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Rawlings A, Hobby AE, Ryan B, Carson-Stevens A, North R, Smith M, Gwyn S, Sheen N, Acton JH. The burden of acute eye conditions on different healthcare providers: a retrospective population-based study. Br J Gen Pract 2024:BJGP.2022.0616. [PMID: 38438268 PMCID: PMC10947371 DOI: 10.3399/bjgp.2022.0616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 06/05/2023] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND The demand for acute eyecare exponentially outstrips capacity. The public lacks awareness of community eyecare services. AIM To quantify the burden of acute eyecare on different healthcare service providers in a national population through prescribing and medicines provision by GPs, optometrists, and pharmacists, and provision of care by accident and emergency (A&E) services. A secondary aim was to characterise some of the drivers of this burden. DESIGN AND SETTING A retrospective data-linkage study set in Wales, UK. METHOD Analysis of datasets was undertaken from the Secure Anonymised Information Linkage Databank (GP and A&E), the Eye Health Examination Wales service (optometry), and the Common Ailments Scheme (pharmacy) during 2017-2018. RESULTS A total of 173 999 acute eyecare episodes delivered by GPs (168 877 episodes) and A&E services (5122) were identified during the study. This resulted in 65.4 episodes of care per 1000 people per year. GPs prescribed a total of 87 973 653 prescriptions within the general population. Of these, 820 693 were related to acute eyecare, resulting in a prescribing rate of 0.9%. A total of 5122 eye-related and 905 224 general A&E attendances were identified, respectively, resulting in an A&E attendance rate of 0.6%. Optometrists and pharmacists managed 51.8% (116 868) and 0.6% (2635) of all episodes, respectively. Older females and infants of both sexes were more likely to use GP prescribing services, while adolescent and middle-aged males were more likely to visit A&E. GP prescribing burden was driven partially by economic deprivation, access to services, and health score. Season, day of the week, and time of day were predictors of burden in GP and A&E. CONCLUSION Acute eyecare continues to place considerable burden on GP and A&E services in Wales, particularly in urban areas with greater economic deprivation and lower overall health. This is likely to increase with a rapidly ageing population. With ongoing pathway development to better utilise optometry and pharmacy, and improved public awareness, there may be scope to change this trajectory.
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Affiliation(s)
- Anna Rawlings
- Swansea University Medical School, Swansea University, Swansea
| | - Angharad E Hobby
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, and University of the West of England, Bristol
| | - Barbara Ryan
- School of Optometry and Vision Sciences, Cardiff University, Cardiff
| | - Andrew Carson-Stevens
- PRIME Centre Wales, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff
| | - Rachel North
- School of Optometry and Vision Sciences and PRIME Centre Wales, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff
| | - Mathew Smith
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff
| | - Sioned Gwyn
- PRIME Centre Wales, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff
| | - Nik Sheen
- Health and Education Improvement Wales (HEIW), Nantgarw
| | - Jennifer H Acton
- School of Optometry and Vision Sciences, Cardiff University, Cardiff
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Boderie NW, van Kippersluis H, Been JV, van Lenthe FJ, Oude Groeniger J. Examining neighborhood effects on mental health utilizing a novel two-stage modeling approach. Ann Epidemiol 2023; 83:60-70.e7. [PMID: 37100099 DOI: 10.1016/j.annepidem.2023.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 02/20/2023] [Accepted: 04/21/2023] [Indexed: 04/28/2023]
Abstract
PURPOSE Neighborhood conditions may affect health, but health may also determine a preference for where to live. This study estimates the effect of neighborhood characteristics on mental health while aiming to adjust for this residential self-selection. METHODS A two-step method was implemented using register data from Statistics Netherlands from all residents of the city of Rotterdam relocating within the city in 2013 (N = 12,456). First, using a conditional logit model, we estimated for each individual the probability of relocating to a neighborhood over all other neighborhoods in Rotterdam, based on personal and neighborhood characteristics in 2013. Second, we corrected this selection process in a model investigating the effects of neighborhood characteristics in 2014 on reimbursed anti-depressant or anti-psychotic medication in 2016. RESULTS Personal and neighborhood characteristics predicted neighborhood choice, indicating strong patterns of selection into neighborhoods. Unadjusted for selection log neighborhood income was associated with reimbursed medication (β = -0.040, 95% CI = -0.060, -0.020), but the association strongly attenuated after controlling for self-selection into neighborhoods (β = -0.010, 95% CI = -0.030, 0.011). The opposite was observed for contact with neighbors; unadjusted for self-selection there was no association (β = -0.020, 95% CI = -0.073, 0.033), but after adjustment increased neighborhood contact was associated with an 8.5% relative reduction in reimbursed medication (β = -0.075, 95% CI = -0.126, -0.025). CONCLUSIONS The method illustrated in this study offers new opportunities to disentangle selection from causation in neighborhood health research.
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Affiliation(s)
- Nienke W Boderie
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, South Holland, The Netherlands
| | - Hans van Kippersluis
- Erasmus School of Economics, Erasmus University Rotterdam, Rotterdam, South Holland, The Netherlands; Tinbergen Institute, Erasmus University Rotterdam, Rotterdam, South Holland, The Netherlands
| | - Jasper V Been
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, South Holland, The Netherlands; Department of Neonatal and Paediatric Intensive Care, Division of Neonatology, Erasmus MC Sophia Children's Hospital, Erasmus University Medical Centre, Rotterdam, South Holland, The Netherlands; Department of Obstetrics and Gynaecology , Erasmus MC Sophia Children's Hospital, Erasmus University Medical Centre, Rotterdam, South Holland, The Netherlands
| | - Frank J van Lenthe
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, South Holland, The Netherlands; Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, The Netherlands
| | - Joost Oude Groeniger
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, South Holland, The Netherlands; Department of Public Administration and Sociology, Erasmus University Rotterdam, Rotterdam, South Holland, The Netherlands.
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Konkor I, Kuuire VZ. Epidemiologic transition and the double burden of disease in Ghana: What do we know at the neighborhood level? PLoS One 2023; 18:e0281639. [PMID: 36827236 PMCID: PMC9956066 DOI: 10.1371/journal.pone.0281639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 01/27/2023] [Indexed: 02/25/2023] Open
Abstract
Many developing countries including Ghana are currently experiencing dual disease burdens emerging from an unprecedented risk overlap that drive their epidemiological transitions. Yet, siloed and disintegrated approaches continue to take precedence in health research and policy programs that drive competition for limited resources to address competing health problems. The objective of this study was to offer empirical evidence in support of a cogent argument for an integrated framework for the study and management of infectious and chronic health conditions in Ghana. We did so by examining the prevalence, determinants, and neighborhoods trajectories of the double burden of disease using data from a cross-sectional neighborhood-based study in Ghana. We fitted multinomial multilevel multivariate models to a sample of 1377 individual surveys and the results presented as odds ratios. Findings show that amidst a rising burden of NCDs, infectious diseases remain the most common health condition and participants in deprived neighborhoods were significantly more likely to report poor health outcomes. Risk factors such as tobacco and alcohol consumption were significantly associated with NCDs and infectious diseases and respondents who reported being diagnosed with NCDs and infectious diseases in the past year were likely to engage in leisure time physical activities and eat healthy. Based on our findings, we recommend health reforms in Ghana and argue for the design and implementation of an integrated framework for the study and management of the double burden of disease in Ghana and similar developing country settings.
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Affiliation(s)
- Irenius Konkor
- Department of Geography, Geomatics and Environment, University of Toronto Mississauga, Mississauga, Canada
- * E-mail:
| | - Vincent Z. Kuuire
- Department of Geography, Geomatics and Environment, University of Toronto Mississauga, Mississauga, Canada
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Lankila T, Puhakka S, Kärmeniemi M, Kangas M, Rusanen J, Korpelainen R. Residential history and changes in perceived health—The Northern Finland Birth Cohort 1966 study. Health Place 2022; 78:102931. [DOI: 10.1016/j.healthplace.2022.102931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022]
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Jokela M. Religiosity, Psychological Distress, and Well-Being: Evaluating Familial Confounding With Multicohort Sibling Data. Am J Epidemiol 2022; 191:584-590. [PMID: 34791015 PMCID: PMC8971076 DOI: 10.1093/aje/kwab276] [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: 11/13/2020] [Revised: 08/27/2021] [Accepted: 11/09/2021] [Indexed: 11/12/2022] Open
Abstract
Several studies have associated religiosity with better mental health, but these studies have only partially addressed the problem of confounding. The present study pooled data from multiple cohort studies with siblings to examine whether associations between religiosity and mental health are confounded by familial factors (i.e., shared family background and siblings' shared genetics). Data were collected between 1982 and 2017. Mental health was assessed with self-reported psychological distress (including depressive symptoms) and psychological well-being. Religious attendance was associated with lower psychological distress (standard-deviation difference between weekly vs. never attendance, B = -0.14, confidence interval (CI): -0.19, -0.09; n = 24,598 pairs), and this was attenuated by almost half in the sibling analysis (B = -0.08, CI: = -0.13, -0.04). Religious attendance was also related to higher well-being (B = 0.29, CI: = 0.14, 0.45; n = 3,728 pairs), and this estimate remained unchanged in sibling analysis. Results were similar for religiousness. The findings suggest that previous longitudinal studies may have overestimated the association between religiosity and psychological distress, as the sibling estimate was only one-third of the previously reported meta-analytical association (standardized correlation -0.03 vs. -0.08).
