Urban upgrading and its impact on health: a "quasi-experimental" mixed-methods study protocol for the BH-Viva Project.

Amélia Augusta De Lima Friche,Waleska Teixeira Caiaffa,Cláudia Silva Dias,Priscila Brandão Dos Reis,Maria Angélica De Salles Dias

doi:10.1590/0102-311x00079715

Amélia Augusta De Lima Friche, Waleska Teixeira Caiaffa + Show 3 more

Open Access

https://doi.org/10.1590/0102-311x00079715

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Abstract

There is little scientific evidence that urban upgrading helps improve health or reduce inequities. This article presents the design for the BH-Viva Project, a "quasi-experimental", multiphase, mixed-methods study with quantitative and qualitative components, proposing an analytical model for monitoring the effects that interventions in the urban environment can have on residents' health in slums in Belo Horizonte, Minas Gerais State, Brazil. A preliminary analysis revealed intra-urban differences in age-specific mortality when comparing areas with and without interventions; the mortality rate from 2002 to 2012 was stable in the "formal city", increased in slums without interventions, and decreased in slums with interventions. BH-Viva represents an effort at advancing methodological issues, providing learning and theoretical backing for urban health research and research methods, allowing their application and extension to other urban contexts.

Highlights

This article presents the design for the BH-Viva Project, a “quasi-experimental”, multiphase, mixed-methods study with quantitative and qualitative components, proposing an analytical model for monitoring the effects that interventions in the urban environment can have on residents’ health in slums in Belo Horizonte, Minas Gerais State, Brazil
The approach known as social determinants of health has contributed to the discussion on the social, political, economic, cultural, behavioral, and individual phenomena that produce iniquities in health
Based on the premise that health events are associated with attributes of individuals nested in the “urban place” and in these individuals’ aggregate properties, Urban Health incorporates the properties of the place and the role of the physical and social environments as health determinants of persons in places, demanding unique approaches [5,6,7,8]

Summary

Introduction

The approach known as social determinants of health has contributed to the discussion on the social, political, economic, cultural, behavioral, and individual phenomena that produce iniquities in health. With growing urbanization and the need to develop methodologies to measure and evaluate how living in cities shapes the population’s state of health, the urban health agenda is emerging within the field of Public Health 4. Based on the premise that health events are associated with attributes of individuals nested in the “urban place” and in these individuals’ aggregate properties, Urban Health incorporates the properties of the place and the role of the physical and social environments as health determinants of persons in places, demanding unique approaches [5,6,7,8]. Most urban growth occurs in less developed countries, concentrated in poverty areas (vulnerable, risky, or precarious areas, irregular urban settlements, or slums). Some 863 million people currently live in slums, with a projected increase to 1.5 billion by 2030 if the demographic dynamics do not change significantly 10

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