An innovative approach to local development of health promotion to reduce social inequalities in health

Abstract

The city of Villeurbanne has made the political choice to reduce social inequalities in health (SIH). The Public Health Department wanted to assess the health impact in the context of this project. The main objective was to analyse the links between urban development and health in order to identify the impact of the urban project on health and to make recommendations to reduce physical inactivity of children. Attention was focused on a neighbourhood of 6,000 inhabitants in the process of urban renewal. A high rate of adults on antidiabetic treatment was observed in this relatively deprived neighbourhood. School medicine also noted a high proportion of overweight children in schools in the neighbourhood, higher than in all schools of the city. The objective of this HIA was therefore to identify the impact of the renovation project on children's mobility and to make recommendations in order to combat their physical inactivity by encouraging spontaneous physical activity. The selected determinants were grouped into four categories: outdoor environment, use of open spaces, adapted sports facilities/equipment, roads. The evaluation was based on analysis of urban planning documents, environmental analysis reports, ad hoc surveys, individual interviews with the various partners and target actors. A bibliographic review confirmed the positive or negative impacts of various aspects of the project on health. Although some aspects of the project had a positive impact on the health of the inhabitants, others have a negative impact on children's mobility, well-being and social capital. About 30 recommendations were proposed and prioritized according to their political support and their technical, economic and temporal feasibility. The HIA created a dynamic cross-working between sectors other than health and provided an opportunity to educate and inform stakeholders on different concepts and their roles in promoting positive health behaviours. The HIA, as a tool to promote health, contributes to implementation of strategies designed to transform living conditions responsible for social inequalities in health.