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How to work with local communities to improve population health: big data and small data
  1. Rafael Cofiño1,2,
  2. Sonia Lopez-Villar3,
  3. Oscar Suárez1
    1. 1Public Health Directorate, Asturias Regional Ministry of Health, Spain
    2. 2Escuela Andaluza de Salud Pública, Granada, Spain
    3. 3Asturias Local Health Governance Systems Project, Spain
    1. Correspondence to Dr Rafael Cofiño, Department of Health Evaluation and Programmes, Directorate of Public Health, Asturias Regional Ministry of Health, C/Ciriaco Miguel Vigil, n° 9, Oviedo, Asturias 33006, Spain; rcofinof{at}

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    The worker must have bread, but she must have roses, tooRose Schneiderman […] ni tampoco para golpear con la frente la tierra,ni para llenarnos el corazón con agua salada,sino para caminar conociendo,para tocar la rectitud con decisiones infinitamente cargadas de sentido.[…] not to beat the earth with our browsor to fill our hearts with salt waterBut to set forth knowing, to touch rectitude with decisions infinitely charged with meaning.Pablo Neruda

    Citizen's input to big data: Maria Teresa's view

    Maria Teresa is a 57-year-old woman who lives in a low-income neighbourhood in an average-sized town in Southern Europe. As a child, she attended primary school but had to leave early in order to work. She made her living from manual works which she had to quit to raise her kids.

    Maria Teresa has never read about the WHO's social determinants of health,1 or heard about ‘Fair Society, Healthy Lives’ by Marmot;2 she would not be able to pronounce Virchow properly, or explain what happened in Silesia.3 She has no idea about what has been going on in the Conferences on Health Promotion over the past three decades. She does not know what the term health assets means or might think Antonovsky4 is a member of that newly arrived immigrant family down the road or an exotic dancer of that famous Russian ballet. However, Maria Teresa could draw an extraordinary picture of the sociodemographic developments of her neighbourhood over the past 40 years; of how unemployment has affected her community; on the different health conditions suffered by women and men; on the effects of drug consumption in the 1980s and how that terrible epidemic took away several dozen lives among the local youths; of how and why more and more women in her neighbourhood take anxiety medication, and about …

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