urban renewal and health: the effects of the neighbourhoods law on health and health inequalities in...
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"Urban renewal and health: The effects of the Neighbourhoods Law on health and health inequalities in Barcelona" by Roshanak Mehdipanah (Universitat Pompeu Fabra & Agència de Salut Pública de Barcelona). PhD defense. Supervisors: Dr. Carme Borrell & Dr. Carles Muntaner. May 23rd 2014.TRANSCRIPT
Roshanak Mehdipanah
Supervisors:Dr. Carme Borrell & Dr. Carles Muntaner
Universitat Pompeu Fabra & Agència de Salut Pública
URBAN RENEWAL & HEALTH:
The eff ects of the Neighbourhoods Law on health and health inequalities in
Barcelona
INTRODUCTION
JUSTIFICATION
OBJECTIVES
STUDY 1
STUDY 2
STUDY 3
DISCUSSION
CONCLUSION
RECOMMENDATIONS
DISSEMINATION
INTRODUCTION
Over 50% of the world’s population lives in urban areas.1
Focus is back on cities and in specific the physical and social makeup of their neighbourhoods and communities.
For a neighbourhood to achieve health & health equity:
Must provide access to basic goods, Encourage social integration, Promote good physical and psychological wellbeing, Be protective of the natural environment.
URBAN HEALTH & HEALTH EQUITY
1UN-HABITAT (2010) State of the world’s cities 2010/ 2011-cities for all: bridging the urban divide. United Nations Human Settlements Programme 4–17.
URBAN HEALTH
PHYSICAL ENVIRONMENT
URBAN HEALTH &PHYSICAL ENVIRONMENT
URBAN HEALTH
SOCIALENVIRONM
ENT
Urban planning and health concerns date back to the 19 th century where overcrowding and unsanitary conditions began as a result of growing industrial cities.1
Urban renewal’s (regeneration) goal is to improve physical infrastructure, promote social integration and increase economic gain within an area intervened.2
Urban renewal has evolved to also address some of the social problems and promote sustainability.3
URBAN PLANNING & RENEWAL
1 Barton H. (2005) “Introduction to the concept of healthy urban planning”. Found in Built Environment: Theme issues – Planning healthy towns & cities. WHO Collaborating Centre for Healthy Cities and Urban Policy 30(4). 2 Spaans M. (2004) The implementation of urban regeneration projects in Europe: Global ambitions, local matters. J Urban Design, 9(3):335-3493 Arbaci S. & Tapada T. (2013) Social inequality and urban regeneration in Barcelona city centre: reconsidering success. Eur Urban Reg Stud,19(3): 287-311.
Specific projects have highlighted the link between urban renewal projects, health and health inequalities:
Increased accessibility to services and resources (healthy food outlets) through transportation improvements.1
The creation of green spaces leading to an increase in physical activity.2
Housing renewal resulting in a decrease of asthma among children.3
URBAN RENEWAL, HEALTH &HEALTH INEQUALITY
1 RydinY.et al. (2012) Shaping cities for health: complexity and the planning of urban environments in the 21st century. Lancet/UCL, London. 2 Mitchell R. & Popham F. (2008) Effects of exposure to natural environment on health inequalities: an observational population study. Lancet, 372: 1655-1660.3 Howden-Chapman P (2008) Effects of improved home heating on asthma in community dwelling children : randomised controlled trial. BMJ;337
URBAN RENEWAL &HEALTH FRAMEWORK
URBAN RENEWAL PROGRAM
PHYSICAL INFRASTRUCTURE
SOCIAL INTEGRATION
ECONOMIC GROWTH
LIVEABILITY
SOCIO-ECONOMIC
MAKEUP
POPULATION TURNOVER
HEALTH &
HEALTH INEQUALITY
A conceptual framework of the link between urban renewal and health/health inequalities.
POLITICAL CONTEXT
Urban renewal policies are complex because: Context in which the intervention is carried out in, Actual projects undertaken, Implementation of the policy, Variability in the outcomes.
This complexity results in diffi culties to do evaluations because: Limited availability and reliability of data related to
intervention for health and socioeconomic indicators, Heavy reliance on quantitative analysis, Dominated by method driven as opposed to theory driven.
The inability to establish clear causal pathways makes the applicability to other situations more diffi cult.
