, UK.
| | - Ketevan Glonti
- School of Humanities and Social Sciences, University of Split, Split, Croatia.,INSERM, U1153 Epidemiology and Biostatistics Sorbonne Paris Cité Research Center (CRESS), Methods of Therapeutic Evaluation of Chronic Diseases Team (METHODS), 75014, Paris, France.,Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - Harry Rutter
- Department of Social & Policy Sciences, University of Bath, Claverton Down, Bath, UK
| | - Nici Zimmermann
- Institute for Environmental Design and Engineering, Bartlett School of Environment, Energy and Resources, University College London, Central House, 14 Upper Woburn Place, London, WC1H 0NN, UK
| | - Paul Wilkinson
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Michael Davies
- Institute for Environmental Design and Engineering, Bartlett School of Environment, Energy and Resources, University College London, Central House, 14 Upper Woburn Place, London, WC1H 0NN, UK
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24
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Kennedy C, O’Reilly P, O’Connell R, O’Leary D, Fealy G, Hegarty J, Brady A, Nicholson E, McNamara M, Casey M. Integrative review; identifying the evidence base for policymaking and analysis in health care. J Adv Nurs 2019; 75:3231-3245. [DOI: 10.1111/jan.14121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 04/10/2019] [Accepted: 04/17/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Catriona Kennedy
- School of Nursing and Midwifery Robert Gordon University Aberdeen Scotland
| | - Pauline O’Reilly
- Department of Nursing and Midwifery University of Limerick Limerick Ireland
| | - Rhona O’Connell
- Catherine McAuley School of Nursing and Midwifery University College Cork Cork Ireland
| | - Denise O’Leary
- School of Hospitality Management and Tourism Dublin Institute of Technology Dublin Ireland
| | - Gerard Fealy
- UCD School of Nursing, Midwifery & Health Systems University College Dublin Dublin Ireland
| | | | - Anne‐Marie Brady
- School of Nursing & Midwifery Trinity College Dublin Dublin Ireland
| | - Emma Nicholson
- UCD School of Nursing, Midwifery & Health Systems University College Dublin Dublin Ireland
| | - Martin McNamara
- UCD School of Nursing, Midwifery & Health Systems University College Dublin Dublin Ireland
| | - Mary Casey
- UCD School of Nursing, Midwifery & Health Systems University College Dublin Dublin Ireland
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Durham J, Fa'avale N, Fa'avale A, Ziesman C, Malama E, Tafa S, Taito T, Etuale J, Yaranamua M, Utai U, Schubert L. The impact and importance of place on health for young people of Pasifika descent in Queensland, Australia: a qualitative study towards developing meaningful health equity indicators. Int J Equity Health 2019; 18:81. [PMID: 31159820 PMCID: PMC6547525 DOI: 10.1186/s12939-019-0978-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 05/03/2019] [Indexed: 11/10/2022] Open
Abstract
Background Health equity is a priority in the global sustainable development agenda. Available health equity indicators often focus on health outcomes, access to healthcare, risk factors and determinants such as income, education, and gender. Less attention has been given to other social determinants, including those related to place and ethnicity. Measures such as income, education, and gender, however, may not provide policy-makers with sufficient information to redress inequities. In this paper, we begin to develop health equity indicators for young Pasifika peoples in Logan, Queensland, Australia. While health data on Pasifika young people in Queensland is scant, available data suggests significant inequalities. The purpose of the study was to develop an understanding of the drivers of these disparities through the lens of the social determinants of health, to create health equity indicators. Methods Following meetings with community stakeholders to develop respectful and collaborative partnership processes, we took a youth participatory action research approach. Six peer researchers (3 male, 3 female) were recruited from the Logan area for the project. Following training, the peer researchers undertook 31 qualitative interviews with young Pasifika (16–24 years old). Data was manually analysed, coded and grouped into themes to develop the draft indicators. Interviews used the culturally appropriate Talanoa storytelling approach. Results Six key themes were identified from the interviews and were used to develop example indicators related to: spiritual and socio-cultural dimensions, place, access to culturally responsive services, economic and material dimensions and political dimensions. The results demonstrate health inequities experienced by Pasifika populations are strongly linked to place and their economic, social and cultural position. Conclusions This study emphasises the need to understand the multiplicity of place-based factors that interact in complex ways to shape health inequities for young Pasifika peoples. It highlights health equity indicators must go beyond healthcare services, outcomes and a limited number of objective determinants, to include a more holistic focus. Starting to measure health and wellbeing via the lens of the social determinants of health will help to identify where policy-makers and programmes can intervene to begin to more adequately address inequities.
