Community health action and COVID-19 in Barcelona neighbourhoods: responses and challenges.

This article examines how community health action (CHA) influenced neighborhood responses to the COVID-19 pandemic in Barcelona, focusing on areas with varying levels of pre-existing CHA development. Using qualitative interviews with community agents across six neighborhoods classified as strong, medium, or emerging CHA, the study found that all neighborhoods organized community-driven responses, such as Mutual Support Networks, during the initial pandemic phase. Neighborhoods with strong CHA, characterized by established participatory structures and cohesive leadership, were better able to manage resources, sustain community engagement, and integrate new participants, while medium-CHA areas experienced exacerbated tensions and fragmented coordination, and emerging-CHA neighborhoods relied on non-health-specific participatory structures to facilitate responses. The pandemic intensified a biomedical health paradigm prioritizing physical protection, challenged community participation through restrictions and technology use, and highlighted the importance of empowering communities through public policies adopting a "health-in-all-policies" approach to enhance equity and crisis resilience.