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Kong AY, Lee JGL, Halvorson-Fried SM, Sewell KB, Golden SD, Henriksen L, Herbert L, Ribisl KM. Neighbourhood inequities in the availability of retailers selling tobacco products: a systematic review. Tob Control 2024:tc-2024-058718. [PMID: 38937098 DOI: 10.1136/tc-2024-058718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 06/03/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVE To examine inequities in tobacco retailer availability by neighbourhood-level socioeconomic, racial/ethnic and same-sex couple composition. DATA SOURCES We conducted a 10 November 2022 search of PubMed, PsycINFO, Global Health, LILACS, Embase, ABI/Inform, CINAHL, Business Source Complete, Web of Science and Scopus. STUDY SELECTION We included records from Organisation for Economic Co-operation and Development member countries that tested associations of area-level measures of tobacco retailer availability and neighbourhood-level sociodemographic characteristics. Two coders reviewed the full text of eligible records (n=58), including 41 records and 205 effect sizes for synthesis. DATA EXTRACTION We used dual independent screening of titles, abstracts and full texts. One author abstracted and a second author confirmed the study design, location, unit of analysis, sample size, retailer data source, availability measure, statistical approach, sociodemographic characteristic and unadjusted effect sizes. DATA SYNTHESIS Of the 124 effect sizes related to socioeconomic inequities (60.5% of all effect sizes), 101 (81.5%) indicated evidence of inequities. Of 205 effect sizes, 69 (33.7%) tested associations between retailer availability and neighbourhood composition of racially and ethnically minoritised people, and 57/69 (82.6%) documented inequities. Tobacco availability was greater in neighbourhoods with more Black, Hispanic/Latine and Asian residents (82.8%, 90.3% and 40.0% of effect sizes, respectively). Two effect sizes found greater availability with more same-sex households. CONCLUSIONS There are stark inequities in tobacco retailer availability. Moving beyond documenting inequities to partnering with communities to design, implement, and evaluate interventions that reduce and eliminate inequities in retail availability is needed to promote an equitable retail environment. PROSPERO REGISTRATION NUMBER CRD42019124984.
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Affiliation(s)
- Amanda Y Kong
- Department of Family and Preventive Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
- Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Joseph G L Lee
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, North Carolina, USA
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
| | - Sarah M Halvorson-Fried
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Kerry B Sewell
- Laupus Health Sciences Library, East Carolina University, Greenville, North Carolina, USA
| | - Shelley Diane Golden
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Lisa Henriksen
- Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, Stanford, California, USA
| | - Lily Herbert
- Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Kurt M Ribisl
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
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van Deelen TRD, Veldhuizen EM, van den Putte B, Kunst AE, Kuipers MAG. Socioeconomic differences in tobacco outlet presence, density, and proximity in four cities in the Netherlands. BMC Public Health 2023; 23:1515. [PMID: 37558979 PMCID: PMC10413623 DOI: 10.1186/s12889-023-16347-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/19/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Previous studies found that tobacco outlets were unevenly distributed by area socioeconomic status (SES). However, evidence from continental Europe is limited. This study aims to assess differences in tobacco outlet presence, density and proximity by area SES in the Netherlands. METHODS All tobacco outlets in four Dutch cities (Amsterdam, and medium-sized cities Eindhoven, Haarlem, and Zwolle) were mapped between September 2019 and June 2020. We estimated associations between average property value of neighbourhoods (as an indicator of SES, grouped into quintiles) and (1) tobacco outlet presence in the neighbourhood (yes/no), (2) density (per km2), and (3) proximity to the closest outlet (in meters), using logistic and linear regression models. RESULTS 46% of neighbourhoods contained at least one tobacco outlet. Tobacco outlets were mostly situated in city centres, but the distribution of tobacco outlets varied per city due to differences in urban structures and functions. In the medium-sized cities, each quintile higher neighbourhood-SES was associated with lower tobacco outlet presence (OR:0.71, 95%CI:0.59;0.85), lower density (B:-1.20 outlets/km2, 95%CI:-2.20;-0.20) and less proximity (B:40.2 m, 95%CI 36.58;43.83). Associations were the other way around for Amsterdam (OR:1.22, 95%CI:1.05;1.40, B:3.50, 95%CI:0.81;6.20, and B:-18.45, 95%CI:-20.41;-16.49, respectively). Results were similar for most types of tobacco outlets. CONCLUSION In medium-sized cities in the Netherlands, tobacco outlets were more often located in low-SES neighbourhoods than high-SES. Amsterdam presented a reverse pattern, possibly due to its unique urban structure. We discuss how licensing might contribute to reducing tobacco outlets in low-SES neighbourhoods.
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Affiliation(s)
- Tessa R D van Deelen
- Department of Public Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Postbus, Amsterdam, 22660, 1100 DD, the Netherlands.
| | - Els M Veldhuizen
- Department of Geography and Planning, University of Amsterdam, Amsterdam, Postbus, Amsterdam, 15629, 1001 NC, The Netherlands
| | - Bas van den Putte
- Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, Postbus, Amsterdam, 15791, 1001 NG, The Netherlands
| | - Anton E Kunst
- Department of Public Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Postbus, Amsterdam, 22660, 1100 DD, the Netherlands
| | - Mirte A G Kuipers
- Department of Public Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Postbus, Amsterdam, 22660, 1100 DD, the Netherlands
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Marsh L, Iosua E, Parkinson L, Doscher C, Quigg R. Is the neighbourhood context important for a tobacco retailer proximity policy? Health Place 2023; 82:103032. [PMID: 37148704 DOI: 10.1016/j.healthplace.2023.103032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/08/2023]
Abstract
A spatial modelling approach was used to explore how a proximity limit (150 m, 300 m, and 450 m) between tobacco retailers may impact different neighbourhoods in New Zealand. Neighbourhoods were categorised into three density groups (0, 1-2, 3+ retailers). As the proximity limit increases, there is a progressive redistribution of neighbourhoods in the three density groups with, the 3+ density group incorporating fewer neighbourhoods and the 0 and 1-2 density groups conversely each consisting of more. The differing measures available at the neighbourhood level enabled our study to discern potential inequities. More directed policies targeting these inequities are needed.
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Affiliation(s)
- Louise Marsh
- Social & Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
| | - Ella Iosua
- Biostatistics Centre, Division of Health Sciences, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
| | - Luke Parkinson
- Geospatial Research Institute, University of Canterbury, Private Bag 4800, Christchurch, 8140, New Zealand.
| | - Crile Doscher
- Faculty of Environment, Society and Design, Lincoln University, PO Box 85084, Ellesmere Junction Road, Lincoln, 7647, Canterbury, New Zealand.
| | - Robin Quigg
- Ngāi Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
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Pätsi SM, Toikka A, Ollila H, Ruokolainen O. Area-level sociodemographic differences in tobacco availability examined with nationwide tobacco product retail licence data in Finland. Tob Control 2023:tc-2022-057798. [PMID: 37015745 DOI: 10.1136/tc-2022-057798] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 03/17/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND Differences in tobacco retailer density between areas by sociodemographic composition have been observed. However, little research comes from European jurisdictions and from countries with a tobacco retail licensing system. In Finland, the system consists of criteria for retailers and supervision fees. METHODS The tobacco product retail licence data and sociodemographic data were retrieved from corresponding Finnish authorities. Area-level tobacco availability was measured as the presence of a retailer and as the number of retailers per 1000 inhabitants by postcode area. Sociodemographic indicators included median income, percentage of inhabitants in the lowest income tertile, percentage of adults with higher education and unemployment rate. Analyses were based on logistic regression and Ordinary Least Squares regression with log-transformed density. RESULTS Lower area-level sociodemographic composition was mainly associated with higher tobacco availability. Income was the strongest correlate of the tobacco retailer availability: areas with higher median income had lower odds of having a tobacco retailer (OR 0.54, 95% CI 0.48 to 0.61 per €1000) and lower retailer density (-4.4% per €1000, Cohen's f=0.51). Areas with a greater proportion of people in the lowest income category had higher densities of tobacco retailers (+2.8% per percentage point, Cohen's f=0.07). Other sociodemographic indicators showed inconsistent associations with retailer presence and density. CONCLUSION Tobacco availability can be higher in areas with lower sociodemographic composition also in a country with a comprehensive tobacco retail licensing system and small income inequalities. Retailing policies should be further developed to reduce tobacco availability and narrow inequalities in tobacco use.
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Affiliation(s)
- Salla-Maaria Pätsi
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Arho Toikka
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Hanna Ollila
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Otto Ruokolainen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
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Röhrbein H, Hilger-Kolb J, Heinrich K, Kairies H, Hoffmann K. An Iterative, Participatory Approach to Developing a Neighborhood-Level Indicator System of Health and Wellbeing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1456. [PMID: 36674211 PMCID: PMC9859574 DOI: 10.3390/ijerph20021456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 12/29/2022] [Accepted: 12/30/2022] [Indexed: 06/17/2023]
Abstract
Despite increased awareness of the essential role of neighborhood characteristics for residents' health and wellbeing, the development of neighborhood-level indicator systems has received relatively little attention to date. To address this gap, we describe the participatory development process of a small-area indicator system that includes information on local health needs in a pilot neighborhood in the German city of Mannheim. To identify relevant indicators, we partnered with representatives of the city's public health department and used an iterative approach that included multiple Plan-Do-Check-Act cycles with ongoing feedback from local key stakeholders. The described process resulted in a web-based indicator system with a total of 86 indicators. Additionally, 123 indicators were perceived as relevant by stakeholders but could not be included due to data unavailability. Overall, stakeholders evaluated the participatory approach as useful. Even though the onset of the COVID-19 pandemic and the lack of some data elements hindered instrument development, close collaboration with public health partners facilitated the process. To identify and target sub-national health inequalities, we encourage local public health stakeholders to develop meaningful and useful neighborhood-level indicator systems, building on our experiences from the applied development process and considering identified barriers and facilitators.
