Focusing urban policies on health equity: the role of evidence in stakeholder engagement in an Italian urban setting

Health equity in All Policies requires decision makers to face the health impact of their decisions and its distribution among different population groups. Since the evidence policy gap often prevents them from using the evidence provided by experts, appropriate mechanisms of governance are needed to overcome this barrier. In Turin (Italy, pop. 900,000) a community of experts, policymakers and stakeholders was engaged in a participatory evidence-based decision-making process to raise awareness and foster intersectoral actions to tackle social health inequalities. This health equity assessment of urban policymaking was based on the action-research model and moved through three steps: i) co-investigation into the mechanisms responsible for generating health inequalities, ii) co-decision of priorities, iii) co-creation and implementation of actions. The two-years process was continuously fed with new evidence from the Turin Longitudinal Study, linking health, resident and socioeconomic stories of individuals and families. Overall, the equity lens is an effective criterion to identify potential health gains as achievable targets for policymaking, a useful metric for comparative analysis of the impact of different policies and a mean to foster stakeholder’ to cooperate. The case-study shows that a systematic cooperative effort with stakeholders is needed to ensure effectiveness and participation in change and innovation.