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Cited by 2Public Health Policies and EducationHealth Services Management and PolicyHealth Policy Implementation Science

European-wide policymaking at the urban level: a qualitative study

Open access
Mueller, Julia, Patterson, Lesley, Jakab, Matyas, Higgerson, James, Steels, Stephanie, Verma, Arpana·2021·European Journal of Public Health
DOI 10.1093/eurpub/ckab016PMC PMC8546880
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Abstract

Background: Inter-urban area (UA) health inequalities can be as dramatic as those between high and low-income countries. Policies need to focus on the determinants of health specific to UAs to effect change. This study therefore aimed to determine the degree to which policymakers from different countries could make autonomous health and wellbeing policy decisions for their urban jurisdiction area. Methods: We conducted a cross-sectional, qualitative interview study with policymakers recruited from eight European countries (N = 37). Results: The reported autonomy among policymakers varied considerably between countries, from little or no autonomy and strict adherence to national directives (e.g. Slovak Republic) to a high degree of autonomy and ability to interpret national guidelines to local context (e.g. Norway). The main perceived barriers to implementation of local policies were political, and the importance of regular and effective communication with stakeholders, especially politicians, was emphasized. Having qualified health professionals in positions of influence within the UA was cited as a strong driver of the public health (PH) agenda at the UA level. Conclusion: Local-level policy development and implementation depends strongly on the degree of autonomy and independence of policymakers, which in turn depends on the organization, structure and financial budget allocation of PH services. While high levels of centralization in small, relatively homogenous countries may enhance efficient use of resources, larger, more diverse countries may benefit from devolution to smaller geographical regions.

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  • Among people living with obesity, more than half (55%) reported that their mental health had worsened during the first COVID-19 lockdown in a recent UK-based survey.

    “Among people living with obesity, more than half (55%) reported that their mental health had worsened during the first COVID-19 lockdown in a recent UK-based survey [6].”

    From Supporting Weight Management during COVID-19: A Randomized Controlled Trial of a Web-Based, ACT-Based, Guided Self-Help Intervention (2022) · cites this paper as [6]

    The Results describe interviews with urban public-health policymakers, including 12 interviews in the UK, rather than a survey of people living with obesity. The Introduction’s 55% figure refers to the share of the world’s population living in cities. Searches for COVID-19 lockdown, worsening mental health, and a UK obesity survey found no passage supporting the claimed finding. (LLM, conf=0.76)

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  • Food consumption and weight increased during the COVID-19 pandemic while physical activity decreased, particularly among those with higher BMI.

    “Evidence suggests that food consumption and weight increased during the pandemic while physical activity decreased, particularly among those with higher BMI [2, 3, 4, 5, 6].”

    From Supporting Weight Management during COVID-19: A Randomized Controlled Trial of a Web-Based, ACT-Based, Guided Self-Help Intervention (2022) · cites this paper as [6]

    The Introduction discusses urban health policy and mentions childhood obesity, but does not report changes in eating, weight, or physical activity during COVID-19. Searches for pandemic-related changes and higher BMI found no passage addressing the claim. (LLM, conf=0.78)

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  • The COVID-19 pandemic has had a negative impact on wellbeing among people with obesity.

    “Emerging evidence indicates that the COVID-19 pandemic has had a negative impact on wellbeing among people with obesity [6].”

    From Supporting Weight Management during COVID-19: A Randomized Controlled Trial of a Web-Based, ACT-Based, Guided Self-Help Intervention (2022) · cites this paper as [6]

    The Introduction mentions childhood obesity in the context of urban policy, while the Discussion addresses policymakers’ autonomy over health and wellbeing decisions; neither reports wellbeing outcomes among people with obesity. Searches for COVID-19, the pandemic, and obesity-related wellbeing found no passage addressing the claim. (LLM, conf=0.78)

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Authors
Mueller, J., Patterson, L., Jakab, M., Higgerson, J., Steels, S., & Verma, A.
Affiliations
  • University of Cambridge (GB)
  • University of Manchester (GB)
  • Manchester Metropolitan University (GB)
Corresponding author
Mueller, Julia
ORCID
Venue
European Journal of Public Health
Publisher
Oxford University Press (OUP)
Published
2021-03-16
Volume
31
Issue
5
Pages
931-936
ISSN
  • 1101-1262 (ISSN-L)
  • 1464-360X
DOI
10.1093/eurpub/ckab016
PMC
PMC8546880
OpenAlex
W3137363533
Cited by
2
References
42
Citations by year
2023: 1 · 2022: 1
FWCI
0.56
Type
journal article
Language
en
Open access
Licence
Locations
  • European Journal of Public Health (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • e-space (Manchester Metropolitan University) (acceptedVersion)
  • Research Explorer (The University of Manchester) (submittedVersion)
Funders
  • EU Commission (FP7/2007-2013)
  • EUROURHIS 2 project (223711)
Topics
  • Health Sciences › Health Professions › General Health Professions › Public Health Policies and Education
  • Health Sciences › Health Professions › General Health Professions › Health Services Management and Policy
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Keywords
local health policy, policy autonomy, decentralization, devolution, public health services, health determinants, stakeholder communication, European Union health policy
MeSH terms
Cross-Sectional Studies, Europe, Humans, Policy Making, Qualitative Research, Policy

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