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Kesanto-Jokipolvi H, Seppänen P, Koivuhovi S, Siipola M, Autio R, Rimpelä A. Selective Classes and Early Health Inequalities in Comprehensive Schools in Finland. THE JOURNAL OF SCHOOL HEALTH 2024. [PMID: 38961003 DOI: 10.1111/josh.13488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 05/13/2024] [Accepted: 05/24/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND The origin of inequalities in health outcomes has been explained by health selection and social causation models. Health selection processes operate particularly at school age. We study, if student allocation to teaching groups with aptitude tests (selective vs general class) differentiates adolescents by health behaviors and mental health. METHODS Finnish schoolchildren 12-13 years from 12 selective classes, n = 248; 41 general classes, n = 703 answered a questionnaire on addictive products (tobacco, snus, alcohol, and energy drinks), digital media use, and mental health (health complaints, anxiety, and depression). Structural equation modeling was conducted to identify structures between outcomes, SEP (socioeconomic position), class type, and academic performance. RESULTS Students in the selective classes reported less addictive digital media and addictive products use than students in the general classes. Differences in academic performance or SEP between the class types did not solely explain these differences. Mental health was not related to the class type. SEP was indirectly associated with health behaviors via the class type and academic performance. CONCLUSIONS Selecting students to permanent teaching groups with aptitude tests differentiates students according to risky health behaviors. The impact of education policies using student grouping should also be evaluated in terms of students' health.
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Affiliation(s)
| | - Piia Seppänen
- Centre for Research on Lifelong Learning and Education CELE, University of Turku, Turku, Finland
| | - Satu Koivuhovi
- Inequalities, Interventions, and a New Welfare State INVEST, University of Turku, Turku, Finland
| | - Mari Siipola
- Centre for Research on Lifelong Learning and Education CELE, University of Turku, Turku, Finland
| | - Reija Autio
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland
| | - Arja Rimpelä
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University; Department of Adolescent Psychiatry, Tampere University Hospital, Tampere, Finland
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Bazyar M, Kakaei H, Jalilian M, Mirzaei A, Mansournia MA, Pakzad R. Socioeconomic inequality in self-rated health and its determinants: an Oaxaca blinder decomposition in Ilam, West of Iran during 2023. BMC Health Serv Res 2023; 23:1203. [PMID: 37924069 PMCID: PMC10625218 DOI: 10.1186/s12913-023-10242-y] [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: 05/06/2023] [Accepted: 10/30/2023] [Indexed: 11/06/2023] Open
Abstract
AIM To determine inequality and decompose it's in Self-Rated Health (SRH). METHOD This population-based cross-sectional study was undertaken on the entire population of the city of Ilam, Iran, in 2023. Multi-stage stratified cluster random sampling with proportion-to-size approach was used to select the participants. Oaxaca-Blinder decomposition technique was used to show the amount of inequity in SRH and to decompose of the gap of SRH between the poor and the rich group of participants. RESULTS 1370 persons participated in the study. The 59.38% of participants stated good SRH status and just 8.86% of participants had poor SRH status. The results of the Oaxaca-Blinder decomposition revealed a considerable gap (15.87%) in the poor status of SRH between the rich and the poor. A large proportion (89.66%) of this difference was described by explained portion of the model. The results of decomposition showed that economic status was directly responsible for explaining 27.98% of overall inequality gap between rich and poor people. Moreover, hopelessness to future (32.64%), having an underlying disease (18.34%) and difference in the education level (10.71%) were associated with an increase in inequality disfavoring the poor. CONCLUSION For people suffering from underlying disease, it is suggested to devise policies to improve access to/and remove healthcare utilization barriers. To address hopelessness to future, it is recommended to carry out further studies to reveal factors which affect it in more details. This can help policy makers to formulate more realistic and evidence-informed policies on order to lessen the current socioeconomic inequity in SRH.
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Affiliation(s)
- Mohammad Bazyar
- Department of Health Management and Economics, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Hojatollah Kakaei
- Department of Occupational Health, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Mohsen Jalilian
- Department of Public Health, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Amin Mirzaei
- Department of Public Health, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Pakzad
- Health and Environment Research Center, Ilam University of Medical Sciences, Ilam, Iran.
- Psychosocial Injuries Research Center, Ilam University of medical Sciences, Ilam, Iran.
- Department of Epidemiology, Faculty of Health, Ilam University of Medical Sciences, Banganjab, Pajouhesh Blvd, Ilam, Iran.
