title: Perceptions and beliefs of public policymakers in a Southern European city.
abstract: BACKGROUND
  Socio-economic inequalities in health are large in urban areas; however, local municipal governments may plan, manage and provide services and policies which can reduce these. The objective of this study was to describe the beliefs and perceptions of public policymakers in a European city, Barcelona. They are the key actors in designing and implementing urban public policies.
  
  
  METHODS
  A qualitative research study describing policymakers' beliefs on health inequalities. The study population were twelve policymakers. These were politicians or officers from the city council. Informant profiles were selected using a theoretical sample. Semi-structured individual interviews were performed to collect the data and a thematic content analysis was carried out.
  
  
  RESULTS
  Politicians were aware of health inequalities in their city and identified diverse social causes. They viewed reducing inequalities as a priority for the city's government. Officers were less knowledgeable and described less efforts in addressing health inequalities. It was stated by some that reducing inequalities in non-health sectors helped to reduce health inequalities indirectly and there was some collaboration between two sectors. The most frequent barriers encountered when implementing policies were funding and the cities' limited authority.
  
  
  CONCLUSIONS
  Officers and policymakers had different levels of awareness and access to information on health and its social determinants. Officers referred to specific causes of health inequalities and policies which related to their sectors and politicians were more familiar with upstream determinants and policies. Some participants explained that policies and programmes needed to be evaluated and very little intersectoral action was said to be carried out. More efforts should be made to provide all policymakers with information on the social determinants of health inequalities. Research on health inequalities and policy should engage with policymakers and promote health as a cross cutting issue in the city council in liaison with the third sector.
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK. j.morrison@ucl.ac.uk.|CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. j.morrison@ucl.ac.uk.|Agència de Salut Pública de Barcelona, Barcelona, Spain. j.morrison@ucl.ac.uk.
authors.forename: Joana
authors.initials: J
authors.lastname: Morrison
authors.affiliation: Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain. mponsv@idiapjgol.info.|Universitat de Girona, Girona, Spain. mponsv@idiapjgol.info.
authors.forename: Mariona
authors.initials: M
authors.lastname: Pons-Vigués
authors.affiliation: CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. ediez@aspb.cat.|Agència de Salut Pública de Barcelona, Barcelona, Spain. ediez@aspb.cat.|Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain. ediez@aspb.cat.
authors.forename: Elia
authors.initials: E
authors.lastname: Díez
authors.affiliation: CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. mpasarin@aspb.cat.|Agència de Salut Pública de Barcelona, Barcelona, Spain. mpasarin@aspb.cat.|Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain. mpasarin@aspb.cat.
authors.forename: Maria Isabel
authors.initials: MI
authors.lastname: Pasarin
authors.affiliation: Agència de Salut Pública de Barcelona, Barcelona, Spain. sergi_salas@hotmail.com.
authors.forename: Sergio
authors.initials: S
authors.lastname: Salas-Nicás
authors.affiliation: CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. cborrell@aspb.cat.|Agència de Salut Pública de Barcelona, Barcelona, Spain. cborrell@aspb.cat.|Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain. cborrell@aspb.cat.|Universitat Pompeu Fabra, Barcelona, Spain. cborrell@aspb.cat.
authors.forename: Carme
authors.initials: C
authors.lastname: Borrell
mesh_terms: D001294:Attitude to Health; D006291:Health Policy / Q000191:economics*; D006801:Humans; D009111:Local Government; D010465:Perception; D011057:Politics; D036301:Qualitative Research; D012959:Socioeconomic Factors; D013030:Spain