51
|
Chalikavada R, Broder JC, O'Hara RL, Xue W, Gasevic D. The association between neighbourhood walkability and after-school physical activity in Australian schoolchildren. Health Promot J Austr 2020; 32:182-188. [PMID: 32337755 DOI: 10.1002/hpja.356] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 03/03/2020] [Accepted: 04/16/2020] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Physical inactivity is a risk factor for many noncommunicable diseases. As reported by the World Health Organisation, 81% of children worldwide are physically inactive. Environmental factors, such as neighbourhood walkability, can shape people's physical activity (PA) behaviour. This study explored the association between neighbourhood walkability and after-school PA among Australian schoolchildren. METHODS The Department for Education and Child Development (DECD) distributed the survey to 189 schools across South Australia to assess the health and well-being of schoolchildren aged between 8 and 14 years. Neighbourhood was defined as an area corresponding to a four digit postcode, and its walkability was measured using Walk Score® . The association between neighbourhood walkability and after-school PA was analysed using multinomial logistic regression adjusted for age, gender, SEIFA score, number of days of TV watching, number of times of eating junk food, neighbourhood safety and children's weight status. RESULTS Children residing in highly walkable areas (walker's paradise) compared to car-dependent areas had higher odds (OR(95%CI)) of engaging in after-school PA three (1.216 (1.029, 1.436), P = .021), four (1.287 (1.064, 1.557), P = .009) and five times a week (1.230 (1.030, 1.133), P = .022) compared to children never participating in PA. CONCLUSION Living in highly walkable areas (walker's paradise), compared to living in car-dependent areas was associated with higher levels of after-school PA. So what? Creating walkable neighbourhoods with greater access to amenities, services and public transportation may help increase after-school PA among schoolchildren.
Collapse
Affiliation(s)
| | | | - Rebecca L O'Hara
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic., Australia
| | - Wenyue Xue
- University of Melbourne, Melbourne, Vic., Australia
| | - Danijela Gasevic
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic., Australia.,Usher Institute, Edinburgh, UK
| |
Collapse
|
52
|
A GIS-Based Method for Analysing the Association Between School-Built Environment and Home-School Route Measures with Active Commuting to School in Urban Children and Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072295. [PMID: 32235341 PMCID: PMC7177458 DOI: 10.3390/ijerph17072295] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 03/25/2020] [Accepted: 03/26/2020] [Indexed: 11/17/2022]
Abstract
In the current call for a greater human health and well-being as a sustainable development goal, to encourage active commuting to and from school (ACS) seems to be a key factor. Research focusing on the analysis of the association between environmental factors and ACS in children and adolescents has reported limited and inconclusive evidence, so more knowledge is needed about it. The main aim of this study is to examine the association between different built environmental factors of both school neighbourhood and home-school route with ACS of children and adolescents belonging to urban areas. The ACS level was evaluated using a self-reported questionnaire. Built environment variables (i.e., density of residents, street connectivity and mixed land use) within a school catchment area and home-school route characteristics (i.e., distance and pedestrian route directness—PRD) were measured using a geographic information system (GIS) and examined together with ACS levels. Subsequently, the association between environmental factors and ACS was analysed by binary logistic regression. Several cut-off points of the route measures were explored using receiver operating characteristic (ROC) curves. In addition, the PRD was further studied regarding different thresholds. The results showed that 70.5% of the participants were active and there were significant associations between most environmental factors and ACS. Most participants walked to school when routes were short (distance variable in children: OR = 0.980; p = 0.038; and adolescents: OR = 0.866; p < 0.001) and partially direct (PRD variable in children: OR = 11.334; p < 0.001; and adolescents: OR = 3.513; p < 0.001), the latter specially for children. Mixed land uses (OR = 2.037; p < 0.001) and a high density of street intersections (OR = 1.640; p < 0.001) clearly encouraged adolescents walking and slightly discouraged children walking (OR = 0.657, p = 0.010; and OR = 0.692, p = 0.025, respectively). The assessment of ACS together with the environmental factors using GIS separately for children and adolescents can inform future friendly and sustainable communities.