- Student Research Committee, Ilam University Medical Sciences, Ilam, Iran.
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3
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Dong X, Chen L, Liu Y, Zhao L, Wang W. Effects of pocket money on weight status among junior high school students: A longitudinal study in China. Medicine (Baltimore) 2023; 102:e34513. [PMID: 37832134 PMCID: PMC10578662 DOI: 10.1097/md.0000000000034513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/05/2023] [Indexed: 10/15/2023] Open
Abstract
Overweight and obesity among adolescents has become a common public health problem, and both obesity rates and the amount of pocket money among adolescents in China are rising. We investigated to what extent the increase in pocket money could lead to weight gain of junior high school students and how this association may vary by school environment in China. Researchers utilized 3 waves of data from the China Education Panel Survey, a national longitudinal study, to investigate the likelihood of overweight and obesity. The Generalized Estimation Equation was employed to analyze the data. Three Generalized Estimation Equation models were constructed to explore the relationship between pocket money and overweight and obesity in 2 distinct food environments surrounding schools. A total of 8903 individuals (4604 boys and 4299 girls) from the China Education Panel Survey were analyzed. After adjusting for confounding factors, it was found that girls who received 20 to 49 yuan and ≥ 50 yuan per week had a higher risk of overweight and obesity compared to those who received 0 to 9 yuan per week (OR = 1.34, 95% CI: 1.07-1.69, OR = 1.53, 95% CI: 1.22-1.92). However, no significant association was observed between pocket money and overweight and obesity when food around the school was not easily accessible. The prevalence of overweight among Chinese teenagers has steadily increased from Wave1 to Wave3. Moreover, junior high school girls who receive more pocket money are at a greater risk of developing obesity and overweight issues.
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Affiliation(s)
- Xiaoyang Dong
- Emergency Office of West China Hospital, Sichuan University, Chengdu, China
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Libin Chen
- Department of Child Health Care, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, Chengdu, China
| | - Yi Liu
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Li Zhao
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Weidong Wang
- National Survey Research Center National Survey Research Center at Renmin University of China, NSRC, Renmin University of China, Beijing, China
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Pająk A, Polak M, Kozela M, Doryńska A, Bobak M. Trajectories in physical functioning at older age in relation to childhood and adulthood SES and social mobility: a population-based cohort study. Front Public Health 2023; 11:1228920. [PMID: 37744505 PMCID: PMC10513394 DOI: 10.3389/fpubh.2023.1228920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Older age is associated with the deterioration of physical functioning (PF), and low PF is strongly related to poor quality of life among older people. We conducted a study to examine the trajectories of PF between middle and old age, considering sex differences as well as the association between socioeconomic status (SES) at different life stages and changes in PF. Methods We analyzed data from the Polish arm of the HAPIEE (Health, Alcohol and Psychosocial factors In Eastern Europe) study, including 1,116 men and 1,178 women aged 45-64 years at baseline. Adult and childhood SES and social mobility were assessed using a retrospectively focused questionnaire. PF was assessed using the 10-question SF-36 scale at baseline examination, face-to-face re-examination, and three postal surveys, covering up to 20 years (on average, 18 years). We employed Generalized Estimating Equations models to assess changes in PF scores over time and compare PF trajectories across different SES categories. Results After adjusting for age and other covariates, we found that, in both sexes, participants with always middle or high SES, as well as those who reported upward mobility, had higher PF scores at baseline compared to those with always low SES. A decline in PF between middle and old age was observed in all SES groups; however, the decline was slower in participants with always middle or high SES compared to those with always low SES. Conclusion This cohort study revealed that lower SES and downward social mobility were cross-sectionally associated with poorer PF, while upward social mobility seemed to largely reverse the effect of low childhood SES. In addition to the cross-sectional associations observed at baseline, advantaged SES was also significantly associated with a slower decline in PF over an 18-year follow-up period.
