The final, formatted version of the article will be published soon.
ORIGINAL RESEARCH article
Front. Public Health
Sec. Life-Course Epidemiology and Social Inequalities in Health
Volume 12 - 2024 |
doi: 10.3389/fpubh.2024.1292032
This article is part of the Research Topic Examining Upstream to Understand Downstream: Use of Telehealth and Other Health Equity Measures for Addressing Health Disparities View all 4 articles
Health equity in urban and rural settings: implementation of the Place Standard Tool in Spain
Provisionally accepted- 1 Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Valencia, Spain
- 2 Gandia Health Department, Gandia, Spain
- 3 Faculty of Health Sciences, Valencian International University, Valencia, Spain
- 4 Valencian International University, Castelló de la Plana, Spain
- 5 Department of Nursing, University of La Rioja, Logroño, Spain
- 6 University of La Rioja, Logroño, Spain
- 7 Other, Valencia, Spain
- 8 Center for Biomedical Research in Epidemiology and Public Health Network, Carlos III Health Institute (ISCIII), Madrid, Madrid, Spain
- 9 Other, Alzira, Valencia, Spain
Physical, social, and economic aspects of neighborhoods and municipalities significantly influence residents' health behaviors and decisions, emphasizing the necessity of addressing local environmental disparities through an intersectoral, participatory, and equity-oriented approach. Community engagement is essential for gaining deeper insights into local contexts, integrating community knowledge and values, and fostering healthier, fairer, and equitable actions. The Place Standard Tool (PST) facilitates discussions on Social Determinants of Health, categorized into 14 themes, serving as a foundational framework for local health interventions. This study describes residents' perceptions of two municipalities in Spain, utilizing the validated Spanish version of the PST. A mixed-method convergent-parallel design was employed to comprehensively understand residents' experiences regarding their physical, economic, and social environment. A total of 356 individuals participated in the study through discussion groups, structured interviews, and online surveys. Descriptive analysis of individual questionnaire responses was conducted, and differences between municipalities were explored. Qualitative thematic analysis was performed on structured interviews and discussion groups, with quantitative and qualitative data integration facilitating comparison and identification of areas of convergence or divergence in the findings. Overall, rural areas garnered more favorable evaluations compared to urban ones, with Public Transport and Work and Local Economy consistently rated the lowest across all groups and contexts, while Identity and Belonging received the highest ratings. Notably, the urban area displayed additional negative ratings for Traffic and Parking, Housing, and Care and Maintenance. Identity and Belonging, Natural Spaces, Streets and Spaces, Social Interaction, and Services emerged as the highest-rated themes overall. In the rural context, positive evaluations were attributed to Walking or Cycling, Traffic and Parking, Housing, and Influence and Sense of Control. Significant differences (p <0.01) between urban and rural settings were observed in dimensions related to mobility, spaces, housing, social interaction, and identity and belonging. The study underscores the PST's efficacy in identifying strengths and weaknesses in local settings affecting health outcomes, highlighting the significance of successful implementation through appropriate territorial delineation. amd support from local authorities. Furthermore, the tool facilitated community involvement in decision-making about local environments, promoting equity by aligning institutional processes with citizen needs.
Keywords: social determinants of health, health equity, Community participation, Urban Health, Surveys and questionnaires, rural areas
Received: 23 Sep 2023; Accepted: 17 Apr 2024.
Copyright: © 2024 Ocaña, Gea-Caballero, Juárez-Vela, Peiró, Pérez-Sanz, Santolalla Arnedo, Sufrate-Sorzano, GARROTE CÁMARA and Paredes-Carbonell. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Ivan Santolalla Arnedo, University of La Rioja, Logroño, Spain
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.