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Affiliation(s)
- Hannah Röhrbein
- Center for Preventive Medicine and Digital Health (CPD), Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany
| | - Jennifer Hilger-Kolb
- Center for Preventive Medicine and Digital Health (CPD), Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany
| | - Kathrin Heinrich
- Youth Welfare Office and Public Health Department, Division for Youth Welfare Planning and Public Health Planning, 68161 Mannheim, Germany
| | - Holger Kairies
- Youth Welfare Office and Public Health Department, Division for Youth Welfare Planning and Public Health Planning, 68161 Mannheim, Germany
| | - Kristina Hoffmann
- Center for Preventive Medicine and Digital Health (CPD), Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany
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Zhang J, Chen Z, Pärna K, van Zon SKR, Snieder H, Thio CHL. Mediators of the association between educational attainment and type 2 diabetes mellitus: a two-step multivariable Mendelian randomisation study. Diabetologia 2022; 65:1364-1374. [PMID: 35482055 PMCID: PMC9283137 DOI: 10.1007/s00125-022-05705-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 02/15/2022] [Indexed: 12/25/2022]
Abstract
AIMS/HYPOTHESIS Type 2 diabetes mellitus is a major health burden disproportionately affecting those with lower educational attainment (EA). We aimed to obtain causal estimates of the association between EA and type 2 diabetes and to quantify mediating effects of known modifiable risk factors. METHODS We applied two-step, two-sample multivariable Mendelian randomisation (MR) techniques using SNPs as genetic instruments for exposure and mediators, thereby minimising bias due to confounding and reverse causation. We leveraged summary data on genome-wide association studies for EA, proposed mediators (i.e. BMI, blood pressure, smoking, television watching) and type 2 diabetes. The total effect of EA on type 2 diabetes was decomposed into a direct effect and indirect effects through multiple mediators. Additionally, traditional mediation analysis was performed in a subset of the National Health and Nutrition Examination Survey 2013-2014. RESULTS EA was inversely associated with type 2 diabetes (OR 0.53 for each 4.2 years of schooling; 95% CI 0.49, 0.56). Individually, the largest contributors were BMI (51.18% mediation; 95% CI 46.39%, 55.98%) and television watching (50.79% mediation; 95% CI 19.42%, 82.15%). Combined, the mediators explained 83.93% (95% CI 70.51%, 96.78%) of the EA-type 2 diabetes association. Traditional analysis yielded smaller effects but showed consistent direction and priority ranking of mediators. CONCLUSIONS/INTERPRETATION These results support a potentially causal protective effect of EA against type 2 diabetes, with considerable mediation by a number of modifiable risk factors. Interventions on these factors thus have the potential of substantially reducing the burden of type 2 diabetes attributable to low EA.
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Affiliation(s)
- Jia Zhang
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Zekai Chen
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Katri Pärna
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Sander K R van Zon
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Harold Snieder
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Chris H L Thio
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
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Tunstall H, Shortt NK, Kong AY, Pearce J. Is tobacco a driver of footfall among small retailers? A geographical analysis of tobacco purchasing using electronic point of sale data. Tob Control 2022; 32:tobaccocontrol-2021-057089. [PMID: 35851260 PMCID: PMC10344415 DOI: 10.1136/tobaccocontrol-2021-057089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 04/27/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Opponents of policies designed to reduce tobacco retail availability argue that tobacco products are a vital driver of 'footfall' in small retailers. This study considers the changing contribution of tobacco to footfall and revenue among convenience stores across Britain, compares tobacco to other 'footfall driver' products and assesses whether tobacco's importance varies by neighbourhood deprivation and urban/rural status. METHODS We conducted an analysis of electronic point of sale systems data from 1253 convenience stores in Britain in 4 weeks in 2016 and 2019. We calculated the number and value of purchased basket types (Tobacco Only, Non-Tobacco, Mixed) in each year and by neighbourhood characteristics. RESULTS The mean numbers of baskets per store containing tobacco fell by 47% during 2016-2019, a greater decline than any other footfall driver product. The sales value of tobacco products rose sharply over this time period due to increasing unit price. However, the proportion of store turnover accounted for by tobacco transactions declined. There were marked falls in the turnover from non-tobacco products in Mixed tobacco baskets. The proportion of baskets containing tobacco and the value of turnover from these baskets was greater in more deprived and urban areas but these places also experienced larger reductions over time, narrowing differences between areas. CONCLUSION Tobacco's importance as a driver of footfall and related turnover among convenience retailers has reduced significantly in Britain in recent years, particularly in deprived and urban areas, undermining industry claims that tobacco is essential to the viability of these businesses.
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Affiliation(s)
- Helena Tunstall
- Centre for Research on Environment, Society and Health, School of GeoSciences, The University of Edinburgh, Edinburgh, UK
| | - Niamh K Shortt
- Centre for Research on Environment, Society and Health, School of GeoSciences, The University of Edinburgh, Edinburgh, UK
| | - Amanda Y Kong
- Family and Preventive Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
- TSET Health Promotion Research Center, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Jamie Pearce
- Centre for Research on Environment, Society and Health, School of GeoSciences, The University of Edinburgh, Edinburgh, UK
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Janssen JMM, van der Velde LA, Kiefte-de Jong JC. Food insecurity in Dutch disadvantaged neighbourhoods: a socio-ecological approach. J Nutr Sci 2022; 11:e52. [PMID: 35836698 PMCID: PMC9257769 DOI: 10.1017/jns.2022.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 11/06/2022] Open
Abstract
Food insecurity is an important public health concern; however, research into this phenomenon within the Netherlands is limited. Food insecurity is not solely related to individual factors, but can also be influenced by various factors in the social and physical environment. Therefore, this study aimed to identify determinants of food insecurity within the personal, social and physical environment, based on the social ecological model (SEM), and to identify their relative importance for experiencing food insecurity. The study population consisted of 307 participants living in disadvantaged neighbourhoods of the Dutch city The Hague, of which approximately one-quarter were food insecure. Participant characteristics showing bivariate associations P < 0⋅20 were placed in a predetermined level of the SEM, after which a multivariate logistic regression was performed for each level and the Nagelkerke pseudo R 2 was presented. Determinants of food insecurity were BMI, gross monthly income, highest educational attainment, smoking status, diet quality, employment status, marital status and religion (P < 0⋅05). The results showed that 29⋅7 % of the total variance in food insecurity status was explained by all included determinants together. The personal, social and physical environment explained 20⋅6, 14⋅0 and 2⋅4 % of the total variance, respectively. Our findings suggest that determinants within the personal environment are most important for explaining differences in experienced food insecurity. The present study contributes to furthering the knowledge about the relative importance of the personal, social and physical environment, indicating that determinants within the personal environment may be most promising for developing targeted interventions to reduce food insecurity.
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Key Words
- BMI, body mass index
- DHC, Dutch Health Council
- Determinants
- Explained variance
- FFQ, food frequency questionnaire
- FI, food insecure
- FS, food secure
- Food insecurity
- Food security
- IQR, interquartile range
- ISCED, International Standard Classification of Education
- LUMC, Leiden University Medical Center
- MAR, missing at random
- MCS, mental component summary
- MI, multiple imputation
- NNC, Netherlands Nutrition Center
- PCS, physical component summary
- SEM, social ecological model
- SEP, socio-economic position
- SF-12, 12-Item Short Form Health Survey
- SNAP, Supplement Nutrition and Assistance Program
- Social ecological model
- USDA, United States Department of Agriculture
- WMO, ‘Wet medisch-wetenschappelijk onderzoek’, in English: Medical Research Involving Human Subjects Act
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Affiliation(s)
- Jolien M. M. Janssen
- Department of Public Health and Primary Care/Health Campus The Hague, Leiden University Medical Centre, The Hague, The Netherlands
| | - Laura A. van der Velde
- Department of Public Health and Primary Care/Health Campus The Hague, Leiden University Medical Centre, The Hague, The Netherlands
| | - Jessica C. Kiefte-de Jong
- Department of Public Health and Primary Care/Health Campus The Hague, Leiden University Medical Centre, The Hague, The Netherlands
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Rinaldi C, D’Aguilar M, Egan M. Understanding the Online Environment for the Delivery of Food, Alcohol and Tobacco: An Exploratory Analysis of 'Dark Kitchens' and Rapid Grocery Delivery Services. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5523. [PMID: 35564918 PMCID: PMC9099441 DOI: 10.3390/ijerph19095523] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 12/04/2022]
Abstract
Online spaces are increasingly important in the sale of food, alcohol and tobacco. This analysis focuses on two developments in online food delivery: delivery-only 'dark kitchens' and rapid grocery delivery services (RGDS), with the aim to understand and assess the availability of health harming and health promoting products through these services. Data was collected for one metropolitan local authority in London, UK, using publicly available online sources. Being explorative in nature, the analysis includes descriptive statistics and qualitative assessment. Three dark kitchens (renting kitchens to 116 food businesses), three grocery delivery apps, and 76 grocery businesses available through online delivery platforms were identified. Most businesses renting dark kitchen space were 'virtual restaurants' (52%) selling fast food (47%) or dessert (21%) through online delivery platforms. RGDS sold a variety of items, with a focus on pre-packaged foods high in fat, salt and sugar, alcoholic beverages and tobacco. These items were also most likely to be promoted through offers and promotional language. Fruits and vegetables were less commonly available and mainly on grocery delivery apps. Online delivery services increase the temporal and geographic availability and promotion of many unhealthy products. Research expanding on the geographic area of interest is needed.
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Affiliation(s)
- Chiara Rinaldi
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK;
| | | | - Matt Egan
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK;
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Kong AY, Henriksen L. Retail endgame strategies: reduce tobacco availability and visibility and promote health equity. Tob Control 2022; 31:243-249. [PMID: 35241596 PMCID: PMC8908901 DOI: 10.1136/tobaccocontrol-2021-056555] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/06/2022] [Indexed: 12/26/2022]
Abstract
An increasing number of countries have set tobacco endgame goals that target dramatic reductions in smoking prevalence. To achieve those targets and promote health equity, policies are needed to reduce the retail supply and visibility of tobacco products. Focusing on retailer reduction strategies and tobacco display bans, this special communication reviews solution-oriented research about the retail environment. It highlights examples of policy implementation and identifies data needs and research gaps for designing and evaluating retail policies to promote population health equitably.