Collapse
|
53
|
Pocock T, Moore A, Molina-García J, Queralt A, Mandic S. School Neighbourhood Built Environment Assessment for Adolescents' Active Transport to School: Modification of an Environmental Audit Tool and Protocol (MAPS Global-SN). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072194. [PMID: 32218286 PMCID: PMC7177319 DOI: 10.3390/ijerph17072194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/22/2020] [Accepted: 03/23/2020] [Indexed: 11/16/2022]
Abstract
School neighbourhood built environments (SN-BE) can influence adolescents' active transport to school habits. Typically, SN-BE assessment has involved micro-scale (i.e., environmental audits) or macro-scale (Geographic Information Systems (GIS)) assessment tools. However, existing environmental audits are time/resource-intensive and not specific to school neighbourhoods, while GIS databases are not generally purposed to include micro-scale data. This study evaluated the inter-rater reliability and feasibility of using a modified audit tool and protocol (Microscale Audit of Pedestrian Streetscapes Global-School Neighbourhood (MAPS Global-SN)) to assess the SN-BE of twelve secondary schools in Dunedin, New Zealand. Correlations between MAPS Global-SN and GIS measures of the SN-BE were also examined. Specifically, MAPS Global-SN audit and GIS spatial analysis (intersection density, residential density, land use mix, walkability) was conducted within a 0.5 km street-network buffer-zone around all twelve schools. Based on investigator and expert consultation, MAPS Global-SN included eight modifications to both auditing processes and items. Inter-rater reliability data was collected from two independent auditors across two schools. The feasibility of a condensed audit protocol (auditing one side of each street segment in the neighbourhood, compared to both sides) was also assessed. Results indicated the modified MAPS Global-SN tool had good to excellent inter-rater reliability and the condensed MAPS Global-SN audit protocol appeared to sufficiently represent the micro-scale SN-BE. Results also highlighted the complementary nature of micro- and macro-scale assessments. Further recommendations for SN-BE assessment are discussed.
Collapse
Affiliation(s)
- Tessa Pocock
- Active Living Laboratory, School of Physical Education, Sport and Exercise Sciences, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand;
- Correspondence:
| | - Antoni Moore
- School of Surveying, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand;
| | - Javier Molina-García
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Avda. dels Tarongers, 4, 46022 Valencia, Spain;
- AFIPS research group, University of Valencia, 46022 Valencia, Spain;
| | - Ana Queralt
- AFIPS research group, University of Valencia, 46022 Valencia, Spain;
- Department of Nursing, University of Valencia, Jaume Roig, s/n, 46010 Valencia, Spain
| | - Sandra Mandic
- Active Living Laboratory, School of Physical Education, Sport and Exercise Sciences, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand;
- Centre for Sustainability, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| |
Collapse
|
54
|
Orkin S, Brokamp C, Yodoshi T, Trout AT, Liu C, Meryum S, Taylor S, Wolfe C, Sheridan R, Seth A, Bhuiyan MAN, Ley S, Arce-Clachar AC, Bramlage K, Kahn R, Xanthakos S, Beck AF, Mouzaki M. Community Socioeconomic Deprivation and Nonalcoholic Fatty Liver Disease Severity. J Pediatr Gastroenterol Nutr 2020; 70:364-370. [PMID: 31651666 PMCID: PMC8054652 DOI: 10.1097/mpg.0000000000002527] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND OBJECTIVES Nonalcoholic fatty liver disease (NAFLD) is linked to obesity. Obesity is associated with lower socioeconomic status (SES). An independent link between pediatric NAFLD and SES has not been elucidated. The objective of this study was to evaluate the distribution of socioeconomic deprivation, measured using an area-level proxy, in pediatric patients with known NAFLD and to determine whether deprivation is associated with liver disease severity. METHODS Retrospective study of patients <21 years with NAFLD, followed from 2009 to 2018. The patients' addresses were mapped to census tracts, which were then linked to the community deprivation index (CDI; range 0--1, higher values indicating higher deprivation, calculated from six SES-related variables available publicly in US Census databases). RESULTS Two cohorts were evaluated; 1 with MRI (magnetic resonance imaging) and/or MRE (magnetic resonance elastography) findings indicative of NAFLD (n = 334), and another with biopsy-confirmed NAFLD (n = 245). In the MRI and histology cohorts, the majority were boys (66%), non-Hispanic (77%-78%), severely obese (79%-80%), and publicly insured (55%-56%, respectively). The median CDI for both groups was 0.36 (range 0.15-0.85). In both cohorts, patients living above the median CDI were more likely to be younger at initial presentation, time of MRI, and time of liver biopsy. MRI-measured fat fraction and liver stiffness, as well as histologic characteristics were not different between the high- and low-deprivation groups. CONCLUSIONS Children with NAFLD were found across the spectrum of deprivation. Although children from more deprived neighborhoods present at a younger age, they exhibit the same degree of NAFLD severity as their peers from less deprived areas.