EVALUATION OF URBAN RENEWAL, HEALTH & HEALTH INEQUALITIES
THE NEIGHBOURHOODS LAWLLEI DE BARRIS
Goal: to improve neighbourhoods in Catalonia, Spain while addressing social issues, especially in deprived areas.
The initiative consists of partial funding
from the regional government to selected
municipals with urban renewal proposals.
143 neighbourhoods across Catalonia
have participated in the initiative.
Approximately 1.3bill ion euros invested.
City of Barcelona: 15 of 73 neighbourhoods have participated. 10% of Barcelona’s population (1.6mill ion).
Source: Departament de Política Territorial i Obres Públiques (2009)
THE NEIGHBOURHOODS LAW
Public space
Rehabilitation
Equipment
New Technologies
Sustainability
Gender equality
Social programs
Accessibility
The Neighbourhoods Law expenditure of projects within each of the seven focus areas.
41.5%
11.3%
31.4%
1.4%
2.2%
2.1%
6.5%5.7%
Source: Departament de Política Territorial i Obres Públiques (2009)
THE NEIGHBOURHOODS LAW &HEALTH FRAMEWORK
A conceptual framework of the link between the Neighbourhoods Law and health/health inequalities.
NEIGHBOURHOODS
LAW
PHYSICAL INFRASTRUCTU
RE
SOCIAL INTEGRATION
ECONOMIC GROWTH
LIVEABILITY
SOCIO-ECONOMIC MAKE UP
POPULATION TURNOVER
HEALTH &
HEALTH INEQUALITY
PUBLIC SPACES
NEW TECHNOLOGY
GREEN SUSTAINABILITY
REGENERATION
EQUIPMENT INSTALLATION
GENDER EQUALITY
SOCIAL PROGRAM
EMPLOYMENT IN NEIGHBOURHOODS
HEALTH IN NEIGHBOURHOODS
POLITICAL CONTEXT
THE NEIGHBOURHOODS LAW &HEALTH FRAMEWORK
A conceptual framework of the link between the Neighbourhoods Law and health/health inequalities.
NEIGHBOURHOODS
LAW
POPULATION TURNOVER
HEALTH &
HEALTH INEQUALITY
PUBLIC SPACES
NEW TECHNOLOGY
GREEN SUSTAINABILITY
REGENERATION
EQUIPMENT INSTALLATION
GENDER EQUALITY
SOCIAL PROGRAM
EMPLOYMENT IN NEIGHBOURHOODS
HEALTH IN NEIGHBOURHOODS
POLITICAL CONTEXT
Traffic safetyWalkabilityAestheticsSecurity
Employment Education
Social cohesion
PHYSICAL INFRASTRUCTU
RE
SOCIAL INTEGRATION
ECONOMIC GROWTH
JUSTIFICATION
Urban renewal policies are becoming priorities for cities but continue to not consider health and health inequality.
There is evidence of positive links between initiatives and health, but it remains limited.
Furthermore, evidence on health inequalities remains sparse mainly due to complexities discussed.
Our study is the fi rst in Spain and among the fi rst in Europe to use a mixed-methods approach to study this relationship.
Such studies are needed to raise the importance of including health and health inequality in the planning, implementation and evaluation of urban renewal programs.
OBJECTIVES
GENERAL OBJECTIVE To study the eff ects of an urban renewal policy, the
Neighbourhoods Law, on health and health inequalities.
SPECIFIC OBJECTIVES To evaluate the perceptions of neighbours towards the
eff ects of recent changes in their neighbourhoods on their wellbeing. (Study 1)
To evaluate the eff ects of the Neighbourhoods Law on the health and social class inequalities in health of residents in intervened neighbourhoods. (Study 2)
To explore how urban renewal programs are linked to health and health inequality and discuss some of the complexities. (Study 3)
RESEARCH APPROACH
QUANTITATIVE COMPONENT
QUALITATIVE COMPONENT
THEORY-DRIVEN APPROACH
STUDY 12010 - 2012
STUDY 1
OBJECTIVE To evaluate the perceptions of neighbours towards the
eff ects of recent changes in their neighbourhoods, including the Neighbourhoods Law, on their wellbeing from two Barcelona neighbourhoods using Concept Mapping methodology.
STUDY 1. METHODS
Concept Mapping is a non-traditional qualitative method that provides a conceptual framework that depicts how a group or a population perceives a particular situation.1
Six steps carried out in three sessions with participants.
