Articlegreen2013

Response-oriented measuring inequalities in Tehran: second round of UrbanHealth Equity Assessment and Response Tool (Urban HEART-2), concepts and framework.

Mohsen Asadi-Lari · Mohammad Reza Vaez Mahdavi · Soghrat Faghihzadeh · Bahman Cherghian · Alireza Esteghamati · Ali Asghar Farshad +13 more

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Public Health and Social Inequalities Public Health Policies and Education Health disparities and outcomes

Abstract

BACKGROUND: Current evidence consistently confirm inequalities in health status among socioeconomic none, gender,ethnicity, geographical area and other social determinants of health (SDH), which adversely influence health ofthe population. SDH refer to a wide range of factors not limited to social component, but also involve economic, cultural,educational, political or environmental problems. Measuring inequalities, improving daily living conditions, andtackling inequitable distribution of resources are highly recommended by international SDH commissioners in recentyears to 'close the gaps within a generation'. To measure inequalities in socio-economic determinants and core healthindicators in Tehran, the second round of Urban Health Equity Assessment and Response Tool (Urban HEART-2)was conducted in November 2011, within the main framework of WHO Centre for Health Development (Kobe Centre). METHOD: For 'assessment' part of the project, 65 indicators in six policy domains namely 'physical and infrastructure','human and social', 'economic', 'governance', 'health and nutrition', and also 'cultural' domain were targetedeither through a population based survey or using routine system. Survey was conducted in a multistage random sampling,disaggregated to 22 districts and 368 neighborhoods of Tehran, where data of almost 35000 households(118000 individuals) were collected. For 'response' part of the project, widespread community based development(CBD) projects were organized in all 368 neighborhoods, which are being undertaken throughout 2013. CONCLUSION: Following the first round of Urban HEART project in 2008, the second round was conducted to trackchanges over time, to institutionalize inequality assessment within the local government, to build up community participationin 'assessment' and 'response' parts of the project, and to implement appropriate and evidence-based actionsto reduce health inequalities within all neighborhoods of Tehran.

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References

2008Closing the gap in a generation: health equity through action on the social determinants of health 1991Health inequalities among British civil servants: the Whitehall II study 1992The Concepts and Principles of Equity and Health 2003Defining equity in health 2011Health Disparities and Health Equity: The Issue Is Justice 2002A glossary for health inequalities 2009Closing the gap in a generation: health equity through action on the social determinants of health. A report of the WHO Commission on Social Determinants of Health (CSDH) 2008.2003Mental health survey of the adult population in Iran

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