Population Health Inequalities Across and Within European Metropolitan Areas through the Lens of the EURO-HEALTHY Population Health Index

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.

Download Full-text

The Role of Cohesion Policy Funds in Decreasing the Health Gaps Measured by the EURO-HEALTHY Population Health Index

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17051567 ◽

2020 ◽

Vol 17 (5) ◽

pp. 1567 ◽

Cited By ~ 1

Author(s):

Paula Santana ◽

Ângela Freitas ◽

Cláudia Costa ◽

Iwa Stefanik ◽

Gonçalo Santinha ◽

...

Keyword(s):

Population Health ◽

Health Determinants ◽

Healthy Population ◽

The European Union ◽

Health Index ◽

Cohesion Policy ◽

Eligibility Criteria ◽

Equity In Health ◽

Main Determinants

Social, economic, and environmental differences across the European Union significantly affect opportunities to move forward in achieving greater equity in health. Cohesion Policy (CP) funds can contribute positively through investments in the main determinants of health. The aim of this study is to analyze to what extent the planned investments for 2014–2020 are addressing the regional health gaps, in light of the population health index (PHI), a multidimensional measure developed by the EURO-HEALTHY project. The operational programs of all regions were analyzed, namely, the CP planned investments by field of intervention. Analysis of variance was performed to examine whether the regional scores in the PHI dimensions were statistically different across regions with different levels of development (measured by gross domestic product (GDP)). Results show that 98% of regions with worse performances on the PHI are less developed regions. Overall, all regions present planned investments in intervention fields linked to dimensions appraised within the PHI (e.g., employment, income, education, pollution). Yet, more needs to be done to focus regional investments in health determinants where regions still lag behind. The PHI has the potential to inform future CP restructuring, providing evidence to extend the current eligibility criteria to other dimensions beyond the GDP.

Download Full-text

The Influence of Mobile Health Adoption on Medication Adherence on Population Health

The Roles of Technology and Globalization in Educational Transformation - Advances in Educational Technologies and Instructional Design ◽

10.4018/978-1-5225-9746-9.ch013 ◽

2020 ◽

pp. 166-175

Author(s):

Florence Funmilola Folami

Keyword(s):

Medication Adherence ◽

Health Outcomes ◽

Population Health ◽

Mobile Health ◽

Health Determinants ◽

Diabetic Patients ◽

Private Hospitals

The fields of population health include health outcomes, patterns of health determinants, and policies interventions. Health is a national and international priority and implementation of mHealth can add a new level of solution to current challenges facing healthcare. The goal of this study is to explore the influence of mobile health adoption on medication adherence. A two-month intervention to monitor patients with poorly controlled diabetes was developed by the researcher diabetic patients that attend two private hospitals in western part of Nigeria. The researcher invented a smart pill container that automatically uploaded its data to the cloud. The pillbox helped patients organize their medications while providing patient-facing reminders and provider-centered feedback on medication adherence patterns. Average medication adherence was consistently above 80%, and even briefly hit 90% during one week of the study. The intervention showed an improvement in the medication adherence among the participants.

Download Full-text

Intersectoral Health Human Resource Policy: The Impact on Population Health Outcomes

PsycEXTRA Dataset ◽

10.1037/e509012013-095 ◽

2004 ◽

Author(s):

Jane Underwood ◽

Andrea Baumann ◽

Jennifer Blythe

Keyword(s):

Health Outcomes ◽

Population Health ◽

Human Resource ◽

Health Human Resource ◽

Human Resource Policy ◽

Resource Policy ◽

The Impact

Download Full-text

Behavioural health outcomes in veterans compared to nonveterans by rural and urban areas in Alabama, 2015–2018

Health & Social Care in the Community ◽

10.1111/hsc.13392 ◽

2021 ◽

Author(s):

David L. Albright ◽

Kari L. Fletcher ◽

Kate H. Thomas ◽

Justin T. McDaniel ◽

Kirsten Laha‐Walsh ◽

...