BRAINSTORMINGSTRUCTURING OF
IDEASINTERPRETATION
OF MAPS
Step 1: PreparationStep 2: Generation of statements
Step 3: Structuring of statementsStep 4: Representation of maps
Step 5: Interpretation of mapsStep 6: Utilization of maps
1 Trochim , W. (1989) An introduction to concept mapping for planning and evaluation. Special Issues of Eval Program Plan 12, 1-16.
STUDY 1. METHODS
ROQUETES
SANTA CATERINA Y SANT PERE
“One change that has occurred within my neighbourhood in recent years that has affected my
family’s or my wellbeing is…”
Group 1: Neighbourhood Association & Community Center (N=14)
Group 2: Senior Day Center (N=12)Group 3: Youth Center (N=19)
STUDY 1. RESULTS
Average cluster rating map of the importance of changes perceived by participants in the Casc Antic day center.
Decrease of economic activity
Abandoned areas
Sense of insecurity
Accessibility by car
Cleaning and repair of streets
Neighbourhoodrelations
Reform of buildings and plazas
Public events and spaces
Community and senior centers
Cluster Layer Layer Value 1 2.99 to 3.22 2 3.22 to 3.44 3 3.44 to 3.67 4 3.67 to 3.89 5 3.89 to 4.12
STUDY 1. RESULTS
Average cluster rating map of the importance of changes perceived by participants in the Casc Antic day center.
Decrease of economic activity
Abandoned areas
Sense of insecurity
Accessibility by car
Cleaning and repair of streets
Neighbourhoodrelations
Reform of buildings and plazas
Public events and spaces
Community and senior centers
Cluster Layer Layer Value 1 2.99 to 3.22 2 3.22 to 3.44 3 3.44 to 3.67 4 3.67 to 3.89 5 3.89 to 4.12
STUDY 1. RESULTS
Cluster: Reform of buildings and plazasABSOLUTE
VALUEPOSITIVE
VALUENEGATIVE
VALUEThe installation of elevators in some residential buildings.
4.29 4.29 0
The replacement of sheds for new apartments. 4 3.14 0.86
The improved liveability throughout the neighbourhood.
3.86 2.57 1.29
The reform of the Community Center. 3.71 3.71 0
The repair of some building facades. 3.71 3.71 0
The re-urbanization of sidewalks and streets. 3.71 3.29 0.43
The reform and re-opening of the Santa Caterina market.
3.57 3.43 0.14
The reform of the central plaza, Pou de la Figuera. 2.71 1.71 1The replacement of old benches with new single-person benches.
2.29 1.14 1.14
AVERAGE 3.51 3.03 0.49MEDIAN 3.71 3.29 0.29
Reform of buildings and plazas
Statements within the cluster, reform of buildings and plazas with corresponding rating values and effect
STUDY 1. RESULTS
Decrease of economic activity
Abandoned areas
Sense of insecurity
Accessibility by car
Cleaning and repair of streets
Neighbourhoodrelations
Reform of buildings and plazas
Public events and spaces
Community and senior centers
Somewhat negativeVery negative
Very positiveSomewhat positive
Average cluster rating map of the importance and effects of changes perceived by participants in the Casc Antic day center.
STUDY 1. RESULTS
Decrease of economic activity
Abandoned areas
Sense of insecurity
Accessibility by car
Cleaning and repair of streets
Neighbourhoodrelations
Reform of buildings and plazas
Public events and spaces
Community and senior centers
POPULATION &SOCIAL CHANGE
URBAN RENEWAL PROJECTS
Somewhat negativeVery negative
Very positiveSomewhat positive
Average cluster rating map of the importance and effects of changes perceived by participants in the Casc Antic day center.
STUDY 22011-2013
STUDY 2
OBJECTIVE To evaluate the eff ects of the Neighbourhoods Law on
the health of residents (women and men) of intervened neighbourhoods in the city of Barcelona and on the social class inequalities in health within these neighbourhoods.
STUDY 2. METHODS
Pre- (2001, 2006) and Post- (2011) intervention periods.
A comparison group of non-intervened neigbourhoods with similar socio-economic indicators based on Census 2001.
Data from Barcelona Health Surveys with population being over the age of 15.
Poor self-rated health and mental health prevalence were described for each sex by neighbourhood group and survey year.
Poisson Regression robust models were used to estimate prevalence ratios and their 95% CI, introducing the interaction between survey year and group.