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Affiliation(s)
- Amanda Y Kong
- Family and Preventive Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
- TSET Health Promotion Center, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Lisa Henriksen
- Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, California, USA
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11
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Ashing KT, Song G, O’Connor T, Obodo U, Abuan F, Dawson CT, Tiep B, Macalintal J, Yeung S, Xie B, Tsou MH. Spatial and Descriptive Analysis of Smoke and Vape Shop Locations Focusing on A Cancer Center Neighboring Catchment Area. PAPERS IN APPLIED GEOGRAPHY 2022; 8:61-71. [PMID: 35664374 PMCID: PMC9162779 DOI: 10.1080/23754931.2021.1947354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Tobacco products cause about 1 in 5 deaths premature deaths each year. With increased retailing of both tobacco and electronic nicotine delivery systems (ENDS) products, cancer centers such as City of Hope are prioritizing tobacco and ENDS control. Therefore, we conducted formative geospatial analyses of dedicated smoke and vape shops linked to neighborhood demographic characteristics. The objective of the study was to analyze local data on smoke and vaping shop locations by age, socio-economic status, and racial/ethnic group. Our geospatial analysis used aggregate data from the U.S. Census, Google Maps, and Yelp. Geospatial maps were created using ArcGIS Pro with American Community Survey and U.S. Census 2010. The distributions of exclusive tobacco and vaping shop locations data were overlaid with data from the U.S. Census 2010 to generate maps of the relative geographic distributions of shops across varying area demographic characteristics. Results showed that a higher concentration of exclusive smoke and vaping shops were in areas with a higher concentration of ethnic minorities and lower income and lower status neighborhoods. These findings suggest that laws and licensing should be evaluated to regulate the placement of these shops to reduce and even prevent targeting of minorities and other vulnerable populations.
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Affiliation(s)
- Kimlin Tam Ashing
- Department of Population Sciences, Beckman Research Institute, City of Hope, CA, USA
| | - Gaole Song
- Department of Population Sciences, Beckman Research Institute, City of Hope, CA, USA,School of Community and Global Health, Claremont Graduate University, CA, USA
| | - Timothy O’Connor
- Department of Cancer Biology, Beckman Research Institute, City of Hope, CA, USA
| | - Udochukwu Obodo
- Department of Cancer Biology, Beckman Research Institute, City of Hope, CA, USA
| | - Faith Abuan
- Department of Population Sciences, Beckman Research Institute, City of Hope, CA, USA
| | - Christyl T. Dawson
- Department of Population Sciences, Beckman Research Institute, City of Hope, CA, USA
| | - Brian Tiep
- Smoking Cessation Program, Medical Center, City of Hope, CA, USA
| | | | - Sophia Yeung
- Smoking Cessation Program, Medical Center, City of Hope, CA, USA
| | - Bin Xie
- School of Community and Global Health, Claremont Graduate University, CA, USA
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Kong AY, Delamater PL, Gottfredson NC, Ribisl KM, Baggett CD, Golden SD. Sociodemographic inequities in tobacco retailer density: Do neighboring places matter? Health Place 2021; 71:102653. [PMID: 34461529 PMCID: PMC8490323 DOI: 10.1016/j.healthplace.2021.102653] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/07/2021] [Accepted: 08/10/2021] [Indexed: 11/28/2022]
Abstract
We apply a spatial perspective to measure the extent to which the 2018 U.S. racial, ethnic, and socioeconomic composition of census tracts were each associated with tobacco retailer density within a tract and in its neighboring tracts (n = 71,409). A 10-percentage point increase in the Black population was associated with 0.07 (p < 0.05) more retailers per square mile within a focal tract and 0.35 (p < 0.001) more retailers per square mile in its neighbors on average. A greater percent of Hispanic/Latino residents was associated with more retailers per square mile, both within a focal tract (b = 0.95, p < 0.001) and in its neighbors 0.39 (p < 0.001). Inverse associations were observed for percent white. We also observed inequities by socioeconomic status. The overall magnitude of inequities may be underestimated if the spatial dependence between focal tracts and their neighbors are not taken into consideration. Policymakers should prioritize interconnected geographic areas experiencing high racialized and socioeconomic segregation when designing and implementing policies to reduce retail tobacco product availability.
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Affiliation(s)
- Amanda Y Kong
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC, 27599-7440, USA.
| | - Paul L Delamater
- Department of Geography, University of North Carolina, Carolina Hall, Chapel Hill, NC, 27599-7435, USA
| | - Nisha C Gottfredson
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC, 27599-7440, USA
| | - Kurt M Ribisl
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC, 27599-7440, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, 101 Manning Drive, Chapel Hill, NC, 27599-7295, USA
| | - Chris D Baggett
- Lineberger Comprehensive Cancer Center, University of North Carolina, 101 Manning Drive, Chapel Hill, NC, 27599-7295, USA; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC, 27599-7435, USA
| | - Shelley D Golden
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC, 27599-7440, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, 101 Manning Drive, Chapel Hill, NC, 27599-7295, USA
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13
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Douglas JA, Subica AM, Franks L, Johnson G, Leon C, Villanueva S, Grills CT. Using Participatory Mapping to Diagnose Upstream Determinants of Health and Prescribe Downstream Policy-Based Interventions. Prev Chronic Dis 2020; 17:E138. [PMID: 33155972 PMCID: PMC7665598 DOI: 10.5888/pcd17.200123] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Participatory mapping is a powerful methodology for working with community residents to examine social and environmental determinants of public health disparities. However, this empowering methodology has only been applied sparingly in public health research and practice, with limited examples in the literature. To address this literature gap, we 1) review participatory mapping approaches that may be applied to exploring place-based factors that affect community health, and 2) present a mixed-methods participatory geographic information systems (PGIS) examination of neighborhood assets (eg, streetlights) and challenges (eg, spaces of crime and violence) related to access to public parks in South Los Angeles, California. By taking a participatory, fine-grained spatial approach to examining public park access with input from 40 South Los Angeles adolescent and adult residents, our community-engaged PGIS approach identified tobacco shops as previously unrecognized community institutions that are associated with increased neighborhood crime and violence. Our investigation revealed unique challenges in community-level public park access that would likely have been overlooked by conventional spatial epidemiology and social science methods, such as surveys and questionnaires. Furthermore, our granular community-informed approach supported resident and stakeholder advocacy efforts toward reducing the proliferation of tobacco shops through community organizing and policy change initiatives. We thus contend that it would benefit public health research and practice to further integrate empowering, grassroots-based participatory mapping approaches toward informing advocacy efforts and policies that promote health and well-being in disadvantaged communities.
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Affiliation(s)
- Jason A Douglas
- Chapman University, Crean College of Health and Behavioral Sciences, Department of Health Sciences, Orange, California.,Chapman University, Crean College of Health and Behavioral Sciences, Department of Health Sciences, One University Dr, Orange, CA 92866.
| | - Andrew M Subica
- University of California, Riverside School of Medicine, Department of Social Medicine, Population, and Public Health, Riverside, California
| | | | | | - Carlos Leon
- Community Coalition, Los Angeles, California
| | - Sandra Villanueva
- Loyola Marymount University, Psychology Applied Research Center, Los Angeles, California
| | - Cheryl T Grills
- Loyola Marymount University, Psychology Applied Research Center, Los Angeles, California
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Puigcorbé S, Villalbí JR, Sureda X, Bosque-Prous M, Teixidó-Compañó E, Franco M, Bartroli M, Espelt A. Assessing the association between tourism and the alcohol urban environment in Barcelona: a cross-sectional study. BMJ Open 2020; 10:e037569. [PMID: 32994241 PMCID: PMC7526313 DOI: 10.1136/bmjopen-2020-037569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES Alcohol availability and promotion are not distributed equally in the urban context. Evidence shows that the socioeconomic level seems to influence the amount of alcohol-related elements in an area. Some studies suggest that tourism could also affect the distribution of these elements. We explore with a valid instrument in a large city whether there is an association between high tourism pressure and a greater presence of alcohol-related elements in the urban environment. DESIGN Observational ecological study. SETTING The study was conducted in Barcelona during 2017-2018. PARTICIPANTS We assessed urban exposure to alcohol by performing social systematic observation using the OHCITIES Instrument in a stratified random sample of 170 census tracts within the city's 73 neighbourhoods. PRIMARY AND SECONDARY OUTCOME MEASURES For each census tract we calculated the density of alcohol premises, and of promotion in public places per 1000 residents. We estimated tourism pressure using the number of tourist beds per 1000 residents in each neighbourhood and calculated quartiles. To assess the relationship between rate ratios of elements of alcohol urban environment and tourism pressure, we calculated Spearman correlations and fitted Poisson regression models with robust error variance. RESULTS The median densities obtained were of 8.18 alcohol premises and of 7.59 alcohol advertising and promotion elements visible from the public space per 1000 population. Census tracts with the highest tourism pressure had 2.5 (95% CI: 1.85-3.38) times more outlets and 2.3 (95% CI: 1.64-3.23) times more promotion elements per 1000 residents than those in the lowest tourism pressure quartile. CONCLUSIONS We observed a strong association between tourism pressure and alcohol exposure in the city of Barcelona.
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Affiliation(s)
- Susanna Puigcorbé
- Agència de Salut Pública de Barcelona, Barcelona, Spain
- Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain
- Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Joan R Villalbí
- Agència de Salut Pública de Barcelona, Barcelona, Spain
- Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain
- Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Xisca Sureda
- Public Health and Epidemiology Research Group. School of Medicine, University of Alcalá, Alcalá de Henares, Spain
- Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York, United States
- Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, l'Hospitalet de Llobregat, Spain
- Consortium for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | - Marina Bosque-Prous
- Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
- Departament de Psicobiologia i Metodologia en Ciències de la Salut, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain
| | - Ester Teixidó-Compañó
- Facultat de Ciències de la Salut de Manresa, Universitat de Vic - Universitat Central de Catalunya (UVicUCC), Manresa, Spain
| | - Manuel Franco
- Public Health and Epidemiology Research Group. School of Medicine, University of Alcalá, Alcalá de Henares, Spain
- Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York, United States
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
| | - Montserrat Bartroli
- Agència de Salut Pública de Barcelona, Barcelona, Spain
- Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain
- Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Albert Espelt
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Departament de Psicobiologia i Metodologia en Ciències de la Salut, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain
- Facultat de Ciències de la Salut de Manresa, Universitat de Vic - Universitat Central de Catalunya (UVicUCC), Manresa, Spain
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15
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Haw S, Currie D, Eadie D, Pearce J, MacGregor A, Stead M, Amos A, Best C, Wilson M, Cherrie M, Purves R, Ozakinci G, MacKintosh AM. The impact of the point-of-sale tobacco display ban on young people in Scotland: before-and-after study. PUBLIC HEALTH RESEARCH 2020. [DOI: 10.3310/phr08010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background
Tobacco displays at point of sale have been shown to increase young people’s pro-smoking attitudes, susceptibility to smoking and smoking initiation. In Scotland, legislation that prohibited tobacco point-of-sale displays was implemented in large stores (i.e. those > 280 m2) in April 2013 and in small retailers in April 2015.