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Affiliation(s)
- Markus Jokela
- Correspondence to Prof. Markus Jokela, Department of Psychology and Logopedics, Haartmaninkatu 3, 00290 Helsinki, Finland (e-mail: )
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Tieges Z, Georgiou M, Smith N, Morison G, Chastin S. Investigating the association between regeneration of urban blue spaces and risk of incident chronic health conditions stratified by neighbourhood deprivation: A population-based retrospective study, 2000-2018. Int J Hyg Environ Health 2022; 240:113923. [PMID: 35045385 DOI: 10.1016/j.ijheh.2022.113923] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 01/06/2022] [Accepted: 01/07/2022] [Indexed: 12/27/2022]
Abstract
Chronic non-communicable diseases are leading causes of poor health and mortality worldwide, disproportionately affecting people in highly deprived areas. We undertook a population-based, retrospective study of 137,032 residents in Glasgow, Scotland, to investigate the association between proximity to urban blue spaces and incident chronic health conditions during a canal regeneration programme. Hazard ratios (HRs) were estimated using Cox proportional hazards models adjusted for age and sex, with the incidence of a given health condition as the dependent variable. The analyses were stratified by socioeconomic deprivation tertiles. We found that, in areas in the highest deprivation tertile, proximity to blue space was associated with a lower risk of incident cardiovascular disease (HR 0.85, 95% Confidence Interval (CI) 0.76-0.95), hypertension (HR 0.85, 95% CI 0.79-0.92), diabetes (HR 0.88, 95% CI 0.83-0.94), stroke (HR 0.85, 95% CI 0.77-0.94) and obesity (HR 0.90, 95% CI 0.86-0.94), but not chronic pulmonary disease, after adjusting for age and sex covariates. In middle and low deprivation tertiles, living closer to the canal was associated with a higher risk of incident chronic pulmonary disease (middle: HR 1.56, 95% CI 1.24-1.97, low: HR 1.34, 95% CI 1.05-1.73). Moreover, in the middle deprivation tertile, a higher risk of stroke (HR 1.36, 95% CI 1.02-1.81) and obesity (HR 1.14, 95% CI 1.01-1.29) was observed. We conclude that exposure to blue infrastructure could be leveraged to mitigate some of the health inequalities in cities.
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Affiliation(s)
- Zoë Tieges
- School of Health and Life Sciences, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK; SMART Technology Centre, School of Computing, Engineering and Built Environment, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK; Geriatric Medicine, Usher Institute, The University of Edinburgh, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, Scotland, UK.
| | - Michail Georgiou
- School of Health and Life Sciences, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK.
| | - Niamh Smith
- School of Health and Life Sciences, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK.
| | - Gordon Morison
- SMART Technology Centre, School of Computing, Engineering and Built Environment, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK; School of Computing, Engineering and Built Environment, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK.
| | - Sebastien Chastin
- School of Health and Life Sciences, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK; Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium.
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Murray ET, Shelton N, Norman P, Head J. Measuring the health of people in places: A scoping review of OECD member countries. Health Place 2021; 73:102731. [PMID: 34929525 DOI: 10.1016/j.healthplace.2021.102731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 11/24/2021] [Accepted: 11/30/2021] [Indexed: 11/04/2022]
Abstract
A scoping review was performed to identify how Organisation for Economic Co-operation and Development (OECD) countries measure overall health for sub-national geographies within each country. Sixty publications were selected from MEDLINE, Scopus and Google Scholar, plus information extracted from 37 of 38 OECD countries statistical agency and/or public health institute websites that were available in English. Data sources varied by categorisation into national statistical agency mortality (n = 7) or population-level survey morbidity (n = 5) health indicators. Region was the most common geographic scale (e.g., eight indicators for 26 countries), slightly fewer indicators for urban areas (max countries per most frequent indicator = 24), followed by municipality (range of 1-14 countries per indicator). Other geographies, particularly those at smaller granularity, were infrequently available across health indicators and countries. Wider availability of health indicators at smaller, and non-administrative, geographies is needed to explore the best way to measure comparative population health in local areas.
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Affiliation(s)
- Emily T Murray
- University College London, Research Department of Epidemiology and Public Health, London, UK.
| | - Nicola Shelton
- University College London, Research Department of Epidemiology and Public Health, London, UK
| | - Paul Norman
- University of Leeds, School of Geography, Leeds, UK
| | - Jenny Head
- University College London, Research Department of Epidemiology and Public Health, London, UK
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Gootjes DV, Posthumus AG, Jaddoe VWV, Steegers EAP. Association between neighbourhood deprivation, fetal growth, small-for-gestational age and preterm birth: a population-based prospective cohort study. BMJ Open 2021; 11:e049075. [PMID: 34785546 PMCID: PMC8596053 DOI: 10.1136/bmjopen-2021-049075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To study the associations between neighbourhood deprivation and fetal growth, including growth in the first trimester, and adverse pregnancy outcomes. DESIGN Prospective cohort study. SETTING The Netherlands, Rotterdam. PARTICIPANTS 8617 live singleton births from the Generation R cohort study. EXPOSITION Living in a deprived neighbourhood. MAIN OUTCOME MEASURES Fetal growth trajectories of head circumference, weight and length. SECONDARY OUTCOMES MEASURES Small-for-gestational age (SGA) and preterm birth (PTB). RESULTS Neighbourhood deprivation was not associated with first trimester growth. However, a higher neighbourhood status score (less deprivation) was associated with increased fetal growth in the second and third trimesters (eg, estimated fetal weight; adjusted regression coefficient 0.04, 95% CI 0.02 to 0.06). Less deprivation was also associated with decreased odds of SGA (adjusted OR 0.91, 95% CI 0.86 to 0.97, p=0.01) and PTB (adjusted OR 0.89, 95% CI 0.82 to 0.96, p=0.01). CONCLUSIONS We found an association between neighbourhood deprivation and fetal growth in the second and third trimester pregnancy, but not with first trimester growth. Less neighbourhood deprivation is associated with lower odds of adverse pregnancy outcomes. The associations remained after adjustment for individual-level risk factors. This supports the hypothesis that living in a deprived neighbourhood acts as an independent risk factor for fetal growth and adverse pregnancy outcomes, above and beyond individual risk factors.
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Affiliation(s)
- Dionne V Gootjes
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, Rotterdam, The Netherlands
- Generation R Study Group, Erasmus MC, Rotterdam, The Netherlands
| | - Anke G Posthumus
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, Rotterdam, The Netherlands
- Generation R Study Group, Erasmus MC, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- Generation R Study Group, Erasmus MC, Rotterdam, The Netherlands
- Department of Paediatrics, Erasmus MC, Rotterdam, The Netherlands
| | - Eric A P Steegers
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, Rotterdam, The Netherlands
- Generation R Study Group, Erasmus MC, Rotterdam, The Netherlands
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Cui X, Chang CT. How Income Influences Health: Decomposition Based on Absolute Income and Relative Income Effects. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010738. [PMID: 34682479 PMCID: PMC8535401 DOI: 10.3390/ijerph182010738] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/16/2021] [Accepted: 10/07/2021] [Indexed: 11/16/2022]
Abstract
Previous research has confirmed a positive association between income and health, but there are still a lot of inconsistencies on how income affects health. Indeed, this impact is caused by overlaying of absolute income and relative income effects, and only by decomposing and comparing their relative importance within an integrated framework can suggestions be made for health inequalities and health intervention. To deal with this issue, using the panel data from the 2011, 2014, and 2017 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a well-designed research model is established to decompose and explore the impact. Our results indicate that relative income, rather than absolute income, has a significant negative impact on health performance, and that these associations may be causal in nature. The health inequity persists throughout the life cycle, but it remains relatively stable, without significant expansion or convergence. To some extent, the research-proposed models enrich the related literature on associations between income and health, and the empirical results suggest that as China moves to the stage of higher incomes and accelerated aging, the Chinese government should pay more attention to income inequality and be alert to the risks of "income-healthy poverty" traps.
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Affiliation(s)
- Xiaodong Cui
- Business School, Nanjing Xiaozhuang University, Nanjing 211171, China;
| | - Ching-Ter Chang
- Department of Information Management, Chang Gung University, Taoyuan 33302, Taiwan
- Clinical Trial Center, Chang Gung Memorial Hospital at Linkou, Taoyuan 33305, Taiwan
- Department of Industrial Engineering and Management, Ming Chi University of Technology, New Taipei 24301, Taiwan
- Correspondence:
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Vaalavuo M, Kailaheimo-Lönnqvist S, Kauppinen TM, Sirniö O. Neighbourhood effects on psychiatric disorders among Finnish adolescents: The moderating impact of family background. Health Place 2021; 71:102671. [PMID: 34555783 DOI: 10.1016/j.healthplace.2021.102671] [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: 03/12/2021] [Revised: 09/08/2021] [Accepted: 09/09/2021] [Indexed: 10/20/2022]
Abstract
We study whether childhood neighbourhood context affects mental health in adolescence in Finland. We also examine heterogeneous effects by family background. By exploiting register data for 1999-2018, we use sibling fixed effects models to gain more robust evidence on the existence of neighbourhood effects. We do not find evidence of an association between neighbourhood characteristics and psychiatric disorders within families. Differences in the effects by family background were not consistent, and variation was mainly found in random effects models. In general, observed family characteristics were strongly associated with psychiatric disorders. This means that interventions should be targeted to children at risk rather than certain neighbourhoods.