Collapse
Affiliation(s)
- Sarah Orkin
- Division of Gastroenterology, Hepatology and Nutrition
| | - Cole Brokamp
- Division of Biostatistics and Epidemiology
- Department of Pediatrics, University of Cincinnati College of Medicine
| | | | - Andrew T. Trout
- Department of Pediatrics, University of Cincinnati College of Medicine
- Department of Radiology
- Department of Radiology, University of Cincinnati College of Medicine
| | | | - Syeda Meryum
- Division of Gastroenterology, Hepatology and Nutrition
| | - Stuart Taylor
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical Center
| | | | | | - Aradhna Seth
- Division of Digestive Diseases, University of Cincinnati
| | | | - Sanita Ley
- Department of Pediatrics, University of Cincinnati College of Medicine
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center
| | - Ana Catalina Arce-Clachar
- Division of Gastroenterology, Hepatology and Nutrition
- Department of Pediatrics, University of Cincinnati College of Medicine
| | | | - Robert Kahn
- Division of General and Community Pediatrics
| | - Stavra Xanthakos
- Division of Gastroenterology, Hepatology and Nutrition
- Department of Pediatrics, University of Cincinnati College of Medicine
| | - Andrew F. Beck
- Department of Pediatrics, University of Cincinnati College of Medicine
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical Center
- Division of General and Community Pediatrics
- Division of Hospital Medicine, Cincinnati Children’s Hospital Medical Center
| | - Marialena Mouzaki
- Division of Gastroenterology, Hepatology and Nutrition
- Department of Pediatrics, University of Cincinnati College of Medicine
| |
Collapse
|
55
|
Nordbø ECA, Nordh H, Raanaas RK, Aamodt G. Promoting activity participation and well-being among children and adolescents. JBI Evid Synth 2020; 18:370-458. [DOI: 10.11124/jbisrir-d-19-00051] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
|
56
|
Cerin E, Conway TL, Barnett A, Smith M, Veitch J, Cain KL, Salonna F, Reis RS, Molina-García J, Hinckson E, Muda WAMW, Anjana RM, van Dyck D, Oyeyemi AL, Timperio A, Christiansen LB, Mitáš J, Mota J, Moran M, Islam MZ, Mellecker RR, Sallis JF. Development and validation of the neighborhood environment walkability scale for youth across six continents. Int J Behav Nutr Phys Act 2019; 16:122. [PMID: 31796075 PMCID: PMC6892154 DOI: 10.1186/s12966-019-0890-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 11/20/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The IPEN International Physical Activity and Environment Network Adolescent project was conducted using common study protocols to document the strength, shape, and generalizability of associations of perceived neighborhood environment attributes with adolescents' physical activity and overweight/obesity using data from 15 countries. Countries did not use identical versions of the Neighborhood Environment Walkability Scale for Youth (NEWS-Y) to measure perceived neighborhood environment attributes. Therefore, this study derived a measurement model for NEWS-Y items common to all IPEN Adolescent countries and developed a scoring protocol for the IPEN Adolescent version of the NEWS-Y (NEWS-Y-IPEN) that maximizes between-country comparability of responses. Additionally, this study examined between- and within-country variability, and construct validity of the NEWS-Y-IPEN subscales in relation to neighborhood-level socio-economic status and walkability. METHODS Adolescents and one of their parents (N = 5714 dyads) were recruited from neighborhoods varying in walkability and socio-economic status. To measure perceived neighborhood environment, 14 countries administered the NEWS-Y to parents and one country to adolescents. Confirmatory factor analysis was used to derive comparable country-specific measurement models of the NEWS-Y-IPEN. Country-specific standard deviations quantified within-country variability in the NEWS-Y-IPEN subscales, while linear mixed models determined the percentage of subscale variance due to between-country differences. To examine the construct validity of NEWS-Y-IPEN subscales, we estimated their associations with the categorical measures of area-level walkability and socio-economic status. RESULTS Final country-specific measurement models of the factor-analyzable NEWS-Y-IPEN items provided acceptable levels of fit to the data and shared the same factorial structure with five latent factors (Accessibility and walking facilities; Traffic safety; Pedestrian infrastructure and safety; Safety from crime; and Aesthetics). All subscales showed sufficient levels of within-country variability. Residential density had the highest level of between-country variability. Associations between NEWS-Y-IPEN subscales and area-level walkability and socio-economic status provided strong evidence of construct validity. CONCLUSIONS A robust measurement model and common scoring protocol of NEWS-Y for the IPEN Adolescent project (NEWS-Y-IPEN) were derived. The NEWS-Y-IPEN possesses good factorial and construct validity, and is able to capture between-country variability in perceived neighborhood environments. Future studies employing NEWS-Y-IPEN should use the proposed scoring protocol to facilitate cross-study comparisons and interpretation of findings.