Objective
To assess the impact of the point-of-sale tobacco display ban on young people’s exposure to tobacco advertising, their attitudes to smoking and smoking susceptibility, and their risk of smoking initiation.
Design
Multimodal before-and-after study design using mixed methods to collect data at baseline (2013) and then longitudinally for 4 years.
Setting
Four main study communities in the central belt of mainland Scotland, UK, purposively selected to reflect two levels of urbanity (urban vs. small town) and two levels of deprivation (high vs. medium/low). Four matched communities.
Participants
In the main study communities, 94 tobacco retail outlets. All Secondary 2 (aged 13 years) and Secondary 4 (aged 15 years) pupils in 2013 and 2014 together with all Secondary 1 to Secondary 6 (aged 12–17 years) pupils in 2015–17. This included 6612 pupils who completed 14,344 questionnaires over 5 years. Three hundred and eighty-two participants in 80 focus groups who were recruited from Secondary 2 and Secondary 4 in 2013–17. In matched communities, 24 retail panel members in 2013–17.
Main outcome measures
Tobacco product and tobacco storage visibility, density of retail outlets (the number of retailers in a pre-defined area such as a residential neighbourhood), tobacco product exposure, brand awareness, perceived accessibility of tobacco, pro-smoking attitudes, pro-smoking norms, smoking susceptibility and smoking initiation.
Data platform and methods
The study had four components – a mapping and spatial analysis of retail outlets; a tobacco marketing audit, including retail panel interviews in matched communities; school surveys; and focus group discussions with secondary school pupils.
Limitations
The study was based on a small number of communities and did not include communities in remote areas.
Results
Compliance with the point-of-sale legislation in Scotland was high. This led to a large reduction in the visibility of tobacco products in retail outlets. However, when the results were stratified by socioeconomic status, declines in retailer density, weighted by total product visibility, were restricted to the least disadvantaged tertile of participants. Nevertheless, the implementation of the legislation was associated with a reduction in risk of both smoking susceptibility and smoking initiation in young people, as well as a reduction in the perceived accessibility of tobacco and in pro-smoking attitudes after both the partial and the comprehensive bans were introduced.
Conclusions
The Scottish point-of-sale legislation has been successful in reducing the overall visibility of tobacco products and is associated with improvements in attitudinal and behavioural outcomes in young people. However, cues that tobacco is for sale are still highly visible, particularly in retail outlets in areas of deprivation. In addition, the increase in retailer density that was observed after 2015 increased inequalities in product visibility. There was also evidence that the emergence of e-cigarettes may have disrupted the full impact of the legislation.
Future work
Our research indicates that further research is needed to examine the longitudinal relationships between tobacco outlet availability and product visibility inequalities; and the impact of e-cigarettes and standardised packaging on smoking initiation and prevalence.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 1. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Sally Haw
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Dorothy Currie
- Centre for Adolescent and Child Health Research, School of Medicine, University of St Andrews, St Andrews, UK
| | - Douglas Eadie
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Jamie Pearce
- Institute of Geography, School of GeoSciences, University of Edinburgh, Edinburgh, UK
| | | | - Martine Stead
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Amanda Amos
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Catherine Best
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Michael Wilson
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Mark Cherrie
- Institute of Geography, School of GeoSciences, University of Edinburgh, Edinburgh, UK
| | - Richard Purves
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Gozde Ozakinci
- School of Medicine, Medical & Biological Sciences, University of St Andrews, St Andrews, UK
| | - Anne Marie MacKintosh
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
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Mohammed SH, Habtewold TD, Birhanu MM, Sissay TA, Tegegne BS, Abuzerr S, Esmaillzadeh A. Neighbourhood socioeconomic status and overweight/obesity: a systematic review and meta-analysis of epidemiological studies. BMJ Open 2019; 9:e028238. [PMID: 31727643 PMCID: PMC6886990 DOI: 10.1136/bmjopen-2018-028238] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Low neighbourhood socioeconomic status (NSES) has been linked to a higher risk of overweight/obesity, irrespective of the individual's own socioeconomic status. No meta-analysis study has been done on the association. Thus, this study was done to synthesise the existing evidence on the association of NSES with overweight, obesity and body mass index (BMI). DESIGN Systematic review and meta-analysis. DATA SOURCES PubMed, Embase, Scopus, Cochrane Library, Web of Sciences and Google Scholar databases were searched for articles published until 25 September 2019. ELIGIBILITY CRITERIA Epidemiological studies, both longitudinal and cross-sectional ones, which examined the link of NSES to overweight, obesity or BMI, were included. DATA EXTRACTION AND SYNTHESIS Data extraction was done by two reviewers, working independently. The methodological quality of included studies was assessed using the Newcastle-Ottawa Scale for the observational studies. The summary estimates of the relationships of NSES with overweight, obesity and BMI statuses were calculated with random-effects meta-analysis models. Heterogeneity was assessed by Cochran's Q and I2 statistics. Subgroup analyses were done by age categories, continents, study designs and NSES measures. Publication bias was assessed by visual inspection of funnel plots and Egger's regression test. RESULT A total of 21 observational studies, covering 1 244 438 individuals, were included in this meta-analysis. Low NSES, compared with high NSES, was found to be associated with a 31% higher odds of overweight (pooled OR 1.31, 95% CI 1.16 to 1.47, p<0.001), a 45% higher odds of obesity (pooled OR 1.45, 95% CI 1.21 to 1.74, p<0.001) and a 1.09 kg/m2 increase in mean BMI (pooled beta=1.09, 95% CI 0.67 to 1.50, p<0.001). CONCLUSION NSES disparity might be contributing to the burden of overweight/obesity. Further studies are warranted, including whether addressing NSES disparity could reduce the risk of overweight/obesity. PROSPERO REGISTRATION NUMBER CRD42017063889.
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Affiliation(s)
- Shimels Hussien Mohammed
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Tesfa Dejenie Habtewold
- Department of Epidemiology, University of Groningen, Groningen, The Netherlands
- Department of Nursing, Debre Berhan University, Debre Berhan, Ethiopia
| | - Mulugeta Molla Birhanu
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | | | | | - Samer Abuzerr
- Department of Environmental Health Engineering, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
- Department of Community Nutrition, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran (the Islamic Republic of)
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17
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Liveable for whom? Prospects of urban liveability to address health inequities. Soc Sci Med 2019; 232:94-105. [DOI: 10.1016/j.socscimed.2019.05.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 03/13/2019] [Accepted: 05/01/2019] [Indexed: 12/31/2022]
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18
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Präger M, Kurz C, Böhm J, Laxy M, Maier W. Using data from online geocoding services for the assessment of environmental obesogenic factors: a feasibility study. Int J Health Geogr 2019; 18:13. [PMID: 31174531 PMCID: PMC6555943 DOI: 10.1186/s12942-019-0177-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 05/29/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The increasing prevalence of obesity is a major public health problem in many countries. Built environment factors are known to be associated with obesity, which is an important risk factor for type 2 diabetes. Online geocoding services could be used to identify regions with a high concentration of obesogenic factors. The aim of our study was to examine the feasibility of integrating information from online geocoding services for the assessment of obesogenic environments. METHODS We identified environmental factors associated with obesity from the literature and translated these factors into variables from the online geocoding services Google Maps and OpenStreetMap (OSM). We tested whether spatial data points can be downloaded from these services and processed and visualized on maps. True- and false-positive values, false-negative values, sensitivities and positive predictive values of the processed data were determined using search engines and in-field inspections within four pilot areas in Bavaria, Germany. RESULTS Several environmental factors could be identified from the literature that were either positively or negatively correlated with weight outcomes in previous studies. The diversity of query variables was higher in OSM compared with Google Maps. In each pilot area, query results from Google showed a higher absolute number of true-positive hits and of false-positive hits, but a lower number of false-negative hits during the validation process. The positive predictive value of database hits was higher in OSM and ranged between 81 and 100% compared with a range of 63-89% for Google Maps. In contrast, sensitivities were higher in Google Maps (between 59 and 98%) than in OSM (between 20 and 64%). CONCLUSIONS It was possible to operationalize obesogenic factors identified from the literature with data and variables available from geocoding services. The validity of Google Maps and OSM was reasonable. The assessment of environmental obesogenic factors via geocoding services could potentially be applied in diabetes surveillance.
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Affiliation(s)
- Maximilian Präger
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München – German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85758 Neuherberg, Germany
- German Center for Diabetes Research, Neuherberg, Germany
| | - Christoph Kurz
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München – German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85758 Neuherberg, Germany
- German Center for Diabetes Research, Neuherberg, Germany
| | - Julian Böhm
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München – German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85758 Neuherberg, Germany
- German Center for Diabetes Research, Neuherberg, Germany
| | - Michael Laxy
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München – German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85758 Neuherberg, Germany
- German Center for Diabetes Research, Neuherberg, Germany
| | - Werner Maier
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München – German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85758 Neuherberg, Germany
- German Center for Diabetes Research, Neuherberg, Germany
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19
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Mohnen SM, Schneider S, Droomers M. Neighborhood characteristics as determinants of healthcare utilization - a theoretical model. HEALTH ECONOMICS REVIEW 2019; 9:7. [PMID: 30840211 PMCID: PMC6734422 DOI: 10.1186/s13561-019-0226-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 02/25/2019] [Indexed: 05/13/2023]
Abstract
BACKGROUND We propose using neighborhood characteristics as demand-related morbidity adjusters to improve prediction models such as the risk equalization model. RESULTS Since the neighborhood has no explicit 'place' in healthcare demand models, we have developed the "Neighborhood and healthcare utilization model" to show how neighborhoods matter in healthcare utilization. Neighborhood may affect healthcare utilization via (1) the supply-side, (2) need, and (3) demand for healthcare - irrespective of need. Three pathways are examined in detail to explain how neighborhood characteristics influence healthcare utilization via need: the physiological, psychological and behavioral pathways. We underpin this theoretical model with literature on all relevant neighborhood characteristics relating to health and healthcare utilization. CONCLUSION Potential neighborhood characteristics for the risk equalization model include the degree of urbanization, public and open space, resources and facilities, green and blue space, environmental noise, air pollution, social capital, crime and violence, socioeconomic status, stability, and ethnic composition. Air pollution has already been successfully tested as an important predictive variable in a healthcare risk equalization model, and it might be opportune to add more neighborhood characteristics.