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Affiliation(s)
- Maria Vaalavuo
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00271 Helsinki, Finland.
| | - Sanna Kailaheimo-Lönnqvist
- Institute of Criminology and Legal Policy, University of Helsinki, P.O. Box 24 (Unioninkatu 40), FI-00014, Finland; Faculty of Social Sciences, Sociology, University of Turku, Assistentinkatu 7, Publicum, FI-20014, Finland.
| | - Timo M Kauppinen
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00271 Helsinki, Finland.
| | - Outi Sirniö
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00271 Helsinki, Finland.
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Psychological distress in late adolescence: The role of inequalities in family affluence and municipal socioeconomic characteristics in Norway. PLoS One 2021; 16:e0254033. [PMID: 34214137 PMCID: PMC8253448 DOI: 10.1371/journal.pone.0254033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 06/17/2021] [Indexed: 11/19/2022] Open
Abstract
The present study aims to explore, in the national context of Norway, how municipal socioeconomic indicators affect anxiety and depressive symptom scores among senior high school students and whether this potential municipal effect is dependent on the adolescents' family affluence levels. This cross-sectional study is based on questionnaire data collected in five waves (2014-2018) of the Ungdata survey. The study sample consisted of 97,460 adolescents aged 16-18 years attending high school in 156 municipalities in Norway. Measures of psychological distress, depression, and anxiety symptoms were based on the screening instrument, Hopkins Symptom Checklist-10. Two-level random intercept models were fitted to distinguish the individual and municipality sources of variation in adolescents' mental health. In general, the results indicate substantial psychological symptom load among the study sample. Inequalities in adolescents' psychological distress between family affluence groups were evident, with the lowest symptom loads in the most affluent families. The predicted depressive and anxiety symptoms among the students increased slightly along with the percentage of municipal residents with tertiary educations and with increasing income inequalities in their residential municipality. However, the interaction models suggest that the adverse effects of higher municipal education level and greater income inequality are, to a certain extent, steepest for adolescents with medium family affluence. This study highlights two key findings. Both municipality effects and family affluence account for a relatively small proportion of the total variance in the students' psychological symptoms loads; however, the mental health inequalities we explored between socioeconomic strata on both the individual and municipal levels are not insignificant in a public health perspective. Results are discussed in the context of psychosocial mechanisms related to social comparison and perceptions of social status that may be applicable in egalitarian welfare states such as Norway.
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Botticello AL, Murphy L, Bogner J, Boninger M, Bryce TN, Chen Y, Heinemann AW, Roach MJ. Who Moves After SCI? Individual, Health, and Neighborhood Predictors of Residential Mobility Among Participants in the National Spinal Cord Injury Model Systems Database. Arch Phys Med Rehabil 2021; 103:822-831. [PMID: 34004163 DOI: 10.1016/j.apmr.2021.03.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 03/11/2021] [Accepted: 03/19/2021] [Indexed: 11/02/2022]
Abstract
OBJECTIVE To investigate residential mobility among community-living adults with spinal cord injury (SCI) and the individual, health, and neighborhood factors associated with the propensity to relocate. DESIGN Retrospective analysis of data from the National SCI Model Systems (SCIMS) Database collected between 2006 and 2018 and linked with the American Community Survey 5-year estimates. SETTING Community. INTERVENTIONS Not applicable. PARTICIPANTS People with traumatic SCI (N=4599) who participated in 2 waves of follow-up and had residential geographic identifiers at the census tract level. MAIN OUTCOME MEASURES Moving was a binary measure reflecting change in residential locations over a 5-year interval. Move distance distinguished nonmovers from local movers (different tracts within the same county) and long-distance movers (to different county or state). Move quality included 4 categories: stayed/low poverty tract, stayed/high poverty tract, moved/low poverty tract, and moved/high poverty tract. RESULTS One in 4 people moved within a 5-year interval (n=1175). Of the movers, 55% relocated to a different census tract within the same county and 45% relocated to a different county or state. Thirty-five percent of all movers relocated to a high poverty census tract. Racial and ethnic minorities, people from low-income households, and younger adults were more likely to move, move locally, and relocate to a high poverty neighborhood. High poverty and racial/ethnic segregation in the origin neighborhood predicted an increased risk for remaining in or moving to a high poverty neighborhood. CONCLUSIONS Although people with SCI relocated at a lower rate than has been reported in the general population, moving was a frequent occurrence postinjury. People from vulnerable groups were more likely to remain in or relocate to socioeconomically disadvantaged neighborhoods, thus increasing the risk for health disparities and poorer long-term outcomes among minorities and people from low-income households. These findings inform policy makers' considerations of housing, health care, and employment initiatives for individuals with SCI and other chronic disabilities.
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Affiliation(s)
- Amanda L Botticello
- Kessler Foundation, West Orange, NJ; Rutgers New Jersey Medical School, Rutgers University, Newark, NJ.
| | - Lauren Murphy
- Kessler Foundation, West Orange, NJ; Rutgers New Jersey Medical School, Rutgers University, Newark, NJ
| | - Jennifer Bogner
- Department of Physical Medicine and Rehabilitation, The Ohio State University, Columbus, OH
| | - Michael Boninger
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Thomas N Bryce
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Yuying Chen
- University of Alabama at Birmingham, Birmingham, AL
| | - Allen W Heinemann
- Shirley Ryan AbilityLab and Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Mary Joan Roach
- Case Western Reserve University, Cleveland, OH; MetroHealth System, Cleveland, OH
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Is a 'culture of plus-size women' the independent effect of neighborhood disadvantage on female BMI? A cross-sectional study in two Chilean Municipalities. Soc Sci Med 2021; 280:114019. [PMID: 34052702 DOI: 10.1016/j.socscimed.2021.114019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/03/2021] [Accepted: 05/06/2021] [Indexed: 11/22/2022]
Abstract
Research has shown that neighborhood disadvantage has an effect on BMI that is independent of individual disadvantage, much more pronounced in women than in men. The mechanisms that explain this gender-specific effect are not yet clear. Since women's body size dissatisfaction is closely linked to gender differences in BMI inequalities, the independent effect of neighborhood disadvantage on female BMI may relate to a local culture of acceptance of female large bodies, that could influence women's parameters for body size dissatisfaction. This study explored how the relation between female BMI, neighborhood income, individual income and education is influenced by body size dissatisfaction in a random sample of 882 women aged 20-60 that reside in two Chilean Municipalities. Data have a two level structure (women nested in 17 neighborhoods); it was collected by direct survey, height and weight were measured with portable instruments. Disadvantaged neighborhoods house mainly poor and low educated women, whereas the wealthier ones were inhabited mostly by affluent women with postsecondary education. The proportion of women without a husband/partner and with more than three children in disadvantaged neighborhoods was higher than better off areas. Multilevel linear regression showed that neighborhood disadvantage had an effect on female BMI that was independent of women's income and education, which was explained by body size dissatisfaction. The mean BMI for body size satisfaction among women in disadvantaged neighborhoods was 2 kg/m2 higher than in affluent areas, which suggests that a 'culture of plus-size women' would emerge in urban clusters of poverty. The findings signal that neighborhood effects on BMI would relate to the socioeconomic polarization of urban areas, with marked concentrations of poverty and wealth, and might be explained by the psychosocial pathways associated to social disadvantage that act in addition to the effects of material conditions to influence people's health.
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Xiao Y, Bian Y, Zhang L. Mental Health of Chinese Online Networkers under COVID-19: A Sociological Analysis of Survey Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238843. [PMID: 33260696 PMCID: PMC7730967 DOI: 10.3390/ijerph17238843] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/14/2020] [Accepted: 11/24/2020] [Indexed: 01/10/2023]
Abstract
This paper reports the results of a recent survey of Chinese WeChat networkers (n = 2015, August 2020) about China’s mental health conditions under COVID-19. The purpose of the survey was to measure symptoms of depression, anxiety, and somatization by using a standard 18-item battery and assess how the results were related to an individual’s socioeconomic status, lifestyle, and social capital under an ongoing pandemic. The survey reveals that the pandemic has had a significant impact, as the respondents had more serious mental symptoms when their residential communities exhibited a greater exposure to the spread of the virus. The socioeconomic status of the respondents was negatively associated with the mental symptoms. It modified the impact of COVID-19, and its effect was substantially mediated by measures of lifestyle and social capital.
