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‣ Condicionantes socioambientais urbanos associados à ocorrência de dengue no município de Araraquara; Urban socio-environmental factors associated with the incidence of dengue fever in Araraquara city.

Oliveira, Maria Aparecida de
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 12/03/2012 Português
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Introdução: Estima-se que 2,5 bilhões de pessoas vivam em áreas de risco de dengue, em mais de 100 países endêmicos. Mais de 50 milhões de infecções ocorrem anualmente com 500.000 casos de dengue hemorrágica e 22.000 mortes, principalmente entre crianças. A cidade de Araraquara apesar de apresentar boas condições sociais e econômicas, tem apresentado graves epidemias de dengue na última década. Objetivo: Este estudo examinou os fatores socioambientais urbanos associados à incidência de dengue em Araraquara, que é uma cidade de médio porte localizada no interior do estado de São Paulo, na região sudeste do Brasil nos anos de 1998 a 2008. Métodos: Foi realizado um estudo ecológico longitudinal, no qual foram avaliados dados de incidência de Dengue notificados no Sistema de Informação de Agravos de Notificação (SINAN) em todas as semanas epidemiológicas dos anos de 1998 a 2008, no município de Araraquara. As variáveis socioambientais urbanas investigadas foram extraídas do censo demográfico, de imagens de satélite e de planos de informações georreferenciados do ambiente construído. As variáveis meteorológicas investigadas foram obtidas a partir de uma estação automática com mediçoes diárias para todo o período analisado. Para investigar o padrão espaço temporal da distribuição da incidência de dengue no município...

‣ Associations between urbanisation and components of the health-risk transition in Thailand. A descriptive study of 87,000 Thai adults

Lim, Lynette; Kjellstrom, Tord; Sleigh, Adrian; Khamman, Suwanee; Seubsman, Sam-ang; Dixon, Jane; Banwell, Cathy
Fonte: Universidade Nacional da Austrália Publicador: Universidade Nacional da Austrália
Tipo: Journal article; Published Version Formato: 13 pages
Português
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BACKGROUND: Social and environmental changes have accompanied the ongoing rapid urbanisation in a number of countries during recent decades. Understanding of its role in the health-risk transition is important for health policy development at national and local level. Thailand is one country facing many of the health challenges of urbanisation. OBJECTIVE: To identify potential associations between individual migration between rural and urban areas and exposure to specific social, economic, environmental and behavioural health determinants. DESIGN: Baseline data from a cohort of 87,134 Thai open university students surveyed in 2005 (mean age 31 years). Four urbanisation status groups were defined according to self-reported location of residence (rural: R or urban: U) in 2005 and when the respondent was 10 12 years old (yo). RESULTS: Fourty-four percent were living in rural areas in 2005 and when they were 10 12yo (Group RR: ruralites); 20% always lived in urban areas (UU: urbanites); 32% moved from rural to urban areas (RU: urbanisers); 4% moved in the other direction (UR: de-urbanisers). The ruralites and urbanites often were the two extremes, with the urbanisers maintaining some of the determinants patterns from ruralites and the deurbanisers maintaining patterns from urbanites. There was a strong relationship between urbanisation status...

‣ Urban health inequities and the added pressure of climate change: an action-oriented research agenda

Friel, Sharon; Hancock, Trevor; Kjellstrom, Tord; McGranahan, Gordon; Monge, Patricia; Roy, Joyashree
Fonte: Springer Verlag Publicador: Springer Verlag
Tipo: Artigo de Revista Científica Formato: 10 pages
Português
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Climate change will likely exacerbate already existing urban social inequities and health risks, thereby exacerbating existing urban health inequities. Cities in low and middle-income countries are particularly vulnerable. Urbanization is both a cause of and potential solution to global climate change. Most population growth in the foreseeable future will occur in urban areas primarily in developing countries. How this growth is managed has enormous implications for climate change given the increasing concentration and magnitude of economic production in urban localities, as well as the higher consumption practices of urbanites, especially the middle classes, compared to rural populations. There is still much to learn about the extent to which climate change affects urban health equity and what can be done effectively in different socio-political and socio-economic contexts to improve the health of urban dwelling humans and the environment. But it is clear that equity-oriented climate change adaptation means attention to the social conditions in which urban populations live—this is not just a climate change policy issue, it requires inter-sectoral action. Policies and programs in urban planning and design, workplace health and safety...