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Affiliation(s)
- Andrzej Pająk
- Department of Epidemiology and Population Studies, Faculty of Health Sciences, Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland
| | - Maciej Polak
- Department of Epidemiology and Population Studies, Faculty of Health Sciences, Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland
| | - Magdalena Kozela
- Department of Epidemiology and Population Studies, Faculty of Health Sciences, Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland
| | - Agnieszka Doryńska
- Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, National Institute of Cardiology, Warsaw, Poland
| | - Martin Bobak
- Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, Brno, Czechia
- Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
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Alves J, Perelman J, Ramos E, Kunst AE. The emergence of socioeconomic inequalities in smoking during adolescence and early adulthood. BMC Public Health 2023; 23:1382. [PMID: 37464370 DOI: 10.1186/s12889-023-16182-w] [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: 01/26/2023] [Accepted: 06/23/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND While it is known that educational inequalities in smoking start during early and middle adolescence, it is unknown how they further develop until adulthood. The aim of this article is to map, in the Portuguese context, how educational inequalities in smoking emerge from pre-adolescence until young adulthood. METHODS This study used longitudinal data from the EPITeen Cohort, which recruited adolescents enrolled in schools in Porto, Portugal. We included the 1,038 participants followed at ages 13 (2003/2004), 17, 21, and 24 years. We computed the odds ratio (OR) for the prevalence of smoking states (never smoking, experimenter, less-than-daily, daily and former smoker) and the incidence of transitions between these states, as function of age and education, stratified by sex. We also added interaction terms between age and education. RESULTS Educational inequalities in daily smoking prevalence, with higher prevalence among those with lower educational level, emerged at 17 years old and persisted until higher ages. They were formed in a cumulative way by the increased risk of experimenting between 13 and 17 years, and increased risk of becoming daily smoker between 17 and 21 years. The incidence of smoking cessation was higher among the higher educated. Inequalities were formed similarly for women and men, but with lower level and showed no significance among women. CONCLUSIONS These results highlight that actions to prevent smoking should also take in account the potential impact in smoking inequalities, and should focus not only on middle adolescence but also on late adolescence and early adulthood.
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Affiliation(s)
- Joana Alves
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Avenida Padre Cruz, Lisbon, 1600-560, Portugal.
| | - Julian Perelman
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Avenida Padre Cruz, Lisbon, 1600-560, Portugal
| | - Elisabete Ramos
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, Porto, 4200-319, Portugal
- EPIUnit - Institute of Public Health, University of Porto, Rua das Taipas 135, Porto, 4050-091, Portugal
| | - Anton E Kunst
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
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Kuipers MAG, Kang K, Dragomir AD, Monshouwer K, Benedetti E, Lombardi G, Luta G, Kunst AE. A Novel Methodological Approach to Measure Linear Trends in Health Inequalities: Proof of Concept With Adolescent Smoking in Europe. Am J Epidemiol 2023; 192:963-971. [PMID: 36745706 PMCID: PMC10516356 DOI: 10.1093/aje/kwad029] [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: 11/16/2021] [Revised: 11/23/2022] [Accepted: 02/02/2023] [Indexed: 02/08/2023] Open
Abstract
We describe a new method for presenting and interpreting linear trends in health inequalities, and present a proof-of-concept analysis of inequalities in smoking among adolescents in Europe. We estimated the regression line of the assumed linear relationship between smoking prevalence in low- and high-socioeconomic status (SES) youth over time. Using simulation, we constructed a 95% confidence interval (CI) for the smoking prevalence in low-SES youth for when this would be 0% in high-SES youth, and we calculated the likelihood of eradicating smoking inequality (<5% for both low and high SES). This method was applied to data on adolescents aged 15-16 years (n = 250,326) from 23 European countries, derived from the 2003-2015 European Survey Project on Alcohol and Other Drugs. Smoking prevalence decreased more slowly among low- than among high-SES adolescents. The estimated smoking prevalence was 9.4% (95% CI: 6.1, 12.7) for boys and 5.4% (95% CI: 1.4, 9.2) for girls with low SES when 0% with high SES. The likelihood of eradicating smoking inequality was <1% for boys and 37% for girls. We conclude that this novel methodological approach to trends in health inequalities is feasible in practice. Applying it to trends in smoking inequalities among adolescents in Europe, we found that Europe is currently not on track to eradicate youth smoking across SES groups.