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Affiliation(s)
- Yang Xiao
- School of Philosophy and Government, Shaanxi Normal University, Xi’an 710119, China;
| | - Yanjie Bian
- Institute for Empirical Social Science Research, Xi’an Jiaotong University, Xi’an 710049, China
- Department of Sociology, University of Minnesota, Minneapolis, MN 55455, USA
- Correspondence:
| | - Lei Zhang
- Department of Sociology, University of Colorado Colorado Springs, Colorado Springs, CO 80918, USA;
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Jacobi CJ, Thiel D, Allum N. Enabling and constraining successful reablement: Individual and neighbourhood factors. PLoS One 2020; 15:e0237432. [PMID: 32886657 PMCID: PMC7473582 DOI: 10.1371/journal.pone.0237432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 07/28/2020] [Indexed: 11/26/2022] Open
Abstract
Using multilevel logistic regression to analyse management data of reablement episodes collected by Essex County Council, a UK local authority, this article identifies constraining and enabling factors for successful reablement. Overall, 59.5% of reablement clients were classed as able to care for themselves when assessed after 13 weeks following the reablement intervention (N = 8,118). Several age-related, disability, referral, and social factors were found to constrain reablement, but some of the largest constraining effects were neighbourhood deprivation as measured through the Index of Multiple Deprivation and, particularly, unfavourable geodemographic profiles as measured through Experian Mosaic consumer classifications. The results suggest that in order to optimise reablement, programmes should consider broader social and environmental influences on reablement rather than only individual and organisational aspects. Reablement might also be better tailored and intensified for client groups with particular underlying disabilities and for those displaying specific geodemographic characteristics.
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Affiliation(s)
- Christopher Justin Jacobi
- Department of Sociology, Nuffield College, University of Oxford, Oxford, Oxfordshire, United Kingdom
- * E-mail:
| | - Darren Thiel
- Department of Sociology, University of Essex, Colchester, Essex, United Kingdom
| | - Nick Allum
- Department of Sociology, University of Essex, Colchester, Essex, United Kingdom
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16
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Designing healthier neighbourhoods: a systematic review of the impact of the neighbourhood design on health and wellbeing. CITIES & HEALTH 2020; 6:1004-1019. [PMID: 36618774 PMCID: PMC9810039 DOI: 10.1080/23748834.2020.1799173] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Several studies have investigated the impact of neighbourhood design on health and wellbeing, yet there are limited reviews investigating the quality of the evidence and the most effective interventions at a population level. This systematic review aims to clarify the impact of the neighbourhood design on health and wellbeing and evaluate the quality of the evidence underpinning such associations. Eight electronic databases were searched for studies conducted between 2000 and 2016. Additional searches were conducted on Google to identify potentially eligible grey literature. A total of 7694 studies were returned from the literature search, and a final selection of 39 studies were deemed eligible for inclusion. Quality appraisal was conducted using the Quality Assessment Tool for Quantitative Studies. Findings from the studies showed important associations between neighbourhood design principles such as walkability, access to green space and amenities on health and wellbeing. Findings from this review also highlight areas with inconsistent findings and gaps in the evidence for future research.
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17
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Rhew IC, Duckworth JC, Hurvitz PM, Lee CM. Within- and between-person associations of neighborhood poverty with alcohol use and consequences: A monthly study of young adults. Drug Alcohol Depend 2020; 212:108068. [PMID: 32442751 PMCID: PMC7340513 DOI: 10.1016/j.drugalcdep.2020.108068] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Studies have shown associations between neighborhood disadvantage and alcohol misuse among adults. Less is known about the role of neighborhood context in young adults (YAs), who engage in more disordered forms of alcohol use compared to other age groups. Using data collected monthly, this study examined whether YAs reported more alcohol use and consequences when they were living in neighborhoods with greater concentration of poverty. METHOD This study used data from 746 participants aged 18-23 years living in the Seattle, WA, region. Surveys were administered each month for 24 consecutive months. Measures included typical number of drinks per week and past month count of alcohol-related consequences. Residential addresses at each month were geocoded and linked to census-tract level percentage of households living at or below poverty threshold. Multilevel over-dispersed Poisson models were used to estimate associations between standardized monthly deviations in tract-level poverty from one's average and alcohol outcomes. RESULTS Across 14,247 monthly observations, the mean number of typical drinks per week was 4.8 (SD = 7.4) and the mean number of alcohol consequences was 2.1 (SD = 3.5). On months when they were living in neighborhoods with higher levels of poverty than their average, participants reported significantly higher levels of alcohol consequences (Count Ratio = 1.05; p = .045). CONCLUSION YAs may engage in more problematic forms of drinking when they reside in neighborhoods with higher levels of disadvantage. During a time of frequent residential changes, YAs moving to more disadvantaged neighborhoods may benefit from additional supports.
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Affiliation(s)
- Isaac C Rhew
- Department of Psychiatry and Behavioral Sciences, University of Washington, Center for the Study of Health and Risk Behaviors, 1100 NE 45th St., #300, Seattle, WA 98105, USA.
| | - Jennifer C Duckworth
- Department of Psychiatry and Behavioral Sciences, University of Washington, Center for the Study of Health and Risk Behaviors, 1100 NE 45th St., #300, Seattle, WA 98105, USA.
| | - Philip M Hurvitz
- Center for Studies in Demography and Ecology, University of Washington, 218 L Raitt Hall, Box 353412, Seattle, WA 98195 USA; College of Built Environments, University of Washington, Urban Form Lab, 1107 NE 45th St., #535, Seattle, WA 98105, USA.
| | - Christine M Lee
- Department of Psychiatry and Behavioral Sciences, University of Washington, Center for the Study of Health and Risk Behaviors, 1100 NE 45th St., #300, Seattle, WA 98105, USA.
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Baranyi G, Cherrie M, Curtis SE, Dibben C, Pearce J. Changing levels of local crime and mental health: a natural experiment using self-reported and service use data in Scotland. J Epidemiol Community Health 2020; 74:806-814. [PMID: 32503890 PMCID: PMC7577093 DOI: 10.1136/jech-2020-213837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 04/24/2020] [Accepted: 04/28/2020] [Indexed: 11/16/2022]
Abstract
Background This study contributes robust evidence on the association between mental health and local crime rates by showing how changing exposure to small area-level crime relates to self-reported and administrative data on mental health. Methods The study sample comprised 112 251 adults aged 16–60 years, drawn from the Scottish Longitudinal Study, a 5.3% representative sample of Scottish population followed across censuses. Outcomes were individual mental health indicators: self-reported mental illness from the 2011 Census and linked administrative data on antidepressants and antipsychotics prescribed through primary care providers in the National Health Service in 2010/2012. Crime rates at data zone level (500–1000 persons) were matched to the participants’ main place of residence, as defined by general practitioner patient registration duration during 2004/2006, 2007/2009 and 2010/12. Average neighbourhood crime exposure and change in area crime were computed. Covariate-adjusted logistic regressions were conducted, stratified by moving status. Results In addition to average crime exposure during follow-up, recent increases in crime (2007/2009–2010/2012) were associated with a higher risk of self-reported mental illness, among ‘stayers’ aged 16–30 years (OR=1.11; 95% CI 1.00 to 1.22), and among ‘movers’ aged 31–45 years (OR=1.07; 95% CI 1.01 to 1.13). Prescribed medications reinforced these findings; worsening crime rates were linked with antidepressant prescriptions among young stayers (OR=1.09; 95% CI 1.04 to 1.14) and with antipsychotic prescriptions among younger middle-aged movers (OR=1.11; 95% CI 1.01 to 1.23). Conclusion Changing neighbourhood crime exposure is related to individual mental health, but associations differ by psychiatric conditions, age and moving status. Crime reduction and prevention, especially in communities with rising crime rates, may benefit public mental health.
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Affiliation(s)
- Gergő Baranyi
- Center for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, UK
| | - Mark Cherrie
- Center for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, UK
| | - Sarah E Curtis
- Center for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, UK.,Geography Department, Durham University, Durham, UK
| | - Chris Dibben
- Center for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, UK
| | - Jamie Pearce
- Center for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, UK
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Jokela M. Selective residential mobility and social influence in the emergence of neighborhood personality differences: Longitudinal data from Australia. JOURNAL OF RESEARCH IN PERSONALITY 2020. [DOI: 10.1016/j.jrp.2020.103953] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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20
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Abstract
This paper examines individuals’ health and whether it improves when individuals move from a region with poorer health on average to a region with better health on average. We used data from Finland, which is a country with large regional differences in health behaviours and outcomes. We found no evidence that moving from a less healthy region to a healthier region would have any significant effect on the health of individuals who move compared with the health of other individuals. We also examined the potential heterogeneity in the analysed relationships. We found evidence of a relationship between moving itself and health improvements, but this generally true only for our subsample of individuals who had only average or poorer health before moving. Finland has very large regional differences in health. Younger and healthier individuals are more likely to migrate, but not necessarily to regions with better health on average. Individuals with average or poorer self-reported health gain health-wise from moving. No such evidence is found for individuals with better than average self-reported health.
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21
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Aretz B, Doblhammer G, Janssen F. Effects of changes in living environment on physical health: a prospective German cohort study of non-movers. Eur J Public Health 2019; 29:1147-1153. [PMID: 30887051 PMCID: PMC6896981 DOI: 10.1093/eurpub/ckz044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Longitudinal studies on associations between changes in living environment and health are few and focus on movers. Next to causal effects, differences in health can, however, result due to residential mobility. The present study explored changes in living environment related to (changes in) physical health among non-movers. Causality was reinforced by a novel study design. METHODS We obtained longitudinal data on both living environment and physical health covering 4601 non-movers aged 18+ with 16 076 health observations from the German Socio-Economic Panel between 1999 and 2014. Changing and stable perceived living environment from three domains (infrastructure, environmental pollution, housing conditions) were included at household level. We performed linear regressions with robust standard errors and generalized estimating equations to predict the physical component summary (PCS) at baseline and changes in PCS over time. RESULTS Stable moderate and worst as well as worsened environmental pollution and infrastructure were associated with worse PCS at baseline, as were stable poor and worsened housing conditions. Stable worst infrastructure was associated with negative changes in PCS for both sexes. Men's changes in PCS were more affected by worsened environmental pollution than women's. CONCLUSION A suboptimal living environment has short- and long-term negative effects on physical health. Because even short-term changes in the living environment have an immediate influence on an individual's health status and health trajectories, public attention to living environment is essential to fight existing health inequalities.
