Area-Based Policies and Potential Health Benefits: A Quasi-Experimental Cohort Study in Vulnerable Urban Areas of Andalusia (Spain)

Ángel R. Zapata-Moya, María J. Martín-Díaz and Francisco J. Viciana-Fernández
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Ángel R. Zapata-Moya: Preventive Medicine and Public Health Area, Department of Anthropology, Psychology and Public Health, Universidad Pablo de Olavide, 41013 Seville, Spain
María J. Martín-Díaz: Centre for Sociology and Urban Policies, The Urban Governance Lab, Pablo de Olavide University, 41013 Seville, Spain
Francisco J. Viciana-Fernández: Demographic and Social Statistics, Institute of Statistics and Cartography of Andalusia, 41071 Seville, Spain

Sustainability, 2021, vol. 13, issue 15, 1-17

Abstract: Area-based policies (ABIs) aim to improve the quality of life and health of residents in socio-economically disadvantaged areas of cities. Although health impact evaluations of ABIs have proliferated in the last decade, several weaknesses have been identified in these evaluations. Inspired by the propositions of the fundamental cause theory (FCT), this paper attempts to address some of these weaknesses by investigating the possible impacts of different combinations of ABIs on premature mortality in vulnerable urban areas of Andalusia (Spain). We conducted a quasi-experimental cohort study, based on the longitudinal statistics on survival and longevity of a population aged 40–70 during the period from 2002 to 2016. Hazard ratios for individuals living in targeted areas relative to control areas were estimated using quasi-Poisson regressions, and the impact was evaluated using a difference-in-difference approach. Most of the ABIs studied do not seem to generate a visible impact on premature mortality. However, the combination of ARB and URBAN interventions is associated with a significant decrease in preventable and all-cause mortality in the targeted versus control areas. The flexible resources proposed by FCT can operate at both the contextual and individual levels, since more comprehensive interventions seem to contribute to achieving health impacts on vulnerable populations. Future evaluations should consider the nature of the intervened areas themselves in relation to the dynamics of the city and the degree of comprehensiveness of the policies, to elucidate what may constitute “fundamental interventions” to reduce health disparities between urban places.

Keywords: area-based policies; health impact; fundamental cause theory; mortality; health inequalities; vulnerable urban contexts (search for similar items in EconPapers)
JEL-codes: O13 Q Q0 Q2 Q3 Q5 Q56 (search for similar items in EconPapers)
Date: 2021
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