‣ Addressing the social and environmental determinants of urban health equity: evidence for action and a research agenda

Friel, Sharon; Akerman, Marco; Hancock, Trevor; Kumaresan, Jacob; Marmot, Michael; Melin, Thomas; Vlahov, David
Fonte: Springer Verlag Publicador: Springer Verlag
Tipo: Artigo de Revista Científica Formato: 15 pages
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Urban living is the new reality for the majority of the world’s population. Urban change is taking place in a context of other global challenges—economic globalization, climate change, financial crises, energy and food insecurity, old and emerging armed conflicts, as well as the changing patterns of communicable and noncommunicable diseases. These health and social problems, in countries with different levels of infrastructure and health system preparedness, pose significant development challenges in the 21st century. In all countries, rich and poor, the move to urban living has been both good and bad for population health, and has contributed to the unequal distribution of health both within countries (the urban–rural divide) and within cities (the rich–poor divide). In this series of papers, we demonstrate that urban planning and design and urban social conditions can be good or bad for human health and health equity depending on how they are set up. We argue that climate change mitigation and adaptation need to go hand-in-hand with efforts to achieve health equity through action in the social determinants. And we highlight how different forms of governance can shape agendas, policies, and programs in ways that are inclusive and health-promoting or perpetuate social exclusion...

‣ Toward a research and action agenda on urban planning/design and health equity in cities in low and middle-income countries

Smit, Warren; Hancock, Trevor; Kumaresen, Jacob; Santos-Burgoa, Carlos; Sánchez-Kobashi Meneses, Raúl; Friel, Sharon
Fonte: Springer Verlag Publicador: Springer Verlag
Tipo: Artigo de Revista Científica Formato: 11 pages
Português
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The importance of reestablishing the link between urban planning and public health has been recognized in recent decades; this paper focuses on the relationship between urban planning/design and health equity, especially in cities in low and middle-income countries (LMICs). The physical urban environment can be shaped through various planning and design processes including urban planning, urban design, landscape architecture, infrastructure design, architecture, and transport planning. The resultant urban environment has important impacts on the health of the people who live and work there. Urban planning and design processes can also affect health equity through shaping the extent to which the physical urban environments of different parts of cities facilitate the availability of adequate housing and basic nfrastructure, equitable access to the other benefits of urban life, a safe living environment, a healthy natural environment, food security and healthy nutrition, and an urban environment conducive to outdoor physical activity. A new research and action agenda for the urban environment and health equity in LMICs should consist of four main components. We need to better understand intra-urban health inequities in LMICs; we need to better understand how changes in the built environment in LMICs affect health equity; we need to explore ways of successfully planning...

‣ Social conditions and urban health inequities: realities, challenges and opportunities to transform the urban landscape through research and action

Salgado de Snyder, V. Nelly; Friel, Sharon; Fotso, Jean Christophe; Khadr, Zeinab; Meresman, Sergio; Monge, Patricia; Patil-Deshmukh, Anita
Fonte: Springer Verlag Publicador: Springer Verlag
Tipo: Artigo de Revista Científica Formato: 11 pages
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The process of urbanization entails social improvements with the consequential better quality-of-life for urban residents. However, in many low-income and some middle-income countries, urbanization conveys inequality and exclusion, creating cities and dwellings characterized by poverty, overcrowded conditions, poor housing, severe pollution, and absence of basic services such as water and sanitation. Slums in large cities often have an absence of schools, transportation, health centers, recreational facilities, and other such amenities. Additionally, the persistence of certain conditions, such as poverty, ethnic heterogeneity, and high population turnover, contributes to a lowered ability of individuals and communities to control crime, vandalism, and violence. The social vulnerability in health is not a “natural” or predefined condition but occurs because of the unequal social context that surrounds the daily life of the disadvantaged, and often, socially excluded groups. Social exclusion of individuals and groups is a major threat to development, whether to the community social cohesion and economic prosperity or to the individual self-realization through lack of recognition and acceptance, powerlessness, economic vulnerability...

‣ Rights, knowledge, and governance for improved health equity in urban settings

Barten, Francoise; Akerman, Marco; Becker, Daniel; Friel, Sharon; Hancock, Trevor; Mwatsama, Modi; Rice, Marilyn; Sheuya, Shaaban; Stern, Ruth
Fonte: Springer Publicador: Springer
Tipo: Artigo de Revista Científica Formato: 10 pages
Português
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All three of the interacting aspects of daily urban life (physical environment, social conditions, and the added pressure of climate change) that affect health inequities are nested within the concept of urban governance, which has the task of understanding and managing the interactions among these different factors so that all three can be improved together and coherently. Governance is defined as: "the process of collective decision making and processes by which decisions are implemented or not implemented": it is concerned with the distribution, exercise, and consequences of power. Although there appears to be general agreement that the quality of governance is important for development, much less agreement appears to exist on what the concept really implies and how it should be used. Our review of the literature confirmed significant variation in meaning as well as in the practice of urban governance arrangements. The review found that the linkage between governance practices and health equity is under-researched and/or has been neglected. Reconnecting the fields of urban planning, social sciences, and public health are essential "not only for improving local governance, but also for understanding and addressing global political change" for enhanced urban health equity. Social mobilization...