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Affiliation(s)
- Benjamin Aretz
- Institute of Sociology and Demography, University of Rostock, Rostock, Germany
- Department of Demography, Faculty of Spatial Sciences, University of Groningen, Groningen, The Netherlands
- Correspondence: Benjamin Aretz, Chair of Empirical Social Research and Demography, Institute of Sociology and Demography, University of Rostock, Ulmenstrasse 69, DE-18057 Rostock, Germany, Tel: +49 381 498 4060, Fax: +49 381 498 4395, e-mail:
| | - Gabriele Doblhammer
- Institute of Sociology and Demography, University of Rostock, Rostock, Germany
- German Centre for Neurodegenerative Diseases, Bonn, Germany
| | - Fanny Janssen
- Department of Demography, Faculty of Spatial Sciences, University of Groningen, Groningen, The Netherlands
- Interdisciplinary Demographic Institute, The Hague, The Netherlands
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Kashem T, Al Sayah F, Tawiah A, Ohinmaa A, Johnson JA. The relationship between individual-level deprivation and health-related quality of life. Health Qual Life Outcomes 2019; 17:176. [PMID: 31783859 PMCID: PMC6883516 DOI: 10.1186/s12955-019-1243-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 11/11/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To examine the association between individual-level deprivation and health-related quality of life (HRQL) in the general population. METHODS Data from a population-based survey in the Canadian province of Alberta were used. Individual-level deprivation was assessed using the Canadian Deprivation Index (CDI) and the Ontario Deprivation Index (ODI). HRQL was assessed using the EQ-5D-5 L. Differences in problems in the EQ-5D-5 L dimensions, index and visual analogue scale (VAS) scores across levels of deprivation were examined. Multivariate logistic and linear regression models adjusted for socio-demographic and other characteristics were used to examine the independent association between deprivation and HRQL. RESULTS Of the 6314 respondents, 39% were aged between 18 and 44 years and 38% between 45 and 64 years; 60% were female. Mean EQ-5D-5 L index and VAS scores were 0.85 (standard deviation [SD] 0.14) and 79.6 (SD 17.7), respectively. Almost one-third (30.6%) of respondents reported no problems on all EQ-5D-5 L dimensions. Few participants reported some problems with mobility (23.8%), self-care (6.2%) and usual activities (25.2%), while 59.3 and 35.5% reported some levels of pain/discomfort and anxiety/depression, respectively. Differences between the most and least deprived in reporting problems in EQ-5D-5 L dimensions, index and VAS scores were statistically significant and clinically important. In adjusted regression models for both deprivation indices, the least well-off, compared to the most well-off, had higher likelihood of reporting problems in all EQ-5D-5 L dimensions. Compared to the most well-off, the least well-off had an EQ-5D-5 L index score decrement of 0.18 (p < 0.01) and 0.17 (p < 0.01) for the CDI and ODI, respectively. Similarly, an inverse association was found between the VAS score and the CDI (β = - 17.3, p < 0.01) as well as the ODI (β = - 13.3, p < 0.01). CONCLUSION Individual-level deprivation is associated with worse HRQL. Poverty reduction strategies should consider the effects of not only neighbourhood-level deprivation, but also that of individual-level deprivation to improve overall health.
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Affiliation(s)
- Tahmid Kashem
- School of Public Health, University of Alberta, 2-040 Li Ka Shing Center for Health Research Innovation, Edmonton, AB, T6G 2E1, Canada.
| | - Fatima Al Sayah
- School of Public Health, University of Alberta, 2-040 Li Ka Shing Center for Health Research Innovation, Edmonton, AB, T6G 2E1, Canada
| | - Andrews Tawiah
- Faculty of Rehabilitation Medicine, University of Alberta, 3-44 Corbett Hall, Edmonton, AB, T6G 2G4, Canada
| | - Arto Ohinmaa
- School of Public Health, University of Alberta, 2-040 Li Ka Shing Center for Health Research Innovation, Edmonton, AB, T6G 2E1, Canada
| | - Jeffery A Johnson
- School of Public Health, University of Alberta, 2-040 Li Ka Shing Center for Health Research Innovation, Edmonton, AB, T6G 2E1, Canada
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Gootjes DV, Koster MPH, Willemsen SP, Koning AHJ, Steegers EAP, Steegers-Theunissen RPM. The Impact of Neighbourhood Deprivation on Embryonic Growth Trajectories: Rotterdam Periconception Cohort. J Clin Med 2019; 8:jcm8111913. [PMID: 31717297 PMCID: PMC6912493 DOI: 10.3390/jcm8111913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 11/04/2019] [Indexed: 11/21/2022] Open
Abstract
Background: Neighbourhood deprivation is a risk factor for impaired health and adverse pregnancy outcomes. We investigated whether living in a deprived neighbourhood is associated with embryonic growth. Methods: From the Predict cohort, we studied 566 women who underwent repeated first trimester ultrasound examinations. Crown rump length (CRL; n = 1707) and embryonic volume (EV; n = 1462) were measured using three-dimensional techniques. Neighbourhood deprivation was assessed using the neighbourhood status scores (NSS) of the Dutch Social Cultural Planning office. A high NSS represents a non-deprived neighbourhood. Associations between the NSS and embryonic growth were investigated using linear mixed models. Adjustment was performed for individual-level factors: maternal age, geographic origin, educational level, BMI, folic acid supplement use, fruit and vegetable intake, alcohol use and smoking habits. Results: The NSS was negatively associated with embryonic growth: a higher score (a less deprived neighbourhood) was associated with a smaller CRL and EV; adjusted β: −0.025 (95% CI −0.046, −0.003) and adjusted β: −0.015 (95% CI −0.026, −0.003). At 11 weeks of pregnancy, we observed a 0.55 cm3 smaller EV (7.65 cm3 vs. 7.10 cm3) and 1.08 mm smaller CRL (43.14 mm vs. 42.06 mm) in the highest compared to the lowest category. Conclusion: In deprived neighbourhoods, embryos are larger than in non-deprived neighbourhoods.
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Affiliation(s)
- Dionne V. Gootjes
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam 3015 GD, The Netherlands (M.P.H.K.); (S.P.W.); (E.A.P.S.)
| | - Maria P. H. Koster
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam 3015 GD, The Netherlands (M.P.H.K.); (S.P.W.); (E.A.P.S.)
| | - Sten P. Willemsen
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam 3015 GD, The Netherlands (M.P.H.K.); (S.P.W.); (E.A.P.S.)
- Department of Biostatistics, Erasmus MC, University Medical Centre Rotterdam, Rotterdam 3015 GD, The Netherlands
| | - Anton H. J. Koning
- Department of Pathology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam 3015 GD, The Netherlands;
| | - Eric A. P. Steegers
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam 3015 GD, The Netherlands (M.P.H.K.); (S.P.W.); (E.A.P.S.)
| | - Régine P. M. Steegers-Theunissen
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam 3015 GD, The Netherlands (M.P.H.K.); (S.P.W.); (E.A.P.S.)
- Correspondence: ; Tel.: +31-010-703-8255
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24
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Jokela M. Neighborhoods, psychological distress, and the quest for causality. Curr Opin Psychol 2019; 32:22-26. [PMID: 31362181 DOI: 10.1016/j.copsyc.2019.06.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 06/13/2019] [Indexed: 12/31/2022]
Abstract
Neighborhood characteristics have been associated with psychological distress, but it is uncertain whether these associations are causal. The current article reviews data from interventions and quasi-experimental studies that have addressed the question of causality of neighborhood associations. Overall, data from neighborhood interventions, longitudinal studies, and twin studies have provided only limited and inconsistent evidence to support causal interpretation of neighborhood associations with psychological distress: very few findings have been replicated across different samples, and many associations have been observed only with some of the multiple measures included the studies. Studies that examine the effects of neighborhood change on people's wellbeing are needed to improve causal inference and policy relevance of neighborhood studies.
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Affiliation(s)
- Markus Jokela
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland.