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Affiliation(s)
- Mirte A G Kuipers
- Correspondence to Dr. Mirte A. G. Kuipers, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, the Netherlands (e-mail: )
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Møller M, Kjær SK, Lindquist S, Brown Frandsen CL, Albieri V, Viuff JH, Nøhr B, Olsen A, Jensen A. Risk of colorectal cancer after use of fertility drugs-results from a large Danish population-based cohort of women with infertility. Fertil Steril 2022; 118:738-747. [PMID: 36041966 DOI: 10.1016/j.fertnstert.2022.06.029] [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: 01/26/2022] [Revised: 06/15/2022] [Accepted: 06/21/2022] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To study the association between use of fertility drugs and colorectal cancer among women with infertility. DESIGN Population-based cohort study. SETTING Not applicable. PATIENT(S) The study cohort was obtained from the Danish Infertility Cohort and consisted of all women with infertility aged 20-45 years living in Denmark during 1995-2017. INTERVENTION(S) Information on the use of specific types of fertility drugs, colorectal cancer diagnoses, covariates, and vital status were obtained from the Danish Infertility Cohort and Danish national registers. MAIN OUTCOME MEASURE(S) Cox proportional hazard models adjusted for potential confounders were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for colorectal cancer overall and rectal and colon cancer separately. RESULTS(S) Among 148,036 women in the final study cohort, 205 women were diagnosed with colorectal cancer. Ever use of clomiphene citrate (CC) was associated with a lower rate of colorectal cancer (unadjusted HR, 0.67; 95% CI, 0.51-0.89; adjusted HR, 0.68; 95% CI, 0.50-0.93). However, the lower rate was only seen among women who first used CC >8 years ago (unadjusted HR, 0.56; 95% CI, 0.41-0.76; adjusted HR, 0.52; 95% CI, 0.36-0.75). No marked associations were found between the use of any of other types of fertility drugs and colorectal cancer. The results for colon and rectal cancer analyzed separately were similar, except for a suggestion of a decreased risk of rectal cancer associated with the use of gonadotropins (adjusted HR, 0.46; 95% CI, 0.20-1.08). CONCLUSION(S) Among women with infertility, the use of most types of fertility drugs was not associated with colorectal cancer. However, CC may decrease the risk of colorectal cancer and gonadotropins might decrease the risk of rectal cancer, but we cannot rule out that these findings may be more related to the underlying conditions in these women or are chance findings. Consequently, the results from this study should be investigated further in large epidemiological studies.
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Affiliation(s)
- Maria Møller
- Lifestyle, Reproduction and Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Susanne K Kjær
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Sofie Lindquist
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | | | - Vanna Albieri
- Statistics and Data Analysis, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Jakob Hansen Viuff
- Diet, Cancer and Health, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Bugge Nøhr
- The Fertility Clinic, Department of Obstetrics and Gynecology, Copenhagen University Hospital Herlev, Herlev, Denmark
| | - Anja Olsen
- Nutrition and Biomarkers, Danish Cancer Society Reseach Center, Copenhagen, Denmark; Institute of Public Health, Aarhus University, Aarhus, Denmark
| | - Allan Jensen
- Lifestyle, Reproduction and Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark.
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Belardinelli P, Torbica A, Fattore G. Longitudinal associations between different measures of socioeconomic status and health behavior among adolescents. Data from a wealthy Italian region. Prev Med 2022; 160:107092. [PMID: 35594925 DOI: 10.1016/j.ypmed.2022.107092] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 04/29/2022] [Accepted: 05/13/2022] [Indexed: 11/26/2022]
Abstract
We investigate the association between socio-economic status and unhealthy behaviors among adolescents. By using different measures of socio-economic status, we capture both subjective aspects, as operationalized by perceived family affluence, and objective aspects, such as parents' educational levels and family affluence scale. We use data from a sample of 11,623 adolescents who participated in the Health Behavior in School-aged Children (HBSC) study in 2007, 2010, and 2014 in the Lombardy region of Italy. Results show that all of our measures of socio-economic status are correlated with unhealthy behaviors among adolescents. In particular, perceiving a family affluence below average is significantly correlated with a higher probability of reporting all of the unhealthy behaviors included in our analysis. Having at least one parent with university education significantly decreases the odds of being obese or overweight, having an unbalance diet, being physically inactive, and reporting sedentary behaviors. However, adolescents with at least one university educated parent are more likely to make use of cannabis. When controlling for all of our SES measures simultaneously, we find that family affluence scale is no longer significant in determining adolescents' behaviors. Our findings suggest that, when focusing on health inequalities among adolescents, self-perceptions and non-material dimensions of SES have more explanatory power than its material dimensions.
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Affiliation(s)
- Paolo Belardinelli
- London School of Economics, Department of Government, Houghton Street, London WC2A 2AE, United Kingdom.
| | - Aleksandra Torbica
- Bocconi University, Department of Social and Political Sciences, Centre for Research on Health and Social Care Management-CERGAS, Via Roentgen 1, Milan 20136, Italy.
| | - Giovanni Fattore
- Bocconi University, Department of Social and Political Sciences, Centre for Research on Health and Social Care Management-CERGAS, Via Roentgen 1, Milan 20136, Italy.