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Affiliation(s)
- Jo Durham
- University of Queensland, Brisbane, Australia.
| | | | | | | | - Eden Malama
- University of Queensland, Brisbane, Australia
| | - Sarai Tafa
- University of Queensland, Brisbane, Australia
| | | | - Jori Etuale
- University of Queensland, Brisbane, Australia
| | | | - Ueta Utai
- University of Queensland, Brisbane, Australia
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26
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Makadzange K, Radebe Z, Maseko N, Lukhele V, Masuku S, Fakudze G, Mengestu TK, Prasad A. Implementation of Urban Health Equity Assessment and Response Tool: a Case of Matsapha, Swaziland. J Urban Health 2018; 95:672-681. [PMID: 29616450 PMCID: PMC6181813 DOI: 10.1007/s11524-018-0241-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Equity in health implies that ideally everyone could attain their full health potential and that no one should be disadvantaged from achieving this potential because of their social position or other socially determined circumstances. Making cities and human settlements inclusive, safe, resilient and sustainable contributes towards ensuring healthy lives and promoting well-being for all at all ages in dignity, equality and in a healthy environment. This paper illustrates a case of applying the Urban Health Equity Assessment and Response Tool (Urban HEART) in a small town in Africa. It describes the process followed, facilitating factors and challenges faced. A descriptive single-case study design using qualitative research methods was adopted to collect data from purposively selected respondents. The study revealed that residents of the Matsapha peri-urban informal settlements faced challenges with conditions of daily living which impacted negatively on their health. There were health equity gaps. The application of the tools was facilitated by the formation of an all-inclusive team, intersectoral collaboration and incorporating strategies for improving urban health equity into existing programmes and projects. Urban HEART is a simple and easy to use valuable tool for pursuing the goal of health equity towards attaining sustainable development through evidence-based approaches for intersectoral action and community involvement.
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Affiliation(s)
- Kevin Makadzange
- World Health Organization, 2nd Floor Lilunga House, P.O. Box 903, Mbabane, Swaziland.
| | | | | | | | | | | | | | - Amit Prasad
- World Health Organization, Geneva, Switzerland
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Van Vliet-Brown CE, Shahram S, Oelke ND. Health in All Policies utilization by municipal governments: scoping review. Health Promot Int 2018; 33:713-722. [PMID: 28334905 DOI: 10.1093/heapro/dax008] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2025] Open
Abstract
The aim of this scoping review was to examine the utilization of a Health in All Policies (HiAP) approach in municipal government settings. Specific objectives included: to review peer reviewed and grey literature, to identify common themes from the literature, and to highlight gaps in the evidence base for HiAP. An iterative scoping review method was used. Documents were identified through searches of academic databases, reference lists and journal indices, and the World Wide Web. Included documents focused on HiAP in the local or municipal government context, published in English, between 2006 and 2015. Data were extracted and analyzed using descriptive statistics and a narrative thematic method. As of June 2015, 26 documents met the inclusion criteria. A lack of research studies examining HiAP in the municipal government context was identified. Three broad themes were abstracted from analysis of the documents: the conceptualization of HiAP, the adoption of HiAP, and the implementation of HiAP. The focus on a HiAP approach at the municipal level of government is growing. A majority of the existing documents provide narrative evidence and recommendations for implementing a HiAP approach at the municipal level. Research is needed in the areas of conceptualization, implementation, adoption and evaluation of a HiAP approach in municipal settings.
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Affiliation(s)
- Cheryl E Van Vliet-Brown
- Faculty of Health and Social Development, School of Nursing, University of British Columbia - Okanagan, ART360, 3333 University Way, Kelowna, BC, Canada
| | - Sana Shahram
- Centre for Addictions Research of British Columbia, STN CSC, Victoria, BC, Canada
| | - Nelly D Oelke
- Faculty of Health and Social Development, School of Nursing, University of British Columbia - Okanagan, ART360, 3333 University Way, Kelowna, BC, Canada
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28
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Buse CG, Lai V, Cornish K, Parkes MW. Towards environmental health equity in health impact assessment: innovations and opportunities. Int J Public Health 2018; 64:15-26. [PMID: 29911285 DOI: 10.1007/s00038-018-1135-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 06/05/2018] [Accepted: 06/07/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES As global environmental change drives inequitable health outcomes, novel health equity assessment methodologies are increasingly required. We review literatures on equity-focused HIA to clarify how equity is informing HIA practice, and to surface innovations for assessing health equity in relation to a range of exposures across geographic and temporal scales. METHODS A narrative review of the health equity and HIA literatures analysed English articles published between 2003 and 2017 across PubMed, PubMed Central, Biomed Central and Ovid Medline. Title and abstract reviews of 849 search results yielded 89 articles receiving full text review. RESULTS Considerations of equity in HIA increased over the last 5 years, but equity continues to be conflated with health disparities rather than their root causes (i.e. inequities). Lessons from six literatures to inform future HIA practice are described: HIA for healthy cities, climate change vulnerability assessment, cumulative health risk assessment, intersectionality-based policy analysis, corporate health impact assessment and global health impact assessment. CONCLUSIONS Academic reporting on incorporating equity in HIA practice has been limited. Nonetheless, significant methodological advancements are being made to examine the health equity implications of multiple environmental exposures.