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Affiliation(s)
- Sigrid M. Mohnen
- National Institute for Public Health and the Environment (RIVM), Centre for Nutrition, Prevention, and Health Services, PO Box 1, 3720 BA Bilthoven, The Netherlands
| | - Sven Schneider
- Mannheim Institute of Public Health, Social and Preventive Medicine (MIPH), Heidelberg University, Mannheim, Germany
| | - Mariël Droomers
- Utrecht Municipality, Department of Public Health, PO Box 16200, 3500 CE Utrecht, The Netherlands
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20
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Cebrecos A, Escobar F, Borrell LN, Díez J, Gullón P, Sureda X, Klein O, Franco M. A multicomponent method assessing healthy cardiovascular urban environments: The Heart Healthy Hoods Index. Health Place 2019; 55:111-119. [DOI: 10.1016/j.healthplace.2018.11.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 11/16/2018] [Accepted: 11/28/2018] [Indexed: 11/26/2022]
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21
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Hoebel J, Kuntz B, Kroll LE, Schienkiewitz A, Finger JD, Lange C, Lampert T. Socioeconomic Inequalities in the Rise of Adult Obesity: A Time-Trend Analysis of National Examination Data from Germany, 1990-2011. Obes Facts 2019; 12:344-356. [PMID: 31167203 PMCID: PMC6696774 DOI: 10.1159/000499718] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 03/16/2019] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Despite extensive study of the obesity epidemic, research on whether obesity has risen faster in lower or in higher socioeconomic groups is inconsistent. This study examined secular trends in obesity prevalence by socioeconomic position and the resulting obesity inequalities in the German adult population. METHODS Data were drawn from three national examination surveys conducted in 1990-1992, 1997-1999 and 2008-2011 (n = 18,541; age range: 25-69 years). Obesity was defined by a body mass index ≥30 kg/m2 using standardised measurements of body height and weight. Education and equivalised household disposable income were used as indicators of socioeconomic position. Time trends in socioeconomic inequalities in obesity were examined using linear probability and log-binomial regression models. RESULTS In each survey period, the highest socioeconomic groups had the lowest prevalence of obesity. The low and medium socioeconomic groups showed increases in obesity prevalence, whereas no such trend was observed in the high socioeconomic groups. Absolute inequalities in obesity by income increased by an average of 0.53 percentage points per year (95% confidence interval [CI] 0.01-1.05, p = 0.047) among men and 0.47 percentage points per year (95% CI 0.05-0.90, p = 0.029) among women. Absolute inequalities in obesity by education increased on average by 0.64 percentage points per year (95% CI 0.19-1.08, p = 0.005) among women but not among men (0.33 percentage points, 95% CI -0.27 to 0.92, p = 0.283). CONCLUSIONS These findings suggest a widening obesity gap between the top and the bottom of the socioeconomic spectrum. This has the potential to have adverse consequences for population health and health inequalities in coming decades. Interventions that are effective in preventing and reducing obesity in socially disadvantaged groups are needed.
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Affiliation(s)
- Jens Hoebel
- Division of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany,
| | - Benjamin Kuntz
- Division of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Lars E Kroll
- Division of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Anja Schienkiewitz
- Division of Health Behaviour, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Jonas D Finger
- Division of Health Behaviour, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Cornelia Lange
- Division of Health Behaviour, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Thomas Lampert
- Division of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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Valiente R, Sureda X, Bilal U, Navas-Acien A, Pearce J, Franco M, Escobar F. Regulating the local availability of tobacco retailing in Madrid, Spain: a GIS study to evaluate compliance. Tob Control 2018; 28:325-333. [DOI: 10.1136/tobaccocontrol-2018-054269] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 05/21/2018] [Accepted: 06/13/2018] [Indexed: 11/04/2022]
Abstract
BackgroundIn Spain, tobacco sales are limited to tobacco-exclusive stores and associated vending machines. A minimum of 150 m between stores is required, unless they exceed a legal sales threshold. Minimum distances to schools are recommended but not defined. We evaluated compliance with these regulations in Madrid, Spain.MethodsInformation about tobacco-exclusive stores and their sales volume was obtained in 2014. We used geographic information system to identify stores closer than 150 m between them and examine whether they exceeded the sales threshold. We estimated distances between stores and schools, considering different distance intervals (<150 m, 150–300 m and >300 m) and calculations (crow flies and street network). We assessed the association of area-level demographic and socioeconomic characteristics with the distribution of tobacco stores.Results5.3% (34/638) of tobacco stores were within 150 m of each other. Among those, 76% (26/34) did not meet the regulation sales threshold. These stores were in areas with lower proportion of young population (<15 years) and higher proportion of people with university-level education. 75% (476/638) of stores were situated closer than 300 m to schools. No differences were identified in sociodemographic and economic characteristics by the store distance to schools.ConclusionMost tobacco stores are compliant with the regulations in Spain. However, these regulations are insufficient to reduce tobacco availability. More restrictive regulations are needed to limit the geographic distribution of tobacco retailers, and health criteria should also be considered in the current legislation. The evaluation of the Spanish regulatory model may provide useful insights for other jurisdictions looking to decrease the tobacco retail availability.
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Macdonald L, Olsen JR, Shortt NK, Ellaway A. Do 'environmental bads' such as alcohol, fast food, tobacco, and gambling outlets cluster and co-locate in more deprived areas in Glasgow City, Scotland? Health Place 2018; 51:224-231. [PMID: 29747132 PMCID: PMC5989655 DOI: 10.1016/j.healthplace.2018.04.008] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 03/12/2018] [Accepted: 04/23/2018] [Indexed: 11/30/2022]
Abstract
This study utilised an innovative application of spatial cluster analysis to examine the socio-spatial patterning of outlets selling potentially health-damaging goods/services, such as alcohol, fast food, tobacco and gambling, within Glasgow City, Scotland. For all categories of outlets combined, numbers of clusters increased linearly from the least to the most income deprived areas (i.e. one cluster within the least deprived quintile to ten within the most deprived quintile). Co-location of individual types of outlets (alcohol, fast food, tobacco and gambling) within similar geographical areas was also evident. This type of research could influence interventions to tackle the co-occurrence of unhealthy behaviours and contribute to policies tackling higher numbers of 'environmental bads' within deprived areas.
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Affiliation(s)
- Laura Macdonald
- MRC/CSO Social and Public Health Sciences, University of Glasgow, Top floor, 200 Renfield Street, Glasgow G2 3QB, United Kingdom.
| | - Jonathan R Olsen
- MRC/CSO Social and Public Health Sciences, University of Glasgow, Top floor, 200 Renfield Street, Glasgow G2 3QB, United Kingdom
| | - Niamh K Shortt
- Centre for Research on Environment, Society and Health, School of Geosciences, University of Edinburgh, Drummond Street, Edinburgh EH8 9XP, United Kingdom
| | - Anne Ellaway
- MRC/CSO Social and Public Health Sciences, University of Glasgow, Top floor, 200 Renfield Street, Glasgow G2 3QB, United Kingdom
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[What potential do geographic information systems have for population-wide health monitoring in Germany? : Perspectives and challenges for the health monitoring of the Robert Koch Institute]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2017; 60:1440-1452. [PMID: 29075811 DOI: 10.1007/s00103-017-2652-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Geographic information systems (GISs) are computer-based systems with which geographical data can be recorded, stored, managed, analyzed, visualized and provided. In recent years, they have become an integral part of public health research. They offer a broad range of analysis tools, which enable innovative solutions for health-related research questions. An analysis of nationwide studies that applied geographic information systems underlines the potential this instrument bears for health monitoring in Germany. Geographic information systems provide up-to-date mapping and visualization options to be used for national health monitoring at the Robert Koch Institute (RKI). Furthermore, objective information on the residential environment as an influencing factor on population health and on health behavior can be gathered and linked to RKI survey data at different geographic scales. Besides using physical information, such as climate, vegetation or land use, as well as information on the built environment, the instrument can link socioeconomic and sociodemographic data as well as information on health care and environmental stress to the survey data and integrate them into concepts for analyses. Therefore, geographic information systems expand the potential of the RKI to present nationwide, representative and meaningful health-monitoring results. In doing so, data protection regulations must always be followed. To conclude, the development of a national spatial data infrastructure and the identification of important data sources can prospectively improve access to high quality data sets that are relevant for the health monitoring.
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Abstract
AbstractOut-of-home foods (takeaway, take-out and fast foods) have become increasingly popular in recent decades and are thought to be a key driver in increasing levels of overweight and obesity due to their unfavourable nutritional content. Individual food choices and eating behaviours are influenced by many interrelated factors which affect the results of nutrition-related public health interventions. While the majority of research based on out-of-home foods comes from Australia, the UK and USA, the same issues (poor dietary habits and increased prevalence of non-communicable disease) are of equal concern for urban centres in developing economies undergoing ‘nutrition transition’ at a global scale. The present narrative review documents key facets, which may influence out-of-home food consumption, drawn from biological, societal, environmental, demographic and psychological spheres. Literature searches were performed and references from relevant papers were used to find supplementary studies. Findings suggest that the strongest determinants of out-of-home food availability are density of food outlets and deprivation within the built environment; however, the association between socio-economic status and out-of-home food consumption has been challenged. In addition, the biological and psychological drives combined with a culture where overweight and obesity are becoming the norm makes it ‘fashionable’ to consume out-of-home food. Other factors, including age group, ethnicity and gender demonstrate contrasting effects and a lack of consensus. It is concluded that further consideration of the determinants of out-of-home food consumption within specific populations is crucial to inform the development of targeted interventions to reduce the impact of out-of-home foods on public health.
