Population Health Inequalities Across and Within European Metropolitan Areas through the Lens of the EURO-HEALTHY Population Health Index
Open Access
- 7 March 2019
- journal article
- research article
- Published by MDPI AG in International Journal of Environmental Research and Public Health
- Vol. 16 (5), 836
- https://doi.org/10.3390/ijerph16050836
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.This publication has 50 references indexed in Scilit:
- Urban Health Challenges in EuropeJournal of Urban Health, 2012
- Why We Need Urban Health Equity Indicators: Integrating Science, Policy, and CommunityPLoS Medicine, 2012
- Tackling the wider social determinants of health and health inequalities: evidence from systematic reviewsJournal of Epidemiology and Community Health, 2009
- Urban health in developing countries: What do we know and where do we go?Health & Place, 2009
- Closing the gap in a generation: health equity through action on the social determinants of healthThe Lancet, 2008
- Neighbourhood socioeconomic status and cardiovascular risk factors: a multilevel analysis of nine cities in the Czech Republic and GermanyBMC Public Health, 2007
- Urban and rural variations in morbidity and mortality in Northern IrelandBMC Public Health, 2007
- Social Determinants of the Health of Urban Populations: Methodologic ConsiderationsJournal of Urban Health, 2007
- Deprivation Indices, Population Health and Geography: An Evaluation of the Spatial Effectiveness of Indices at Multiple ScalesJournal of Urban Health, 2007
- Urban as a Determinant of HealthJournal of Urban Health, 2007