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Affiliation(s)
- Chris G Buse
- School of Health Sciences, University of Northern British Columbia, Prince George, BC, Canada.
| | - Valerie Lai
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Katie Cornish
- School of Health Sciences, University of Northern British Columbia, Prince George, BC, Canada
| | - Margot W Parkes
- School of Health Sciences, University of Northern British Columbia, Prince George, BC, Canada
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Guglielmin M, Muntaner C, O'Campo P, Shankardass K. A scoping review of the implementation of health in all policies at the local level. Health Policy 2018; 122:284-292. [PMID: 29305241 DOI: 10.1016/j.healthpol.2017.12.005] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 11/29/2017] [Accepted: 12/12/2017] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Health in All Policies (HiAP) is an approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies, and avoids harmful health impacts in order to improve population health and health equity. HiAP implementation can involve engagement from multiple levels of government; however, factors contributing or hindering HiAP implementation at the local level are largely unexplored. Local is defined as the city or municipal level, wherein government is uniquely positioned to provide leadership for health and where many social determinants of health operate. This paper presents the results of a scoping review on local HiAP implementation. METHODS Peer reviewed articles and grey literature were systematically searched using the Arksey and O'Malley framework. Characteristics of articles were then categorized, tallied and described. RESULTS 23 scholarly articles and four government documents were identified, ranging in publication year from 2002 to 2016 and originating from 14 countries primarily from North America and Europe. A wide range of themes emerged relating to HiAP implementation locally including: funding, shared vision, national leadership, ownership and accountability, local leadership and dedicated staff, Health Impact Assessment, and indicators. CONCLUSION Common themes were found in the literature regarding HiAP implementation locally. However, to better clarify these factors to contribute to theory development on HiAP implementation, further research is needed that specifically investigates the facilitators and barriers of HiAP locally within their political and policy context.
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Affiliation(s)
- Maria Guglielmin
- Bloomberg School of Nursing University of Toronto, Toronto, Ontario, Canada.
| | - Carles Muntaner
- Bloomberg School of Nursing University of Toronto, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Patricia O'Campo
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada
| | - Ketan Shankardass
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada; Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada
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30
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Corburn J, Sverdlik A. Slum Upgrading and Health Equity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E342. [PMID: 28338613 PMCID: PMC5409543 DOI: 10.3390/ijerph14040342] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 03/15/2017] [Accepted: 03/17/2017] [Indexed: 11/16/2022]
Abstract
Informal settlement upgrading is widely recognized for enhancing shelter and promoting economic development, yet its potential to improve health equity is usually overlooked. Almost one in seven people on the planet are expected to reside in urban informal settlements, or slums, by 2030. Slum upgrading is the process of delivering place-based environmental and social improvements to the urban poor, including land tenure, housing, infrastructure, employment, health services and political and social inclusion. The processes and products of slum upgrading can address multiple environmental determinants of health. This paper reviewed urban slum upgrading evaluations from cities across Asia, Africa and Latin America and found that few captured the multiple health benefits of upgrading. With the Sustainable Development Goals (SDGs) focused on improving well-being for billions of city-dwellers, slum upgrading should be viewed as a key strategy to promote health, equitable development and reduce climate change vulnerabilities. We conclude with suggestions for how slum upgrading might more explicitly capture its health benefits, such as through the use of health impact assessment (HIA) and adopting an urban health in all policies (HiAP) framework. Urban slum upgrading must be more explicitly designed, implemented and evaluated to capture its multiple global environmental health benefits.
