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Irvine DS, McGarity-Shipley E, Lee EY, Janssen I, Leatherdale ST. Longitudinal associations between e-cigarette use, cigarette smoking, physical activity and recreational screen time in Canadian adolescents. Nicotine Tob Res 2021; 24:978-985. [PMID: 34850182 DOI: 10.1093/ntr/ntab248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 11/03/2021] [Accepted: 11/25/2021] [Indexed: 11/14/2022]
Abstract
INTRODUCTION This study examined longitudinal associations between e-cigarette use, cigarette smoking, physical activity, and recreational screen time (ST) in a cohort of Canadian adolescents (ages 14-17 years; grades 9-12). METHODS Data from 5,951 adolescents who participated in COMPASS Year 4 (2015-16; baseline) and Year 6 (2017-18; follow-up) were used. Exposures included e-cigarette use and cigarette smoking. Outcomes included cut-points for moderate- to vigorous- physical activity (MVPA; ≥ 60 min/d), muscular strengthening exercises (MSE; ≥ 3 time/wk), participation in sport (SP; intramural or competitive), and recreational screen time (ST; ≤ 430 min/day). Generalized linear mixed models were performed. RESULTS E-cigarette use (16.6% vs 39.2%), cigarette smoking (0.9% vs 4.7%) and dual use (0.8% vs 4.1%) increased from baseline to follow-up. SP (70.8% vs 61.3%) and the prevalence of meeting MVPA (49.8% vs 42.1%) and MSE cut-points (54.0% vs 45.3%) decreased from baseline to follow-up. Recreational ST remained similar from baseline to follow-up. New e-cigarette use at follow-up was associated with maintenance of SP and meeting MVPA and MSE cut-points, but also with increased ST. New cigarette smoking at follow-up was associated with maintaining high ST and low SP. Cigarette smoking at baseline and follow-up was associated with maintaining high ST, low MSE, and low SP. Cigarette smoking cessation at follow-up was associated with increasing MVPA and MSE, decreasing ST, and maintaining low SP. CONCLUSION Given the clustering and co-occurring unhealthy behavioral patterns, intervention strategies to promote healthy lifestyles should take a holistic approach, by targeting multiple behavioral changes simultaneously. IMPLICATIONS This investigation highlighted that, unhealthy behaviors, particularly e-cigarette use, cigarette smoking, and excessive use of screens, tend to co-occur among Canadian adolescents. Therefore, intervention strategies to promote healthy lifestyles should take a holistic approach, by targeting multiple behavioral changes simultaneously particularly in school and community settings. As an exception, new and stable e-cigarette use appears to co-occur with achieving sufficient levels of physical activity. Increasing awareness about the risk of e-cigarette use may target population groups that are physically and socially active (e.g., athletes, sport teams).
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Affiliation(s)
- Dylan S Irvine
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada.,College of Osteopathic Medicine, Nova Southeastern University, Davie, FL, United States of America
| | | | - Eun-Young Lee
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada.,Department of Gender Studies, Queen's University, Kingston, ON, Canada
| | - Ian Janssen
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada.,Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | - Scott T Leatherdale
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
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Vallarta-Robledo JR, Sandoval JL, De Ridder D, Ladoy A, Marques-Vidal P, Humair JP, Cornuz J, Probst-Hensch N, Schaffner E, Stringhini S, Joost S, Guessous I. Spatial clusters of daily tobacco consumption before and after a smoke-free policy implementation. Health Place 2021; 70:102616. [PMID: 34225236 DOI: 10.1016/j.healthplace.2021.102616] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 06/17/2021] [Accepted: 06/24/2021] [Indexed: 11/25/2022]
Abstract
This study assessed the spatial dependence of daily tobacco consumption and how it is spatially impacted by individual and neighborhood socioeconomic determinants, and tobacco consumption facilities before and after a smoke-free implementation. Individual data was obtained from the Bus Santé, a cross-sectional survey in Geneva. Spatial clusters of high and low tobacco consumption were assessed using Getis-Ord Gi*. Daily tobacco consumption was not randomly clustered in Geneva and may be impacted by tobacco consumption facilities independently of socioeconomic factors and a smoking ban. Spatial analysis should be considered to highlight the impact of smoke-free policies and guide public health interventions.
