Work package n 4: Literature review and appraisal

1

• Work package n 4 Literature review and
  appraisal
• Erik van Ameijden
• Kaspar Bams
• Epidemiology and Information Department, Utrecht
  Municipal Health Service, The Netherlands

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European system of urban health
indicatorsEURO-URHIS

• Objectives work package 4
• Assessment of health indicator frameworks from
  the urban health perspective
• Identification of relevant data sources and gaps
  in existing health indicator frameworks to
  describe urban health
• Inventory of major international collaborative
  actions on health indicators their
  implementation

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European system of urban health
indicatorsEURO-URHIS

• Task 1 Assessment of health indicator frameworks
  from the urban health perspective

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European system of urban health
indicatorsEURO-URHIS

• Assessment of health indicator frameworks
• 1. What is urban health research?
• 2. What are (urban) health indicators?
• 3. Which processes, conditions and determinants
  influence urban health?

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European system of urban health
indicatorsEURO-URHIS

• What is urban health? Definition
• The study of urban health concerns itself with
  the determinants of health and diseases in urban
  areas and with the urban context itself as the
  exposure of interest.
• Vlahov and Galea, Center for Epidemiologic
  Studies at The New York Academy of Medicine.

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European system of urban health
indicatorsEURO-URHIS

• What is urban health research?
• Public health research specific for the urban
  context
• Differences public and urban health research
• Emphasis on specific themes
• More effort needed to get good data
• Interaction between indicators is more complex

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European system of urban health
indicatorsEURO-URHIS

• What are (urban) health indicators?
• should tell us something about an area of
  interest for (policy) action, sometimes defined
  as a concrete policy target (e.g., reduce the
  percentage of smokers to less than 20)
• should do this in a maximally efficient way to
  give a robust view of the situation

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European system of urban health
indicatorsEURO-URHIS

• Sorts of indicators
• Generic indicators. Referring to topics, issues
  or determinants e.g. Alcohol use
• Proximate indicators. Precisely defined
  operational indicators e.g. 14-18 years old
  drinking alcohol
• In this study only generic indicators

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European system of urban health
indicatorsEURO-URHIS

• Model for the study of urban health

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European system of urban health
indicatorsEURO-URHIS

• Task 2 Identification of relevant data sources
  and gaps in existing health indicator frameworks
  to describe urban health

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European system of urban health
indicatorsEURO-URHIS

• Indicator selection
• ECHI short list starting point
• indicators from the perspective of a high level
  public health policy maker who wants to obtain a
  helicopter view on the most important issues
• Assumption indicators which are important for
  public health are by definition important for
  urban health
• Thus, all shortlist indicators are according this
  point of view potential qualified for selection

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European system of urban health
indicatorsEURO-URHIS

• Indicator selection
• Other indicators
• Especially relevant for the urban setting, but
  not listed in ECHI shortlist
• Urban health model, scientific literature and
  policy reports
• Existing definitions ECHI longlist, Urban Audit,
  Megapoles, WHO, OECD

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European system of urban health
indicatorsEURO-URHIS

• Indicator selection. Criteria, the Euro-Urhis
  indicators should
• Cover the processes, conditions, determinants and
  outcomes as pointed out in the model
• Support policy-making. Information to local
  government officials that is needed for
  developing health prevention and intervention
  strategies
• Specify a preventability issue
• Allow flexible use
• Be capable of being monitored
• Be easy to understand
• Maintain possibilities for innovation
• Meet methodological criteria

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European system of urban health
indicatorsEURO-URHIS

• Methodological criteria such as
• Validity (does the indicator measure what it is
  intended to measure?)
• Reliability (is the measurement reproducible?)
• Sensitivity (is the measurement sufficiently
  discriminative in space or time?)
• Clarity (is the measurement easy to understand?)
• Usability (is it easy to work with the
  measurement?)

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European system of urban health
indicatorsEURO-URHIS

• Findings literature study
• Most studies about urban health are from North
  America. Some are from Western Europe. It is hard
  to find literature on health (in English) from
  East and South European countries
• Studies emphasize environmental issues and
  marginalized populations as important aspects of
  urban health
• In national public health programmes is not much
  attention for special urban issues

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European system of urban health
indicatorsEURO-URHIS

• Gaps in ECHI shortlist to describe urban health
• Nationality/ ethnic minority groups
• Single parent families
• Population density
• Migration
• Homeless people
• Sexual minority groups
• Safe sexuality
• Access to green spaces
• Noise exposure
• Bad housing conditions damp houses
• Drinking water supply/ sewerage connection
• Safety/ crime

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European system of urban health
indicatorsEURO-URHIS

• Task 3 Inventory of major international
  collaborative actions on health indicators
  their implementation

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European system of urban health
indicatorsEURO-URHIS

• Overview collaborative actions
• European Union
• DG Sanco. Programme of Community Action in the
  Field of Public Health e.g. ECHIM, Isare, Euphix,
  Euro-Urhis
• DG Eurostat
• DG Regional Policy. The Urban Audit
• European Environment Agency
• European Urban Knowledge Network
• WHO/ Europe
• Healthy cities programme
• European Observatory on Health Systems and
  Policies
• Environment and Health Information System
• OECD

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European system of urban health
indicatorsEURO-URHIS

• Three forms of collaboration
• Data collection
• Possible partners The Urban Audit
• Data/ information dissemination
• Possible partners The Urban Audit, EUPHIX
• Networking
• Possible partners WHO Healthy cities, European
  Urban Knowledge Network

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European system of urban health
indicatorsEURO-URHIS

• Thanks for listening
• Questions?