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Affiliation(s)
- Jason Corburn
- Department of City and Regional Planning & School of Public Health, University of California, Berkeley, CA 94720, USA.
| | - Alice Sverdlik
- Department of City and Regional Planning & School of Public Health, University of California, Berkeley, CA 94720, USA.
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31
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Urban Place and Health Equity: Critical Issues and Practices. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14020117. [PMID: 28134756 PMCID: PMC5334671 DOI: 10.3390/ijerph14020117] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 01/17/2017] [Accepted: 01/19/2017] [Indexed: 11/23/2022]
Abstract
Urban places and health equity are two of the most challenging concepts for 21st century environmental health. More people live in cities than at any other time in human history and health inequities are increasing. Health inequities are avoidable differences in the social, environmental and political conditions that shape morbidity and mortality, and disproportionately burden the poor, racial, ethnic and religious minorities and migrants. By linking urban place and health inequities, research and action brings into sharp relief the challenges of achieving urban environmental justice. This article briefly reviews the complex definitions of urban places and how they can shape health equity in cities. I suggest that a more relational or integrated approach to defining urban places and acting on health equity can complement other approaches and improve the ability of public health to meet 21st century challenges. I close with suggestions for research and practice that might focus environmental public health on healthy urban place making. The practices include community driven map making, Health in All Policies (HiAP), promoting urban ecosystem services for health, and participatory and integrated approaches to urban slum upgrading. I conclude that if the global community is serious about the sustainable development goals (SDGs), greater attention must be paid to understanding and acting to improve urban places, living conditions and the social and economic conditions that can promote health equity.
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32
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Newell B, Siri J. A role for low-order system dynamics models in urban health policy making. ENVIRONMENT INTERNATIONAL 2016; 95:93-97. [PMID: 27553880 DOI: 10.1016/j.envint.2016.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 07/22/2016] [Accepted: 08/12/2016] [Indexed: 06/06/2023]
Abstract
Cities are complex adaptive systems whose responses to policy initiatives emerge from feedback interactions between their parts. Urban policy makers must routinely deal with both detail and dynamic complexity, coupled with high levels of diversity, uncertainty and contingency. In such circumstances, it is difficult to generate reliable predictions of health-policy outcomes. In this paper we explore the potential for low-order system dynamics (LOSD) models to make a contribution towards meeting this challenge. By definition, LOSD models have few state variables (≤5), illustrate the non-linear effects caused by feedback and accumulation, and focus on endogenous dynamics generated within well-defined boundaries. We suggest that experience with LOSD models can help practitioners to develop an understanding of basic principles of system dynamics, giving them the ability to 'see with new eyes'. Because efforts to build a set of LOSD models can help a transdisciplinary group to develop a shared, coherent view of the problems that they seek to tackle, such models can also become the foundations of 'powerful ideas'. Powerful ideas are conceptual metaphors that provide the members of a policy-making group with the a priori shared context required for effective communication, the co-production of knowledge, and the collaborative development of effective public health policies.
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Affiliation(s)
- Barry Newell
- Fenner School of Environment and Society, The Australian National University, Acton, ACT 2601, Australia; International Institute of Global Health, United Nations University, UKM Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000, Cheras, Federal Territory of Kuala Lumpur, Malaysia.
| | - José Siri
- International Institute of Global Health, United Nations University, UKM Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000, Cheras, Federal Territory of Kuala Lumpur, Malaysia.
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33
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Weiss D, Lillefjell M, Magnus E. Facilitators for the development and implementation of health promoting policy and programs - a scoping review at the local community level. BMC Public Health 2016; 16:140. [PMID: 26869177 PMCID: PMC4751684 DOI: 10.1186/s12889-016-2811-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 02/02/2016] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Health promotion, with a focus on multidimensional upstream factors and an ecological, life-course approach, is establishing itself as the guiding philosophy for addressing public health. Action at the political and programmatic level on the Social Determinants of Health has proven effective for promoting and building public health at all levels but has been particularly evident at the national and international levels - due in large part to available documents and guidelines. Although research and experience establish that health promotion is most effective when settings-based, the development of health promoting policies and programs at the local level is still difficult. This study intended to investigate available knowledge on the development and implementation of health promoting policies and programs at the local level and identify factors most important for facilitating capacity building and outcome achievement. METHODS We used a scoping review in order to review the current literature on local policy development and program implementation. Keywords were chosen based on results of a previous literature review. A total of 53 articles were divided into two categories: policy and implementation. Critical analysis was conducted for each article and a summary assembled. Data was charted with specific focus on the aims of the study, data acquisition, key theories/concepts/frameworks used, outcome measures, results, and conclusions. RESULTS The articles included in this study primarily focused on discussing factors that facilitate the development of health promoting policy and the implementation of health promotion programs. Most significant facilitators included: collaborative decision-making, agreement of objectives and goals, local planning and action, effective leadership, building and maintaining trust, availability of resources, a dynamic approach, a realistic time-frame, and trained and knowledgeable staff. Within each of these important facilitating factors, various elements supporting implementation were discussed and highlighted in this study. CONCLUSION Our results indicate that clear and consistent facilitators exist for supporting health promoting policy development and program implementation at the local level. These results offer a starting point for local action on the Social Determinants of Health and have the potential to contribute to the development of a framework for improving action at the local level.
