The HHH Project
Research-based writing on cardiovascular disease, urban neighbourhoods, and the social determinants of heart health across European cities.
Edinburgh and Madrid have very little in common. One sits on a northern Atlantic coast, shaped by industrial heritage and a National Health Service; the other lies on the high Castilian plateau, Mediterranean in character, with a different welfare tradition and a healthcare system excellent at acute care but historically less focused on prevention. Yet…
When John Snow plotted cholera deaths on a map of Soho in 1854, he did something that changed public health forever. By placing disease in space — treating location as data — he identified the Broad Street water pump as the source of an outbreak that had killed hundreds within days. The map did not…
In Madrid, tobacco is sold through a licensed network of estancos — specialist shops that hold an exclusive state concession to sell tobacco products. There are roughly 5,000 estancos in the Madrid metropolitan area. They are not evenly distributed. Research conducted as part of the HHH Project mapped the geographic distribution of tobacco retail outlets…
Villaverde sits in the southern reaches of Madrid, separated from the city’s prosperous north by more than geography. It is one of the capital’s most densely populated districts and one of its most socioeconomically deprived. Premature mortality from cardiovascular disease here is significantly higher than the Madrid average — following the socioeconomic gradient in cardiovascular…
Photovoice is a participatory action research method in which community members use photography to document their own environment, then collaboratively analyse and discuss what they have captured. The technique was formally developed by Caroline Wang and Mary Ann Burris in 1992, initially in the context of women’s health in rural China, and has since been…
Heart disease is the leading cause of death across Europe, responsible for roughly 45 percent of all deaths each year. Yet the burden is distributed with striking unevenness. In virtually every major European city, cardiovascular mortality rates vary dramatically from one neighbourhood to the next — often by a factor of two or three within…