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25
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Lawlor ER, Cupples ME, Donnelly M, Tully MA. Promoting physical activity among community groups of older women in socio-economically disadvantaged areas: randomised feasibility study. Trials 2019; 20:234. [PMID: 31023329 PMCID: PMC6482492 DOI: 10.1186/s13063-019-3312-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 03/21/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Insufficient physical activity (PA) is a major public health issue. Whilst PA is an important contributor to disease prevention, engagement in PA decreases with age, particularly among women in socio-economically disadvantaged areas. Research using existing support networks to engage 'hard to reach' populations in PA interventions is sparse. We developed and tested the feasibility of a PA-promoting intervention for older women within existing community groups in socio-economically disadvantaged areas. METHODS The Medical Research Council guidelines for complex interventions were used to guide the intervention's development. We recruited participants (n = 40) from older (aged ≥50 years) women's groups from four different community centres. A 12-week programme was delivered during existing sessions, informed by Social Practice Theory. The sessions provided education about PA, social support in the form of a PA 'buddy', group discussion and follow-up telephone calls, as well as printed information about local opportunities to participate in PA. The main uncertainties tested were rates of participant recruitment, retention, and completion of assessments of PA by accelerometry and of mental health using the Hospital Anxiety and Depression Scale (HADS). Intervention acceptability was assessed by questionnaire, and focus group interviews elicited participants' views about the intervention. Qualitative data were subjected to framework analysis. RESULTS The recruitment rate was high; 87% (n = 40/46) of women consented to participate, and 78% (n = 31) attended all education sessions. Uptake of follow-up telephone calls and PA 'buddies' was low. Few participants provided valid accelerometer data, but 63% (n=25) completed the HADS questionnaire at all time points. The printed materials and education sessions were viewed positively; telephone calls and 'buddy' support were not valued. Participants believed that organised group activities would lead to increased PA engagement, and whilst participants disliked wearing a waist accelerometer, they thought that regular PA feedback would facilitate necessary goal-setting. CONCLUSIONS High recruitment and retention rates suggest that use of existing social support groups is an acceptable and attractive method of delivering a PA intervention to this population. A randomised controlled trial of the intervention appears feasible, but its design requires refinement of the social support component, facilitation of goal-setting and reconsideration of the assessment of PA. TRIAL REGISTRATION ClinicalTrials.gov, NCT02880449 . Registered on 26 August 2016.
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Affiliation(s)
- Emma R Lawlor
- UKCRC Centre of Excellence for Public Health (Northern Ireland), School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Clinical Sciences Block B, Royal Victoria Hospital, Belfast, BT12 6BA, Northern Ireland, UK.
| | - Margaret E Cupples
- UKCRC Centre of Excellence for Public Health (Northern Ireland), School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Clinical Sciences Block B, Royal Victoria Hospital, Belfast, BT12 6BA, Northern Ireland, UK.,Department of General Practice and Primary Care, Queen's University Belfast, 1 Dunluce Avenue, Belfast, BT9 7HR, Northern Ireland, UK
| | - Michael Donnelly
- UKCRC Centre of Excellence for Public Health (Northern Ireland), School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Clinical Sciences Block B, Royal Victoria Hospital, Belfast, BT12 6BA, Northern Ireland, UK
| | - Mark A Tully
- UKCRC Centre of Excellence for Public Health (Northern Ireland), School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Clinical Sciences Block B, Royal Victoria Hospital, Belfast, BT12 6BA, Northern Ireland, UK.,School of Health Sciences, Institute of Mental Health Sciences, Ulster University, Shore Road, Newtownabbey, BT37 0QB, Northern Ireland, UK
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Murray ET, Zaninotto P, Fleischmann M, Stafford M, Carr E, Shelton N, Stansfeld S, Kuh D, Head J. Linking local labour market conditions across the life course to retirement age: Pathways of health, employment status, occupational class and educational achievement, using 60 years of the 1946 British Birth Cohort. Soc Sci Med 2019; 226:113-122. [PMID: 30852391 DOI: 10.1016/j.socscimed.2019.02.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 01/29/2019] [Accepted: 02/24/2019] [Indexed: 10/27/2022]
Abstract
Several studies have documented that older workers who live in areas with higher unemployment rates are more likely to leave work for health and non-health reasons. Due to tracking of area disadvantage over the life course, and because negative individual health and socioeconomic factors are more likely to develop in individuals from disadvantaged areas, we do not know at what specific ages, and through which specific pathways, area unemployment may be influencing retirement age. Using data from the MRC National Survey of Health and Development, we use structural equation modelling to investigate pathways linking local authority unemployment at three ages (4y, 26y and 53y) to age of retirement (right-censored). We explored five hypothesized pathways: (1) residential tracking, (2) health, (3) employment status, (4) occupational class, and (5) education. Initially, pathways between life course area unemployment, each pathway and retirement age were assessed individually. Mediation pathways were tested in the full model. Our results showed that area unemployment tracked across the life course. Higher area unemployment at ages 4 and 53 were independently associated with earlier retirement age [1% increase = mean -0.64 (95% CI: -1.12, -0.16) and -0.25 (95% CI: -0.43, -0.06) years]. Both were explained by adjustment for individual employment status at ages 26 and 53 years. Higher area unemployment at age 26 was associated with poorer health and lower likelihood of employment at aged 53; and these 2 individual pathways were identified as the key mediators between area unemployment and retirement age. In conclusion, these results suggest that interventions designed to create local employment opportunities for young adults should lead to extended working through improved employment and health at mid-life.
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Affiliation(s)
- Emily T Murray
- University College London, Department of Epidemiology and Public Health, London, United Kingdom.
| | - Paola Zaninotto
- University College London, Department of Epidemiology and Public Health, London, United Kingdom
| | - Maria Fleischmann
- University College London, Department of Epidemiology and Public Health, London, United Kingdom
| | - Mai Stafford
- Medical Research Council Unit for Lifelong Health and Ageing at University College London, London, United Kingdom
| | - Ewan Carr
- University College London, Department of Epidemiology and Public Health, London, United Kingdom; Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Nicola Shelton
- University College London, Department of Epidemiology and Public Health, London, United Kingdom
| | - Stephen Stansfeld
- Queen Mary University of London, Wolfson Institute of Preventive Medicine, Centre for Psychiatry, London, United Kingdom
| | - Diana Kuh
- Medical Research Council Unit for Lifelong Health and Ageing at University College London, London, United Kingdom
| | - Jenny Head
- University College London, Department of Epidemiology and Public Health, London, United Kingdom
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Xiao Q, Berrigan D, Powell-Wiley TM, Matthews CE. Ten-Year Change in Neighborhood Socioeconomic Deprivation and Rates of Total, Cardiovascular Disease, and Cancer Mortality in Older US Adults. Am J Epidemiol 2018; 187:2642-2650. [PMID: 30137194 DOI: 10.1093/aje/kwy181] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 08/14/2018] [Indexed: 12/24/2022] Open
Abstract
Low neighborhood socioeconomic status has been linked to adverse health outcomes. However, it is unclear whether changing the neighborhood may influence health. We examined 10-year change in neighborhood socioeconomic deprivation in relation to mortality rate among 288,555 participants aged 51-70 years who enrolled in the National Institutes of Health-AARP Diet and Health Study in 1995-1996 (baseline) and did not move during the study. Changes in neighborhood socioeconomic deprivation between 1990 and 2000 were measured by US Census data at the census tract level. All-cause, cardiovascular disease, and cancer deaths were ascertained through annual linkage to the Social Security Administration Death Master File between 2000 and 2011. Overall, our results suggested that improvement in neighborhood socioeconomic status was associated with a lower mortality rate, while deterioration was associated with a higher mortality rate. More specially, a 30-percentile-point reduction in neighborhood deprivation among more deprived neighborhoods was associated with 11% and 19% reductions in the total mortality rate among men and women, respectively. On the other hand, a 30-point increase in neighborhood deprivation in less deprived neighborhoods was associated with an 11% increase in the mortality rate among men. Our findings support a longitudinal association between changing neighborhood conditions and mortality.
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Affiliation(s)
- Qian Xiao
- Department of Health and Human Physiology, College of Liberal Arts and Sciences, University of Iowa, Iowa City, Iowa
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - David Berrigan
- Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Tiffany M Powell-Wiley
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, Maryland
- Intramural Research Program of the National Institute of Minority Health and Health Disparities, Bethesda, Maryland
| | - Charles E Matthews
- Metabolic Epidemiological Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
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Shackleton N, Darlington-Pollock F, Norman P, Jackson R, Exeter DJ. Longitudinal deprivation trajectories and risk of cardiovascular disease in New Zealand. Health Place 2018; 53:34-42. [PMID: 30053650 DOI: 10.1016/j.healthplace.2018.07.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 05/31/2018] [Accepted: 07/16/2018] [Indexed: 01/26/2023]
Abstract
We used longitudinal information on area deprivation status to explore the relationship between residential-deprivation mobility and Cardiovascular Disease (CVD). Data from 2,418,397 individuals who were: enrolled in any Primary Health Organisation within New Zealand (NZ) during at least 1 of 34 calendar quarters between 1st January 2006 and 30th June 2014; aged between 30 and 84 years (inclusive) at the start of the study period; had no prior history of CVD; and had recorded address information were analysed. Including a novel trajectory analysis, our findings suggest that movers are healthier than stayers. The deprivation characteristics of the move have a larger impact on the relative risk of CVD for younger movers than for older movers. For older movers any kind of move is associated with a decreased risk of CVD.