Comparison neighbourhoods
Intervened neighbourhoods
2006 20110%
5%
10%
15%
20%
25%
30%
WOMEN
2006 20110%
5%
10%
15%
20%
25%
30%
MEN
STUDY 2. RESULTS
1.25 (0.69 - 2.27)
1.93* (1.23 - 3.01)
0.95 (0.69 - 1.31)
0.86 (0.58 - 1.27)
Trends in age-standardised prevalence of poor mental health by neighbourhood groups.
Intervened Comparison
*p<0.05 **p<0.01 ***p<0.001. Numbers shown correspond to Prevalence Ratios calculated using 2006 as reference year
2006 20110%
5%
10%
15%
20%
25%
30%
35%
40%
45%
WOMEN
2006 20110%
5%
10%
15%
20%
25%
30%
35%
40%
45%
MEN
STUDY 2. RESULTS
0.74*(0.56 - 0.97)
1.07 (0.85 - 1.35)
0.53*** (0.36 - 0.78)
1.04 (0.77 - 1.41)
Intervened
*p<0.05 **p<0.01 ***p<0.001. Numbers shown correspond to Prevalence Ratios calculated using 2006 as reference year
Trends in age-standardised prevalence of poor self-rated health by neighbourhood groups.
Comparison
2006 20110%
10%
20%
30%
40%
50%
60%WOMEN - COMPARISON
STUDY 2. RESULTS
Manual ManualNon-manual Non-manual
Intervened Comparison
Trends in age-standardised prevalence of poor self-rated health by neighbourhood group and social class.
0.72* (0.53 - 0.97)
*p<0.05 **p<0.01 ***p<0.001. Numbers shown correspond to Prevalence Ratios calculated using 2006 as reference year
2006 20110%
10%
20%
30%
40%
50%
60%WOMEN - INTERVENED
STUDY 2. RESULTS
Manual ManualNon-manual Non-manual
Intervened Comparison
Trends in age-standardised prevalence of poor self-rated health by neighbourhood group and social class.
2006 20110%
10%
20%
30%
40%
50%
60%MEN - COMPARISON
*p<0.05 **p<0.01 ***p<0.001. Numbers shown correspond to Prevalence Ratios calculated using 2006 as reference year
2006 20110%
10%
20%
30%
40%
50%
60%MEN - INTERVENED
0.45*** (0.29 - 0.69)
STUDY 3. OBJECTIVES
Article 3. Exploring complex causal pathways between
urban renewal, health and health inequality using a theory-
driven approach. R. Mehdipanah, A. Manzano, C. Borrell, D.
Malmusi, M. Rodríguez-Sanz, J. Greenhalgh, C. Muntaner, R.
Pawson. Social Science & Medicine (Under 2nd review).
OBJECTIVE To explore how urban renewal programs are linked to
health and health inequality and discuss some of the complexities associated with these causal pathways using a theory-driven approach.
STUDY 3. METHODS
Theory-driven approach allows the development of links between the program, its outcomes and the context in which it was carried out in.1
Requires a full understanding of the program and its goals while having a constant consideration of the contextual settings in which they are implemented. 2,3
Flexible in methods used and encourages both quantitative and qualitative data as long as they serve to confirm, refine or dismiss the mechanisms studied.2
In the case of this study, we took a realist evaluation approach. 1Chen H.T. (2012) Theory-driven evaluation: Conceptual framework, application and advancement. Evaluation von Programmen und
Projektenfüreine Kultur2Pawson, R. & Sridharan, S. (2010). “Theory-driven evaluation of public health programmes”. In Killoran A., Kelly M.P. (Ed) Evidence-Based Public Health: effectiveness and efficiency, Oxford University Press, Oxford UK. 3Donaldson S. et al. (2003) Theory-driven evaluation in action: lessons from a $20 million statewide Work and Health Initiative. Eval Program Plan, 26, 355-366.
STUDY 3. RESULTS
Two proposed causal pathways linking urban renewal to health & health inequality.
12
STUDY 3. RESULTS
1
Urban renewal programs increase access and availability of resources and opportunities for neighbours.
Two proposed causal pathways linking urban renewal to health & health inequality.
STUDY 3. RESULTS
2
Health and health inequalities will improve if neighbours use and adapt to the changes produced by the intervention.
Two proposed causal pathways linking urban renewal to health & health inequality.
