Angela Freitas

Angela Freitas
University of Coimbra | UC ·  Centro de Estudos em Geografia e Ordenamento do Território (CEGOT)

Geographer. Doctoral Researcher in Human Geography - Urban Health | MSc GIS and Spatial Planning | BSc Geography, Spatial Planning and Development

About

43
Publications
11,634
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Citations
Introduction
Angela Freitas is a PhD candidate in Geography in the University of Coimbra, Portugal. She holds a BSc degree in Geography, Spatial Planning and Development and a Master in GIS and Spatial Planning. Since 2012, she has been involved in scientific projects in the field of health geography and health equity, at national and international levels (eg. GEOHEALTHS and EURO-HEALTHY). Her research focuses on the link between place, policies and health equity, from a spatial and political perspective. Research methods include qualitative, quantitative and mixed-methods with different study designs (eg. GIS, Geostatistics, Delphi). Since 2014, she is a Fellow of The Ryoichi Sasakawa Young Leaders Fellowship Fund. In 2018, she was a Visiting Researcher at the University of Berkeley, California (USA).
Additional affiliations
September 2017 - present
University of Coimbra
Position
  • PhD Student
Description
  • PhD in Health Geography with a thesis that explores the link between ‘place, policies and population health’, focusing on local government roles and on place-based approaches to health equity in the city of Lisbon, Portugal.
August 2015 - August 2017
University of Coimbra
Position
  • Research Associate
Description
  • Project EURO-HEALTHY: Shaping EUROpean policies to promote HEALTH equitY (EU Horizon 2020 R&I under Grant Agreement No 643398) http://www.euro-healthy.eu/
July 2012 - August 2015
University of Coimbra
Position
  • Research Associate
Description
  • Project GeoHealthS: Geography of Health Status. Application of the Population Health Index in the last 20 years (PTDC/CS-GEO/122566/2010) http://www.uc.pt/en/fluc/gigs/GeoHealths
Education
October 2013 - October 2019
University of Coimbra
Field of study
  • Geography
October 2008 - December 2011
University of Porto
Field of study
  • GIS (Geographic Information Systems) and Spatial Planning
January 2007 - July 2007
University of Aveiro
Field of study
  • Municipal GIS (Geographic Information System)