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Affiliation(s)
- Nichola Shackleton
- Centre of Methods and Policy Application in the Social Sciences (COMPASS), Faculty of Arts, The University of Auckland, Auckland, New Zealand.
| | | | - Paul Norman
- School of Geography, University of Leeds, UK
| | - Rodney Jackson
- Section of Epidemiology & Biostatistics, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Daniel John Exeter
- Section of Epidemiology & Biostatistics, School of Population Health, The University of Auckland, Auckland, New Zealand
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Jonsson F, Sebastian MS, Hammarström A, Gustafsson PE. Are neighbourhood inequalities in adult health explained by socio-economic and psychosocial determinants in adolescence and the subsequent life course in northern Sweden? A decomposition analysis. Health Place 2018; 52:127-134. [PMID: 29886129 DOI: 10.1016/j.healthplace.2018.05.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 05/03/2018] [Accepted: 05/29/2018] [Indexed: 12/13/2022]
Abstract
This study explains neighbourhood deprivation inequalities in adult health for a northern Swedish cohort by examining the contribution of socio-economic and psychosocial determinants from adolescence (age 16), young adulthood (age 21) and midlife (age 42) to the disparity. Self-reported information from 873 participants was drawn from questionnaires, with complementary neighbourhood register data. The concentration index was used to estimate the inequality while decomposition analyses were run to attribute the disparity to its underlying determinants. The results suggest that socio-economic and psychosocial factors in midlife explain a substantial part, but also that the inequality can originate from conditions in adolescence and young adulthood.
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Affiliation(s)
- Frida Jonsson
- Department of Public Health and Clinical Medicine, Unit of Epidemiology and Global Health, Umeå University, SE-90187 Umeå, Sweden.
| | - Miguel San Sebastian
- Department of Public Health and Clinical Medicine, Unit of Epidemiology and Global Health, Umeå University, SE-90187 Umeå, Sweden.
| | - Anne Hammarström
- Department of Public Health and Caring Sciences, Uppsala University, SE-751 22 Uppsala, Sweden.
| | - Per E Gustafsson
- Department of Public Health and Clinical Medicine, Unit of Epidemiology and Global Health, Umeå University, SE-90187 Umeå, Sweden.
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Population characteristics and geographic coverage of primary care facilities. BMC Health Serv Res 2018; 18:398. [PMID: 29859087 PMCID: PMC5984830 DOI: 10.1186/s12913-018-3221-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 05/22/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The location of General Practitioner (GP) facilities is an important aspect in the design of healthcare systems to ensure they are accessible by populations with healthcare needs. A key consideration in the facility location decision involves matching the population need for the services with the supply of healthcare resources. The literature points to several factors which may be important in the decision making process, such as deprivation, transportation, rurality, and population age. METHODS This study uses two approaches to examine the factors associated with GP accessibility in Northern Ireland. The first uses multinomial regression to examine the factors associated with GP coverage, measured as the proportion of people who live within 1.5 km road network distance from the nearest GP practice. The second focuses on the factors associated with the average travel distance to the nearest GP practice, again measured using network distance. The empirical research is carried out using population and geospatial data from Northern Ireland, across 890 Super Output Areas and 343 GP practices. RESULTS In 19% of Super Output Areas, all of the population live within 1.5 km of a GP practice, whilst in 24% none of the population live within 1.5 km. The regression results show that there are higher levels of population coverage in more deprived areas, smaller areas, and areas that have more elderly populations. Similarly, the average travel distance is related to deprivation, population age, and area size. CONCLUSIONS The results indicate that GP practices are located in areas with higher levels of service need, but also that care needs to be taken to ensure rural populations have sufficient access to services, whether delivered through GP practices or through alternative services where GP practices are less accessible. The methodology and results should be considered by policy makers and healthcare managers when making decisions about GP facility location and service provision.
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Bilal U, Jones-Smith J, Diez J, Lawrence RS, Celentano DD, Franco M. Neighborhood social and economic change and retail food environment change in Madrid (Spain): The heart healthy hoods study. Health Place 2018; 51:107-117. [PMID: 29579697 DOI: 10.1016/j.healthplace.2018.03.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 03/01/2018] [Accepted: 03/13/2018] [Indexed: 10/17/2022]
Abstract
This study explores the association between neighborhood social and economic change from 2009 to 2013 and changes in the retail food environment from 2013 to 2017 in Madrid (Spain). We classified neighborhoods into four types: decreasing SES, new housing/gentrifying, increasing SES, and aging (population and housing). Food store data was obtained from a retail spaces census and classified as supermarket, specialized small store, or fruit and vegetable store. Compared to aging areas, new housing/gentrifying and areas with increasing SES had a higher baseline presence and proportion of supermarkets and a lower proportion of specialized stores and fruit and vegetable stores. Areas with decreasing SES had an initially higher presence and proportion of fruit and vegetable stores but showed a declining trend in both presence and proportion of fruit and vegetable stores.
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Affiliation(s)
- Usama Bilal
- Department of Epidemiology. Johns Hopkins Bloomberg School of Public Health. Baltimore, MD, USA; Social and Cardiovascular Research Group. Universidad de Alcalá. Alcalá de Henares, Madrid, Spain; Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, PA, USA.
| | - Jessica Jones-Smith
- Department of Health Services, University of Washington School of Public Health, Seattle, WA, USA
| | - Julia Diez
- Social and Cardiovascular Research Group. Universidad de Alcalá. Alcalá de Henares, Madrid, Spain
| | - Robert S Lawrence
- Department of Environmental Health and Engineering and Center for a Livable Future. Johns Hopkins Bloomberg School of Public Health. Baltimore, MD, USA
| | - David D Celentano
- Department of Epidemiology. Johns Hopkins Bloomberg School of Public Health. Baltimore, MD, USA
| | - Manuel Franco
- Department of Epidemiology. Johns Hopkins Bloomberg School of Public Health. Baltimore, MD, USA; Social and Cardiovascular Research Group. Universidad de Alcalá. Alcalá de Henares, Madrid, Spain
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Ghosh A, Millett C, Subramanian S, Pramanik S. Neighborhood heterogeneity in health and well-being among the elderly in India – Evidence from Study on global AGEing and adult health (SAGE). Health Place 2017; 47:100-107. [DOI: 10.1016/j.healthplace.2017.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Revised: 03/18/2017] [Accepted: 08/01/2017] [Indexed: 01/08/2023]
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Neighborhood SES is particularly important to the cardiovascular health of low SES individuals. Soc Sci Med 2017; 188:60-68. [PMID: 28732236 DOI: 10.1016/j.socscimed.2017.07.005] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 06/26/2017] [Accepted: 07/07/2017] [Indexed: 01/15/2023]
Abstract
RATIONALE Health disparities defined by neighborhood socioeconomic status (SES) are well established; it is less well understood whether neighborhood SES is differentially associated with health depending on one's own SES. OBJECTIVE The double jeopardy hypothesis, collective resources model, fundamental cause theory, and relative deprivation hypothesis support differential patterns of association between neighborhood and individual SES with health. The first three models suggest that higher neighborhood SES predicts health more strongly among lower, as compared to higher, SES individuals. The relative deprivation hypothesis suggests that higher SES neighborhoods bring no extra health benefit to low SES individuals and could even bring a health deficit. This study examined competing hypotheses with prospective associations between cardiovascular (CV) health and individual SES, neighborhood SES, and their interaction. METHOD Data were from two waves of the Midlife in the United States (MIDUS) Study (N = 1012), a national survey of adults ages 25 and older at baseline. Neighborhood SES was a composite of five census tract-level SES indicators from the 1990 census. Individual SES was a composite of educational attainment and household income at wave one (1995-1996). CV health at wave two (2004-2008), was computed as a composite based on smoking status, body mass index, physical activity, diet, total cholesterol, blood pressure, and glucose. RESULTS Individual and neighborhood SES were each associated with CV health net of baseline health status and other covariates. Interactions between individual and neighborhood SES showed that higher neighborhood SES was associated with better CV health for those of lower, not higher, individual SES. CONCLUSION Results are consistent with the double jeopardy hypothesis, the collective resources model, and the fundamental cause theory, but not with a relative deprivation hypothesis. Results suggest that additional attention to the neighborhood socioeconomic context of lower SES individuals may reduce SES disparities in cardiovascular health.
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How do moving and other major life events impact mental health? A longitudinal analysis of UK children. Health Place 2017; 46:257-266. [PMID: 28666235 DOI: 10.1016/j.healthplace.2017.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 06/06/2017] [Accepted: 06/22/2017] [Indexed: 11/22/2022]
Abstract
Research has suggested that children who move home report poorer mental health than those who remain residentially stable. However, many previous studies have been based on cross sectional data and have failed to consider major life events as confounders. This study uses longitudinal data from ALSPAC, a UK population based birth cohort study, and employs within-between random effect models to decompose the association between moving in childhood and poor mental health. Results suggest that while unobserved between-individual differences between mobile and non-mobile children account for a large portion of this association, within-individual differences remain and indicate that moving may have a detrimental impact upon subsequent mental health. There is heterogeneity in children's response to moving, suggesting that a dichotomy of movers vs stayers is overly simplistic.