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Foster S, Hooper P, Knuiman M, Trapp G, Wood L. Does alcohol outlet density differ by area-level disadvantage in metropolitan Perth? Drug Alcohol Rev 2017; 36:701-708. [PMID: 28295745 DOI: 10.1111/dar.12469] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 07/13/2016] [Accepted: 07/13/2016] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND AIMS Research suggests that there are area-level disparities in alcohol outlets, with greater density in disadvantaged areas. In part, this might be explained by the inequitable distribution of retail, attracted by lower rents to disadvantaged neighbourhoods. This ecological study examines the distribution of liquor licences in Perth, Australia, and whether discrepancies in the distribution of retail land-uses could account for a socio-economic gradient. DESIGN AND METHODS Area disadvantage was determined for each Statistical Area 1 (SA1) using the Australian Bureau of Statistics Index of Relative Socio-economic Disadvantage, and licence locations were mapped in GIS. Negative binomial loglinear models examined whether licence densities within SA1s differed by area disadvantage, controlling for demographics and spatial correlation. Models included an offset term, so the estimated effects of area-level disadvantage were on licences per km2 , or licences per retail destination. RESULTS In the area-based analyses, for every unit increase in disadvantage decile (i.e. a reduction in relative disadvantage), general licences reduced by 15% (P = 0.000) and liquor stores reduced by 7% (P = 0.004). These gradients were not apparent when licences were examined as a function of retail; however, for every unit increase in disadvantage decile, the density of on-premise licences per retail destination increased by 14% (P = 0.000). DISCUSSION AND CONCLUSIONS The direction of the socio-economic gradient for general licences and liquor stores in Perth is concerning, as all licences selling packaged alcohol were more abundant in disadvantaged areas. However, the over-representation of packaged liquor in disadvantaged areas may relate to the increased provision of retail.
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Affiliation(s)
- Sarah Foster
- Centre for the Built Environment and Health, School of Sport Science, Exercise & Health and School of Earth and Environment, The University of Western Australia, Perth, Australia
| | - Paula Hooper
- Centre for the Built Environment and Health, School of Sport Science, Exercise & Health and School of Earth and Environment, The University of Western Australia, Perth, Australia
| | - Matthew Knuiman
- School of Population Health, The University of Western Australia, Perth, Australia
| | - Georgina Trapp
- Centre for the Built Environment and Health, School of Sport Science, Exercise & Health and School of Earth and Environment, The University of Western Australia, Perth, Australia.,School of Population Health, The University of Western Australia, Perth, Australia.,Telethon Kids Institute, Perth, Australia
| | - Lisa Wood
- School of Population Health, The University of Western Australia, Perth, Australia
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Lytle LA, Sokol RL. Measures of the food environment: A systematic review of the field, 2007-2015. Health Place 2017; 44:18-34. [PMID: 28135633 DOI: 10.1016/j.healthplace.2016.12.007] [Citation(s) in RCA: 162] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 11/21/2016] [Accepted: 12/02/2016] [Indexed: 12/24/2022]
Abstract
BACKGROUND Many studies have examined the relationship between the food environment and health-related outcomes, but fewer consider the integrity of measures used to assess the food environment. The present review builds on and makes comparisons with a previous review examining food environment measures and expands the previous review to include a more in depth examination of reliability and validity of measures and study designs employed. METHODS We conducted a systematic review of studies measuring the food environment published between 2007 and 2015. We identified these articles through: PubMed, Embase, Web of Science, PsycINFO, and Global Health databases; tables of contents of relevant journals; and the National Cancer Institute's Measures of the Food Environment website. This search yielded 11,928 citations. We retained and abstracted data from 432 studies. RESULTS The most common methodology used to study the food environment was geographic analysis (65% of articles) and the domination of this methodology has persisted since the last review. Only 25.9% of studies in this review reported the reliability of measures and 28.2% reported validity, but this was an improvement as compared to the earlier review. Very few of the studies reported construct validity. Studies reporting measures of the school or worksite environment have decreased since the previous review. Only 13.9% of the studies used a longitudinal design. CONCLUSIONS To strengthen research examining the relationship between the food environment and population health, there is a need for robust and psychometrically-sound measures and more sophisticated study designs.
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Affiliation(s)
- Leslie A Lytle
- Department of Health Behavior, Campus Box 7440, UNC Gillings School of Global Public Health, Chapel Hill, NC 27599-7440, United States.
| | - Rebeccah L Sokol
- Department of Health Behavior, Campus Box 7440, UNC Gillings School of Global Public Health, Chapel Hill, NC 27599-7440, United States
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Scribner RA, Simonsen NR, Leonardi C. The Social Determinants of Health Core: Taking a Place-Based Approach. Am J Prev Med 2017; 52:S13-S19. [PMID: 27989288 PMCID: PMC6540790 DOI: 10.1016/j.amepre.2016.09.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 08/31/2016] [Accepted: 09/19/2016] [Indexed: 12/16/2022]
Abstract
INTRODUCTION There is growing recognition that health disparities research needs to incorporate social determinants in the local environment into explanatory models. In the transdisciplinary setting of the Mid-South Transdisciplinary Collaborative Center (TCC), the Social Determinants of Health (SDH) Core developed an approach to incorporating SDH across a variety of studies. This place-based approach, which is geographically based, transdisciplinary, and inherently multilevel, is discussed. METHODS From 2014 through 2016, the SDH Core consulted on a variety of Mid-South TCC research studies with the goal of incorporating social determinants into their research designs. The approach used geospatial methods (e.g., geocoding) to link individual data files with measures of the physical and social environment in the SDH Core database. Once linked, the method permitted various types of analysis (e.g., multilevel analysis) to determine if racial disparities could be explained in terms of social determinants in the local environment. RESULTS The SDH Core consulted on five Mid-South TCC research projects. In resulting analyses for all the studies, a significant portion of the variance in one or more outcomes was partially explained by a social determinant from the SDH Core database. CONCLUSIONS The SDH Core approach to addressing health disparities by linking neighborhood social and physical environment measures to an individual-level data file proved to be a successful approach across Mid-South TCC research projects.
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Affiliation(s)
- Richard A Scribner
- Louisiana Cancer Research Center, School of Public Health, Louisiana State University, New Orleans, Louisiana.
| | - Neal R Simonsen
- Louisiana Cancer Research Center, School of Public Health, Louisiana State University, New Orleans, Louisiana
| | - Claudia Leonardi
- Louisiana Cancer Research Center, School of Public Health, Louisiana State University, New Orleans, Louisiana
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Choo J, Kim HJ, Park S. Neighborhood Environments: Links to Health Behaviors and Obesity Status in Vulnerable Children. West J Nurs Res 2016; 39:1169-1191. [PMID: 27753629 DOI: 10.1177/0193945916670903] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to identify the actual and perceived features of neighborhood environments linked to health behaviors and obesity status in vulnerable children by using geographic information systems, walking surveys, and focus group interviews. The participants were 126 children registered at community child centers and 10 mothers of study participants. Increased availability of fast food outlets and convenience stores was significantly and positively associated with fast food and sugar-sweetened beverage consumption and inversely with physical activity. Reduced availability of physical activity outlets was significantly and positively associated with sedentary behaviors. Mothers' perceptions of their neighborhoods fell into three content categories: (a) changed to be unfriendly for children, (b) adapted to fast food and convenience eating, and (c) confined to physically inactive living. Based on these findings, community-level environmental strategies for reducing unhealthy behaviors linked to neighborhood environments should be prioritized to prevent childhood obesity in vulnerable populations.
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Affiliation(s)
- Jina Choo
- 1 Korea University, Seoul, South Korea
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Ray JG, Turner L, Gozdyra P, Matheson FI, Robert B, Bartsch E, Park AL. On-Premise Alcohol Establishments and Ambulance Calls for Trauma, Assault, and Intoxication. Medicine (Baltimore) 2016; 95:e3669. [PMID: 27175699 PMCID: PMC4902541 DOI: 10.1097/md.0000000000003669] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Alcohol contributes to intentional and unintentional injury. We explored on-premise licensed alcohol establishments (LAEs) and emergency medical service (EMS) ambulance calls.We completed a retrospective population-based study in the Region of Peel, Ontario, 2005 to 2014, where alcohol sales are tightly regulated and healthcare is universally available. We included participants age ≥ 19 years. Longitude-latitude coordinates of all 696 LAEs and all 267,477 EMS ambulance calls were ascertained, and then assigned to 1 of 1568 dissemination areas (DA) in Peel. Relative risks (RRs) described the association between density of on-premise LAEs (by DA deciles) and the rate of EMS calls, adjusted for material deprivation, and density of beer/liquor stores in each DA.There was a curvilinear relation between LAE density and EMS calls for trauma, rising from 45.3 per 1000 in DAs with no LAEs to 381.0 per 1000 in decile-10 (adjusted RR 7.83, 95% confidence interval [CI] 6.15-9.97). This relation was more pronounced for alcohol-focused LAEs, and highest among younger males. Calls for assault (RR 2.67, 95% CI 1.26-5.65) and intoxication (RR 4.00, 95% CI 1.41-11.38) were more likely on the last day of the month and the day thereafter, compared to 1 week prior. At 02:00 hours, when LAEs must stop selling alcohol, there was a considerable rise in assault-related calls in DAs with LAE but not in DAs without LAEs.On-premise LAEs contribute to EMS calls for trauma and assault, especially among young males, around last call, and when monthly pay cheques are cashed.
