PT | EN
|Combating health inequality constitutes one of the greatest challenges faced by public health administrations, and as this issue has been made a priority by the European Union, and namely by Portugal, the topic has assumed even greater importance given the context of the present economic and financial crisis. This challenge demands that the scientific response be both multi-disciplinary and interdisciplinary, thus going beyond the exclusive traditional medical approach to health and extending it to a more integrated, matrix-based and holistic perspective. It therefore becomes necessary to develop a multidimensional assessment tool which makes both temporal and spatial comparisons possible and which contributes to the identification of priority areas for future intervention.|
The main objective underlying the project Geography of Health Status – An application of a Population Health Index in the last 20 Years (GeoHealthS) is to evaluate the health of the Portuguese population over the last 20 years through the construction, application, and availability of a Population Health Index on the municipal level.
This index will (1) serve as a multi-dimensional, comprehensive, and consistent measure of the general population’s health profile and the factors which influence health and (2) aid in supporting the decision making process at the local level.
The construction of the holistic Population Health Index (INES) will be founded on a socio-technical approach that combines the MACBETH multicriteria approach (Measuring Attractiveness by a Categorical Based Evaluation Technique) and participatory methods.
These methods included the involvement of experts from a variety of disciplines, representing a range of national and regional institutions that participated in Delphi panels and in decision conferences (see Participating Institutions).
Constructing the INES took place in various phases:
The Population Health Index (INES) features the six dimensions which correspond to the greatest areas of concern in terms of health – socio-economic status, physical environment, lifestyle, health care, mortality and morbidity – bringing together 43 evaluation criteria to which one or more indicators are assigned that will describe the performance of each Municipality with respect to each criterion.
The results of the multicriteria model has enabled us to monitor and assess the health of the population for each Municipality at three moments in time (1991, 2001 and 2011), considering the Index score for the following outputs: i) the performance profile, ii) the score for each evaluation criterion, iii) the score for each dimension and areas of concern, and iv) the global score for population health.
Overall, the Population Health Index (INES) reveals that in the last 20 years: i) the health of the Portuguese population (Continental Portugal) has improved, ii) inequalities seen amongst Municipalities have diminished, and iii) INES’ geographical pattern has been marked by urban and demographic dynamics. In 2011, the INES geography went further to flag a group of municipalities, alerting to their index score and identifying them as potential areas for priority intervention.
For the presentation and dissemination of the results, a public access WebSIG platform was created, a technological platform founded on geographic information systems. The platform saudemunicipio makes available the maps and geographical information of INES results from Portuguese municipalities over the last 20 years. It also allows users to visualize, analyse and compare the Index outputs on the municipal level, be it the global score, the score for each dimension and area of concern, or the score for each evaluation criterion.
The GeoHealthS Project enjoys the support and features the participation of a wide-reaching and multidisciplinary group of experts from a variety of public institutions on the national level (the Directorate-General of Health, the Central Administration of the Health System, the Portuguese Environment Agency and the Directorate-General for Territorial Development), the regional level (the Regional Health Administrations of the North, the Centre, for Lisbon and the Tagus River Valley, the Alentejo, and the Algarve), and from hospitals (Hospital Beatriz Ângelo and Hospital Prof. Doutor Fernando da Fonseca).
Also involved in the project are researchers and technical consultants from a variety of institutions which conduct scientific research (the University of Coimbra’s Centre of Studies on Geography and Spatial Planning, IST – the Technical University of Lisbon, Universidade Nova de Lisboa – the National School of Public Health, the Faculty of Medicine, the Faculty of Social and Human Sciences (e-GEO), and the Dr. Ricardo Jorge National Institute of Health).
Last update: 4th November 2015