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Population Health Inequalities Across and Within European Metropolitan Areas through the Lens of the EURO-HEALTHY Population Health Index

Author

Listed:
  • Claudia Costa

    (Centre of Studies in Geography and Spatial Planning, University of Coimbra, 3004-530 Coimbra, Portugal)

  • Paula Santana

    (Centre of Studies in Geography and Spatial Planning, University of Coimbra, 3004-530 Coimbra, Portugal
    Department of Geography and Tourism, University of Coimbra, 3004-530 Coimbra, Portugal)

  • Sani Dimitroulopoulou

    (Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton OX11 0RQ, Oxon, UK)

  • Bo Burstrom

    (Karolinska Institutet, Department of Public Health Sciences, Division of Social Medicine, 171 77 Stockholm, Sweden)

  • Carme Borrell

    (Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain
    CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
    Institut d’Investigació Biomèdica (IIB Sant Pau), 08041 Barcelona, Spain
    Universitat Pompeu Fabra, 08002 Barcelona, Spain)

  • Jürgen Schweikart

    (Department of Civil Engineering and Geoinformation, Beuth University of Applied Sciences Berlin, 13437 Berlin, Germany)

  • Dagmar Dzurova

    (Department of Social Geography and Regional Development, Faculty of Science, Charles University, 128 43 Prague, Czech Republic)

  • Nicolás Zangarini

    (Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy)

  • Klea Katsouyanni

    (Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, 115 27 Athens, Greece)

  • Patrick Deboseree

    (Interface Demography, University of Brussels, 1050 Brussels, Belgium)

  • Ângela Freitas

    (Centre of Studies in Geography and Spatial Planning, University of Coimbra, 3004-530 Coimbra, Portugal)

  • Christina Mitsakou

    (Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton OX11 0RQ, Oxon, UK)

  • Evangelia Samoli

    (Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, 115 27 Athens, Greece)

  • Sotiris Vardoulakis

    (Institute of Occupational Medicine, Edinburgh EH14 4AP, UK)

  • Marc Marí Dell’Olmo

    (Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain
    CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
    Institut d’Investigació Biomèdica (IIB Sant Pau), 08041 Barcelona, Spain)

  • Mercè Gotsens

    (Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain
    CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
    Institut d’Investigació Biomèdica (IIB Sant Pau), 08041 Barcelona, Spain
    Universitat Pompeu Fabra, 08002 Barcelona, Spain)

  • Michala Lustigova

    (Department of Social Geography and Regional Development, Faculty of Science, Charles University, 128 43 Prague, Czech Republic)

  • Diana Corman

    (The National Board of Health and Welfare, 106 30 Stockholm, Sweden)

  • Giuseppe Costa

    (Medical School of the University of Turin, University of Turin, 10124 Turin, Italy)

Abstract

The different geographical contexts seen in European metropolitan areas are reflected in the uneven distribution of health risk factors for the population. Accumulating evidence on multiple health determinants point to the importance of individual, social, economic, physical and built environment features, which can be shaped by the local authorities. The complexity of measuring health, which at the same time underscores the level of intra-urban inequalities, calls for integrated and multidimensional approaches. The aim of this study is to analyse inequalities in health determinants and health outcomes across and within nine metropolitan areas: Athens, Barcelona, Berlin-Brandenburg, Brussels, Lisbon, London, Prague, Stockholm and Turin. We use the EURO-HEALTHY Population Health Index (PHI), a tool that measures health in two components: Health Determinants and Health Outcomes. The application of this tool revealed important inequalities between metropolitan areas: Better scores were found in Northern cities when compared with their Southern and Eastern counterparts in both components. The analysis of geographical patterns within metropolitan areas showed that there are intra-urban inequalities, and, in most cities, they appear to form spatial clusters. Identifying which urban areas are measurably worse off, in either Health Determinants or Health Outcomes, or both, provides a basis for redirecting local action and for ongoing comparisons with other metropolitan areas.

Suggested Citation

  • Claudia Costa & Paula Santana & Sani Dimitroulopoulou & Bo Burstrom & Carme Borrell & Jürgen Schweikart & Dagmar Dzurova & Nicolás Zangarini & Klea Katsouyanni & Patrick Deboseree & Ângela Freitas & C, 2019. "Population Health Inequalities Across and Within European Metropolitan Areas through the Lens of the EURO-HEALTHY Population Health Index," IJERPH, MDPI, vol. 16(5), pages 1-17, March.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:5:p:836-:d:211990
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    References listed on IDEAS

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    1. Jason Corburn, 2017. "Urban Place and Health Equity: Critical Issues and Practices," IJERPH, MDPI, vol. 14(2), pages 1-10, January.
    2. Diez Roux, A.V., 2001. "Investigating neighborhood and area effects on health," American Journal of Public Health, American Public Health Association, vol. 91(11), pages 1783-1789.
    3. Jason Corburn & Alison K Cohen, 2012. "Why We Need Urban Health Equity Indicators: Integrating Science, Policy, and Community," PLOS Medicine, Public Library of Science, vol. 9(8), pages 1-6, August.
    4. Christine Stauber & Ellis A. Adams & Richard Rothenberg & Dajun Dai & Ruiyan Luo & Scott R. Weaver & Amit Prasad & Megumi Kano & John Heath, 2018. "Measuring the Impact of Environment on the Health of Large Cities," IJERPH, MDPI, vol. 15(6), pages 1-14, June.
    5. Tallarek née Grimm, Marie J. & Helgesen, Marit K. & Fosse, Elisabeth, 2013. "Reducing social inequities in health in Norway: Concerted action at state and local levels?," Health Policy, Elsevier, vol. 113(3), pages 228-235.
    6. Cummins, Steven & Curtis, Sarah & Diez-Roux, Ana V. & Macintyre, Sally, 2007. "Understanding and representing 'place' in health research: A relational approach," Social Science & Medicine, Elsevier, vol. 65(9), pages 1825-1838, November.
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    Cited by:

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    2. María Jesús Rodríguez-García & Clemente J. Navarro-Yáñez & Ángel R. Zapata-Moya, 2022. "Local Welfare Systems and Health Inequalities: The Effects of Institutional Overlapping and Local Variations," IJERPH, MDPI, vol. 19(23), pages 1-16, November.
    3. Jinling Sui & Guoqin Zhang & Tao Lin & Nicholas A. S. Hamm & Chunlin Li & Xian Wu & Kaiqun Hu, 2023. "Quantitative Evaluation of Spatial Accessibility of Various Urban Medical Services Based on Big Data of Outpatient Appointments," IJERPH, MDPI, vol. 20(6), pages 1-18, March.

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