‣ Community context of health system development: implications for health sector reform in Pakistan

Mahmood, M.; Moss, J.; Karmaliani, R.
Fonte: World Health Organization, Regional Office for the Eastern Mediterranean Publicador: World Health Organization, Regional Office for the Eastern Mediterranean
Tipo: Artigo de Revista Científica
Publicado em //2003 Português
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To describe local sociopolitical and organizational factors that influence health system development in Karachi, Pakistan, we conducted participant observation while working with health providers and communities in one urban district to reorient services towards a primary health care district health system. We found that the community characteristics, particularly the diverse socialpolitical and cultural make-up and organizational complexity that involved multiple levels of government, influenced efforts towards collaboration and shaped the development of the health system. We conclude that for effective implementation of health sector reform there is a need to comprehend fully the community context and complexity of existing health service provision.; M.A. Mahmood, J. Moss and R. Karmaliani; © World Health Organisation. Regional Office for the Eastern Mediterranean

‣ Tantalus and the Tyranny of Territory: Pursuing the dream of parity in rural and metropolitan population health outcomes through effective primary health care programmes

Harvey, P.
Fonte: Australian Journal Primary Health, Australian Institute Primary Care & School Public Health Publicador: Australian Journal Primary Health, Australian Institute Primary Care & School Public Health
Tipo: Artigo de Revista Científica
Publicado em //2004 Português
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Many health professionals and rural health academics are motivated by the challenge of achieving equitable access to health care in rural communities with the implicit vision that fairer access to services might ultimately lead to more equitable health outcomes for people living in rural and remote settings. The purpose of this paper is to put the issue of rural and urban health outcome parity into perspective and assess recent progress towards achieving the ultimate goal of improving rural health status. I will also explore ways in which rural communities might increase their access to and use of primary health care revenue in the future to improve community health outcomes. While some improvements have been achieved across the rural health system in recent times, the fundamental problem of maintaining infrastructure to service community needs in rural areas remains as daunting as ever. Extensive evidence has now been assembled to show that rural people generally enjoy a much lower standard of health care, health outcomes and life expectancy than their urban cousins. The question underlying all of this evidence, however, is... must this always be so? Is it possible to redress the current inequities between rural and urban populations and could new primary health care initiatives...

‣ Urban health: it's time to get moving!

Barbiero, Victor K
Fonte: Global Health: Science and Practice Publicador: Global Health: Science and Practice
Tipo: Artigo de Revista Científica
Publicado em 13/05/2014 Português
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The global health community should mainstream urban health and implement urban health programs to address the triple health burden of communicable diseases, noncommunicable diseases, and injuries in low- and middle-income countries.

‣ Perspectives on urban conditions and population health

Vlahov,David; Galea,Sandro; Gibble,Emily; Freudenberg,Nicholas
Fonte: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz Publicador: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2005 Português
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The majority of the world's population will live in cities in the next few years and the pace of urbanization worldwide will continue to accelerate over the coming decades. While the number of megacities is projected to increase, the largest population growth is expected to be in cities of less than one million people. Such a dramatic demographic shift can be expected to have an impact on population health. Although there has been historic interest in how city living affects health, a cogent framework that enables systematic study of urban health across time and place has yet to emerge. Four alternate but complementary approaches to the study of urban health today are presented (urban health penalty, urban health advantage, urban sprawl, and an integrative urban conditions model) followed by three key questions that may help guide the study and practice of urban health in coming decades.

‣ Saúde e meio ambiente: uma análise de diferenciais intra-urbanos enfocando o Município de São Paulo, Brasil; Environment and health: an analysis of intra-urban differentials in the City of S. Paulo, Brazil

