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Daban F, Pasarín MI, Borrell C, Artazcoz L, Pérez A, Fernández A, Porthé V, Díez E. Barcelona Salut als Barris: Twelve years' experience of tackling social health inequalities through community-based interventions. GACETA SANITARIA 2020; 35:282-288. [PMID: 32527681 DOI: 10.1016/j.gaceta.2020.02.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 02/06/2020] [Accepted: 02/07/2020] [Indexed: 10/24/2022]
Abstract
Community health can reduce inequalities in health and improve the health of the most disadvantaged populations. In 2007, Barcelona Salut als Barris (Barcelona Health in the Neighbourhoods) was launched, a community health programme to reduce social inequalities in health. In 2018, this programme reached the 25 most disadvantaged neighbourhoods of the city. This article shares the lessons learned after 12 years of work. The programme was initially funded by a research grant and the funds were maintained during the economic crisis and were tripled when the programme became a political priority in the last municipal government. During the 12-year period, partnerships with stakeholders were generally stable and productive. Maximum community participation was obtained in the detection of health assets and needs and in action plans. During 2018, Barcelona Salut als Barris worked with more than 460 agents that co-produced 183 interventions involving more than 13,600 people. Most of the interventions assessed showed improvements in the health of participants, which could help to reduce health inequalities. The greatest difficulties were: a) citizen participation, b) the sustainability of working groups over the years, c) conflicts of interest, d) the sustainability of interventions, e) reaching certain minority groups and f) evaluation. The increase in resources in the last period contributed to the maturity and expansion of the programme. Key factors in its scope and results were political will, strong technical capacity and methodology, strong intersectoral partnerships and continued community work.
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Affiliation(s)
- Ferran Daban
- Agència de Salut Pública de Barcelona, Barcelona, Spain; Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain.
| | - M Isabel Pasarín
- Agència de Salut Pública de Barcelona, Barcelona, Spain; Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Carme Borrell
- Agència de Salut Pública de Barcelona, Barcelona, Spain; Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Lucía Artazcoz
- Agència de Salut Pública de Barcelona, Barcelona, Spain; Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Anna Pérez
- Agència de Salut Pública de Barcelona, Barcelona, Spain; Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain
| | - Ana Fernández
- Agència de Salut Pública de Barcelona, Barcelona, Spain; Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Victoria Porthé
- Agència de Salut Pública de Barcelona, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Elia Díez
- Agència de Salut Pública de Barcelona, Barcelona, Spain; Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
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Borrell C, Pasarín MI, Díez E, Pérez K, Malmusi D, Pérez G, Artazcoz L. [Health inequalities as a political priority in Barcelona]. GACETA SANITARIA 2019; 34:69-76. [PMID: 31288951 DOI: 10.1016/j.gaceta.2019.04.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 04/11/2019] [Accepted: 04/12/2019] [Indexed: 10/26/2022]
Abstract
There is a wealth of information and research on health inequalities in Barcelona, but this issue has not been clearly prioritised on the political agenda. The arrival in government of a new left-wing party (Barcelona en Comú) in 2015, gave an important boost to the political agenda to reduce inequalities and health inequalities. The aim of this review is to describe the progress made in relation to health inequalities in these four years and especially in the areas involving public health. With respect to evidence and communication on health inequalities, the progress made is presented in the Barcelona annual health report and the creation of the Observatory on Health, Inequalities and Impacts of Municipal Policies. The policies presented refer to different municipal strategies, the Health Plan, the promotion of the Barcelona Health in the Neighbourhoods programme and the Plan for Tackling Inequalities in the Barcelona Public Health Agency. The combination of political will, technical capacity and the drive of citizens have facilitated progress in the city of Barcelona in policies to reduce social inequalities in health.
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Affiliation(s)
- Carme Borrell
- Agència de Salut Pública de Barcelona, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, España; Departamento de Ciencias Experimentales y de la Salud, Universitat Pompeu Fabra, Barcelona, España.
| | - M Isabel Pasarín
- Agència de Salut Pública de Barcelona, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, España; Departamento de Ciencias Experimentales y de la Salud, Universitat Pompeu Fabra, Barcelona, España
| | - Elia Díez
- Agència de Salut Pública de Barcelona, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, España; Departamento de Ciencias Experimentales y de la Salud, Universitat Pompeu Fabra, Barcelona, España
| | - Katherine Pérez
- Agència de Salut Pública de Barcelona, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, España
| | - Davide Malmusi
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, España; Direcció de Serveis de Salut, Ajuntament de Barcelona, Barcelona, España
| | - Glòria Pérez
- Agència de Salut Pública de Barcelona, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, España; Departamento de Ciencias Experimentales y de la Salud, Universitat Pompeu Fabra, Barcelona, España
| | - Lucía Artazcoz
- Agència de Salut Pública de Barcelona, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, España; Departamento de Ciencias Experimentales y de la Salud, Universitat Pompeu Fabra, Barcelona, España
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