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BMJ Open. 2014 May 28;4(5):e004454. doi: 10.1136/bmjopen-2013-004454.

Health inequalities in European cities: perceptions and beliefs among local policymakers.

Author information

1
Department of Epidemiology and Public Health, University College London, London, UK CIBER de Epidemiología y Salud Pública (CIBERESP), Spain Agència de Salut Pública de Barcelona, Barcelona, Spain.
2
Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain Universitat de Girona, Girona, Spain.
3
School of Social Sciences, University of Manchester, Manchester, UK.
4
Karolinska Institutet, Stockholm, Sweden.
5
Subdirección General de Promoción de la Salud y Prevención. Consejería de Sanidad. Comunidad de Madrid (Subdirectorate-General for Health Promotion and Prevention. Madrid Regional Health Authority), Spain.
6
CIBER de Epidemiología y Salud Pública (CIBERESP), Spain Agència de Salut Pública de Barcelona, Barcelona, Spain.
7
Department of Clinical and Biological Science, University of Turin, Turin, Italy.
8
Department of Epidemiology and Public Health, University College London, London, UK.
9
Epidemiology Department, Local Health Unit TO3, Turin, Italy Ministry of Health, Italy, Rome, Italy.
10
Erasmus Medical Centre, Rotterdam, The Netherlands.
11
Centro de Estudos de Geografia e Ordenamento do Território (CEGOT), Departamento de Geografia, Universidade de Coimbra, Coimbra , Portugal.
12
CIBER de Epidemiología y Salud Pública (CIBERESP), Spain Agència de Salut Pública de Barcelona, Barcelona, Spain Universitat Pompeu Fabra, Barcelona, Spain.

Abstract

OBJECTIVE:

To describe the knowledge and beliefs of public policymakers on social inequalities in health and policies to reduce them in cities from different parts of Europe during 2010 and 2011.

DESIGN:

Phenomenological qualitative study.

SETTING:

13 European cities.

PARTICIPANTS:

19 elected politicians and officers with a directive status from 13 European cities.

MAIN OUTCOME:

Policymaker's knowledge and beliefs.

RESULTS:

Three emerging discourses were identified among the interviewees, depending on the city of the interviewee. Health inequalities were perceived by most policymakers as differences in life-expectancy between population with economic, social and geographical differences. Reducing health inequalities was a priority for the majority of cities which use surveys as sources of information to analyse these. Bureaucracy, funding and population beliefs were the main barriers.

CONCLUSIONS:

The majority of the interviewed policymakers gave an account of interventions focusing on the immediate determinants and aimed at modifying lifestyles and behaviours in the more disadvantaged classes. More funding should be put towards academic research on effective universal policies, evaluation of their impact and training policymakers and officers on health inequalities in city governments.

KEYWORDS:

Health Inequalities; Knowledge; Municipal Government; Policymaker; Public Policies; Qualitative Research

PMID:
24871536
PMCID:
PMC4039864
DOI:
10.1136/bmjopen-2013-004454
[Indexed for MEDLINE]
Free PMC Article

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