Akerman, Marco; Stephens, Carolyn; Campanario, Paulo; Maia, Paulo Borlina
Fonte: Universidade de São Paulo. Faculdade de Saúde Pública Publicador: Universidade de São Paulo. Faculdade de Saúde Pública
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; ; Formato: application/pdf
Publicado em 01/08/1994 Português
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A project concerned with the study of intra-urban health differentials in S. Paulo city, Brazil, is described. A brief outline of urban problems in the city is presented, followed by a review of the locally published literature on the subject of geographical differentials (stratification by socioeconomic status and environment). Two topics are introduced: geographical subdvision of the area studied and the methods used to choose the socio-environmental indicators for the construction of a deprivation index with to stratify the city. Suggestions are made as to possible applications of results achieved by the project.; Apresenta-se projeto na área de diferenciais intra-urbanos de saúde no Município de São Paulo, SP, Brasil. Focalizam-se alguns aspectos do problema urbano na cidade, seguindo-se uma revisão bibliográfica de trabalhos que abordam a questão dos diferenciais geográficos na literatura paulista. São outras temáticas: a desagregação geográfica do território a ser estudado e a metodologia de construção do índice de carência para definição de zonas homogêneas no Município de São Paulo, Brasil. Aponta-se qual seria a aplicação dos resultados finais obtidos pelo projeto.

‣ Perspectives on urban conditions and population health

Vlahov,David; Galea,Sandro; Gibble,Emily; Freudenberg,Nicholas
Fonte: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz Publicador: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2005 Português
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The majority of the world's population will live in cities in the next few years and the pace of urbanization worldwide will continue to accelerate over the coming decades. While the number of megacities is projected to increase, the largest population growth is expected to be in cities of less than one million people. Such a dramatic demographic shift can be expected to have an impact on population health. Although there has been historic interest in how city living affects health, a cogent framework that enables systematic study of urban health across time and place has yet to emerge. Four alternate but complementary approaches to the study of urban health today are presented (urban health penalty, urban health advantage, urban sprawl, and an integrative urban conditions model) followed by three key questions that may help guide the study and practice of urban health in coming decades.

‣ The urban environment and health in a world of increasing globalization: issues for developing countries

McMichael,Anthony J.
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2000 Português
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Urban living is the keystone of modern human ecology. Cities have multiplied and expanded rapidly worldwide over the past two centuries. Cities are sources of creativity and technology, and they are the engines for economic growth. However, they are also sources of poverty, inequality, and health hazards from the environment. Urban populations have long been incubators and gateways for infectious diseases. The early industrializing period of unplanned growth and laissez-faire economic activity in cities in industrialized countries has been superseded by the rise of collective management of the urban environment. This occurred in response to environmental blight, increasing literacy, the development of democratic government, and the collective accrual of wealth. In many low-income countries, this process is being slowed by the pressures and priorities of economic globalization. Beyond the traditional risks of diarrhoeal disease and respiratory infections in the urban poor and the adaptation of various vector-borne infections to urbanization, the urban environment poses various physicochemical hazards. These include exposure to lead, air pollution, traffic hazards, and the ‘‘urban heat island’’ amplification of heatwaves. As the number of urban consumers and their material expectations rise and as the use of fossil fuels increases...

‣ Urban upgrading and its impact on health: a “quasi-experimental” mixed-methods study protocol for the BH-Viva Project

Friche,Amélia Augusta de Lima; Dias,Maria Angélica de Salles; Reis,Priscila Brandão dos; Dias,Cláudia Silva; Caiaffa,Waleska Teixeira
Fonte: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz Publicador: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/11/2015 Português
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Abstract There is little scientific evidence that urban upgrading helps improve health or reduce inequities. This article presents the design for the BH-Viva Project, a “quasi-experimental”, multiphase, mixed-methods study with quantitative and qualitative components, proposing an analytical model for monitoring the effects that interventions in the urban environment can have on residents’ health in slums in Belo Horizonte, Minas Gerais State, Brazil. A preliminary analysis revealed intra-urban differences in age-specific mortality when comparing areas with and without interventions; the mortality rate from 2002 to 2012 was stable in the “formal city”, increased in slums without interventions, and decreased in slums with interventions. BH-Viva represents an effort at advancing methodological issues, providing learning and theoretical backing for urban health research and research methods, allowing their application and extension to other urban contexts.

‣ Brief introductory guide to agent-based modeling and an illustration from urban health research

Auchincloss,Amy H.; Garcia,Leandro Martin Totaro
Fonte: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz Publicador: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/11/2015 Português
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Abstract There is growing interest among urban health researchers in addressing complex problems using conceptual and computation models from the field of complex systems. Agent-based modeling (ABM) is one computational modeling tool that has received a lot of interest. However, many researchers remain unfamiliar with developing and carrying out an ABM, hindering the understanding and application of it. This paper first presents a brief introductory guide to carrying out a simple agent-based model. Then, the method is illustrated by discussing a previously developed agent-based model, which explored inequalities in diet in the context of urban residential segregation.

