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澳大利亚悉尼的城市交易与健康公平

City deals and health equity in Sydney, Australia.

机构信息

Centre for Health Equity Training, Research & Evaluation (CHETRE), Part of the UNSW Australia Research Centre for Primary Health Care & Equity, A Unit of Population Health, South Western Sydney Local Health District, NSW Health A Member of the Ingham Institute, Liverpool Hospital Locked Bag 7103, Liverpool BC, NSW, 1871, Australia.

Southgate Institute for Health, Society and Equity, Flinders University, Australia.

出版信息

Health Place. 2022 Jan;73:102711. doi: 10.1016/j.healthplace.2021.102711. Epub 2021 Nov 20.

Abstract

'City Deals' are new governance instruments for urban development. Vast evidence exists on the relationship between urban factors and health equity, but little research applies a health equity lens to urban policy-making. This paper does precisely that for the Western Sydney City Deal (WSCD) in Australia. We conducted a critical discourse analysis of publicly available documents and interviews with the WSCD's main architects, applying insights from relevant theories. We find 'pro-growth' discourse to encourage economic investment dominates any references to disadvantage. Interviewees maintained the WSCDs fundamental purpose is to rebalance urban investment toward the historically disadvantaged West. However, the WSCD makes limited reference to health and none to equity. Institutionalised governance practices that favour private investments in infrastructure remain the dominant force behind the WSCD. We document how a shift to 'place-based' infrastructure has promise for equity but struggles to overcome institutionalised approaches to urban investments.

摘要

“城市协议”是城市发展的新治理工具。大量证据表明城市因素与健康公平之间存在关联,但很少有研究从健康公平的角度来制定城市政策。本文正是针对澳大利亚的西悉尼城市协议(WSCD)进行了这样的研究。我们对公开文件进行了批判性话语分析,并对 WSCD 的主要设计者进行了采访,运用了相关理论的见解。我们发现,“促进增长”的话语鼓励经济投资,这主导了对劣势的任何提及。受访者坚持认为,WSCD 的根本目的是重新平衡城市投资,向历史上处于不利地位的西部地区倾斜。然而,WSCD 很少提及健康,也没有提及公平。有利于基础设施的私人投资的制度化治理实践仍然是 WSCD 的主要推动力。我们记录了从“基于地点”的基础设施转变为公平的承诺,但在克服城市投资的制度化方法方面仍存在困难。

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