STUDY 3. RESULTS
Open Spaces: Areas that allow residents to participate in public spaces, promote social interaction and are accessible by all compared to private areas.
Public spaces linked to health and health inequalities:
Increased opportunity for physical activity.1
Circulatory disease mortality lower in populations that have access to such public spaces. 2
Features within these open spaces can increase social interaction. 3
1 Rydin Y et al. (2012) Shaping cities for health: complexity and the planning of urban environments in the 21st century. Lancet/UCL, London.2 Mitchell R. &Popham F. (2008) Effects of exposure to natural environment on health inequalities: an observational population study. Lancet, 372: 1655-1660.3 Borja J. & Muxi Z. (2001) Espai Públic: Ciutat I Ciutadania. Diputació de Barcelona, Barcelona.4 Kearns A. et al. (2009) Regeneration and health: Conceptualising the connection. J Urb Regen Ren 3(1): 56-76.
STUDY 3. RESULTS
Causal pathways for the renewal of public open spaces – Pou de la Figuera
MECHANISMS
OUTCOMES
CONTEXT
INTERVENTION
Social
Interaction
Safety &
Security
Accessibility
Children’s playground
Soccer & Basketball
courts
Community garden
Benches around plaza
Planted trees
Changes in Health
+/-Health
Inequality
Population composition
History
DISCUSSION
GENERAL FINDINGS
The Neighbourhoods Law has had positive eff ects on the health and health inequalities of residents.
Neighbours perceived the majority of the Neighbourhoods Law’s interventions as positive and important for their wellbeing.
Poor self-rated health improved in neighbourhoods intervened for both men and women especially in the manual classes compared to those not intervened.
Poor mental health remained constant in both men and women while it increased in the non-intervened group.
Urban renewal programs increase resources and create opportunities in a neighbourhood, but neighbours must use and adapt to these changes in order to benefit optimally.
DISCUSSION
What do these results mean?
Whose health does urban renewal programs aff ect?
How do urban renewal programs aff ect health and health inequalities?
Why do urban renewal programs aff ect health and health inequalities?
WHOSE?
In the fi rst four years the Neighbourhoods Law was estimated to aff ect approximately 10% of the population.1
Results from both quantitative and qualitative studies and existing evidence indicate that not all neighbours have benefitted equally:
Interventions can be population specific.
1Departament de Política Territorial I Obres Públiques – DPTOP (2009) La Llei de barris: Una aposta collectiva per la cohesió social. Generalitat de Catalunya. Spain.
WHOSE?
AGE Younger populations focus more on employment services,
activities, play areas. Older populations focus more on accessibility, social spaces and
safety.
GENDER Both women’s and men’s health outcomes improved.
SOCIAL CLASS Manual social class generally benefi tted more than the non-
manual social class.
WHOSE?
POPULATION TURNOVER
The Neighbourhoods Law, did not contain a housing renewal component.1
Risk of displacement by the law was addressed through the promotion and protection of social housing in the areas intervened.
In the Catalonia context, a large proportions of owners versus renters with deeper roots in neighbourhoods. 2
In our quantitative study, we saw no signifi cant diff erences in populations with more than 5 years living in the neighbourhood and with total population.
However, displacement can become an issue with the eff ects of the current economic crisis.
1Kearns A. & Mason P. (2013) Defining and Measuring Displacement: Is relocation from restructure neighbourhoods always unwelcome and disruptive? Housing Studies, 28(2): 177-2042Nel·lo O. (2011) The five challenges of urban rehabilitation. The Catalan experience. Urban Research & Practice. 4(3): 308-325
HOW?
One change that has aff ected my wellbeing is… Each reply forms a hypothesis of how the Neighbourhoods
Law aff ected the wellbeing of residents:
In Roquetes, the installation of outdoor escalators and elevators was recognized as important and positive for neighbours’ wellbeing.
The removal of a physical barrier. The improvement of accessibility to resources.
HOW?
One change that has aff ected my wellbeing is… Each reply forms a hypothesis of how the Neighbourhoods
Law aff ected the wellbeing of residents:
In Roquetes, the installation of outdoor escalators and elevators was recognized as important and positive for neighbours’ wellbeing.
The removal of a physical barrier. The improvement of accessibility to resources.
POPULATION & SOCIAL CHANGEURBAN RENEWAL PROJECTS
PHYSICAL ENVIRONMENT
SOCIAL ENVIRONMENT
HOW?