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Affiliation(s)
- Juan R Vallarta-Robledo
- Unit of Population Epidemiology, Department of Primary Care, Geneva University Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland; Group of Geographic Information Research and Analysis in Population Health (GIRAPH), Geneva, Switzerland
| | - José Luis Sandoval
- Group of Geographic Information Research and Analysis in Population Health (GIRAPH), Geneva, Switzerland; Division of Primary Care, Department of Primary Care, Geneva University Hospitals, Geneva, Switzerland; Department of Oncology, Geneva University Hospitals, Geneva, Switzerland
| | - David De Ridder
- Unit of Population Epidemiology, Department of Primary Care, Geneva University Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland; Group of Geographic Information Research and Analysis in Population Health (GIRAPH), Geneva, Switzerland; Laboratory of Geographic Information Systems (LASIG), School of Architecture, Civil and Environmental Engineering (ENAC), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Anaïs Ladoy
- Group of Geographic Information Research and Analysis in Population Health (GIRAPH), Geneva, Switzerland; Laboratory of Geographic Information Systems (LASIG), School of Architecture, Civil and Environmental Engineering (ENAC), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Pedro Marques-Vidal
- Group of Geographic Information Research and Analysis in Population Health (GIRAPH), Geneva, Switzerland; Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Jean-Paul Humair
- Division of Primary Care, Department of Primary Care, Geneva University Hospitals, Geneva, Switzerland
| | - Jacques Cornuz
- University Centre for General Medicine and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Emmanuel Schaffner
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Silvia Stringhini
- Unit of Population Epidemiology, Department of Primary Care, Geneva University Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland; Group of Geographic Information Research and Analysis in Population Health (GIRAPH), Geneva, Switzerland; University Centre for General Medicine and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Stéphane Joost
- Unit of Population Epidemiology, Department of Primary Care, Geneva University Hospitals, Geneva, Switzerland; Group of Geographic Information Research and Analysis in Population Health (GIRAPH), Geneva, Switzerland; Laboratory of Geographic Information Systems (LASIG), School of Architecture, Civil and Environmental Engineering (ENAC), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Idris Guessous
- Unit of Population Epidemiology, Department of Primary Care, Geneva University Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland; Group of Geographic Information Research and Analysis in Population Health (GIRAPH), Geneva, Switzerland; Division of Primary Care, Department of Primary Care, Geneva University Hospitals, Geneva, Switzerland; Laboratory of Geographic Information Systems (LASIG), School of Architecture, Civil and Environmental Engineering (ENAC), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland.
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3
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Socio-spatial inequalities in smoking among young adults: What a ‘go-along’ study says about local smoking practices. Soc Sci Med 2020; 253:112920. [DOI: 10.1016/j.socscimed.2020.112920] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 01/27/2020] [Accepted: 03/12/2020] [Indexed: 11/20/2022]
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4
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McCready G, Glenn NM, Frohlich KL. "Don't smoke in public, you look like trash": An exploratory study about women's experiences of smoking-related stigmatisation and the connection to neighbourhood-level deprivation. Health Place 2019; 58:102142. [PMID: 31203033 DOI: 10.1016/j.healthplace.2019.05.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 04/16/2019] [Accepted: 05/17/2019] [Indexed: 12/01/2022]
Abstract
In this exploratory qualitative study we used Goffman's theory of stigmatisation to examine how women experience smoking-related stigma in relation to neighbourhood-level deprivation. From an existing cohort, we recruited fifteen women who smoked. We found differences in the women's experiences and abilities to negotiate and avoid a stigmatised smoking identity based on neighbourhood-level deprivation. Women in high-deprivation neighbourhoods described limited access to such places and this restricted their abilities to 'pass' as non- or not-quite-smokers and avoid smoking-related stigmatisation. We discuss the implications of the findings in relation to social-spatial inequalities in health and public health policy.
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Affiliation(s)
- Geneviève McCready
- Institut de recherche en santé publique de l'Université de Montréal, Université de Montréal, 7101 av. du Parc, C.P. 6128, Succ. Centre-Ville, Montréal, QC, H3C 3J7, Canada; Département de médecine sociale et préventive, ESPUM, Université de Montréal, 7101 av. du Parc, Office 3128, Montréal, QC, H1B 3C1, Canada.
