Assessing health equity inconsistencies in the World Health Organization’s Urban HEART initiative: findings from key informant interviews
Abstract Background To date, no studies have assessed how the World Health Organization’s (WHO) work operationalizes health equity in practice. To fill the gap, this study investigates the WHO’s Urban Health Equity Assessment and Response Tool (Urban HEART) that focuses on assessing and responding t...
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2025-02-01
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| Online Access: | https://doi.org/10.1186/s12889-025-21786-5 |
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| author | Michelle Amri Patricia O’Campo Theresa Enright Arjumand Siddiqi Erica Di Ruggiero Jesse B. Bump |
| author_facet | Michelle Amri Patricia O’Campo Theresa Enright Arjumand Siddiqi Erica Di Ruggiero Jesse B. Bump |
| author_sort | Michelle Amri |
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| description | Abstract Background To date, no studies have assessed how the World Health Organization’s (WHO) work operationalizes health equity in practice. To fill the gap, this study investigates the WHO’s Urban Health Equity Assessment and Response Tool (Urban HEART) that focuses on assessing and responding to inequities within cities. This qualitative research answers the question: “how does Urban HEART and associated policy and practice align (or not) with inconsistent approaches to health in/equity?” In other words, asking if past findings from investigating WHO key texts also transpire into Urban HEART and its practices. Methods Purposive sampling was employed to undertake synchronous electronic interviews with key informants to glean a multi-faceted perspective of how equity was operationalized through Urban HEART. Data was collected from 18 key informants who had diverse experiences with Urban HEART. Results The results of this study provided insights on how the WHO’s Urban HEART fares with respect to the three inconsistencies. For the first inconsistency, measurement, Urban HEART was evaluated to measure inequities across districts and neighbourhoods, but not inter-city, demonstrating alignment with WHO texts discussing measurement across groups and not individuals. For the second inconsistency, the goals or approaches sought in striving for health equity, despite Urban HEART presenting “three main approaches to reduce health inequities,” informants expressed the most alignment of Urban HEART action with only one of these approaches (“targeting disadvantaged population groups or social classes”). However, informants also shared how actions taken as part of Urban HEART largely aligned with “striving for a baseline level of health for all,” which is not explicitly specified by the WHO as a main approach. And lastly, in assessing the third inconsistency of whether Urban HEART aligned with addressing inequity through focusing on socioeconomic status/position versus broader social determinants of health, Urban HEART was strongly aligned with the latter. Conclusions This study presents disconnects between WHO’s intentions and actions that followed from Urban HEART. Moving forward, it would be important to discuss goals or approaches sought, prior to any global health initiatives, whether explicitly focused on health equity or not. |
| format | Article |
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| language | English |
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| spelling | doaj-art-b9c65ee09c614dbb9519d811ff1aa3cd2025-08-20T02:13:15ZengBMCBMC Public Health1471-24582025-02-0125111310.1186/s12889-025-21786-5Assessing health equity inconsistencies in the World Health Organization’s Urban HEART initiative: findings from key informant interviewsMichelle Amri0Patricia O’Campo1Theresa Enright2Arjumand Siddiqi3Erica Di Ruggiero4Jesse B. Bump5The W. Maurice Young Centre for Applied Ethics, School of Population and Public Health, University of British ColumbiaDalla Lana School of Public Health, University of TorontoDepartment of Political Science, University of TorontoDalla Lana School of Public Health, University of TorontoDalla Lana School of Public Health, University of TorontoTakemi Program in International Health, Harvard T.H. Chan School of Public HealthAbstract Background To date, no studies have assessed how the World Health Organization’s (WHO) work operationalizes health equity in practice. To fill the gap, this study investigates the WHO’s Urban Health Equity Assessment and Response Tool (Urban HEART) that focuses on assessing and responding to inequities within cities. This qualitative research answers the question: “how does Urban HEART and associated policy and practice align (or not) with inconsistent approaches to health in/equity?” In other words, asking if past findings from investigating WHO key texts also transpire into Urban HEART and its practices. Methods Purposive sampling was employed to undertake synchronous electronic interviews with key informants to glean a multi-faceted perspective of how equity was operationalized through Urban HEART. Data was collected from 18 key informants who had diverse experiences with Urban HEART. Results The results of this study provided insights on how the WHO’s Urban HEART fares with respect to the three inconsistencies. For the first inconsistency, measurement, Urban HEART was evaluated to measure inequities across districts and neighbourhoods, but not inter-city, demonstrating alignment with WHO texts discussing measurement across groups and not individuals. For the second inconsistency, the goals or approaches sought in striving for health equity, despite Urban HEART presenting “three main approaches to reduce health inequities,” informants expressed the most alignment of Urban HEART action with only one of these approaches (“targeting disadvantaged population groups or social classes”). However, informants also shared how actions taken as part of Urban HEART largely aligned with “striving for a baseline level of health for all,” which is not explicitly specified by the WHO as a main approach. And lastly, in assessing the third inconsistency of whether Urban HEART aligned with addressing inequity through focusing on socioeconomic status/position versus broader social determinants of health, Urban HEART was strongly aligned with the latter. Conclusions This study presents disconnects between WHO’s intentions and actions that followed from Urban HEART. Moving forward, it would be important to discuss goals or approaches sought, prior to any global health initiatives, whether explicitly focused on health equity or not.https://doi.org/10.1186/s12889-025-21786-5Health equityHealth inequityGlobal healthHealth policyPublic policyGlobal health policy |
| spellingShingle | Michelle Amri Patricia O’Campo Theresa Enright Arjumand Siddiqi Erica Di Ruggiero Jesse B. Bump Assessing health equity inconsistencies in the World Health Organization’s Urban HEART initiative: findings from key informant interviews BMC Public Health Health equity Health inequity Global health Health policy Public policy Global health policy |
| title | Assessing health equity inconsistencies in the World Health Organization’s Urban HEART initiative: findings from key informant interviews |
| title_full | Assessing health equity inconsistencies in the World Health Organization’s Urban HEART initiative: findings from key informant interviews |
| title_fullStr | Assessing health equity inconsistencies in the World Health Organization’s Urban HEART initiative: findings from key informant interviews |
| title_full_unstemmed | Assessing health equity inconsistencies in the World Health Organization’s Urban HEART initiative: findings from key informant interviews |
| title_short | Assessing health equity inconsistencies in the World Health Organization’s Urban HEART initiative: findings from key informant interviews |
| title_sort | assessing health equity inconsistencies in the world health organization s urban heart initiative findings from key informant interviews |
| topic | Health equity Health inequity Global health Health policy Public policy Global health policy |
| url | https://doi.org/10.1186/s12889-025-21786-5 |
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