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Zijp A, van Deelen TRD, van den Putte B, Kunst AE, Kuipers MAG. Educational inequalities in exposure to tobacco promotion at the point of sale among adolescents in four Dutch cities. Health Place 2022; 76:102824. [PMID: 35660750 DOI: 10.1016/j.healthplace.2022.102824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 04/29/2022] [Accepted: 05/12/2022] [Indexed: 11/30/2022]
Abstract
This study aimed to assess educational differences in adolescents' exposure to tobacco outlets. Data were collected among 312 13-17-year-old non-smoking secondary school students in four Dutch cities. In a smartphone app, exposure (≤10 m from outlet) was measured using GPS and participants reported their educational track (pre-vocational vs. pre-university). Associations were estimated in negative binomial regression models. Mean exposure to tobacco outlet was 16.6 times in 14 days. Pre-vocational education was associated with higher exposure compared to pre-university education (IRR:1.46, 95%CI:1.08-1.98), especially around school (IRR:2.61,95%CI:1.50-4.55). These differences may contribute to socioeconomic inequalities in smoking.
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Affiliation(s)
- Anne Zijp
- Department of Public and Occupational Health, Amsterdam UMC-University of Amsterdam, Meibergdreef 15, 1105, AZ, Amsterdam, the Netherlands.
| | - Tessa R D van Deelen
- Department of Public and Occupational Health, Amsterdam UMC-University of Amsterdam, Meibergdreef 15, 1105, AZ, Amsterdam, the Netherlands
| | - Bas van den Putte
- Amsterdam School of Communication Research, University of Amsterdam, Nieuwe Achtergracht 166, 1018, WV, Amsterdam, the Netherlands
| | - Anton E Kunst
- Department of Public and Occupational Health, Amsterdam UMC-University of Amsterdam, Meibergdreef 15, 1105, AZ, Amsterdam, the Netherlands
| | - Mirte A G Kuipers
- Department of Public and Occupational Health, Amsterdam UMC-University of Amsterdam, Meibergdreef 15, 1105, AZ, Amsterdam, the Netherlands
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10
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Zou X, Wang R, Yang Z, Wang Q, Fu W, Huo Z, Ge F, Zhong R, Jiang Y, Li J, Xiong S, Hong W, Liang W. Family Socioeconomic Position and Lung Cancer Risk: A Meta-Analysis and a Mendelian Randomization Study. Front Public Health 2022; 10:780538. [PMID: 35734761 PMCID: PMC9207765 DOI: 10.3389/fpubh.2022.780538] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundFamily socioeconomic position (SEP) in childhood is an important factor to predict some chronic diseases. However, the association between family SEP in childhood and the risk of lung cancer is not clear.MethodsA systematic search was performed to explore their relationship. We selected education level, socioeconomic positions of parents and childhood housing conditions to represent an individual family SEP. Hazard ratios (HRs) of lung cancer specific-mortality were synthesized using a random effects model. Two-sample Mendelian randomization (MR) was carried out with summary data from published genome-wide association studies of SEP to assess the possible causal relationship of SEP and risk of lung cancer.ResultsThrough meta-analysis of 13 studies, we observed that to compared with the better SEP, the poorer SEP in the childhood was associated with the increased lung cancer risk in the adulthood (HR: 1.25, 95% CI: 1.10 to 1.43). In addition, the dose-response analysis revealed a positive correlation between the poorer SEP and increased lung cancer risk. Same conclusion was reached in MR [(education level) OR 0.50, 95% CI: 0.39 to 0.63; P < 0.001].ConclusionThis study indicates that poor family socioeconomic position in childhood is causally correlated with lung cancer risk in adulthood.Systematic Review Registrationidentifier: 159082.