| | - Nicole M Glenn
- Institut de recherche en santé publique de l'Université de Montréal, Université de Montréal, 7101 av. du Parc, C.P. 6128, Succ. Centre-Ville, Montréal, QC, H3C 3J7, Canada; Département de médecine sociale et préventive, ESPUM, Université de Montréal, 7101 av. du Parc, Office 3128, Montréal, QC, H1B 3C1, Canada; Centre for Healthy Communities, School of Public Health, University of Alberta, 3-035 ECHA, 11405 87 Ave, Edmonton, AB, T6G 1C9, Canada.
| | - Katherine L Frohlich
- Institut de recherche en santé publique de l'Université de Montréal, Université de Montréal, 7101 av. du Parc, C.P. 6128, Succ. Centre-Ville, Montréal, QC, H3C 3J7, Canada; Département de médecine sociale et préventive, ESPUM, Université de Montréal, 7101 av. du Parc, Office 3128, Montréal, QC, H1B 3C1, Canada.
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Glenn NM, Lapalme J, McCready G, Frohlich KL. Young adults' experiences of neighbourhood smoking-related norms and practices: A qualitative study exploring place-based social inequalities in smoking. Soc Sci Med 2017; 189:17-24. [DOI: 10.1016/j.socscimed.2017.07.021] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 06/07/2017] [Accepted: 07/24/2017] [Indexed: 11/28/2022]
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Levasseur M, Dubois MF, Généreux M, Menec V, Raina P, Roy M, Gabaude C, Couturier Y, St-Pierre C. Capturing how age-friendly communities foster positive health, social participation and health equity: a study protocol of key components and processes that promote population health in aging Canadians. BMC Public Health 2017; 17:502. [PMID: 28545415 PMCID: PMC5445415 DOI: 10.1186/s12889-017-4392-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 05/08/2017] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND To address the challenges of the global aging population, the World Health Organization promoted age-friendly communities as a way to foster the development of active aging community initiatives. Accordingly, key components (i.e., policies, services and structures related to the communities' physical and social environments) should be designed to be age-friendly and help all aging adults to live safely, enjoy good health and stay involved in their communities. Although age-friendly communities are believed to be a promising way to help aging Canadians lead healthy and active lives, little is known about which key components best foster positive health, social participation and health equity, and their underlying mechanisms. This study aims to better understand which and how key components of age-friendly communities best foster positive health, social participation and health equity in aging Canadians. Specifically, the research objectives are to: 1) Describe and compare age-friendly key components of communities across Canada 2) Identify key components best associated with positive health, social participation and health equity of aging adults 3) Explore how these key components foster positive health, social participation and health equity METHODS: A mixed-method sequential explanatory design will be used. The quantitative part will involve a survey of Canadian communities and secondary analysis of cross-sectional data from the Canadian Longitudinal Study on Aging (CLSA). The survey will include an age-friendly questionnaire targeting key components in seven domains: physical environment, housing options, social environment, opportunities for participation, community supports and healthcare services, transportation options, communication and information. The CLSA is a large, national prospective study representative of the Canadian aging population designed to examine health transitions and trajectories of adults as they age. In the qualitative part, a multiple case study will be conducted in five Canadian communities performing best on positive health, social participation and health equity. DISCUSSION Building on new and existing collaborations and generating evidence from real-world interventions, the results of this project will help communities to promote age-friendly policies, services and structures which foster positive health, social participation and health equity at a population level.
