Energy poverty and health inequalities in Barcelona: A cross-sectional trends study in the context of COVID-19, energy crisis and climate change, 2016-2021.

The aim of this study was to analyse the time trends in Barcelona before and during the adverse context of COVID-19, energy crisis, and climate change in 1) the energy poverty (EP) prevalence; 2) the association between EP and health and 3) the impact of EP on health, according to the axes of inequality (sex, age, social class, and country of birth). We conducted a cross-sectional trends study using data from the 2016 and 2021 Barcelona Health Survey. This study clearly recognizes that EP continues to be an important public health problem in the context of Barcelona.

Forecast skill assessment of an operational continental heat-cold-health forecasting system: New avenues for health early warning systems.

More than 110,000 Europeans died as a result of the record-breaking temperatures of 2022 and 2023. A new generation of impact-based early warning systems, using epidemiological models to transform weather forecasts into health forecasts for targeted population subgroups, is an essential adaptation strategy to increase resilience against climate change. Here, we assessed the skill of an operational continental heat-cold-health forecasting system.

Short-Term Exposure to Ambient Air Pollution and Antimicrobial Use for Acute Respiratory Symptoms.

Importance: Ambient air pollution and antimicrobial resistance pose significant global public health challenges. It is not known whether ambient air pollution is associated with increased consumption of antimicrobials.

Objective: To assess whether a short-term association exists between ambient air pollution levels and antimicrobial consumption among the general population seeking primary care consultations for acute respiratory symptoms.

Evaluating the effect of passive cooling strategies in school buildings on children's well-being in Barcelona: A quasi-experimental, mixed methods study.

Passive cooling strategies were implemented in 11 school buildings in Barcelona within a pilot project to improve thermal conditions. The present study aimed to evaluate the intervention's impact on students' comfort and well-being at school. A quasi-experimental pre-post study based on mixed methods was conducted.

Spatial Bayesian distributed lag non-linear models (SB-DLNM) for small-area exposure-lag-response epidemiological modelling.

Background: Distributed lag non-linear models (DLNMs) are the reference framework for modelling lagged non-linear associations. They are usually used in large-scale multi-location studies. Attempts to study these associations in small areas either did not include the lagged non-linear effects, did not allow for geographically-varying risks or downscaled risks from larger spatial units through socioeconomic and physical meta-predictors when the estimation of the risks was not feasible due to low statistical power.

Adapting Schools to Climate Change with Green, Blue, and Grey Measures in Barcelona: Study Protocol of a Mixed-Method Evaluation.

Under the framework of the Urban Innovative Actions program of the European Commission, in 2020, 11 primary schools in Barcelona were transformed into climate shelters by implementing green, blue, and grey measures. Schoolyards were also opened to the local community to be used during non-school periods. Here we present the study protocol of a mixed-method approach to evaluate the effectiveness of the interventions in terms of improving environmental quality and health for users.

Association of drought conditions and heavy rainfalls with the quality of drinking water in Barcelona (2010-2022).

Background: Climate change influences the incidence and scope of climate extreme events that affect communities and the environment around the world. In an urban context such as Barcelona, these climate extremes can have a negative impact on drinking water quality. The worsening of drinking water quality can have important repercussions on human health, leading to the appearance of different diseases.

Socioeconomic inequalities in COVID-19 incidence during the first six waves in Barcelona.

Background: The emergence of SARS-CoV-2 affected urban areas. In Barcelona, six waves of COVID-19 hit the city between March 2020 and March 2022. Inequalities in the incidence of COVID-19 have been described.

A City Surveillance System for Social Health Inequalities: The Case of Barcelona.

Introduction: In the past, health inequalities were not prioritised in the political agenda of Barcelona. The change of city government (2015) was an opportunity to develop a Surveillance System for Social Health Inequalities in the city, which is described in this article.

Methods: The design of the Surveillance System formed part of the Joint Action for Health Equity in Europe (JAHEE), funded by the European Union.