Publications

Publications (43)
Book
Full-text available
Despite the significant advances that have been made at the European Union (EU) level in terms of health inequality measurement, there is still a lack of comparable health-related data across countries and regions 1. Existing measures and indicators of health status and quality of life are considered inadequate2 to capture the holistic understandin...
Article
Full-text available
Background Indicators are essential instruments for monitoring and evaluating population health. The selection of a multidimensional set of indicators should not only reflect the scientific evidence on health outcomes and health determinants, but also the views of health experts and stakeholders. The aim of this study is to describe the Delphi sele...
Article
Full-text available
Background: Population health measurements are recognised as appropriate tools to support public health monitoring. Yet, there is still a lack of tools that offer a basis for policy appraisal and for foreseeing impacts on health equity. In the context of persistent regional inequalities, it is critical to ascertain which regions are performing bes...
Article
Full-text available
Social, economic, and environmental differences across the European Union significantly affect opportunities to move forward in achieving greater equity in health. Cohesion Policy (CP) funds can contribute positively through investments in the main determinants of health. The aim of this study is to analyze to what extent the planned investments fo...
Article
Full-text available
Urban health inequities often reflect and follow the geographic patterns of inequality in the social, economic and environmental conditions within a city—the so-called determinants of health. Evidence of patterns within these conditions can support decision-making by identifying where action is urgent and which policies and interventions are needed...
Article
Promoting participation and combining evidence with expert knowledge in constructing composite indices that can be meaningfully interpreted are key open challenges identified in performance measurement literature. To address them, this article proposes a sociotechnical decision-aid process, under a collaborative value-modelling framework, rooted in...
Article
Full-text available
O objetivo deste estudo foi avaliar o contributo do ambiente construído, entre outros fatores, no excesso de peso, em Portugal, utilizando como amostra a Rede Portuguesa de Municípios Saudáveis (RPMS). Foi aplicado um estudo transversal com inquérito de base populacional, realizado entre maio/2020-abril/2021, com uma amostra de 10.047 indivíduos ad...
Article
Full-text available
While the use of social media by local governments has gained relevance in recent years, crises are critical situations that reinforce the need to reach citizens to disclose information, demonstrate the government's commitment, and increase the citizens' level of preparedness and awareness of resources. This paper examines the factors that influenc...
Article
Full-text available
There is considerable evidence pointing to the existence of a socioeconomic gradient in mortality, which tends to be steeper in urban areas. Similar to other European cities, Lisbon is far from homogeneous since considerable geographical inequalities exist between the more advantaged and the more deprived neighborhoods. The main goals of this study...
Article
Full-text available
Background The availability of reliable and comparable data at the regional level is extremely important to measure regional health inequalities. The aim of this research is to assess the data availability of the indicators included in EURO-HEALTHY’s Population Health Index (PHI), a multidimensional tool developed to measure population health acros...
Article
Full-text available
Background: The ability to measure regional health inequalities across Europe and to build adequate population health indices depends significantly on the availability of reliable and comparable data at the regional level. Within the scope of the EU-funded project EURO-HEALTHY, a Population Health Index (PHI) was built. This model aggregates 39 in...
Article
Full-text available
Background: Health inequalities have been consistently reported across and within European countries and continue to pose major challenges to policy-making. The development of scenarios regarding what could affect population health (PH) inequalities across Europe in the future is considered critical. Scenarios can help policy-makers prepare and be...
Article
Full-text available
The different geographical contexts seen in European metropolitan areas are reflected in the uneven distribution of health risk factors for the population. Accumulating evidence on multiple health determinants point to the importance of individual, social, economic, physical and built environment features, which can be shaped by the local authoriti...
Article
Background: Metropolitan areas (MAs) in Europe face diverse risk factors affecting population health. Within the scope of EUROHEALTHY project, a multidimensional measure - Population Health Index (PHI) - was built to reflect population health in an integrated approach, considering two main components - health outcomes and determinants -, both disag...
