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

Morrison Esteve, Joana, 1977-; Pons-Vigués, Mariona; Bécares, Laia; Burström, Bo; Gandarillas, Ana; Domínguez-Berjón, María Felicitas; Díez, Elia; Costa, Giuseppe; Ruiz, Milagros; Pikhart, Hynek; Marinacci, Chiara; Hoffman, Rasmus; Santana, Paula; Borrell i Thió, Carme

doi:http://dx.doi.org/10.1136/bmjopen-2013-004454

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

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Morrison J, Pons-Vigués M, Bécares L, Burström B, Gandarillas A, Domínguez-Berjón F, et al. Health inequalities in European cities: perceptions and beliefs among local policymakers. BMJ Open. 2014 May 28;4(5):e004454. DOI: 10.1136/bmjopen-2013-004454

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.