title: Urban regeneration as population health intervention: a health impact assessment in the Bay of Pasaia (Spain).
abstract: An important health issue in urban areas is how changes arising from the regeneration of city-areas affect social determinants of health and equity. This paper examines the impacts attributable to a new fish market and to delays in the regeneration of a port area in a deteriorated region of the Bay of Pasaia (Spain). Potential differential impacts on local residents and socially vulnerable groups were evaluated to determine health inequalities.
  
  
  
  An in-depth, prospective and concurrent Health-Impact-Assessment (HIA) focused on equity was conducted by the regional Public Health Department, following the Merseyside guidelines. Data from different sources was triangulated and impacts were identified using qualitative and quantitative methods.
  
  
  
  The intervention area is characterised by poor social, environmental, and health indicators. The distinctness of the two projects generates contrasting health and inequality impacts: generally positive for the new fish market and negative for the port area. The former creates recreational spaces and improves urban quality and social cohesion. By contrast, inaction and stagnation of the project in the port area perpetuates deterioration, a lack of safety, and poor health, as well as increased social frustration.
  
  
  
  In addition to assessing the health impacts of both projects this HIA promoted intersectoral partnerships, boosted a holistic and positive view of health and incorporated health and equity into the political discourse. Community-level participatory action enabled public health institutions to respond to new urban planning challenges and responsibilities in a more democratic manner.
authors.affiliation: Public Health and Addictions Division of Gipuzkoa, Regional Public Health Centre Bidasoa, Basque Government, Avd. Navarra, 41-20302, Irún, Spain. esk-irun9@euskadi.eus.
authors.forename: Elena
authors.initials: E
authors.lastname: Serrano
authors.affiliation: Public Health and Addictions Division of Gipuzkoa, Basque Government, Avd. Navarra 4, 20013, San Sebastian, Spain.|BIODONOSTIA Health Research Institute, San Sebastian, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Larrañaga
authors.affiliation: BIOEF Basque Institute of Health Research, Bilbao, Spain.
authors.forename: Maite
authors.initials: M
authors.lastname: Morteruel
authors.affiliation: San Pedro Health Center, Osakidetza-Basque Public Health Service, c/Los Marinos 1, 20110, Pasaia, Spain.
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Baixas de Ros
authors.affiliation: Public Health and Addictions Division of Gipuzkoa, Basque Government, Avd. Navarra 4, 20013, San Sebastian, Spain.|BIODONOSTIA Health Research Institute, San Sebastian, Spain.|Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Barcelona, Spain.
authors.forename: Mikel
authors.initials: M
authors.lastname: Basterrechea
authors.affiliation: BIODONOSTIA Health Research Institute, San Sebastian, Spain.|Department of Environment and Regional Planning, Basque Government, c/Infanta Cristina. 11- Villa Begoña, 20008, San Sebastian, Gipuzkoa, Spain.
authors.forename: Dolores
authors.initials: D
authors.lastname: Martinez
authors.affiliation: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Barcelona, Spain.|Public Health and Addictions Directorate, Basque Government, Vitoria-Gasteiz, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Aldasoro
authors.affiliation: Department of Sociology 2, University of the Basque Country (UPV/EHU), Leioa, Spain.|OPIK- Research Group Social Determinants of Health and Demographic Change, Leioa, Spain.
authors.forename: Amaia
authors.initials: A
authors.lastname: Bacigalupe
mesh_terms: D003256:Community Participation; D062489:Health Impact Assessment; D006801:Humans; D000075485:Population Health; D011446:Prospective Studies; D011634:Public Health; D036301:Qualitative Research; D012038:Regeneration; D012959:Socioeconomic Factors; D013030:Spain; D014505:Urban Population / Q000706:statistics & numerical data*; D014506:Urban Renewal / Q000458:organization & administration*
keywords: Health impact assessment; Health inequalities; Mixed method design; Social determinants of health; Urban regeneration