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Affiliation(s)
- Mélanie Levasseur
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4 Canada
- Research Centre on Aging, Centre integré universitaire de santé et de services sociaux de l’Estrie — Centre hospitalier universitaire de Sherbrooke (CIUSSS de l’Estrie – CHUS), 1036 Belvedere South, Sherbrooke, Quebec, J1H 4C4 Canada
| | - Marie-France Dubois
- Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4 Canada
- Research Centre on Aging, Centre integré universitaire de santé et de services sociaux de l’Estrie — Centre hospitalier universitaire de Sherbrooke (CIUSSS de l’Estrie – CHUS), 1036 Belvedere South, Sherbrooke, Quebec, J1H 4C4 Canada
| | - Mélissa Généreux
- Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4 Canada
- Research Centre on Aging, Centre integré universitaire de santé et de services sociaux de l’Estrie — Centre hospitalier universitaire de Sherbrooke (CIUSSS de l’Estrie – CHUS), 1036 Belvedere South, Sherbrooke, Quebec, J1H 4C4 Canada
| | - Verena Menec
- Department of Community Health Sciences, University of Manitoba, S113 Medical Services Building, 750 Bannatyne Ave, Winnipeg, MB R3E 0W3 Canada
| | - Parminder Raina
- McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8 Canada
| | - Mathieu Roy
- CIUSSS de l’Estrie – CHUS, 375, rue Argyll, Sherbrooke, Quebec, J1J 3H5 Canada
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4 Canada
| | - Catherine Gabaude
- Institut français des sciences et technologies des transports, de l’aménagement et des réseaux, 14-20 bd Newton - Cité Descartes, Champs-sur-Marne, 77447 Marne-la-Vallée Cedex 2, France
| | - Yves Couturier
- Research Centre on Aging, Centre integré universitaire de santé et de services sociaux de l’Estrie — Centre hospitalier universitaire de Sherbrooke (CIUSSS de l’Estrie – CHUS), 1036 Belvedere South, Sherbrooke, Quebec, J1H 4C4 Canada
- Department of Social Services, Faculty of Letters and Humanities, Université de Sherbrooke, 2500, boul. de l’Université, Sherbrooke, Quebec, J1K 2R1 Canada
| | - Catherine St-Pierre
- Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4 Canada
- Research Centre on Aging, Centre integré universitaire de santé et de services sociaux de l’Estrie — Centre hospitalier universitaire de Sherbrooke (CIUSSS de l’Estrie – CHUS), 1036 Belvedere South, Sherbrooke, Quebec, J1H 4C4 Canada
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7
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Duncan DT, Rienti M, Kulldorff M, Aldstadt J, Castro MC, Frounfelker R, Williams JH, Sorensen G, Johnson RM, Hemenway D, Williams DR. Local spatial clustering in youths' use of tobacco, alcohol, and marijuana in Boston. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2016; 42:412-21. [PMID: 27096932 DOI: 10.3109/00952990.2016.1151522] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Understanding geographic variation in youth drug use is important for both identifying etiologic factors and planning prevention interventions. However, little research has examined spatial clustering of drug use among youths by using rigorous statistical methods. OBJECTIVES The purpose of this study was to examine spatial clustering of youth use of tobacco, alcohol, and marijuana. METHODS Responses on tobacco, alcohol, and marijuana use from 1,292 high school students ages 13-19 who provided complete residential addresses were drawn from the 2008 Boston Youth Survey Geospatial Dataset. Response options on past month use included "none," "1-2," "3-9," and "10 or more." The response rate for each substance was approximately 94%. Spatial clustering of youth drug use was assessed using the spatial Bernoulli model in the SatScan™ software package. RESULTS Approximately 12%, 36%, and 18% of youth reported any past-month use of tobacco, alcohol, and/or marijuana, respectively. Two clusters of elevated past tobacco use among Boston youths were generated, one of which was statistically significant. This cluster, located in the South Boston neighborhood, had a relative risk of 5.37 with a p-value of 0.00014. There was no significant localized spatial clustering in youth past alcohol or marijuana use in either the unadjusted or adjusted models. CONCLUSION Significant spatial clustering in youth tobacco use was found. Finding a significant cluster in the South Boston neighborhood provides reason for further investigation into neighborhood characteristics that may shape adolescents' substance use behaviors. This type of research can be used to evaluate the underlying reasons behind spatial clustering of youth substance and to target local drug abuse prevention interventions and use.
