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ABSTRACT
Despite the increase in global research on health inequalities, more needs to be done to strengthen efforts to inform local interventions. In this article, we ask what determines the local capacity to engage in research on health inequalities. A bibliometric analysis identified Spain as the 10th highest global contributor to this research field (1966–2015), yet a significant proportion of this production was affiliated to just a few institutions in Barcelona. How and why has the city produced so much health inequalities research over four decades? A realist explanatory case study was conducted to test and refine six causal mechanisms, and identify the contextual conditions that might have activated them to generate this outcome. Data was triangulated from 10 semi-structured interviews, and scientific and grey literature. Our findings confirmed that several of our proposed mechanisms - functioning under certain conditions over time - explain the large volume of health inequalities research in Barcelona. Based on these findings, key lessons from the city's experience are suggested. Further research is needed on this topic.
Acknowledgements
Joan Benach gratefully acknowledges the financial support by Catalan Institute for Advanced Research and Studies (ICREA) under the ICREA Academia programme. However, ICREA did not provide direct financial support for the research, or publication of this article.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Authors contributions
LCG and JB conceived the idea for the study, and conducted the interviews; LCG drafted the manuscript and conducted the first analysis; JB, EMH and AEP made substantial contributions to the analysis and manuscript writing. LCG reviewed the consistency of the manuscript, the veracity of data, assured the approval of all authors, and submitted the paper on behalf of the authors.
Ethics approval and consent to participate
This work has received approval by the Institutional Committee for Ethical Review of Projects (CIREP) at Pompeu Fabra University, Barcelona, Spain. Approval Number 138; 31.01.2020.
Additional information
Notes on contributors
Lucinda Cash-Gibson
Lucinda Cash- Gibson, BSc, MSc, MA, PhD, is Research Manager at the Johns Hopkins University - Pompeu Fabra University Public Policy Center; Senior Lecturer at the UPF- Barcelona School of Management (UPF-BSM), and Researcher at the Research Group on Health Inequalities, Environment, Employment Conditions Knowledge Network (GREDS-EMCONET) Department of Political and Social Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain.
Eliana Martinez-Herrera
Eliana Martinez- Herrera, MDM, MSc, PhD, is a Professor at National School of Public Health ‘Héctor Abad Gómez’, University of Antioquia, Medellín, Colombia; Visiting Researcher at the Research Group on Health Inequalities, Environment, Employment Conditions Knowledge Network (GREDS-EMCONET) at UPF, and Visiting Researcher at the Johns Hopkins University - Pompeu Fabra University Public Policy Center, Barcelona, Spain.
Astrid Escrig-Pinol
Astrid Escrig Piñol, BA, MA, PhD, is a Professor at the Mar Nursing School (ESIMar, UPF); Research Associate at the Toronto Rehabilitation Institute, and Researcher at the Research Group on Health Inequalities, Environment, Employment Conditions Knowledge Network (GREDS-EMCONET) UPF, Barcelona, Spain.
Joan Benach
Joan Benach, MD, MPH, PhD, is a Full Professor of Sociology in the Department of Political and Social Sciences at UPF, Director of the Research Group on Health Inequalities, Environment, Employment Conditions Network (GREDS-EMCONET), and Co-Director of the Johns Hopkins – UPF Public Policy Center, Barcelona, Spain. He served as Co-Chair of the Employment Conditions Knowledge Network of the World Health Organization’s Commission on Social Determinants of Health.