Advancing tools to promote health equity across European Union regions : The EURO-HEALTHY project

Population health measurements are recognised as appropriate tools to support public health monitoring. Yet, there is still a lack of tools that offer a basis for policy appraisal and for foreseeing impacts on health equity. In the context of persistent regional inequalities, it is critical to ascertain which regions are performing best, which factors might shape future health outcomes and where there is room for improvement. Under the EURO-HEALTHY project, tools combining the technical elements of multi-criteria value models and the social elements of participatory processes were developed to measure health in multiple dimensions and to inform policies. The flagship tool is the Population Health Index (PHI), a multidimensional measure that evaluates health from the lens of equity in health determinants and health outcomes, further divided into sub-indices. Foresight tools for policy analysis were also developed, namely: (1) scenarios of future patterns of population health in Europe in 2030, combining group elicitation with the Extreme-World method and (2) a multi-criteria evaluation framework informing policy appraisal (case study of Lisbon). Finally, a WebGIS was built to map and communicate the results to wider audiences. The Population Health Index was applied to all European Union (EU) regions, indicating which regions are lagging behind and where investments are most needed to close the health gap. Three scenarios for 2030 were produced - (1) the 'Failing Europe' scenario (worst case/increasing inequalities), (2) the 'Sustainable Prosperity' scenario (best case/decreasing inequalities) and (3) the 'Being Stuck' scenario (the EU and Member States maintain the status quo). Finally, the policy appraisal exercise conducted in Lisbon illustrates which policies have higher potential to improve health and how their feasibility can change according to different scenarios. The article makes a theoretical and practical contribution to the field of population health. Theoretically, it contributes to the conceptualisation of health in a broader sense by advancing a model able to integrate multiple aspects of health, including health outcomes and multisectoral determinants. Empirically, the model and tools are closely tied to what is measurable when using the EU context but offering opportunities to be upscaled to other settings

Who, why, when and how do people use urban green spaces? A study of users from 18 parks in France

Urban green spaces impact the individual and collective health of populations. At the city level, they act as regulators of environmental hazards and constitute collective protective factors. At the individual level, they constitute social spaces for encounters and rejuvenation. But, these functions depend on the use made of these green spaces which can be inequitable. This paper presents the results of the analysis of the use of green spaces in the 6 French cities selected in the WHO French Healthy City Network conducted as part of the GREENH-City research project

Health in all policies and urban green spaces: the baseline study of the GREENH-City project

International audienceHealth in all policies (HiAP) is a key strategy for tackling social inequalities in health (SIH) and contributes to act on health determinants, among which environmental determinants play a major role. In France, cities have levers to act on environmental determinants such as green spaces. This communication aims to present the baseline study of the GREENH-City interventional participatory project (INCa n°2017-003). The general goal of the project is to identify the most promising interventions to operationalize HiAP at the city level and act on the social inequalities in health through green space policy in urban area. The baseline study will contribute to analyze the HiAP approach among the cities of the French Healthy Cities Network. The objective of this presentation is to provide profiles of the cities regarding the degree of maturity of the HiAP approaches.MethodsDrawing on the HiAP analytical framework, a qualitative analysis will be conducted among 80 cities of the French Healthy Cities Network by using an online survey addressed to elected official and technicians from public health departments in the cities. Items will rely on the degree of maturity of HiAP approaches regarding the modes of collaborations between sectors, the consideration of health, social inequalities in health and green spaces accessibility equity.ResultsThe survey will identify profiles of cities regarding their style of HiAP. These results, crossed with SIH indicators and green space indicators will define 6 cases.ConclusionsThe six cases should enable us to profile the cities in terms of their HiAP approaches and how they address social inequalities in health as part of their policies and interventions on green spaces

Intervention research partnerships: enablers for activating health in all policies approach?

International audienceIntroductionAction on the determinants of health and equity involves the participation of all sectors, including non-health sectors. Understanding the opportunities and constraints to engage in the complex issue of health inequalities requires opening the black box of policy making. It also requires close interaction between field actors and researchers. This paper will aim to analyze the modalities of collaboration between researchers and field actors in the service of knowledge sharing, within the GREENH-City project.MethodsThe GREENH-City project was built in an interdisciplinary and intersectoral manner and involves close collaboration with the WHO French Healthy Cities Network (FHCN). Its objective is to characterize the most promising health interventions in all policies at the city level to promote equity through green space policies. Based on the knowledge sharing model and the theory of diffusion of innovations, we will analyze how this research allows initiating collaborations between the different municipal sectors on health issues.ResultsThe intervention nature of the project seems to help the dissemination of collaborations, particularly between health services and green space services within the cities of the FHCN. The analysis, using theoretical models, of the body of empirical data collected from cities will make it possible to identify the levers and collateral effects activated by the research project.DiscussionThe GREENH-City project was built on the basis of an interventional research framework. This choice was made precisely because of the interaction it induces between researchers and practice environments. Initial empirical results suggest that it promotes the dissemination of knowledge, a necessary first step in the evolution of practices. Indeed, the effective appropriation of research results can only be assessed in the long term and must take into account the contextual elements specific to each FHCN involved in the research

Conflict resolution tactics and bullying: the influence of social learning

Copyright © 2003 SAGE Publications Teachers' reports were used to define school children, ages 10 and 11 years, as bullies (n = 47), passive victims (n = 37), aggressive victims (n = 29), and controls (n = 220). Teachers' ratings of children's styles of interactions with peers were consistent with these assignments, confirming significantly different kinds of conflict resolution strategies between the four groups. Compared to controls or passive victims, bullies and aggressive victims were judged to display higher levels of aggression. In contrast, controls scored above bullies or aggressive victims for prosocial behaviors. These results were partially confirmed by children's reports about their own behaviors. Attempts to establish whether bullying and victimization could be linked to social learning of conflict resolution tactics from parents, television, or peers suggested that peers had a role in sustaining aggressive behaviors. Carlene Wilson, Lisa Parry, Ted Nettelbeck, Jodie Bel