Collapse
Affiliation(s)
- Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
- School of Public Health, The University of Hong Kong, Hong Kong, China.
| | - Terry L Conway
- Department of Family Medicine and Public Health, University of California, San Diego, USA
| | - Anthony Barnett
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Melody Smith
- School of Nursing, The University of Auckland, Auckland, New Zealand
| | - Jenny Veitch
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Australia
| | - Kelli L Cain
- Department of Family Medicine and Public Health, University of California, San Diego, USA
| | - Ferdinand Salonna
- Institute of Active Lifestyle, Palacky University of Olomouc, Olomouc, Czech Republic
| | - Rodrigo S Reis
- Prevention Research Center, Brown School, Washington University in St. Louis, St Louis, USA
| | - Javier Molina-García
- Department of Teaching of Corporal Expression, University of Valencia, Valencia, Spain
| | - Erica Hinckson
- School of Sport & Recreation, Auckland University of Technology, Auckland, New Zealand
| | | | - Ranjit Mohan Anjana
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialties Centre, Chennai, India
| | - Delfien van Dyck
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Adewale L Oyeyemi
- Department of Physiotherapy, University of Maiduguri, Maiduguri, Nigeria
| | - Anna Timperio
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Australia
| | - Lars Breum Christiansen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Josef Mitáš
- Institute of Active Lifestyle, Palacky University of Olomouc, Olomouc, Czech Republic
| | - Jorge Mota
- Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal
| | - Mika Moran
- Institute for Urban and Regional Development, University of California Berkeley, Berkeley, USA
- School of Public Health, University of Haifa, 3498839, Haifa, Israel
| | - Mohammed Zakiul Islam
- Department of Architecture, Bangladesh University of Engineering & Technology, Dhaka, Bangladesh
| | | | - James F Sallis
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
- Department of Family Medicine and Public Health, University of California, San Diego, USA
| |
Collapse
|
57
|
Associations between Neighborhood Walkability and Incident and Ongoing Asthma in Children. Ann Am Thorac Soc 2019; 15:728-734. [PMID: 29664674 DOI: 10.1513/annalsats.201708-693oc] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
RATIONALE Childhood asthma has shown variable associations with children's physical activity. Neighborhood walkability captures community features that promote walking and is protective against some chronic conditions, such as obesity and diabetes. OBJECTIVES We evaluated associations between home neighborhood walkability and incident and ongoing childhood asthma. METHODS In this population-based cohort study, we used prospectively collected administrative healthcare data for the Province of Ontario housed at the Institute for Clinical Evaluative Sciences. We followed an administrative data cohort of 326,383 Toronto children born between 1997 and 2003, inclusive, until ages 8-15 years. Home neighborhood walkability quintile was measured using a validated walkability index with four dimensions: population density, dwelling density, access to retail and services, and street connectivity. Incident asthma was defined by time of entry into the validated Ontario Asthma Surveillance Information System database, which requires two outpatient visits for asthma within two consecutive years or any hospitalization for asthma and follows children with asthma longitudinally starting at any age. Associations between walkability and incident asthma were examined using Cox proportional hazards models. Associations between ongoing asthma and walkability in each year of life were examined using generalized linear mixed models. RESULTS Twenty-one percent of children (n = 69,628) developed incident asthma and were followed longitudinally in the Ontario Asthma Surveillance Information System database. Low birth home neighborhood walkability was associated with an increased incidence of asthma (hazard ratio, 1.11; 95% confidence interval, 1.08-1.14). Among children with asthma, low walkability in a given year of a child`s life was associated with greater odds of ongoing asthma in the same year (odds ratio, 1.12; 95% confidence interval, 1.09-1.14). CONCLUSIONS Children living in neighborhoods with low walkability were at increased risk of incident and ongoing asthma. Neighborhood walkability improvement, such as by adding pedestrian paths to improve street connectivity, offers potential strategies to contribute to primary asthma prevention.
Collapse
|
58
|
Molina-García J, Menescardi C, Estevan I, Martínez-Bello V, Queralt A. Neighborhood Built Environment and Socioeconomic Status are Associated with Active Commuting and Sedentary Behavior, but not with Leisure-Time Physical Activity, in University Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173176. [PMID: 31480418 PMCID: PMC6747177 DOI: 10.3390/ijerph16173176] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/23/2019] [Accepted: 08/29/2019] [Indexed: 12/18/2022]
Abstract
The role of neighborhood characteristics in promoting physical activity and sedentary behaviors (SB) has not been extensively studied in university students. The study purpose was to analyze the associations of neighborhood built environment and neighborhood socioeconomic status (SES) with active commuting, leisure-time physical activity (LTPA), and SB among university students. This is a cross-sectional study of 308 undergraduate students from two urban universities in Valencia, Spain. Participants' residential neighborhoods were classified according to walkability and SES levels. Walkability was defined as an index of three built environment attributes (i.e., residential density, land-use mix, and street connectivity) based on geographical information system data. Active commuting to and from university (ACU), active commuting in the neighborhood, LTPA, and SB were evaluated through a questionnaire. Mixed model regression analyses were performed. There were no significant SES-walkability interactions for any of the outcomes analyzed. However, university students living in more walkable areas reported two more ACU trips per week compared to those living in less walkable neighborhoods (p < 0.01). University students living in lower-SES neighborhoods reported more ACU trips per week than those living in higher-SES neighborhoods (p < 0.05). Regarding LTPA, there were no significant SES or walkability main effects. Neighborhood SES was negatively related to active commuting in the neighborhood and to time spent in SB (all p < 0.05). Participants living in lower-SES neighborhoods reported more active commuting per week and had the highest average minutes spent in SB. This study highlights the relevance of assessing university's residential environment when active transportation and SB are analyzed.
