Impact of area regeneration policies: performing integral interventions, changing opportunity structures and reducing health inequalities

J Epidemiol Community Health. 2017 Mar;71(3):239-247. doi: 10.1136/jech-2015-207080. Epub 2016 Aug 24.

Abstract

Background: Urban regeneration policies are area-based interventions addressing multidimensional problems. In this study, we analyse the impact of urban regeneration processes on the evolution of inequalities in mortality from certain causes. On the basis of Fundamental Cause Theory (FCT), our main hypothesis is that the impact of urban regeneration programmes will be more clearly observed on the causes of preventable deaths, as these programmes imply a direct or indirect improvement to a whole range of 'flexible resources' that residents in relevant areas have access to, and which ultimately may influence the inverse relationship between socioeconomic status and health.

Methods: Using a quasi-experimental design and data from Longitudinal Statistics on Survival and Longevity of Andalusia (Spain), we analyse differences in the evolution of standard mortality ratios for preventable and less-preventable causes of premature death. This encompasses 59 neighbourhoods in 37 municipalities where urban regeneration projects were implemented in the last decade within the framework of three different programmes and in 59 counterparts where these policies were not implemented.

Results: As expected in line with FCT, there are no significant patterns in the evolution of internal differences in terms of less-preventable mortality. However, excessive preventable mortality strongly decreases in the neighbourhoods with intervention programmes, specifically in those where two or more projects were in force. This is even more apparent for women.

Conclusions: The urban regeneration policies studied seem to contribute to reducing health inequity when the interventions are more integral in nature.

Keywords: HEALTH IMPACT ASSESSMENT; Health inequalities; MORTALITY; Neighborhood/place; POLICY.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cause of Death
  • Censuses
  • Female
  • Health Status Disparities*
  • Humans
  • Longevity
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Mortality / trends*
  • Risk Factors
  • Social Class
  • Spain / epidemiology
  • Urban Health*
  • Urban Renewal*