Mehdipanah Roshanak, Rodríguez-Sanz Maica, Malmusi Davide, Muntaner Carles, Díez Elia, Bartoll Xavier, Borrell Carme
Agència de Salut Pública de Barcelona, Barcelona, Spain Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.
Agència de Salut Pública de Barcelona, Barcelona, Spain Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain Ciber de Epidemiología y Salud Publica (CIBERESP), Barcelona, Spain.
J Epidemiol Community Health. 2014 Sep;68(9):811-7. doi: 10.1136/jech-2013-203434. Epub 2014 May 6.
In the last decade, the Neighbourhoods Law in Catalonia (Spain) funded municipalities that presented urban renewal projects within disadvantaged neighbourhoods focusing on physical, social and economic improvements. The objective of the study was to evaluate the effects of this law on the health and health inequalities of residents in the intervened neighbourhoods in the city of Barcelona.
A quasi-experimental predesign and postdesign was used to compare adult residents in five intervened neighbourhoods with eight non-intervened comparison neighbourhoods with similar socioeconomic characteristics. The Barcelona Health Survey was used for studying self-rated and mental health in pre (2001, 2006) and post (2011) years. Poisson regression models stratified by sex were used to compute prevalence ratios comparing 2011 with 2006, and later stratified by social class, to study health inequalities.
The intervened neighbourhoods had a significant decrease in poor self-rated health in both sexes while no significant changes occurred in the comparison group. When stratified by social class, a significant improvement was observed in poor self-rated health in the manual group of the intervened neighbourhoods in both sexes, resulting in a decrease in self-rated health inequalities. Similar results were observed in poor mental health of women, while in men, poor mental health worsens in both neighbourhood groups but mostly in the comparison group.
The Neighbourhoods Law had a positive effect on self-rated health and seems to prevent poor mental health increases in both sexes and especially among manual social classes.
在过去十年中，西班牙加泰罗尼亚的《社区法》为那些在弱势社区开展城市更新项目的市政当局提供资金，这些项目侧重于物质、社会和经济改善。本研究的目的是评估该法律对巴塞罗那市干预社区居民健康及健康不平等状况的影响。
采用准实验性的前测与后测设计，将五个干预社区的成年居民与八个具有相似社会经济特征的非干预对照社区的居民进行比较。使用巴塞罗那健康调查来研究2001年、2006年（前测）和2011年（后测）的自评健康和心理健康状况。采用按性别分层的泊松回归模型计算2011年与2006年的患病率比，随后按社会阶层分层，以研究健康不平等情况。
干预社区的男女自评健康状况不佳者显著减少，而对照组无显著变化。按社会阶层分层时，干预社区体力劳动者组的男女自评健康状况不佳者均有显著改善，导致自评健康不平等状况有所减少。在女性心理健康不佳方面也观察到类似结果，而在男性中，两个社区组的心理健康不佳情况均有所恶化，但主要是在对照组。
《社区法》对自评健康有积极影响，似乎能防止男女尤其是体力劳动者社会阶层的心理健康状况恶化。