Collapse
Affiliation(s)
- Javier Molina-García
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Avda. dels Tarongers, 4, 46022 Valencia, Spain.
- AFIPS research group, University of Valencia, 46022 Valencia, Spain.
| | - Cristina Menescardi
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Avda. dels Tarongers, 4, 46022 Valencia, Spain
- AFIPS research group, University of Valencia, 46022 Valencia, Spain
| | - Isaac Estevan
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Avda. dels Tarongers, 4, 46022 Valencia, Spain
- AFIPS research group, University of Valencia, 46022 Valencia, Spain
| | - Vladimir Martínez-Bello
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Avda. dels Tarongers, 4, 46022 Valencia, Spain
- COS research group, University of Valencia, 46022 Valencia, Spain
| | - Ana Queralt
- AFIPS research group, University of Valencia, 46022 Valencia, Spain
- Department of Nursing, University of Valencia, Jaume Roig, s/n, 46010 Valencia, Spain
| |
Collapse
|
59
|
Arbel Y, Fialkoff C, Kerner A. The Association of Pension Income with the Incidence of Type I Obesity among Retired Israelis. J Obes 2019; 2019:5101867. [PMID: 31428470 PMCID: PMC6683769 DOI: 10.1155/2019/5101867] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 04/14/2019] [Accepted: 05/22/2019] [Indexed: 11/18/2022] Open
Abstract
Previous studies have identified obesity and overweight as the fourth leading risk factor for global mortality. The objective of the current study is to investigate gender differences and the impact of wealth and income from pensions, sociodemographic variables, and self-assessment of health conditions on the projected probability to become obese in the postretirement age (67 years and older). We are unaware of previous studies, which explored the direct relationship between obesity, monetary income from pensions, wealth, and self-assessment of health conditions. To conduct this research, we make use of an extensive questionnaire concerning the economic and sociodemographic features and health and housing conditions of individuals administered within the framework of the 2015-2016 longitudinal survey conducted by the Israeli Central Bureau of Statistics (CBS). The survey is representative of the Israeli population and also includes information regarding the weight, height, gender, and age of each household member. Results of our study demonstrate that while for the female respondents older than 67, the projected probability of type I obesity (BMI ≥ 30) drops by 0.41% (p=0.0021) to 0.52% (p=0.0001) with an incremental 10,000 NIS (about $2,500) rise of gross annual income from a pension, for the male respondents above 67 years, the projected probability remains unchanged (p=0.4225). This outcome remains robust even when the 2015 BMI measurement of type I obesity (BMI ≥ 30) is controlled. This drop among women attenuates with a cutoff point increase from BMI ≥ 25 (overweight) to BMI ≥ 30 (type I obesity) to BMI ≥ 35 (type II obesity). Further results indicate that for both genders above 67 years and for men above 62 years, the projected BMI drop of one year decreases with income from a pension (p=0.013, p=0.039, and p=0.007, respectively), although the spread around the projection becomes wider. Compared with other martial status categories, for widowed females, the projected probability of obesity and self-reporting on improved health conditions drops by 6.58% (p=0.0419) to 11.28% (p=0.0048) and 6.55% (p=0.0190) to 7.47% (p=0.0036), respectively. For females older than 67, family status divorced drops the projected probability of obesity by 9.25% (p=0.0319). For males older than 67, results show a rise in projected obesity with car ownership by 6.10% (p=0.0897) to 6.41% (p=0.0469) and a drop in projected obesity with academic degree status by 9.93% (p=0.0106) to 10.14% (p=0.0118) and immigration status from American-European countries by 7.67% (p=0.0821) to 8.99% (p=0.0398) and Asian-African countries by 11.63% (p=0.0245) to 11.99% (p=0.02). Research findings stress the differences and similarities in male-female patterns of obesity after the retirement age of 67 years and may be of assistance to welfare and public health experts.
