Urban Health Index
In 2011, WHO Kobe Centre began exploring the feasibility and utility of constructing an Urban Health Index for assessments of intra-urban inequalities in health determinants and outcomes, as well as for inter-city comparisons. Numerous health indicators, either singularly or in a set, are used to measure the health status of urban populations. However, available urban health metrics focus primarily on large area rankings. Less has been done to develop an index that provides information about level of health and health disparities for small areas within cities.
In order to pursue this work, a research collaboration was established between the School of Public Health, Georgia State University (Atlanta, USA) and the WHO Kobe Centre. This has resulted in the development of a flexible Urban Health Index for measuring small-area disparities. A description of the method along with some example applications are now published in the Journal of Urban Health (see below for information on how to access the article).
Adopting a method used by the Human Development Index, we standardized indicators for small area units on a (0, 1) interval and combined them using their geometric mean to form an Urban Health Index. Disparities were assessed using the ratio of the highest to lowest decile and measurement of the slope of the eight middle deciles (middle 80 %) of the data. We examined the sensitivity of the measure to weighting, to changes in the method, to correlation among indicators, and to substitution of indicators.
The research collaborative has since grown to include urban health researchers from the University of Manchester (UK), the Universidade Federal da Bahia (Brazil), and Fudan University (China), and is welcoming more partners. So far, the Urban Health Index has been successfully computed for Atlanta, USA, Rio de Janeiro, Brazil, Shanghai, China, and Tokyo, Japan. The results suggest that a flexible tool, whose method rather than content is standardized, may be of use for local evaluation, for decision making, and for area comparison.
- Rothenberg R, Weaver SR, Dai D, Stauber C, Prasad A, Kano M. A flexible Urban Health Index for small area disparities. Journal of Urban Health. 2014;91(5):823-835. doi: 10.1007/s11524-014-9867-6.
- Rothenberg R, Stauber C, Weaver SR, Dai D, Prasad A, Kano M. Urban health indicators and indices—current status. BMC Public Health. 2015;15:494. doi: 10.1186/s12889-015-1827-x.
- Bortz M, Kano M, Ramroth H, Barcellos C, Weaver SR, Rothenberg R, Magalhães M. Disaggregating health inequalities within Rio de Janeiro, Brazil, 2002-2010, by applying an urban health inequality index. Cadernos Saúde Pública [online]. 2015;31(suppl.1):107-119. doi: http://dx.doi.org/10.1590/0102-311X00081214.
Rothenberg R, Weaver SR, Dai D, Stauber C. Final report: development of an Urban Health Index. Prepared for the World Health Organization Centre for Health Development. Atlanta: Georgia State University; 2012.