Keyword(s):

Health Outcomes ◽

Urban Areas ◽

Rural And Urban Areas ◽

Behavioural Health ◽

Rural And Urban

Download Full-text

Are Discount Rates Too High? Population Health and Intergenerational Equity

Medical Decision Making ◽

10.1177/0272989x20979816 ◽

2021 ◽

Vol 41 (2) ◽

pp. 245-249

Author(s):

R. Scott Braithwaite ◽

Mark S. Roberts

Keyword(s):

Health Policy ◽

Cost Effectiveness ◽

Decision Theory ◽

Health Outcomes ◽

Societal Perspective ◽

Environmental Damage ◽

Healthy Population ◽

Discount Rates ◽

Policy Decisions ◽

Effectiveness Analysis

Increasing attention is being paid to policy decisions in which shorter-term benefits may be eclipsed by longer-term harms, such as environmental damage. Health policy decisions have largely been spared this scrutiny, even though they too may contribute to longer-term harms. Any healthy population or society must sustain itself through reproduction, and therefore, transgenerational outcomes should be of intrinsic importance from a societal perspective. Yet, the discount rates typically employed in cost-effectiveness analyses have the effect of minimizing the importance of transgenerational health outcomes. We argue that, because cost-effectiveness analysis is based on foundational axioms of decision theory, it should value transgenerational outcomes consistently with those axioms, which require discount rates substantially lower than 3%. We discuss why such lower rates may not violate the Cretin-Keeler paradox.

Download Full-text

The Rural-Urban Continuum of Polarization: Understanding the Geography of the 2018 Midterms

The Forum ◽

10.1515/for-2020-2102 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Kenneth M. Johnson ◽

Dante J. Scala

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Metropolitan Areas ◽

Political Attitudes ◽

The United States ◽

Rural America ◽

Rural Regions ◽

Urban America ◽

Urban And Rural Areas ◽

The Continuum

Abstract This study of the 2018 congressional midterms demonstrates how voting patterns and political attitudes vary across a spectrum of urban and rural areas in the United States. Rural America is no more a monolith than is urban America. The rural-urban gradient is better represented by a continuum than a dichotomy. This is evident in the voting results in 2018, just as it was in 2016. We found that the political tipping point lies beyond major metropolitan areas, in the suburban counties of smaller metropolitan areas. Democrats enjoyed even greater success in densely populated urban areas in 2018 than in 2016. Residents of these urban areas display distinctive and consistent social and political attitudes across a range of scales. At the other end of the continuum in remote rural areas, Republican candidates continued to command voter support despite the challenging national political environment. Voters in these rural regions expressed social and political attitudes diametrically opposed to their counterparts in large urban cores.

Download Full-text

Cross-border mobility in European countries: associations between cross-border worker status and health outcomes

BMC Public Health ◽

10.1186/s12889-021-10564-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Lucas Nonnenmacher ◽

Michèle Baumann ◽

Etienne le Bihan ◽

Philippe Askenazy ◽

Louis Chauvel

Keyword(s):

European Union ◽

Health Outcomes ◽

Chronic Diseases ◽

Reference Group ◽

Labour Force ◽

High Risk Population ◽

The European Union ◽

Health Index ◽

Cross Sectional Survey ◽

Cross Border

Abstract Background Mobility of workers living in one country and working in a different country has increased in the European Union. Exposed to commuting factors, cross-border workers (CBWs) constitute a potential high-risk population. But the relationships between health and commuting abroad are under-documented. Our aims were to: (1) measure the prevalence of the perceived health status and the physical health outcomes (activity limitation, chronic diseases, disability and no leisure activities), (2) analyse their associations with commuting status as well as (3) with income and health index among CBWs. Methods Based on the ‘Enquête Emploi’, the French cross-sectional survey segment of the European Labour Force Survey (EU LFS), the population was composed of 2,546,802 workers. Inclusion criteria for the samples were aged between 20 and 60 years and living in the French cross-border departments of Germany, Belgium, Switzerland and Luxembourg. The Health Index is an additional measure obtained with five health variables. A logistic model was used to estimate the odds ratios of each group of CBWs, taking non-cross border workers (NCBWs) as the reference group, controlling by demographic background and labour status variables. Results A sample of 22,828 observations (2456 CBWs vs. 20,372 NCBWs) was retained. The CBW status is negatively associated with chronic diseases and disability. A marginal improvement of the health index is correlated with a wage premium for both NCBWs and CBWs. Commuters to Luxembourg have the best health outcomes, whereas commuters to Germany the worst. Conclusion CBWs are healthier and have more income. Interpretations suggest (1) a healthy cross-border phenomenon steming from a social selection and a positive association between income and the health index is confirmed; (2) the existence of major health disparities among CBWs; and (3) the rejection of the spillover phenomenon assumption for CBWs. The newly founded European Labour Authority (ELA) should take into account health policies as a promising way to support the cross-border mobility within the European Union.

Download Full-text