Collapse
Affiliation(s)
- Yuval Arbel
- Sir Harry Solomon School of Economics and Management, Western Galilee College, Acre 2412101, Israel
| | - Chaim Fialkoff
- Institute of Urban and Regional Studies, Hebrew University of Jerusalem, Mt. Scopus, Jerusalem 9190501, Israel
| | - Amichai Kerner
- School of Real Estate, Netanya Academic College, 1 University Street, Netanya 4223587, Israel
| |
Collapse
|
60
|
The Relationships between Adolescents' Obesity and the Built Environment: Are They City Dependent? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16091579. [PMID: 31064107 PMCID: PMC6539234 DOI: 10.3390/ijerph16091579] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 04/25/2019] [Accepted: 04/26/2019] [Indexed: 12/28/2022]
Abstract
There is evidence that the built environment can promote unhealthy habits which may increase the risk for obesity among adolescents. However, the majority of evidence is from North America, Europe and Australia, and less is known about other world regions. The purpose of this study was to examine how the number of overweight and obese adolescents may vary in relation to the built environment, area socioeconomic status (SES), physical activity (PA) and nutritional home environment. We performed a telephone survey of 904 adolescents ages 15-18 from three different cities in Israel. The questionnaire included: reported PA, sedentary behaviors and nutritional home environment. Body Mass Index (BMI) was attained from records of Maccabi Healthcare Services (MHS). The built environment measures were calculated by Geographic Information System (GIS). Multivariable logistic regression analysis was performed to identify variables associated with adolescents' overweight and obesity. The highest level of overweight and obese adolescents was in Beer Sheva (29.2%). The three cities did not differ in built environment characteristics, PA and sedentary behaviors. In Haifa, a more positive nutritional home environment was reported (p = 0.001). Boys, in all three cities presented higher rates of overweight and obesity (29%). After adjusting for covariates, adolescents' overweight and obesity was associated with built environment measures only in a low SES peripheral city (OR = 0.72; 95% CI: 0.56-0.92), and positively associated with higher level of sedentary behavior in the total sample (OR = 1.23; 95% CI:1.03-1.47). This may imply a much more complex causal pathway between the built environment, SES and obesity than suggested in previous literature.
Collapse
|
61
|
Physical Activity and Active Commuting in Relation to Objectively Measured Built-Environment Attributes Among Adolescents. J Phys Act Health 2019; 16:371-374. [DOI: 10.1123/jpah.2018-0170] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
62
|
Associations Between Socio-Economic Status and Child Health: Findings of a Large German Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050677. [PMID: 30813530 PMCID: PMC6427670 DOI: 10.3390/ijerph16050677] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 02/08/2019] [Accepted: 02/22/2019] [Indexed: 02/07/2023]
Abstract
The familial social background of a child can significantly impact their behavior and health. We investigated associations between socio-economic status (SES) and health parameters and behaviors in German children and adolescents. Data were collected between 2011 and 2018 in the framework of the LIFE Child study. Participants included 2998 children aged 3⁻18 years. SES was represented by an index combining information on parental education, occupation, and income. Associations between SES and health outcomes were estimated using linear and logistic regression analyses. In a moderator analysis, all associations were checked for interactions between SES and age or sex. A higher SES composite score was associated with better health (lower body mass index (β = -0.26), fewer behavioral difficulties (β = -0.18), higher quality of life (β = 0.21), fewer critical life events (odds ratio (OR) = 0.93); all p < 0.05) and a healthier lifestyle (healthier nutrition (β = 0.16), less excessive television use (OR = 0.87), less nicotine consumption (OR = 0.93), and more physical activity (OR = 1.18); all p < 0.05). However, SES was not associated with alcohol consumption (OR = 1.02) or sleep problems (β = -0.04). The strengths of the associations between SES and child health did not differ depending on SES indicator (education, occupation, income). The associations between SES and parent-reported behavioral difficulties and physical activity were stronger in older vs. younger children. In contrast, none of the observed associations were moderated by sex. This study highlights the strong association between socio-economic status and child health, even in modern Western societies.
Collapse
|
63
|
Recognition of Barriers to Physical Activity Promotion in Immigrant Children in Spain: A Qualitative Case Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030431. [PMID: 30717329 PMCID: PMC6388143 DOI: 10.3390/ijerph16030431] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 01/29/2019] [Accepted: 01/31/2019] [Indexed: 01/12/2023]
Abstract
Physical activity facilitates the acquisition of healthy habits from childhood to adulthood. Differences exist regarding the performance of physical activity among immigrant children compared to native Spanish children. The purpose of the study was to describe the barriers that exist for the promotion of physical activity. A qualitative case-study approach was implemented. Parents of immigrant children, teachers, a school principal, and priests were included, using purposeful sampling. Data were collected from 25 participants, via unstructured and semi-structured interviews, focus groups, and researchers’ field notes. A thematic analysis was performed and ecological levels were identified. Our findings revealed the following barriers to performing physical activity: (a) the meaning of physical activity, (b) gender inequalities, (c) academic burden, (d) lack of social contact, (e) expenses and family economy, (f) lack of infrastructure and natural surroundings, (g) time constraints, (h) fear and insecurity, and (i) the reason for immigrating. These results may be used to revise the school curriculum, promoting equal opportunities for physical activity and encouraging family participation. Additionally, urban design policies should be encouraged to facilitate access to open spaces for recreation within cities.
