Environmental and social inequalities in health: Neighborhood-level composite indices as a decision-making tool

The environmental health research carried out on a broad scale does not provide decision -makers with tools for managing environmental and social inequalities in health on a fine scale. The goal of the present study was to develop a method for neighborhood -level territorial diagnosis that decision -makers can use to incorporate health issues into their planning policies. The primary objective was to analyze composite spatial vulnerability and resilience indices in the Lille metropolitan area in northern France. The secondary objective was to refine these results by taking account of neighborhood -level characteristics. The study highlights the interest of transdisciplinary research and collaboration with local experts to effectively evaluate and address environmental health issue (more than 30 experts gathered and 12 thematic workshops organized). The results showed that the proposed method allows for the comparison of neighborhoods; however, certain specificities may be underestimated. The real importance of certain variables linked to specific contexts can be minimized, which can distort our understanding of the challenges these neighborhoods face. Analyzing the environmental and social inequalities in health in the metropolitan area's center vs. its belt made it possible to take better account of the characteristics of the areas studied.