Factors and processes influencing health inequalities in urban areas

Carme Borrell · Mariona Pons‐Vigués · Joana Morrison · Èlia Díez

124 citations0/0 files storedJournal of Epidemiology & Community Health

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Health disparities and outcomes Urban Transport and Accessibility Public Health and Social Inequalities

Abstract

In 2010, half of the world's population lived in cities, reaching three quarters in Europe.1 ,2 Health inequalities tend to be more marked in urban areas because they include neighbourhoods which concentrate deprived and poor populations. A number of scholars with a long tradition in studying ‘place effects and health’,3 ,4 ‘neighbourhoods and health’5 ,6 and ‘urban areas and health’2 ,7–13 have conceptualised the determinants of health inequalities in neighbourhoods and/or urban areas. All of them have stated the importance of aspects related to the physical environment, mainly the built environment,12 and also to the socioeconomic environment. Based on these backgrounds, this editorial presents a conceptual framework of the factors and processes (determinants) influencing health inequalities in European urban areas (figure 1), which are also determinants of health behaviours, under the responsibility of municipal governments and citizens. National or international wider factors described by other authors have not been included,10 ,11 although the model may also be used for municipalities smaller than urban areas. We propose this framework as a helpful tool to analyse local policies to address inequalities in health as well as to place health equity in the political agenda of European cities. Compared with other frameworks based on urban areas, it focuses mainly on European cities, not highlighting aspects that may be more relevant for cities from other continents.2 Moreover, it includes aspects not taken into account in other approaches. The framework has been designed within the ‘Socioeconomic inequalities in mortality: evidence and policies in cities of Europe’ project (INEQ-CITIES, https://www.ucl.ac.uk/ineqcities/), funded by the European Union, which aims to analyse the different patterns of small-area health inequalities and to describe policies to reduce them in European cities. The paragraphs below detail the main sections of …

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References

2010Neighborhoods and health 2002Place effects on health: how can we conceptualise, operationalise and measure them?2007Understanding and representing ‘place’ in health research: A relational approach 2012Shaping cities for health: complexity and the planning of urban environments in the 21st century 2003Urban environmental quality and human well-being 2003Sorting Out the Connections Between the Built Environment and Health: A Conceptual Framework for Navigating Pathways and Planning Healthy Cities 2004Cities and population health 2003Neighborhoods and Health: An Overview

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