Understanding Urban Health Inequalities: Methods and Design of the Heart Health Hoods Qualitative Project

Abstract

Objective: Qualitative methods may help to understand features related to health urban inequalities as a way to include citizens' perceptions of their neighbourhoods in relation to their health-related behaviours. The aim of this article is to describe the methods and design of a qualitative urban health study.

Methods: The Heart Healthy Hoods (HHH) analyses cardiovascular health in an urban environment using mixed methods: electronic health records, quantitative individual questionnaires, physical examination, semi-structured Interviews (SSIs), focus groups (FGs) and participatory technics such as photovoice. This article focuses on the HHH qualitative methods and design. A case study was used to select three neighbourhoods in Madrid with different socioeconomic levels: low, medium, and high. The selection process for these three neighbourhoods was as follows: classification of all Madrid's neighbourhoods (128) according to their socioeconomic level; after ranking this classification, nine neighbourhoods, three by socioeconomic level, were short-listed; different urban sociology criteria and non-participant observation were used for the final selection of three neighbourhoods. After selecting the three neighbourhoods, thirty SSIs were held with residents and six SSIs were held with key informants. Finally, twenty-nine FGs will be conducted over the course of 8 months, between May and December of 2018.

Conclusions: Systematization in the selection of neighbourhoods and the use of adequate techniques are essential for the qualitative study of urban health inequalities.

Keywords: Barrios; Desigualdades en salud; Health inequalities; Metodología cualitativa; Neighbourhoods; Qualitative method; Salud urbana; Urban health.