Air Pollution and Birth Outcomes: Health Impact and Economic Value Assessment in Spain.

Air pollution is considered an ongoing major public health and environmental issue around the globe, affecting the most vulnerable, such as pregnant women and fetuses. The aim of this study is to estimate the health impact and economic value on birth outcomes, such as low birthweight (LBW), preterm birth (PTB), small for gestational age (SGA), attributable to a reduction of PM levels in Spain. Reduction based on four scenarios was implemented: fulfillment of WHO guidelines and EU limits, and an attributable reduction of 15% and 50% in annual PM levels.

Climate Change and Health in Urban Areas with a Mediterranean Climate: A Conceptual Framework with a Social and Climate Justice Approach.

The consequences of climate change are becoming increasingly evident and highlight the important interdependence between the well-being of people and ecosystems. Although climate change is a global phenomenon, its causes and consequences vary dramatically across territories and population groups. Among settings particularly susceptible to health impacts from climate change are cities with a Mediterranean climate.

Estimating ambient air pollution mortality and disease burden and its economic cost in Barcelona.

Background: The new WHO air quality guidelines indicate that the air pollution disease burden is greater than previously reported. We aimed to estimate the air pollution disease burden and its economic cost in Barcelona to inform local action.

Methods: We used a quantitative health impact assessment to estimate the non-accidental mortality and incidence of childhood asthma and lung cancer attributable to long-term air pollution exposure in the city of Barcelona (Spain) in 2018-2019.

Neighbourhood income inequalities in mental health in Barcelona 2001-2016: a Bayesian smoothed estimate.

Objective: Obtaining reliable health estimates at the small area level (such as neighbourhoods) using survey data usually poses the problem of small sample sizes. To overcome this limitation, we explored smoothing techniques in order to estimate poor mental health prevalence at the neighbourhood level and analyse its profile by income in Barcelona city (Spain).

Method: A Bayesian smoothing model with a logit-normal transformation was applied to four repeated cross-sectional waves of the Barcelona health survey for 2001, 2006, 2011 and 2016.

Effectiveness of an Energy-Counseling Intervention in Reducing Energy Poverty: Evidence from a Quasi-Experimental Study in a Southern European City.

Energy poverty is a serious social problem with well-known adverse health consequences. This problem has been addressed mainly through improvements in the energy efficiency of housing. Still, little is known about the effects of information-based measures on energy poverty and their impacts on health.

Multi-level policy responses to tackle socioeconomic inequalities in the incidence of COVID-19 in a European urban area.

Background: Spain has been hit hard by COVID-19 since March 2020, especially in its metropolitan areas. We share experiences from Barcelona in measuring socioeconomic inequalities in the incidence of COVID-19 in the different waves, and in implementing coordinated and equity-oriented public health policy responses.

Methods: We collected daily data on confirmed COVID-19 cases, geocoded the address of residence to assign each case to one of the 73 neighborhoods and 1068 census tracts, and calculated the cumulative incidence of COVID-19 by neighborhood and five income groups (quintiles of census tracts) by sex across four waves of the pandemic.

Socioeconomic Inequalities in Chronic Liver Diseases and Cirrhosis Mortality in European Urban Areas before and after the Onset of the 2008 Economic Recession.

Objective: To analyse the trends in chronic liver diseases and cirrhosis mortality, and the associated socioeconomic inequalities, in nine European cities and urban areas before and after the onset of the 2008 financial crisis.

Methods: This is an ecological study of trends in three periods of time: two before (2000-2003 and 2004-2008), and one after (2009-2014) the onset of the economic crisis. The units of analysis were the geographical areas of nine cities or urban areas in Europe.

The Association of Energy Poverty with Health and Wellbeing in Children in a Mediterranean City.

Children have been identified as being particularly vulnerable to energy poverty (EP), but little empirical research has addressed the effect of EP on children's health and wellbeing, especially in southern Europe. In this work we aimed to provide an in-depth description of the distribution of EP by sociodemographic, socioeconomic and housing characteristics, as well as to analyse the association between EP and health and wellbeing in children in Barcelona. We performed a cross-sectional study using data from the Barcelona Health Survey for 2016 ( = 481 children under 15 years).

