An evaluation of an urban renewal program and its effects on neighborhood resident's overall wellbeing using concept mapping Roshanak Mehdipanah a,b,n , Davide Malmusi a,b,c , Carles Muntaner d , Carme Borrell a,b,c a Agència de Salut Pública de Barcelona, Spain b Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain c Ciber de Epidemiología y Salud Publica (CIBERESP), Spain d Bloomberg Faculty of Nursing, Dalla Lana School of Public Health, Department of Psychiatry, University of Toronto, Canada article info Article history: Received 30 November 2012 Received in revised form 10 April 2013 Accepted 30 April 2013 Available online 16 May 2013 Keywords: Concept mapping Mixed methods Urban renewal Wellbeing Urban health abstract Urban renewal programs aim to improve physical and socioeconomic position of neighborhoods. However, due to the intervention's complexity, there is often little evidence of their impact on health and health inequalities. This study aimed to identify the perception of a group of neighborhood residents towards a large-scale urban renewal program in Barcelona and to explore its effects and importance on their wellbeing using concept mapping methodology. Our results indicate that the majority of urban renewal projects within the initiative, including improved walkability, construction of new public spaces and more community programs, have positive and important effects on the overall wellbeing of participants. This study presents an innovative method that diverts from traditional outcome-based evaluations studies often used within this field. & 2013 Elsevier Ltd. All rights reserved. 1. Introduction In 2010, it was estimated that three quarters of Europe's population was residing in urban areas and it is predicted that this number will continue to grow (United Nations, 2010; World Bank, 2012). In order to accommodate these numbers, cities are continuously involved in developing areas through urban renewal projects that provide general improvements in physical infrastruc- ture as well as boosting economic, political and cultural gains (Rydin et al., 2012; Spaans, 2004; United Nations, 2010). Despite efforts in linking urban planning to health, there continues to be a lack of collaboration between these two sectors resulting in minimal considerations of health and health inequal- ities during the planning of renewal projects (Rydin et al., 2012; Thomson, 2008; Thomson et al., 2006). One of the consequences of this weak linkage is the limited research available on the evalua- tion of health effects of urban renewal projects due to reasons such as restrictions in the availability of data, inadequate baseline and post-intervention data, and insufficient time intervals to study the effects of projects on various health outcomes (Thomson et al., 2006). Of the existing evaluations, the Healthy Cities commission has been successful in highlighting the importance of investment in transportation to improve accessibility, green space for physical activity, and better water and sanitation regulations to alleviate health risks (Rydin et al., 2012). Some studies focusing on smaller scale urban renewal projects have reported positive effects on the environment and economic status of the area affected in addition to small positive health impacts in self-rated health, mental health and mortality (Curtis et al., 2002; Thomson et al., 2006). However, despite this growing empirical evidence of the health effects of renewal projects, there remains limited understanding of the mechanisms causing these effects resulting in inadequate evalua- tions that may underestimate and undervalue the initiative as a whole (Petticrew et al., 2009; Thomson, 2008). A possible solution to improve current evaluations would be the advancement from evaluations consisting of a single metho- dology, to the incorporation of various methodologies in order to explore the complex relationship between urban renewal and the health of residents. Traditionally, evaluations in this field have relied on quantitative studies looking at mortality, self-reported health status, employment status, education and household income, pre and post-intervention (Thomson et al., 2006). How- ever, qualitative methods can contribute to these studies by providing a deeper understanding of the pathways linking urban renewal and health by capturing the resident's perspectives and experiences (Curtis et al., 2002; Muntaner et al. 2009; Petticrew et al., 2009). By studying the perceptions of overall wellbeing, Contents lists available at SciVerse ScienceDirect journal homepage: www.elsevier.com/locate/healthplace Health & Place 1353-8292/$ - see front matter & 2013 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.healthplace.2013.04.009 n Correspondence to: Agència de Salut Pública de Barcelona, Plaça Lesseps, 1, 08023 Barcelona, Spain. Tel.: +34 932384545; fax: +34 932173197. E-mail address: rmehdipa.work@gmail.com (R. Mehdipanah). Health & Place 23 (2013) 9–17