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Affiliation(s)
- Daniel Weiss
- Department of Occupational Therapy, Norwegian University of Science and Technology, Faculty of Health and Social Science, NO-7491, Trondheim, Norway.
| | - Monica Lillefjell
- Department of Occupational Therapy, Norwegian University of Science and Technology, Faculty of Health and Social Science, NO-7491, Trondheim, Norway.
| | - Eva Magnus
- Department of Occupational Therapy, Norwegian University of Science and Technology, Faculty of Health and Social Science, NO-7491, Trondheim, Norway.
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Prasad A, Gray CB, Ross A, Kano M. Metrics in Urban Health: Current Developments and Future Prospects. Annu Rev Public Health 2016; 37:113-33. [PMID: 26789382 DOI: 10.1146/annurev-publhealth-032315-021749] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The research community has shown increasing interest in developing and using metrics to determine the relationships between urban living and health. In particular, we have seen a recent exponential increase in efforts aiming to investigate and apply metrics for urban health, especially the health impacts of the social and built environments as well as air pollution. A greater recognition of the need to investigate the impacts and trends of health inequities is also evident through more recent literature. Data availability and accuracy have improved through new affordable technologies for mapping, geographic information systems (GIS), and remote sensing. However, less research has been conducted in low- and middle-income countries where quality data are not always available, and capacity for analyzing available data may be limited. For this increased interest in research and development of metrics to be meaningful, the best available evidence must be accessible to decision makers to improve health impacts through urban policies.
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Affiliation(s)
- Amit Prasad
- Center for Health Development, World Health Organization (WHO), Chuo-ku, Kobe 651-0073, Japan; , , ,
| | - Chelsea Bettina Gray
- Center for Health Development, World Health Organization (WHO), Chuo-ku, Kobe 651-0073, Japan; , , ,
| | - Alex Ross
- Center for Health Development, World Health Organization (WHO), Chuo-ku, Kobe 651-0073, Japan; , , ,
| | - Megumi Kano
- Center for Health Development, World Health Organization (WHO), Chuo-ku, Kobe 651-0073, Japan; , , ,
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35
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Katz AS, Cheff RM, O'Campo P. Bringing stakeholders together for urban health equity: hallmarks of a compromised process. Int J Equity Health 2015; 14:138. [PMID: 26590020 PMCID: PMC4654839 DOI: 10.1186/s12939-015-0252-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 10/20/2015] [Indexed: 12/02/2022] Open
Abstract
There is a global trend towards the use of ad hoc participation processes that seek to engage grassroots stakeholders in decisions related to municipal infrastructure, land use and services. We present the results of a scholarly literature review examining 14 articles detailing specific cases of these processes to contribute to the discussion regarding their utility in advancing health equity. We explore hallmarks of compromised processes, potential harms to grassroots stakeholders, and potential mitigating factors. We conclude that participation processes often cut off participation following the planning phase at the point of implementation, limiting convener accountability to grassroots stakeholders, and, further, that where participation processes yield gains, these are often due to independent grassroots action. Given the emphasis on participation in health equity discourse, this study seeks to provide a real world exploration of the pitfalls and potential harms of participation processes that is relevant to health equity theory and practice.
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Affiliation(s)
- Amy S Katz
- Centre for Research on Inner City Health, St. Michael's Hospital, 30 Bond Street, M5B 1W8, Toronto, ON, Canada.
| | - Rebecca M Cheff
- Centre for Research on Inner City Health, St. Michael's Hospital, 30 Bond Street, M5B 1W8, Toronto, ON, Canada.
| | - Patricia O'Campo
- Centre for Research on Inner City Health, St. Michael's Hospital, 30 Bond Street, M5B 1W8, Toronto, ON, Canada. O'
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