Chapter
Full-text available
The “Multidimensional health assessment of the population: the case of Estarreja” is discussed in Chapter 9, where Paula Santana, Ângela Freitas, Ricardo Almendra and Cláudia Costa present the Population Health Index (INES) of the municipality of Estarreja between 1991 and 2011. This chapter aims to characterize the health of the population of this...
Article
Full-text available
This study’s aims are: (i) identifying spatial patterns for the risk of hospitalization due to mental illness and for the potential risk resulting from contextual factors with influence on mental health; and (ii) analyzing the spatial association between risk of hospitalization due to mental illness and potential risk resulting from contextual fact...
Conference Paper
Full-text available
Background Reducing health inequalities is one of the main challenges of European governments, confronting decision-makers at all levels. In the present economic-financial crisis, in which public resources are becoming scarcer, difficult decisions regarding the allocation of public funds arise; particularly, policy-makers have to prioritize which p...
Chapter
Full-text available
O Suicídio é um problema de saúde pública em crescimento em todo o mundo e também em Portugal. Pretende-se identificar o padrão geográfico do risco de morte por suicídio e a associação estatística com a privação social e material nas Áreas Metropolitanas de Lisboa e Porto. Foi desenvolvido um estudo ecológico transversal dos óbitos por suicídio e l...
Chapter
Full-text available
Este texto pretende apresentar e analisar o papel dos municípios nos fatores que influenciam a saúde e o bem-estar da população, ilustrando com os casos de estudo da Amadora, Lisboa, Mafra e Oeiras. Foram utilizadas técnicas de análise qualitativa para tratar a informação relativa: i) aos instrumentos para o desenvolvimento de políticas promotoras...
Conference Paper
Full-text available
The reduction of health inequalities within and among countries is stated as one of the main challenges on the present political agenda, confronting decision-makers at all government levels and in all sectors. Local governments are responsible for the most important policy levers for promoting health (e.g. spatial planning, environment, water and...
Article
Full-text available
Population health is influenced by complex interactions between multiple determinants, but there are still large gaps in knowledge about how to comprehensively evaluate the impact of these factors on health. This paper presents the participatory approach used to select a comprehensive set of dimensions and indicators to integrate the Population Hea...
Conference Paper
Full-text available
Introdução: A esperança de vida à nascença (EVN) é uma das principais medidas resumo da população que permite avaliar não só o estado de saúde de um país ou região, como também o seu desenvolvimento. Contudo, não indica por si só onde é necessário intervir para melhorar a saúde da população. A mortalidade evitável (ME), pela prevenção da doença e p...
Conference Paper
Full-text available
Avoidable mortality is an appropriate indicator for monitoring health policies and services. It corresponds to causes of death selected from a cluster of deaths considered to be avoidable given the existing possibilities for primary prevention and medical care. The aim of this study is: i) to assess the contribution of amenable causes of death due...
Thesis
Full-text available
Esta investigação explora a importância da análise do comportamento da procura, nomeadamente o papel das preferências individuais, na análise espacial da habitação, em particular na localização residencial, cuja heterogeneidade sócio-espacial tem enorme influência no processo de estruturação urbana, pelos efeitos que produz nas dinâmicas de ocupaçã...
Conference Paper
Full-text available
Esta investigação explora a importância da análise do comportamento da procura, nomeadamente o papel das preferências individuais, na análise espacial da dinâmica habitacional, a qual exerce um papel activo no processo de estruturação urbana, pela influência que produz nas dinâmicas da ocupação e transformação do solo. A elevada variação espacial d...
Article
Full-text available
O desafio de elaborar uma Carta Social Dinâmica capaz de suportar a totalidade de um sistema social e das temáticas relacionadas directa ou indirectamente e dotada de uma capacidade de actualização imediata e permanente foi o ponto de partida para a realização de um dos projectos mais ambiciosos que se poderia ter aceite no âmbito da criação de fer...
Technical Report
Full-text available
Ao Estado cabe definir, globalmente, as orientações e as metas a atingir, regular ações e apoiar iniciativas, garantindo a luta contra as desigualdades e o cumprimento do papel social e cultural da educação, enquanto bem individual e coletivo, ao serviço de cada um, de todos e da sociedade, no sentido de se aumentar a qualidade do sistema educativo...