One change that has aff ected my wellbeing is…
PHYSICAL ENVIRONMENT
SOCIAL ENVIRONMENT
LIVEABILITY
SOCIO-ECONOMIC
MAKEUP
Each reply forms a hypothesis of how the Neighbourhoods Law aff ected the wellbeing of residents:
In Roquetes, the installation of outdoor escalators and elevators was recognized as important and positive for neighbours’ wellbeing.
The removal of a physical barrier. The improvement of accessibility to resources.
WHY?
• Economic means.• Lifestyle preferences.
WHY?
PLACE-BOUND
Individual characteristics:• Age• Gender• Socio-economic position• Health status
WHY?
USE & ADAPTATION: Neighbours can increase the eff ects of urban renewal.
The presence of neighbourhood associations in program planning and evaluation can empower neighbours to make decisions on the status of their neighbourhoods. 1 ,2
Such groups can impact the wellbeing of residents by addressing issues with production and distribution of specifi c resources throughout the neighbourhood that may be otherwise. 1
Roquetes is a good example of this the strong involvement and participation of neighbours throughout the entire process.
1Matheson A., et al. (2009) Complexity, evaluation and the effectiveness of community-based interventions to reduce health inequalities. Health Prom J. 20:221-2262Pasarin et al. (2010) Community health: integration of primary care and public health competencies. SESPAS report 2010. Gaceta 24(S1): 23-27,
STRENGTHS & LIMITATIONS
Strengths Mixed-methods approach to study the eff ects of a
complex urban renewal intervention and its eff ects on health and health inequalities.
Study serves as a strong example of how structural policies can aff ect health and health inequalities despite incorporating these outcomes in the planning and implementation of these laws.
Limitations Census tract boundary changes between the pre and
post periods in order to accommodate for population growth and political reasoning.
Heavy reliance on the Barcelona Health Surveys where samples are representative of the general population but often size did not permit for subpopulation analysis.
CONCLUSIONS
GENERAL CONCLUSIONS
The majority of projects within the Neighbourhoods Law were perceived as positive and important to the wellbeing of neighbours.
On the contrary, population and social changes in these neighbourhoods were largely observed as negative and important.
The incorporation of neighbours’ perspectives is critical for understanding better the compositional and contextual factors in a neighbourhood.
The division found in the maps of the concept mapping, provided support for the concepts of liveability and population turnover found in the conceptual framework.
GENERAL CONCLUSIONS
In both women and men, self-rated health improved in the neighbourhoods intervened by the Neighbourhoods Law, especially those within the manual social classes, compared to non-intervened neighbourhoods with similar socio-demographic characteristics.
Similar results as above were seen for the mental health status of women in the intervened neighbourhoods.
The Neighbourhoods Law appears to moderate further increases in poor mental health observed in men from the comparison group.
Although urban renewal programs may improve opportunities and resources in a neighbourhood, residents must use and adapt to these changes in order to benefi t optimally.
A focus on theory is needed to explore potential causal pathways linking urban renewal to health outcomes.
RECOMMENDATIONS
Health and health inequality outcomes should be included in the evaluations of urban renewal programs conducted.
A thorough understanding of contextual and compositional factors in which the intervention was carried out is essential in order to understand the infl uence it may have on the outcomes attained.
In the case of the Neighbourhoods Law, information from this dissertation can be used to lobby political groups to allow for the continuation of such interventions.
Furthermore, future urban renewal policies should take into account potential eff ects on health and health inequality at both the planning and evaluation phases resulting in the need for intersectoral work.
RECOMMENDATIONS
DISSEMINATION
KNOWLEDGE TRANSFER
KNOWLEDGE TRANSFER
KNOWLEDGE TRANSFER
VIDEO
THANK YOU
CARME BORRELL & CARLES MUNTANERMAICA RODRIGUEZ-SANZ & DAVIDE
MALMUSIALL THE CO-AUTHORS
SESIS SALUT ALS BARRIS & SALUT COMUNITARI
UNIVERSITY OF LEEDS, UKROQUETES PLA COMUNITARI & TON I GUIDA
C.C. CENTRE DE DIA CASC ANTIC & PALAU ALOS
CROMAENRIC CREMADES & ORIOL NEL·LO
THE NEIGHBOURS OF ROQUETES & S.CATERINA