Sociodemographic determinants of intraurban variations in COVID-19 incidence: the case of Barcelona.

Background: Intraurban sociodemographic risk factors for COVID-19 have yet to be fully understood. We investigated the relationship between COVID-19 incidence and sociodemographic factors in Barcelona at a fine-grained geography.

Methods: This cross-sectional ecological study is based on 10 550 confirmed cases of COVID-19 registered during the first wave in the municipality of Barcelona (population 1.

Geographical Variability in Mortality in Urban Areas: A Joint Analysis of 16 Causes of Death.

The geographical distribution of mortality has frequently been studied. Nevertheless, those studies often consider isolated causes of death. In this work, we aim to study the geographical distribution of mortality in urban areas, in particular, in 26 Spanish cities.

Socioeconomic Inequalities in COVID-19 in a European Urban Area: Two Waves, Two Patterns.

: The objective of this paper is to analyze social inequalities in COVID-19 incidence, stratified by age, sex, geographical area, and income in Barcelona during the first two waves of the pandemic. : We collected data on COVID-19 cases confirmed by laboratory tests during the first two waves of the pandemic (1 March to 15 July and 16 July to 30 November, 2020) in Barcelona. For each wave and sex, we calculated smooth cumulative incidence by census tract using a hierarchical Bayesian model.

Energy poverty and health: Trends in the European Union before and during the economic crisis, 2007-2016.

The aim of this study is to analyse the time trends in the European Union (EU) before and during the economic crisis in 1) the energy poverty (EP) prevalence; 2) the association between EP and health and 3) the impact of EP on health. We analyse trends among women and men in two EU macro regions, defined by a novel index of structural vulnerability to EP. The study shows how EP and its impact on health worsened during the economic crisis and identifies groups at higher risk such as women and people living in Mediterranean and Eastern European countries, which have been found to be countries with higher structural vulnerability to EP.

The association of energy poverty with health, health care utilisation and medication use in southern Europe.

Energy poverty (EP) is defined as the inability of a household to secure a socially and materially required level of energy services in the home. The main objective of this study was to analyse the association between EP and distinct indicators of health status, health services utilisation and medication use in southern Europe, using the city of Barcelona as a case study. We conducted a cross-sectional study using the data of the Barcelona Health Survey for 2016 (n = 3519, 53.

Energy poverty, its intensity and health in vulnerable populations in a Southern European city.

Objective: To describe and compare the health status between vulnerable population participating in a program to tackle energy poverty (Energía, la justa) and the non-energy poor Barcelona (Spain) population and to analyse among participants the effect of energy poverty intensity on health.

Method: Cross-sectional study based on data from program participants obtained before the intervention. Participants (1799 women and 671 men) were compared to non-energy poor population of Barcelona (1393 women and 1215 men) sampled from the Barcelona Public Health Survey (2016).

Socio-economic inequalities on cancer mortality in nine European areas: The effect of the last economic recession.

Background: The effect of inequalities aggravated by economic recessions in the mortality rates of certain diseases has been previously described. In this study, we analyzed the relationship between socio-economic deprivation and cancer mortality. We focused on lung, colon, prostate, and breast cancers in nine European urban areas over three periods: two before (2000-2003 and 2004-2008) and one after (2009-2014) the onset of the 2008 financial crisis.

Study Protocol for the Evaluation of the Health Effects of Superblocks in Barcelona: The "Salut Als Carrers" (Health in the Streets) Project.

Superblocks are currently being introduced in Barcelona to respond to the city's scarcity of green spaces and high levels of air pollution, traffic injuries, and sedentariness. The aim is to calm the streets by reducing the number of square meters dedicated to private vehicles and to reclaim part of this public space for people. Salut als Carrers (Health in the Streets) is a project to evaluate the potential environmental and health effects of the superblock model with an equity perspective in Barcelona.