International differences in self-reported health measures in 33 major metropolitan areas in Europe.

"Conflicts of interest : None declared."

"Funding Glasgow Centre for Population Health; Chief Scientist Office of the Health Directorate of the Scottish GovernmentWBS U.1300.00.001.00013.01. Conflicts of interest: None declared. Key pointsWhat is already known on this subject? Population health varies across countries in Europe.The increasing concentration of populations into large metropolitan centres in recent decades has not been matched by international health assessments which hitherto largely focused on the national level.There is a need to compare health measures across Europe metropolitan areas and to determine the extent to which differences are due to socio-economic factors. What does this study add? Findings suggest indicators of poor health are generally higher than average in the metropolitan areas in the north and west of the UK and the central belt and south east of Germany and lower in the areas in Sweden generally and north west Belgium.Variations between the socio-economic composition of the local area populations do not explain European metropolitan health differences.Further research based on internationally standardized survey data is required to explore the underlying causes of Europe metropolitan health differentials and inform health policy."