The Experience of Implementing Urban HEART Barcelona: a Tool for Action
Por:
Novoa, AM, Perez, G, Espelt, A, Echave, C, de Olalla, PG, Calvo, MJ, Pasarin, M, Diez, E, Borrell, C, Cormenzana, B, Cortes, I, Gomez, J, Pallares, M, Rodriguez-Sanz, M
Publicada:
1 oct 2018
Resumen:
Urban Health Equity Assessment and Response Tool (HEART) is a tool developed by the World Health Organization whose objective is to provide evidence on urban health inequalities so as to help to decide the best interventions aimed to promote urban health equity. The aim of this paper is to describe the experience of implementing Urban HEART in Barcelona city, both the adaptation of Urban HEART to the city of Barcelona, its use as a means of identifying and monitoring health inequalities among city neighbourhoods, and the difficulties and barriers encountered throughout the process. Although ASPB public health technicians participated in the Urban HEART Advisory Group, had large experience in health inequalities analysis and research and showed interest in implementing the tool, it was not until 2015, when the city council was governed by a new left-wing party for which reducing health inequalities was a priority that Urban HEART could be used. A provisional matrix was developed, including both health and health determinant indicators, which allowed to show how some neighbourhoods in the city systematically fare worse for most of the indicators while others systematically fare better. It also allowed to identify 18 neighbourhoods-those which fared worse in most indicators-which were considered a priority for intervention, which entered the Health in the Barcelona Neighbourhoods programme and the Neighbourhoods Plan. This provisional version was reviewed and improved by the Urban HEART Barcelona Working Group. Technicians with experience in public health and/or in indicator and database management were asked to indicate suitability and relevance from a list of potential indicators. The definitive Urban HEART Barcelona version included 15 indicators from the five Urban HEART domains and improved the previous version in several requirements. Several barriers were encountered, such as having to estimate indicators in scarcely populated areas or finding adequate indicators for the physical context domain. In conclusion, the Urban HEART tool allowed to identify urban inequalities in the city of Barcelona and to include health inequalities in the public debate. It also allowed to reinforce the community health programme Health in the Barcelona Neighbourhoods as well as other city programmes aimed at reducing health inequalities. A strong political will is essential to place health inequalities in the political agenda and implement policies to tackle them.
Filiaciones:
Novoa, AM:
Agencia Salut Publ Barcelona, Pl Lesseps 1, Barcelona 08023, Spain
Inst Invest Biomed IIB St Pau, Pl Lesseps 1, Barcelona 08023, Spain
Perez, G:
Agencia Salut Publ Barcelona, Pl Lesseps 1, Barcelona 08023, Spain
Inst Invest Biomed IIB St Pau, Pl Lesseps 1, Barcelona 08023, Spain
Univ Pompeu Fabra, Barcelona, Spain
CIBERESP, Barcelona, Spain
Espelt, A:
Agencia Salut Publ Barcelona, Pl Lesseps 1, Barcelona 08023, Spain
Inst Invest Biomed IIB St Pau, Pl Lesseps 1, Barcelona 08023, Spain
CIBERESP, Barcelona, Spain
UVicUCC, Fac Ciencies Salut Manresa, Ave Univ 46, Manresa 08242, Spain
Echave, C:
Agencia Ecol Urbana, Barcelona, Spain
de Olalla, PG:
Agencia Salut Publ Barcelona, Pl Lesseps 1, Barcelona 08023, Spain
Inst Invest Biomed IIB St Pau, Pl Lesseps 1, Barcelona 08023, Spain
Calvo, MJ:
Ajuntament Barcelona, Gabinet Tecn Programacio, Barcelona, Spain
Pasarin, M:
Agencia Salut Publ Barcelona, Pl Lesseps 1, Barcelona 08023, Spain
Inst Invest Biomed IIB St Pau, Pl Lesseps 1, Barcelona 08023, Spain
Diez, E:
Agencia Salut Publ Barcelona, Pl Lesseps 1, Barcelona 08023, Spain
Inst Invest Biomed IIB St Pau, Pl Lesseps 1, Barcelona 08023, Spain
Borrell, C:
Agencia Salut Publ Barcelona, Pl Lesseps 1, Barcelona 08023, Spain
Inst Invest Biomed IIB St Pau, Pl Lesseps 1, Barcelona 08023, Spain
Univ Pompeu Fabra, Barcelona, Spain
CIBERESP, Barcelona, Spain
Cortes, I:
Agencia Salut Publ Barcelona, Pl Lesseps 1, Barcelona 08023, Spain
Rodriguez-Sanz, M:
Agencia Salut Publ Barcelona, Pl Lesseps 1, Barcelona 08023, Spain
Green Published
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