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Affiliation(s)
- Dustin T Duncan
- a Department of Population Health , New York University School of Medicine , New York , NY , USA.,b College of Global Public Health , New York University , New York , NY , USA.,c Center for Drug Use and HIV Research , New York University College of Nursing , New York , NY , USA.,d Population Center , New York University College of Arts and Science , New York , NY , USA.,e Center for Data Science , New York University , New York , NY , USA
| | - Michael Rienti
- f Department of Geography , University at Buffalo, State University of New York , Buffalo , NY , USA.,g Center for Health and Social Research , SUNY Buffalo State, Buffalo , NY , USA
| | - Martin Kulldorff
- h Department of Medicine , Brigham and Women's Hospital and Harvard Medical School , Boston , MA , USA
| | - Jared Aldstadt
- f Department of Geography , University at Buffalo, State University of New York , Buffalo , NY , USA
| | - Marcia C Castro
- i Department of Global Health and Population , Harvard T.H. Chan School of Public Health , Boston , MA , USA.,j Harvard Center for Population and Development Studies , Harvard University , Cambridge , MA , USA
| | - Rochelle Frounfelker
- k Department of Social and Behavioral Sciences , Harvard T.H. Chan School of Public Health , Boston , MA , USA
| | - James H Williams
- a Department of Population Health , New York University School of Medicine , New York , NY , USA
| | - Glorian Sorensen
- l Center for Community-based Research , Dana-Farber Cancer Institute , Boston , MA , USA.,m Lung Cancer Disparities Center , Harvard T.H. Chan School of Public Health , Boston , MA USA.,n Department of Mental Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| | - Renee M Johnson
- n Department of Mental Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| | - David Hemenway
- o Department of Health Policy and Management , Harvard T.H. Chan School of Public Health , Boston , MA , USA
| | - David R Williams
- k Department of Social and Behavioral Sciences , Harvard T.H. Chan School of Public Health , Boston , MA , USA.,m Lung Cancer Disparities Center , Harvard T.H. Chan School of Public Health , Boston , MA USA.,p Departments of African and African American Studies, and Sociology , Harvard University , Cambridge , MA , USA
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Hosseinpoor AR, Bergen N, Barros AJD, Wong KLM, Boerma T, Victora CG. Monitoring subnational regional inequalities in health: measurement approaches and challenges. Int J Equity Health 2016; 15:18. [PMID: 26822991 PMCID: PMC4730638 DOI: 10.1186/s12939-016-0307-y] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 01/18/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Monitoring inequalities based on subnational regions is a useful practice to unmask geographical differences in health, and deploy targeted, equity-oriented interventions. Our objective is to describe, compare and contrast current methods of measuring subnational regional inequality. We apply a selection of summary measures to empirical data from four low- or middle-income countries to highlight the characteristics and overall performance of the different measures. METHODS We use data from Demographic and Health Surveys conducted in Bangladesh, Egypt, Ghana and Zimbabwe to calculate subnational regional inequality estimates for reproductive, maternal, newborn, and child health services generated from 11 summary measures: pairwise measures included high to low absolute difference, high to low relative difference, and high to low ratio; complex measures included population attributable risk, weighted variance, absolute weighted mean difference from overall mean, index of dissimilarity, Theil index, population attributable risk percentage, coefficient of variation, and relative weighted mean difference from overall mean. Four of these summary measures (high to low absolute difference, high to low ratio, absolute weighted mean difference from overall mean, and relative weighted mean difference from overall mean) were selected to compare their performance in measuring trend over time in inequality for one health indicator. RESULTS Overall, the 11 different measures were more remarkable for their similarities than for their differences. Pairwise measures tended to support the same conclusions as complex summary measures-that is, by identifying same best and worst coverage indicators in each country and indicating similar time trends. Complex measures may be useful to illustrate more nuanced results in countries with a great number of subnational regions. CONCLUSIONS When pairwise and complex measures lead to the same conclusions about the state of subnational regional inequality, pairwise measures may be sufficient for reporting inequality. In cases where complex measures are required, mean difference from mean measures can be easily communicated to non-technical audiences.
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Affiliation(s)
- Ahmad Reza Hosseinpoor
- Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland.
| | - Nicole Bergen
- Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland.
| | - Aluisio J D Barros
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil.
| | - Kerry L M Wong
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil.
| | - Ties Boerma
- Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland.
| | - Cesar G Victora
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil.
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Verlato G, Accordini S, Nguyen G, Marchetti P, Cazzoletti L, Ferrari M, Antonicelli L, Attena F, Bellisario V, Bono R, Briziarelli L, Casali L, Corsico AG, Fois A, Panico M, Piccioni P, Pirina P, Villani S, Nicolini G, de Marco R. Socioeconomic inequalities in smoking habits are still increasing in Italy. BMC Public Health 2014; 14:879. [PMID: 25159912 PMCID: PMC4159540 DOI: 10.1186/1471-2458-14-879] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 08/18/2014] [Indexed: 11/10/2022] Open
Abstract
Background Socioeconomic inequalities in smoking habits have stabilized in many Western countries. This study aimed at evaluating whether socioeconomic disparities in smoking habits are still enlarging in Italy and at comparing the impact of education and occupation. Methods In the frame of the GEIRD study (Gene Environment Interactions in Respiratory Diseases) 10,494 subjects, randomly selected from the general population aged 20–44 years in seven Italian centres, answered a screening questionnaire between 2007 and 2010 (response percentage = 57.2%). In four centres a repeated cross-sectional survey was performed: smoking prevalence recorded in GEIRD was compared with prevalence recorded between 1998 and 2000 in the Italian Study of Asthma in Young Adults (ISAYA). Results Current smoking was twice as prevalent in people with a primary/secondary school certificate (40-43%) compared with people with an academic degree (20%), and among unemployed and workmen (39%) compared with managers and clerks (20-22%). In multivariable analysis smoking habits were more affected by education level than by occupation. From the first to the second survey the prevalence of ever smokers markedly decreased among housewives, managers, businessmen and free-lancers, while ever smoking became even more common among unemployed (time-occupation interaction: p = 0.047). At variance, the increasing trend in smoking cessation was not modified by occupation. Conclusion Smoking prevalence has declined in Italy during the last decade among the higher socioeconomic classes, but not among the lower. This enlarging socioeconomic inequality mainly reflects a different trend in smoking initiation.