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Affiliation(s)
- Joel G Ray
- From the Department of Medicine, St. Michael's Hospital, University of Toronto (JGR); Sunnybrook Centre for Prehospital Medicine, Sunnybrook Health Science Centre (LT, BR); Centre for Research on Inner City Health, St. Michael's Hospital (PG, FIM, ALP); and University of Toronto (EB), Toronto, Ontario
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The Global Laboratory of Tobacco Control: Research to Advance Tobacco Cessation in LMICs. J Smok Cessat 2016. [DOI: 10.1017/jsc.2015.22] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
For over half a century, the U.S. National Cancer Institute (NCI) has supported research on tobacco and health, which has contributed to reductions in tobacco-caused morbidity and mortality in the U.S. But while tobacco use has been slowly declining in most high-income nations, including the US, it has continued to increase in other parts of the globe. Of the 800 million adult men who currently smoke cigarettes, over 80% are in low- and middle-income countries (LMICs), and these countries will bear an increasing share of the health and economic burden of tobacco use. At the same time, there are additional challenges to implementing tobacco control programs in LMICs, including a diversity of tobacco products, limited capacity and resources for tobacco control, and competing health priorities. While a large body of evidence has been generated around tobacco dependence treatment and other measures in high-income countries, this work is only partly applicable to many LMICs. In this paper we focus on research needs and opportunities around tobacco cessation interventions for LMICs, highlighting four areas: understanding diverse tobacco products, development of low-cost cessation interventions, integrating tobacco cessation into health systems, and understanding tobacco use behaviors across different contexts. Expanding tobacco control research and research capacity in LMICs is crucial to reducing tobacco use and cancer rates worldwide. Furthermore, research conducted in countries around the world can yield important insights for understanding tobacco use behaviors and the effectiveness of tobacco control interventions in the US.
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Fekete C, Weyers S. Soziale Ungleichheit im Ernährungsverhalten. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2015; 59:197-205. [DOI: 10.1007/s00103-015-2279-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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D'Angelo H, Evenson KR, Rose SW, Fleischhacker S, Myers AE, Ribisl KM. Examination of community and consumer nutrition, tobacco and physical activity environments at food and tobacco retail stores in three diverse North Carolina communities. Prev Med Rep 2015; 2:730-736. [PMID: 26516620 PMCID: PMC4620577 DOI: 10.1016/j.pmedr.2015.08.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
To advance our understanding of multiple health-related dimensions of the built environment, this study examined associations among nutrition, tobacco, and physical activity community and consumer environments. Community environment measures included supermarket access, tobacco outlet density, and physical activity resource density in store neighborhoods. Cross-sectional observations of the nutrition, tobacco and physical activity environments were conducted in 2011 at and around 303 food stores that sold tobacco products in three North Carolina counties. Pearson correlation coefficients and multiple linear regression were used to examine associations between community and consumer environments. Correlations between community nutrition, tobacco, and physical activity environments ranged from slight to fair (− 0.35 to 0.20) and from poor to fair (− 0.01 to − 0.38) between consumer environments. Significant relationships between consumer tobacco and nutrition environments were found after controlling for store and neighborhood characteristics. For example, stores with higher amounts of interior tobacco marketing had higher healthy food availability (p = 0.001), while stores with higher amounts of exterior tobacco marketing had lower healthy food availability (p = 0.02). Community and consumer environments for nutrition, tobacco, and physical activity were interrelated. Measures that assess single aspects of community or consumer environments could miss characteristics that may influence customer purchasing. Even chain supermarkets, typically regarded as healthful food sources compared to smaller food stores, may expose customers to tobacco marketing inside. Future research could explore combining efforts to reduce obesity and tobacco use by addressing tobacco marketing, healthy food availability and physical activity opportunities at retail food outlets. Nutrition, tobacco, and physical activity environments were interrelated. Stores with more interior tobacco marketing had greater healthy food availability. Stores with more exterior tobacco marketing had lower healthy food availability. Walkability was positively correlated with tobacco and activity resource density. Future work could combine obesity prevention and tobacco control efforts in stores.
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Affiliation(s)
- Heather D'Angelo
- Gillings School of Global Public Health, Department of Health Behavior, University of North Carolina, Chapel Hill, NC, USA
- Corresponding author at: Department of Health Behavior, UNC Gillings School of Global Public Health, CB 7440, Chapel Hill, NC 27599-7440. Fax: + 1 919 966 2921.Department of Health BehaviorUNC Gillings School of Global Public HealthCB 7440Chapel HillNC27599-7440
| | - Kelly R. Evenson
- Gillings School of Global Public Health, Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA
| | - Shyanika W. Rose
- Gillings School of Global Public Health, Department of Health Behavior, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA
| | - Sheila Fleischhacker
- National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases Office of Nutrition Research, Bethesda, MD, USA
| | - Allison E. Myers
- Gillings School of Global Public Health, Department of Health Behavior, University of North Carolina, Chapel Hill, NC, USA
| | - Kurt M. Ribisl
- Gillings School of Global Public Health, Department of Health Behavior, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
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A cross-sectional analysis of the relationship between tobacco and alcohol outlet density and neighbourhood deprivation. BMC Public Health 2015; 15:1014. [PMID: 26437967 PMCID: PMC4595054 DOI: 10.1186/s12889-015-2321-1] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 09/22/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a strong socio-economic gradient in both tobacco-and alcohol-related harm. One possible factor contributing to this social gradient may be greater availability of tobacco and alcohol in more socially-deprived areas. A higher density of tobacco and alcohol outlets is not only likely to increase supply but also to raise awareness of tobacco/alcohol brands, create a competitive local market that reduces product costs, and influence local social norms relating to tobacco and alcohol consumption. This paper examines the association between the density of alcohol and tobacco outlets and neighbourhood-level income deprivation. METHODS Using a national tobacco retailer register and alcohol licensing data this paper calculates the density of alcohol and tobacco retail outlets per 10,000 population for small neighbourhoods across the whole of Scotland. Average outlet density was calculated for neighbourhoods grouped by their level of income deprivation. Associations between outlet density and deprivation were analysed using one way analysis of variance. RESULTS There was a positive linear relationship between neighbourhood deprivation and outlets for both tobacco (p <0.001) and off-sales alcohol (p <0.001); the most deprived quintile of neighbourhoods had the highest densities of both. In contrast, the least deprived quintile had the lowest density of tobacco and both off-sales and on-sales alcohol outlets. CONCLUSIONS The social gradient evident in alcohol and tobacco supply may be a contributing factor to the social gradient in alcohol- and tobacco-related disease. Policymakers should consider such gradients when creating tobacco and alcohol control policies. The potential contribution to public health, and health inequalities, of reducing the physical availability of both alcohol and tobacco products should be examined in developing broader supply-side interventions.
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Gelormino E, Melis G, Marietta C, Costa G. From built environment to health inequalities: An explanatory framework based on evidence. Prev Med Rep 2015; 2:737-45. [PMID: 26844145 PMCID: PMC4721462 DOI: 10.1016/j.pmedr.2015.08.019] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE The Health in All Policies strategy aims to engage every policy domain in health promotion. The more socially disadvantaged groups are usually more affected by potential negative impacts of policies if they are not health oriented. The built environment represents an important policy domain and, apart from its housing component, its impact on health inequalities is seldom assessed. METHODS A scoping review of evidence on the built environment and its health equity impact was carried out, searching both urban and medical literature since 2000 analysing socio-economic inequalities in relation to different components of the built environment. RESULTS The proposed explanatory framework assumes that key features of built environment (identified as density, functional mix and public spaces and services), may influence individual health through their impact on both natural environment and social context, as well as behaviours, and that these effects may be unequally distributed according to the social position of individuals. CONCLUSION In general, the expected links proposed by the framework are well documented in the literature; however, evidence of their impact on health inequalities remains uncertain due to confounding factors, heterogeneity in study design, and difficulty to generalize evidence that is still very embedded to local contexts.
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Affiliation(s)
- Elena Gelormino
- Department of Public Health, Local Health Authority TO5, Piedmont Region, Italy
| | - Giulia Melis
- Environmental Heritage and Urban Redevelopment — SiTI Higher Institute on Territorial Systems for Innovation, Turin, via Pier Carlo Boggio 61, 10138 Torino, Italy
| | - Cristina Marietta
- Environmental Heritage and Urban Redevelopment Unit — SiTI Higher Institute on Territorial Systems for Innovation, Turin, via Pier Carlo Boggio 61, 10138 Torino, Italy
| | - Giuseppe Costa
- Department of Clinical and Biological Sciences, University of Turin, Turin, via Sabaudia 94, 10095 Grugliasco, Torino, Italy
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Lamb KE, Thornton LE, Cerin E, Ball K. Statistical Approaches Used to Assess the Equity of Access to Food Outlets: A Systematic Review. AIMS Public Health 2015; 2:358-401. [PMID: 29546115 PMCID: PMC5690240 DOI: 10.3934/publichealth.2015.3.358] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 07/19/2015] [Indexed: 11/21/2022] Open
Abstract
Background Inequalities in eating behaviours are often linked to the types of food retailers accessible in neighbourhood environments. Numerous studies have aimed to identify if access to healthy and unhealthy food retailers is socioeconomically patterned across neighbourhoods, and thus a potential risk factor for dietary inequalities. Existing reviews have examined differences between methodologies, particularly focussing on neighbourhood and food outlet access measure definitions. However, no review has informatively discussed the suitability of the statistical methodologies employed; a key issue determining the validity of study findings. Our aim was to examine the suitability of statistical approaches adopted in these analyses. Methods Searches were conducted for articles published from 2000–2014. Eligible studies included objective measures of the neighbourhood food environment and neighbourhood-level socio-economic status, with a statistical analysis of the association between food outlet access and socio-economic status. Results Fifty-four papers were included. Outlet accessibility was typically defined as the distance to the nearest outlet from the neighbourhood centroid, or as the number of food outlets within a neighbourhood (or buffer). To assess if these measures were linked to neighbourhood disadvantage, common statistical methods included ANOVA, correlation, and Poisson or negative binomial regression. Although all studies involved spatial data, few considered spatial analysis techniques or spatial autocorrelation. Conclusions With advances in GIS software, sophisticated measures of neighbourhood outlet accessibility can be considered. However, approaches to statistical analysis often appear less sophisticated. Care should be taken to consider assumptions underlying the analysis and the possibility of spatially correlated residuals which could affect the results.