‣ Disaggregating health inequalities within Rio de Janeiro, Brazil, 2002-2010, by applying an urban health inequality index

Bortz,Martin; Kano,Megumi; Ramroth,Heribert; Barcellos,Christovam; Weaver,Scott R.; Rothenberg,Richard; Magalhães,Monica
Fonte: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz Publicador: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/11/2015 Português
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Abstract An urban health index (UHI) was used to quantify health inequalities within Rio de Janeiro, Brazil, for the years 2002-2010. Eight main health indicators were generated at the ward level using mortality data. The indicators were combined to form the index. The distribution of the rank ordered UHI-values provides information on inequality among wards, using the ratio of the extremes and the gradient of the middle values. Over the decade the ratio of extremes in 2010 declined relative to 2002 (1.57 vs. 1.32) as did the slope of the middle values (0.23 vs. 0.16). A spatial division between the affluent south and the deprived north and east is still visible. The UHI correlated on an ecological ward-level with socioeconomic and urban environment indicators like square meter price of apartments (0.54, p < 0.01), low education of mother (-0.61, p < 0.01), low income (-0.62, p < 0.01) and proportion of black ethnicity (-0.55, p < 0.01). The results suggest that population health and equity have improved in Rio de Janeiro in the last decade though some familiar patterns of spatial inequality remain.

‣ The Belo Horizonte Observatory for Urban Health: its history and current challenges

Dias,Maria Angelica de Salles; Friche,Amélia Augusta de Lima; Oliveira,Veneza Berenice de; Caiaffa,Waleska Teixeira
Fonte: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz Publicador: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/11/2015 Português
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Abstract The Belo Horizonte Observatory for Urban Health (OSUBH), housed in an academic setting, was founded in 2002 as part of a broader agenda to strengthen local and national health systems. Its mission is to build the capacity of the workforce in research on population health and to conduct studies on urban issues that can guide the planning of activities aimed at improving the health of populations, especially in heavily urbanized areas, associated with intra-urban inequalities. It focuses on the acquisition of advanced knowledge on urban health (metric) through scientific research, to contribute to public policies that may interfere with health, both at individual and community levels. During its lifetime, many partnerships and studies have been developed, but many challenges still exist in order for it to consolidate its position as a legitimate space and as a tool to generate systematic information for governments and populations.

‣ Developing an academia-based public health observatory: the new global public health observatory with emphasis on urban health at Johns Hopkins Bloomberg School of Public Health

Castillo-Salgado,Carlos
Fonte: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz Publicador: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/11/2015 Português
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Abstract Health observatories may differ according to their mission, institutional setting, topical emphasis or geographic coverage. This paper discusses the development of a new urban-focused health observatory, and its operational research and training infrastructure under the academic umbrella of the Department of Epidemiology and the Institute of Urban Health at the Johns Hopkins Bloomberg School of Public Health (BSPH) in Baltimore, USA. Recognizing the higher education mission of the BSPH, the development of a new professional training in public health was an important first step for the development of this observatory. This new academia-based observatory is an innovative public health research and training platform offering faculty, investigators, professional epidemiology students and research partners a physical and methodological infrastructure for their operational research and training activities with both a local urban focus and a global reach. The concept of a public health observatory and its role in addressing social health inequalities in local urban settings is discussed.

‣ Linking evidence to action on social determinants of health using Urban HEART in the Americas

Prasad,Amit; Groot,Ana Maria Mahecha; Monteiro,Teofilo; Murphy,Kelly; O'Campo,Patricia; Broide,Emilia Estivalet; Kano,Megumi
Fonte: Organización Panamericana de la Salud Publicador: Organización Panamericana de la Salud
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2013 Português
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OBJECTIVE: To evaluate the experience of select cities in the Americas using the Urban Health Equity Assessment and Response Tool (Urban HEART) launched by the World Health Organization in 2010 and to determine its utility in supporting government efforts to improve health equity using the social determinants of health (SDH) approach METHODS: The Urban HEART experience was evaluated in four cities from 2010-2013: Guarulhos (Brazil), Toronto (Canada), and Bogotá and Medellín (Colombia). Reports were submitted by Urban HEART teams in each city and supplemented by first-hand accounts of key informants. The analysis considered each city's networks and the resources it used to implement Urban HEART; the process by which each city identified equity gaps and prioritized interventions; and finally, the facilitators and barriers encountered, along with next steps RESULTS: In three cities, local governments spearheaded the process, while in the fourth (Toronto), academia initiated and led the process. All cities used Urban HEART as a platform to engage multiple stakeholders. Urban HEART's Matrix and Monitor were used to identify equity gaps within cities. While Bogotá and Medellín prioritized among existing interventions, Guarulhos adopted new interventions focused on deprived districts. Actions were taken on intermediate determinants...