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Affiliation(s)
- Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Public Health and Community Medicine, University of Verona, Verona, Italy.
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10
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Roy M, Généreux M, Laverdière E, Vanasse A. Surveillance of social and geographic inequalities in housing-related issues: the case of the Eastern Townships, Quebec (Canada). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:4825-44. [PMID: 24806192 PMCID: PMC4053890 DOI: 10.3390/ijerph110504825] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 04/25/2014] [Accepted: 04/28/2014] [Indexed: 11/16/2022]
Abstract
Even though health inequalities are conditioned by many aspects of the environment, much of the existing research focuses on the social environment. This emphasis has the effect to neglect other environmental aspects such as its physical dimension. The physical environment, which is linked to housing conditions, may contribute to the uneven distribution of health. In this study, we examined 19 housing-related issues among a representative sample of 2,000 adults residing in a Quebec (Canada) health region characterized by a mix of rural, semi-rural, and urban areas. The distribution of these issues was examined according to socioeconomic and geographic indicators of social position. Summary measures of inequalities were assessed. Our results showed that the prevalence of nearly all housing-related issues was higher among low-income households compared to more affluent ones. Highly educated individuals showed better housing conditions, whereas different issues tended to cluster in deprived or densely populated areas. To conclude, we observed steep gradients between social class and poor housing conditions. This may explain a substantial part of health inequality on the regional scale. The surveillance of housing-related issues is therefore essential to properly inform and mobilize local stakeholders and to develop interventions that target vulnerable groups on this level.
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Affiliation(s)
- Mathieu Roy
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec J1H 5N4, Canada.
| | - Mélissa Généreux
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec J1H 5N4, Canada.
| | - Emélie Laverdière
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec J1H 5N4, Canada.
| | - Alain Vanasse
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec J1H 5N4, Canada.
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Stockings E, Bowman J, McElwaine K, Baker A, Terry M, Clancy R, Bartlem K, Wye P, Bridge P, Knight J, Wiggers J. Readiness to quit smoking and quit attempts among Australian mental health inpatients. Nicotine Tob Res 2012; 15:942-9. [PMID: 23089486 PMCID: PMC3621580 DOI: 10.1093/ntr/nts206] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Mental health inpatients smoke at higher rates than general population smokers. However, provision of nicotine-dependence treatment in inpatient settings is low, with barriers to the provision of such care including staff views that patients do not want to quit. This paper reports the findings of a survey of mental health inpatients at a psychiatric hospital in New South Wales, Australia, assessing smoking and quitting motivations and behaviors. METHODS Smokers (n = 97) were surveyed within the inpatient setting using a structured survey tool, incorporating the Fagerström Test for Nicotine Dependence, Reasons for Quitting Scale, Readiness and Motivation to Quit Smoking Questionnaire, and other measures of smoking and quitting behavior. RESULTS Approximately 47% of smokers reported having made at least one quit attempt within the past 12 months, despite nearly three quarters (71.2%) being classified as in a "precontemplative" stage of change. Multinomial logistic regressions revealed that self-reporting "not enjoying being a smoker" and having made a quit attempt in the last 12 months predicted having advanced beyond a precontemplative stage of change. A high self-reported desire to quit predicted a quit attempt having been made in the last 12 months. CONCLUSIONS The majority of smokers had made several quit attempts, with a large percentage occurring recently, suggesting that the actual quitting behavior should be considered as an important indication of the "desire to quit." This paper provides further data supporting the assertion that multimodal smoking cessation interventions combining psychosocial and pharmacological support should be provided to psychiatric inpatients who smoke.
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