Understanding the systems dynamics of neighborhood socioeconomic inequities in health in European cities: a causal loop diagram

Urban neighborhood inequities in health remain a persistent public health issue, despite many efforts to promote health equity. Given the complex nature of these inequities, a complex systems science approach is essential to identify and understand their underlying causes. In this study, a causal loop diagram (CLD) was developed to visualize the underlying mechanisms contributing to urban neighborhood inequities in self-assessed health. The CLD was based on the results from a scoping literature review and the input from an interdisciplinary group of researchers. Three overarching themes were identified: 1) Uneven power dynamic in decision-making, 2) Socioeconomic sorting through environmental factors, 3) Mutual reinforcement of social cohesion and the physical environment. The interplay of these themes demonstrates that addressing neighborhood inequities in health requires an integrated approach that is inclusive in the decision-making processes and empowers communities.