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Xiao Q, Berrigan D, Matthews CE. A prospective investigation of neighborhood socioeconomic deprivation and self-rated health in a large US cohort. Health Place 2017; 44:70-76. [PMID: 28183012 DOI: 10.1016/j.healthplace.2017.01.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 01/09/2017] [Accepted: 01/21/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Neighborhood characteristics play a critical role in health. Self-rated health (SRH) is an important indicator of quality of life and a strong predictor of premature death. Prospective study on neighborhood deprivation and SRH is limited. METHODS We examined neighborhood socioeconomic deprivation with reporting fair/poor SRH at follow-up (2004-2006) in 249,265 men and women (age 50-71) who reported SRH as good or better at baseline (1995-1996) in the NIH-AARP Health and Diet Study. Baseline addresses were geocoded and linked to 2000 Census. Census tract level variables were used to generate a socioeconomic deprivation index by principle component analysis. RESULTS Residents of more deprived neighborhoods had a higher risk of developing poor/fair SRH at follow-up, even after adjusting for individual-level factors (Odds ratio (95% confidence interval) Q5 vs Q1: 1.26 (1.20, 1.32), p-trend: <0.0001). The results were largely consistent across subgroups with different demographics, health behaviors, and disease conditions and after excluding participants who moved away from their baseline address. CONCLUSION Neighborhood disadvantage predicts SRH over 10 years.
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Affiliation(s)
- Qian Xiao
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA.
| | - David Berrigan
- Division of Cancer Control and Population Sciences, National Cancer Institute, USA
| | - Charles E Matthews
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, USA
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Abstract
There is geographical variation in the ways in which people think, feel, and behave. How are we to understand the causes and consequences of such variation? Geographical psychology is an emerging subarea of research concerned with the spatial organization of psychological phenomena and how individual characteristics, social entities, and physical features of the environment contribute to their organization. Studies at multiple levels of analysis have indicated that social influence, ecological influence, and selective migration are key mechanisms that contribute to the spatial clustering of psychological characteristics. Investigations in multiple countries have shown that the psychological characteristics common in particular regions are respectively linked to important political, economic, and health indicators. Furthermore, results from large multilevel studies have shown that the psychological characteristics of individuals interact with features of the local environment to impact psychological development and well-being. Future research is needed to better understand the scale and impact of person-environment associations over time.
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Affiliation(s)
| | - Markus Jokela
- Institute of Behavioral Sciences, University of Helsinki
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Pierse N, Carter K, Bierre S, Law D, Howden-Chapman P. Examining the role of tenure, household crowding and housing affordability on psychological distress, using longitudinal data. J Epidemiol Community Health 2016; 70:961-6. [DOI: 10.1136/jech-2015-206716] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Accepted: 04/15/2016] [Indexed: 11/04/2022]
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Glass TA, Bilal U. Are neighborhoods causal? Complications arising from the 'stickiness' of ZNA. Soc Sci Med 2016; 166:244-253. [PMID: 26830654 DOI: 10.1016/j.socscimed.2016.01.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Revised: 12/23/2015] [Accepted: 01/03/2016] [Indexed: 02/06/2023]
Abstract
Are neighborhoods causal? The answer remains elusive. Armed with new multilevel methods, enthusiasm for neighborhoods research surged at the turn of the century. However, a wave of skepticism has arisen based on the difficulty of drawing causal inferences from observational studies in which selection to neighborhoods is non-random. Researchers have sought answers from experimental and quasi-experimental studies of movers vs. stayers. We develop two related concepts in this essay in the hopes of shedding light on this problem. First, the inceptive environment into which persons are born (which we term ZNA for Zip code Nativity Area) exerts a potentially powerful causal impact on health. Detecting that causal effect is challenging for reasons similar that obtain in other fields (including genetics). Second, we explicate the problem of neighborhood 'stickiness' in terms of the persistence of neighborhood treatment assignment, and argue that under-appreciation of stickiness has led to systematic bias in causal estimates of neighborhoods proportional to the degree of stickiness. In sticky contexts, failure to account for the lasting influences of ZNA by adjusting for intermediate individual socioeconomic and health variables on the causal pathway can result in neighborhood effects estimates that are biased toward the null. We follow with an example drawn from evidence of neighborhood 'stickiness' and obesity. The stickiness of ZNA cautions us that experimental evidence may be insufficient or misleading as a solution to causal inference problems in neighborhood research.
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Affiliation(s)
- Thomas A Glass
- Johns Hopkins Bloomberg School of Public Health, United States.
| | - Usama Bilal
- Johns Hopkins Bloomberg School of Public Health, United States; Social and Cardiovascular Research Group, School of Medicine, University of Alcala, Madrid, Spain
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McAneney H, Tully MA, Hunter RF, Kouvonen A, Veal P, Stevenson M, Kee F. Individual factors and perceived community characteristics in relation to mental health and mental well-being. BMC Public Health 2015; 15:1237. [PMID: 26655388 PMCID: PMC4677043 DOI: 10.1186/s12889-015-2590-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 12/09/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It has been argued that though correlated with mental health, mental well-being is a distinct entity. Despite the wealth of literature on mental health, less is known about mental well-being. Mental health is something experienced by individuals, whereas mental well-being can be assessed at the population level. Accordingly it is important to differentiate the individual and population level factors (environmental and social) that could be associated with mental health and well-being, and as people living in deprived areas have a higher prevalence of poor mental health, these relationships should be compared across different levels of neighbourhood deprivation. METHODS A cross-sectional representative random sample of 1,209 adults from 62 Super Output Areas (SOAs) in Belfast, Northern Ireland (Feb 2010 - Jan 2011) were recruited in the PARC Study. Interview-administered questionnaires recorded data on socio-demographic characteristics, health-related behaviours, individual social capital, self-rated health, mental health (SF-8) and mental well-being (WEMWBS). Multi-variable linear regression analyses, with inclusion of clustering by SOAs, were used to explore the associations between individual and perceived community characteristics and mental health and mental well-being, and to investigate how these associations differed by the level of neighbourhood deprivation. RESULTS Thirty-eight and 30 % of variability in the measures of mental well-being and mental health, respectively, could be explained by individual factors and the perceived community characteristics. In the total sample and stratified by neighbourhood deprivation, age, marital status and self-rated health were associated with both mental health and well-being, with the 'social connections' and local area satisfaction elements of social capital also emerging as explanatory variables. An increase of +1 in EQ-5D-3 L was associated with +1SD of the population mean in both mental health and well-being. Similarly, a change from 'very dissatisfied' to 'very satisfied' for local area satisfaction would result in +8.75 for mental well-being, but only in the more affluent of areas. CONCLUSIONS Self-rated health was associated with both mental health and mental well-being. Of the individual social capital explanatory variables, 'social connections' was more important for mental well-being. Although similarities in the explanatory variables of mental health and mental well-being exist, socio-ecological interventions designed to improve them may not have equivalent impacts in rich and poor neighbourhoods.
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Affiliation(s)
- Helen McAneney
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK.
| | - Mark A Tully
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK. .,UKCRC Centre of Excellence for Public Health (NI), Queen's University Belfast, Belfast, Northern Ireland, UK.
| | - Ruth F Hunter
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK. .,UKCRC Centre of Excellence for Public Health (NI), Queen's University Belfast, Belfast, Northern Ireland, UK.
| | - Anne Kouvonen
- UKCRC Centre of Excellence for Public Health (NI), Queen's University Belfast, Belfast, Northern Ireland, UK. .,Department of Social Research, University of Helsinki, Helsinki, Finland. .,University of Social Sciences and Humanities, Faculty in Wroclaw, Wroclaw, Poland.
| | - Philip Veal
- UKCRC Centre of Excellence for Public Health (NI), Queen's University Belfast, Belfast, Northern Ireland, UK. .,Public Health Agency, Northern Ireland, UK.
| | - Michael Stevenson
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK. .,UKCRC Centre of Excellence for Public Health (NI), Queen's University Belfast, Belfast, Northern Ireland, UK.
| | - Frank Kee
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK. .,UKCRC Centre of Excellence for Public Health (NI), Queen's University Belfast, Belfast, Northern Ireland, UK.
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Getting Bigger, Quicker? Gendered Socioeconomic Trajectories in Body Mass Index across the Adult Lifecourse: A Longitudinal Study of 21,403 Australians. PLoS One 2015; 10:e0141499. [PMID: 26496435 PMCID: PMC4619864 DOI: 10.1371/journal.pone.0141499] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 10/08/2015] [Indexed: 11/19/2022] Open
Abstract
Do socioeconomic inequities in body mass index (BMI) widen across the adult lifecourse? BMI data for 29,104 male and 32,454 female person-years aged 15 years and older (21,403 persons in total) were extracted from the Household, Income and Labour Dynamics in Australia between 2006 and 2012. Multilevel linear regression was used to examine age and gender specific trajectories in BMI by quintiles of neighborhood socioeconomic circumstance. Models were adjusted for probable sources of confounding, including couple status, number of children resident, if somebody in the household had been pregnant in the last 12 months, the highest level of education achieved, the average household gross income, and the percentage of time in the last year spent unemployed. Approximately 9.6% of BMI variation was observed between neighborhoods. High neighborhood disadvantage was associated with 2.09 kg/m2 heavier BMI (95%CI 1.82, 2.36). At age 15-24y, socioeconomic inequity in BMI was already evident among men and women especially (22.6 kg/m2 among women in the most affluent areas compared with 25.4 kg/m2 among the most disadvantaged). Among women only, the socioeconomic gap widened from 2.8 kg/m2 at age 15-24y to 3.2 kg/m2 by age 35-44y. Geographical factors may contribute to more rapid weight gain among women living in disadvantaged neighborhoods.
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