Collapse
|
64
|
Molina-García J, García-Massó X, Estevan I, Queralt A. Built Environment, Psychosocial Factors and Active Commuting to School in Adolescents: Clustering a Self-Organizing Map Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 16:E83. [PMID: 30597975 PMCID: PMC6339221 DOI: 10.3390/ijerph16010083] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 12/17/2018] [Accepted: 12/23/2018] [Indexed: 01/08/2023]
Abstract
Although the built environment and certain psychosocial factors are related to adolescents' active commuting to and from school (ACS), their interrelationships have not been explored in depth. This study describes these interrelationships and behavioral profiles via a self-organizing map (SOM) analysis. The sample comprised 465 adolescents from the IPEN (International Physical Activity and the Environment Network) Adolescent study in Valencia, Spain. ACS, barriers to ACS, physical self-efficacy, social support and sociodemographics were measured by questionnaire. Street-network distance to school, net residential density and street intersection density were calculated from the Geographic Information System. The clustering of the SOM outcomes resulted in eight areas or clusters. The clusters which correspond to the lowest and highest ACS levels were then explored in depth. The lowest ACS levels presented interactions between the less supportive built environments (i.e., low levels of residential density and street connectivity in the neighborhood and greater distances to school) and unfavorable psychosocial variables (i.e., low values of physical self-efficacy and medium social support for ACS) and good access to private motorized transport at home. The adolescents with the lowest ACS values exhibited high ACS environment/safety and planning/psychosocial barrier values. Future interventions should be designed to encourage ACS and change multiple levels of influence, such as individual, psychosocial and environmental factors.
Collapse
Affiliation(s)
- Javier Molina-García
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Avda. dels Tarongers, 4, 46022 Valencia, Spain.
- AFIPS research group, University of Valencia, 46022 Valencia, Spain.
| | - Xavier García-Massó
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Avda. dels Tarongers, 4, 46022 Valencia, Spain.
- HUMAG research group, University of Valencia, 46010 Valencia, Spain.
| | - Isaac Estevan
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Avda. dels Tarongers, 4, 46022 Valencia, Spain.
- AFIPS research group, University of Valencia, 46022 Valencia, Spain.
| | - Ana Queralt
- AFIPS research group, University of Valencia, 46022 Valencia, Spain.
- Department of Nursing, University of Valencia, Jaume Roig, s/n, 46010 Valencia, Spain.
| |
Collapse
|
65
|
Estevan I, Queralt A, Molina-García J. Biking to School: The Role of Bicycle-Sharing Programs in Adolescents. THE JOURNAL OF SCHOOL HEALTH 2018; 88:871-876. [PMID: 30392192 DOI: 10.1111/josh.12697] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 12/29/2017] [Accepted: 01/05/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND The purpose of this study was to: (1) describe modes of transport to school, with a specific focus on the use of public bicycle share programs (PBSP); and (2) assess sociodemographic, psychosocial, and environmental correlates of bike and PBSP use to go to school. METHODS A group of 465 adolescents from the International Physical Activity and the Environment Network (IPEN) Adolescent Study (Valencia, Spain) participated in the research. Mixed regression analyses were conducted on the data obtained. RESULTS Not having bicycle access, a PBSP card, or a public bike lane close to the school is negatively associated with bicycle use. PBSP is positively associated with physical self-efficacy and bicycle availability and negatively associated with the number of vehicles per drivers at home and not having PBSP stations close to the school. CONCLUSIONS The strongest predictive factor, as regards cycling as an active mode of transport to school among adolescents is having a PBSP card. Schools have a crucial role in promoting bicycle use through collaboration when designing public policies that consider access to bike lane networks and PBSP stations and therefore should encourage local government implementation policies and/or increase PBSP stations within 250 m of the school.
Collapse
Affiliation(s)
- Isaac Estevan
- AFIPS Research Group, Department of Teaching of Music, Visual and Corporal Expression, University of Valencia, Avenida dels Tarongers, 4, 46022 Valencia, Spain
| | - Ana Queralt
- AFIPS Research Group, Department of Nursing, University of Valencia, Jaume Roig, s/n, 46010 Valencia, Spain
| | - Javier Molina-García
- AFIPS Research Group, Department of Teaching of Music, Visual and Corporal Expression, University of Valencia, Avenida dels Tarongers, 4, 46022 Valencia, Spain
| |
Collapse
|
66
|
Physical and spatial assessment of school neighbourhood built environments for active transport to school in adolescents from Dunedin (New Zealand). Health Place 2018; 55:1-8. [PMID: 30446347 DOI: 10.1016/j.healthplace.2018.10.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 10/08/2018] [Accepted: 10/14/2018] [Indexed: 11/22/2022]
Abstract
Adolescent active transport to school (ATS) is influenced by demographic, social, environmental and policy factors. Yet, the relationship between school neighbourhood built environment (SN-BE) and adolescents' ATS remains largely unexplored. This observational study examined associations between observed, objectively-measured and perceived SN-BE features and adolescents' ATS in Dunedin (New Zealand). Adolescents' perception of safety of walking to school was the strongest correlate of ATS among adolescents living ≤ 2.25 km of school, whereas assessed micro- and macro-scale SN-BE features were not significantly correlated with ATS. Adolescents' perceptions of walking safety should be considered as a part of comprehensive efforts to encourage ATS.