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Affiliation(s)
- Karen E Lamb
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Lukar E Thornton
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Ester Cerin
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Kylie Ball
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
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Duncan DT, Kawachi I, Melly SJ, Blossom J, Sorensen G, Williams DR. Demographic disparities in the tobacco retail environment in Boston: a citywide spatial analysis. Public Health Rep 2014; 129:209-15. [PMID: 24587559 DOI: 10.1177/003335491412900217] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Dustin T Duncan
- Dustin Duncan was a Postdoctoral Fellow in the Department of Social and Behavioral Sciences at HSPH in Boston, Massachusetts, and at the HSPH Lung Cancer Disparities Center in Boston. He is currently an Assistant Professor in the Department of Population Health at New York University School of Medicine in New York City. Ichiro Kawachi is a Professor in the Department of Social and Behavioral Sciences at HSPH and at the HSPH Lung Cancer Disparities Center. Steven Melly is a Geographic Information Systems (GIS) Specialist at the HSPH Department of Environmental Health. Jeffrey Blossom is a Senior GIS Specialist at the Harvard University Center for Geographic Analysis in Cambridge, Massachusetts. Glorian Sorensen is a Professor in the Department of Social and Behavioral Sciences at HSPH, at the HSPH Lung Cancer Disparities Center, and at the Dana-Farber Cancer Institute, Center for Community-Based Research in Boston. David Williams is a Professor in the Department of Social and Behavioral Sciences at HSPH, at the HSPH Lung Cancer Disparities Center, and in the Departments of African and African American Studies, and Sociology at Harvard University in Cambridge
| | - Ichiro Kawachi
- Dustin Duncan was a Postdoctoral Fellow in the Department of Social and Behavioral Sciences at HSPH in Boston, Massachusetts, and at the HSPH Lung Cancer Disparities Center in Boston. He is currently an Assistant Professor in the Department of Population Health at New York University School of Medicine in New York City. Ichiro Kawachi is a Professor in the Department of Social and Behavioral Sciences at HSPH and at the HSPH Lung Cancer Disparities Center. Steven Melly is a Geographic Information Systems (GIS) Specialist at the HSPH Department of Environmental Health. Jeffrey Blossom is a Senior GIS Specialist at the Harvard University Center for Geographic Analysis in Cambridge, Massachusetts. Glorian Sorensen is a Professor in the Department of Social and Behavioral Sciences at HSPH, at the HSPH Lung Cancer Disparities Center, and at the Dana-Farber Cancer Institute, Center for Community-Based Research in Boston. David Williams is a Professor in the Department of Social and Behavioral Sciences at HSPH, at the HSPH Lung Cancer Disparities Center, and in the Departments of African and African American Studies, and Sociology at Harvard University in Cambridge
| | - Steven J Melly
- Dustin Duncan was a Postdoctoral Fellow in the Department of Social and Behavioral Sciences at HSPH in Boston, Massachusetts, and at the HSPH Lung Cancer Disparities Center in Boston. He is currently an Assistant Professor in the Department of Population Health at New York University School of Medicine in New York City. Ichiro Kawachi is a Professor in the Department of Social and Behavioral Sciences at HSPH and at the HSPH Lung Cancer Disparities Center. Steven Melly is a Geographic Information Systems (GIS) Specialist at the HSPH Department of Environmental Health. Jeffrey Blossom is a Senior GIS Specialist at the Harvard University Center for Geographic Analysis in Cambridge, Massachusetts. Glorian Sorensen is a Professor in the Department of Social and Behavioral Sciences at HSPH, at the HSPH Lung Cancer Disparities Center, and at the Dana-Farber Cancer Institute, Center for Community-Based Research in Boston. David Williams is a Professor in the Department of Social and Behavioral Sciences at HSPH, at the HSPH Lung Cancer Disparities Center, and in the Departments of African and African American Studies, and Sociology at Harvard University in Cambridge
| | - Jeffrey Blossom
- Dustin Duncan was a Postdoctoral Fellow in the Department of Social and Behavioral Sciences at HSPH in Boston, Massachusetts, and at the HSPH Lung Cancer Disparities Center in Boston. He is currently an Assistant Professor in the Department of Population Health at New York University School of Medicine in New York City. Ichiro Kawachi is a Professor in the Department of Social and Behavioral Sciences at HSPH and at the HSPH Lung Cancer Disparities Center. Steven Melly is a Geographic Information Systems (GIS) Specialist at the HSPH Department of Environmental Health. Jeffrey Blossom is a Senior GIS Specialist at the Harvard University Center for Geographic Analysis in Cambridge, Massachusetts. Glorian Sorensen is a Professor in the Department of Social and Behavioral Sciences at HSPH, at the HSPH Lung Cancer Disparities Center, and at the Dana-Farber Cancer Institute, Center for Community-Based Research in Boston. David Williams is a Professor in the Department of Social and Behavioral Sciences at HSPH, at the HSPH Lung Cancer Disparities Center, and in the Departments of African and African American Studies, and Sociology at Harvard University in Cambridge
| | - Glorian Sorensen
- Dustin Duncan was a Postdoctoral Fellow in the Department of Social and Behavioral Sciences at HSPH in Boston, Massachusetts, and at the HSPH Lung Cancer Disparities Center in Boston. He is currently an Assistant Professor in the Department of Population Health at New York University School of Medicine in New York City. Ichiro Kawachi is a Professor in the Department of Social and Behavioral Sciences at HSPH and at the HSPH Lung Cancer Disparities Center. Steven Melly is a Geographic Information Systems (GIS) Specialist at the HSPH Department of Environmental Health. Jeffrey Blossom is a Senior GIS Specialist at the Harvard University Center for Geographic Analysis in Cambridge, Massachusetts. Glorian Sorensen is a Professor in the Department of Social and Behavioral Sciences at HSPH, at the HSPH Lung Cancer Disparities Center, and at the Dana-Farber Cancer Institute, Center for Community-Based Research in Boston. David Williams is a Professor in the Department of Social and Behavioral Sciences at HSPH, at the HSPH Lung Cancer Disparities Center, and in the Departments of African and African American Studies, and Sociology at Harvard University in Cambridge
| | - David R Williams
- Dustin Duncan was a Postdoctoral Fellow in the Department of Social and Behavioral Sciences at HSPH in Boston, Massachusetts, and at the HSPH Lung Cancer Disparities Center in Boston. He is currently an Assistant Professor in the Department of Population Health at New York University School of Medicine in New York City. Ichiro Kawachi is a Professor in the Department of Social and Behavioral Sciences at HSPH and at the HSPH Lung Cancer Disparities Center. Steven Melly is a Geographic Information Systems (GIS) Specialist at the HSPH Department of Environmental Health. Jeffrey Blossom is a Senior GIS Specialist at the Harvard University Center for Geographic Analysis in Cambridge, Massachusetts. Glorian Sorensen is a Professor in the Department of Social and Behavioral Sciences at HSPH, at the HSPH Lung Cancer Disparities Center, and at the Dana-Farber Cancer Institute, Center for Community-Based Research in Boston. David Williams is a Professor in the Department of Social and Behavioral Sciences at HSPH, at the HSPH Lung Cancer Disparities Center, and in the Departments of African and African American Studies, and Sociology at Harvard University in Cambridge
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Han D, Gorman DM. Socio-spatial patterning of off-sale and on-sale alcohol outlets in a Texas city. Drug Alcohol Rev 2013; 33:152-60. [PMID: 24320205 DOI: 10.1111/dar.12096] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 11/10/2013] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND AIMS To examine the socio-spatial patterning of off-sale and on-sale alcohol outlets following a policy change that ended prohibition of off-sale outlets in Lubbock, Texas. DESIGN AND METHODS The spatial patterning of alcohol outlets by licensing type was examined using the k-function difference (D statistic) to compare the relative degree of spatial aggregation of the two types of alcohol outlets and by the spatial scan statistic to identify statistically significant geographic clusters of outlets. The sociodemographic characteristics of the areas containing clusters of outlets were compared with the rest of the city. In addition, the socioeconomic characteristics of census block groups with and without existing on-sale outlets were compared, as were the socioeconomic characteristics of census block groups with and without the newly issued off-sale licenses. RESULTS The existing on-sale premises in Lubbock and the newly established off-sale premises introduced as a result of the 2009 policy change displayed different spatial patterns, with the latter being more spatially dispersed. A large cluster of on-sale outlets identified in the north-east of the city was located in a socially and economically disadvantaged area of the city. DISCUSSION AND CONCLUSION The findings support the view that it is important to understand the local context of deprivation within a city when examining the location of alcohol outlets and add to the existing research by drawing attention to the importance of geographic scale in assessing such relationships.
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Affiliation(s)
- Daikwon Han
- Department of Epidemiology and Biostatistics, School of Rural Public Health, Texas A&M University, College Station, USA
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Longitudinal influences of neighbourhood built and social environment on children's weight status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:5083-96. [PMID: 24132135 PMCID: PMC3823344 DOI: 10.3390/ijerph10105083] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/25/2013] [Revised: 10/01/2013] [Accepted: 10/07/2013] [Indexed: 12/31/2022]
Abstract
The objective was to examine longitudinal 4-year-relationships between neighbourhood social environment and children’s body mass index-standard deviation score (BMI-SDS) taking into account the built environment. Furthermore, we have analysed the influence of potential interactions between the social environment and family/social data on children’s BMI-SDS. Between 2006–2008 and 2010–2012, anthropometric measurements were conducted among 485 children (age at baseline: 6.1 (5.8–6.4)). Socio-demographic characteristics and perception of residential environment were reported by parents. Geographic Information Systems were used to examine street length, number of food outlets and distance to the nearest playground and park/green space within an 800 m Euclidian buffer of each participant address point. Additional data on neighbourhood characteristics (e.g., traffic density, walkability, crime rates) were obtained from the State Capital of Kiel, Germany. In a multivariate model, walkability, street type, socioeconomic status of the district and perceived frequency of passing trucks/busses were associated with BMI-SDS over 4 years, but only neighbourhood SES had an effect on change in BMI-SDS. However, familial/social factors rather than neighbourhood environment (especially social environment) had an impact on children’s BMI-SDS over 4 years. Thus, social inequalities in childhood overweight are only partially explained by social neighbourhood environment.
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Bibliography Current World Literature. CURRENT ORTHOPAEDIC PRACTICE 2013. [DOI: 10.1097/bco.0b013e3182a6a18b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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