Projects

Projects (3)
Archived project
The goal of this project is to assess the effect of environmental and territorial health determinants on the mental health and on the use of mental health services in times of social and economic crises. This goal integrates specific objectives: 1 To study the associations between the evolution of contextual characteristics of a number of Portuguese municipalities in the last 10 years, and psychiatric morbidity and use of mental health services in these municipalities during the same period; 2 To understand how the mental health of individuals is affected by socioeconomic crises, depending on community support, social capital and urban planning; 3 To propose changes in the physical and social environment that may contribute, in periods of crisis, to promote mental health and reduce psychiatric morbidity of the populations. The current study final recommendations will be aimed at orienting action, programs and policies with a possible impact on the negative effects on mental health and longevity of the more vulnerable groups to financial crises like the one we are currently experiencing in Portugal and in Europe.
Archived project
Background: Reducing health inequalities is one of the main challenges of European governments, confronting decision-makers at all levels. In the present economic-financial crisis, in which public resources are becoming scarcer, difficult decisions regarding the allocation of public funds arise; particularly, policy-makers have to prioritize which problems and populations they should address. This challenge demands that the scientific response be both multi-disciplinary and interdisciplinary, thus going beyond the exclusive traditional medical approach to health and extending it to a more integrated, matrix-based and holistic perspective. Hence, tools that can evaluate population health in its multiple dimensions are needed, particularly to inform the choice of interventions with potential to reduce health inequalities and improve population health. Aim: The main objective underlying the project GeoHealthS is to develop a holistic Population Health Index (INES) to evaluate Portuguese population’s health in a multidimensional and disaggregated way, at a municipality scale in the last 2 decades (1991-2011). This index will (1) serve as a multi-dimensional, comprehensive, and consistent measure of the general population’s health profile and the factors which influence health and (2) aid in supporting the decision making process at the local level. Methods: The construction of INES is based on a framework that combines the MACBETH multicriteria approach with participatory methods, including a modified Delphi process with a large group of stakeholders and experts, and decision conferencing with a strategic group. Constructing the INES took place in various phases: i) the identification and selection of indicators characterizing the Portuguese population’s health over the last 20 years; ii) the construction of a multi-criteria model (structuring and evaluation activities), and iii) the application of the Index to Portuguese municipalities. The Index features the six dimensions which correspond to the major areas of concern in terms of population health – socio-economic environment, physical environment, lifestyles, health care services, mortality and morbidity – bringing together 43 evaluation criteria to which one or more indicators are assigned, describing the performance of each municipality with respect to each criterion. Results: The results of the multicriteria model has enabled us to monitor and assess the health of the population for each municipality at three moments in time (1991, 2001 and 2011), considering the Index score for the following outputs: i) the performance profile, ii) the score for each evaluation criterion, iii) the score for each dimension and areas of concern, and iv) the global score for population health. Overall, the Population Health Index (INES) reveals that in the last 20 years: i) the health of the Portuguese population (Continental Portugal) has improved, ii) inequalities seen amongst Municipalities have diminished, and iii) INES’ geographical pattern has been marked by urban and demographic dynamics. In 2011, the INES geography went further to flag a group of municipalities, alerting to their index score and identifying them as potential areas for priority intervention. INES constitutes a valuable tool for decision-support. A WebGIS platform (technological platform founded on geographic information systems) provides a snapshot of population health for each municipality, which enables comparison locally and over time, the health of the population in each area of concern, dimension and indicator. The platform saudemunicipio play an important role in: raising awareness of the factors that influence population health in each municipality; illuminating which dimensions need priority intervention; and being a starting point for future research on simulating the impact of policies on population health. Participating institutions: The GeoHealthS Project enjoys the support and features the participation of a wide-reaching and multidisciplinary group of experts from a variety of public institutions on the national level (the Directorate-General of Health, the Central Administration of the Health System, the Portuguese Environment Agency and the Directorate-General for Territorial Development), the regional level (the Regional Health Administrations of the North, the Centre, for Lisbon and the Tagus River Valley, the Alentejo, and the Algarve), and from hospitals (Hospital Beatriz Ângelo and Hospital Prof. Doutor Fernando da Fonseca). Also involved in the project are researchers and technical consultants from a variety of institutions which conduct scientific research (the University of Coimbra’s Centre of Studies on Geography and Spatial Planning, IST – the Technical University of Lisbon, Universidade Nova de Lisboa – the National School of Public Health, the Faculty of Medicine, the Faculty of Social and Human Sciences (e-GEO), and the Dr. Ricardo Jorge National Institute of Health). Funding: FEDER funds through the Operational Programme for Competitiveness Factors - COMPETE and National Funds through FCT - Foundation for Science and Technology under the project PTDC/ CS-GEO/122566/2010. Website: http://www.uc.pt/en/fluc/gigs/GeoHealths/ WebGIS: http://saudemunicipio.uc.pt/
Project
The EURO-HEALTHY project, standing for "Shaping EUROpean policies to promote HEALTH equitY", is a three-year research project funded by the European Horizon 2020 Research & Innovation programme (Grant agreement No 643398). This project, launched in January 2015, is coordinated by the University of Coimbra (UC - Portugal) and has brought together fifteen institutions from twelve European countries. EURO-HEALTHY aims to evaluate which policies have the highest potential to improve health and health equity across European regions and within metropolitan areas. To achieve this, the project will develop tools, based on a Population Health Index (PHI), to evaluate population health at different geographical levels (for NUTS 2 regions and for 10 metropolitan areas - Athens, Barcelona, Berlin, Brussels, Lisbon, London, Paris, Prague, Stockholm and Turin). Its construction considers the multiple dimensions of population health (socioeconomic, physical and built environment, demographic change, lifestyles, healthcare services and health outcomes), the scientific evidence on the relationship between determinants and health outcomes, and the points of views of various health experts and stakeholders. The index structure will be based on a multi-criteria model that captures how different fac¬tors contribute to the health of the European population. Build¬ing the multi-criteria model will follow a socio-technical approach, integrating the technical elements of a multi-criteria val¬ue model and the social elements of in¬terdisciplinary and participatory process¬es to collect the views from stakeholders and experts. Accounting for population health scenarios, the PHI will be used to foresee and discuss the impact of policies and how different combinations of policies can influence population health and health equity, thus providing a basis for policy dialogue. Two case studies (Lisbon and Turin) will allow study, in more detail, the impact of multilevel policies at the local level. Multi-criteria resource allocation models, conflict analyses, analysis of policy feasi¬bility, and scenario analyses will assist in providing evidence on which policies have the highest potential to improve health and to reduce health inequities, and will aid in suggesting alternative policy options for health policy development and regulation. The space-time analysis and comparison of the population health across European regions will be enabled by a user-friendly WebGIS platform, a web-based Geographic Information System, which will make available all project-related health spatial data. This interactive tool will give a snapshot of PHI outputs at regional and metropolitan scales. More info: Website: http://www.euro-healthy.eu/ Facebook: https://www.facebook.com/Euro-Healthy-501650579992101/ Twitter: https://twitter.com/euro_healthy