Collapse
|
67
|
Aznar S, Queralt A, García-Massó X, Villarrasa-Sapiña I, Molina-García J. Multifactorial combinations predicting active vs inactive stages of change for physical activity in adolescents considering built environment and psychosocial factors: A classification tree approach. Health Place 2018; 53:150-154. [PMID: 30142498 DOI: 10.1016/j.healthplace.2018.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 07/28/2018] [Accepted: 08/03/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Susana Aznar
- PAFS Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Toledo, Spain.
| | - Ana Queralt
- Department of Nursing, University of Valencia, Valencia, Spain; AFIPS research group. University of Valencia, Valencia, Spain
| | - Xavier García-Massó
- Department of Teaching of Musical, Visual and Corporal Expression. University of Valencia, Valencia, Spain
| | - Israel Villarrasa-Sapiña
- Department of Teaching of Musical, Visual and Corporal Expression. University of Valencia, Valencia, Spain
| | - Javier Molina-García
- AFIPS research group. University of Valencia, Valencia, Spain; Department of Teaching of Musical, Visual and Corporal Expression. University of Valencia, Valencia, Spain
| |
Collapse
|
68
|
Krist L, Bürger C, Ströbele-Benschop N, Roll S, Lotz F, Rieckmann N, Müller-Nordhorn J, Willich SN, Müller-Riemenschneider F. Association of individual and neighbourhood socioeconomic status with physical activity and screen time in seventh-grade boys and girls in Berlin, Germany: a cross-sectional study. BMJ Open 2017; 7:e017974. [PMID: 29288179 PMCID: PMC5770905 DOI: 10.1136/bmjopen-2017-017974] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 11/03/2017] [Accepted: 11/10/2017] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Few studies have explored the impact of neighbourhood socioeconomic status (SES) on health behaviours in youths in Germany. Our aim was to investigate the association of individual and neighbourhood SES with physical activity (PA) and screen time (ST) in students aged 12-13 years in Berlin. DESIGN Cross-sectional study. SETTING Secondary schools (high schools and integrated secondary schools) in Berlin, Germany. PARTICIPANTS A total of 2586 students aged 12-13 years (seventh grade). MAIN OUTCOME MEASURES Sociodemographics, anthropometric data and health behaviours were assessed by self-report during classes. Primary outcome was the association of individual and neighbourhood SES with meeting daily PA and exceeding daily ST recommendations. Students' characteristics were described with means or percentages. Comparisons were performed using generalised linear mixed model yielding ORs with 95% CIs. RESULTS Mean (±SD) age was 12.5±0.5 years, 50.5% were girls and 34.1% had a migrant background. When adjusting for individual covariates, associations of low versus high individual SES were 0.85 (0.48; 1.52) for PA and 2.08 (1.26; 3.43) for ST. Associations of low versus high neighbourhood SES were 1.76 (1.12; 2.75) for PA and 1.54 (1.10; 2.17) for ST. After additional adjustment for school type and school neighbourhood SES, associations comparing low versus high individual and neighbourhood SES were attenuated for PA (individual SES 0.74 (0.41; 1.33) and neighbourhood SES 1.51 (0.93; 2.46)) and ST (individual SES 1.88 (1.12; 3.14) and neighbourhood SES 1.40(0.98; 2.00). CONCLUSIONS Lower individual and neighbourhood SES were associated with higher ST. Lower neighbourhood but not individual SES was associated with higher PA. After consideration of school type and school neighbourhood SES associations were attenuated and became insignificant for the relationship between neighbourhood SES, PA and ST. Further research is warranted to unravel the complex relationships between individual SES, neighbourhood SES and school environment to develop more targeted health promotion strategies in the future.
Collapse
Affiliation(s)
- Lilian Krist
- Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany
| | - Christin Bürger
- Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany
| | | | - Stephanie Roll
- Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany
| | - Fabian Lotz
- Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany
| | - Nina Rieckmann
- Institute of Public Health, Charité Universitätsmedizin, Berlin, Germany
| | | | - Stefan N Willich
- Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany
| | - Falk Müller-Riemenschneider
- Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| |
Collapse
|