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Affiliation(s)
- Xusen Zou
- South China University of Technology, School of Public Administration, Guangzhou, China
| | - Runchen Wang
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Nanshan School, Guangzhou Medical University, Guangzhou, China
| | - Zhao Yang
- Peking University First Hospital, Beijing, China
| | - Qixia Wang
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Nanshan School, Guangzhou Medical University, Guangzhou, China
| | - Wenhai Fu
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- First Clinical School, Guangzhou Medical University, Guangzhou, China
| | - Zhenyu Huo
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Nanshan School, Guangzhou Medical University, Guangzhou, China
| | - Fan Ge
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- First Clinical School, Guangzhou Medical University, Guangzhou, China
| | - Ran Zhong
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yu Jiang
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Nanshan School, Guangzhou Medical University, Guangzhou, China
| | - Jiangfu Li
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shan Xiong
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wen Hong
- South China University of Technology, School of Public Administration, Guangzhou, China
- Wen Hong
| | - Wenhua Liang
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- *Correspondence: Wenhua Liang
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El-Amin S, Kinnunen JM, Rimpelä A. Adolescents' Perceptions of Harmfulness of Tobacco and Tobacco-like Products in Finland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1485. [PMID: 35162508 PMCID: PMC8834861 DOI: 10.3390/ijerph19031485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 12/05/2022]
Abstract
During the recent years, new tobacco and tobacco-like products, e.g., e-cigarettes, have emerged on the market. Adolescents often underestimate health risks in general, including those concerning tobacco. Little is known of adolescents' perceptions of health risks of the newer products. Our paper compares adolescents' perceptions of harmfulness of cigarettes, e-cigarettes, snus, water pipes, and nicotine in Finland, a country with a long history of strict tobacco control policy. Online surveys to nationally representative samples of 12-18-year-olds were conducted in 2017 and 2019, with 7578 answering the surveys. Only 3% of boys and 2% of girls did not agree that cigarettes are harmful to health. The percentages were slightly higher for snus (6% and 3%, respectively) and nicotine (12%, 8%) but much higher for e-cigarettes (30%, 22%) and water pipes (36%, 38%). Those who used the product, whose parents were smokers or had lower education, and whose school performance was lower, less often agreed with the harmful health effects of the products. Our results showed that adolescents understood the harmfulness of older tobacco products better than the harmfulness of the newer ones. Our results also showed the need to strengthen health education and fix adolescents' misperceptions of the health effects of the newer products.
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Affiliation(s)
- Salma El-Amin
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, 33014 Tampere, Finland; (S.E.-A.); (A.R.)
| | - Jaana M. Kinnunen
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, 33014 Tampere, Finland; (S.E.-A.); (A.R.)
| | - Arja Rimpelä
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, 33014 Tampere, Finland; (S.E.-A.); (A.R.)
- Department of Adolescent Psychiatry, Tampere University Hospital, P.O. Box 2000, 33521 Tampere, Finland
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12
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Kinnunen JM, Paakkari L, Rimpelä AH, Kulmala M, Richter M, Kuipers MAG, Kunst AE, Lindfors PL. The role of health literacy in the association between academic performance and substance use. Eur J Public Health 2022; 32:182-187. [PMID: 34986239 PMCID: PMC8975541 DOI: 10.1093/eurpub/ckab213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND To address social inequalities in adolescent substance use and consequent disparities in health, it is important to identify the mechanisms of the association between substance use and academic performance. We study the role of health literacy (HL) in the association between academic performance and weekly smoking, monthly alcohol use and cannabis ever-use among adolescents in Europe. METHODS SILNE-R school survey data, which was collected in 2016-17 with paper-and-pencil-method from Hanover (GE), Amersfoort (NL) and Tampere (FI), were used (N = 5088, age 13-19). Health Literacy for School-aged Children instrument was used to assess students' HL. Logistic regression analyzed the association of substance use with academic performance and HL, separately and in the same model. Linear and multinomial logistic regression analyzed the association between academic performance and HL. RESULTS Poor academic performance compared with high was associated with smoking [odds ratio (OR) 3.94, 95% confidence interval (CI) 2.83-5.49], alcohol use (OR: 2.94, 95% CI: 2.34-3.68) and cannabis use (OR: 2.56, 95% CI: 1.89-3.48). Poor HL was also associated with each substance use (with ORs of 2.32, 1.85 and 1.29). HL was positively associated with academic performance (β = 1.04, 95% CI: 0.89-1.20). The associations between academic performance and substance use were only slightly attenuated after controlling for HL. CONCLUSIONS Academic performance and HL were both determinants of substance use, confirming their role in tackling the disparities in substance use. However, HL did not demonstrably mediate the association between academic performance and substance use. A wider set of factors needs to be tackled to address emerging social inequalities in adolescent substance use.
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Affiliation(s)
- Jaana M Kinnunen
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Leena Paakkari
- Research Centre for Health Promotion, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Arja H Rimpelä
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland.,Department of Adolescent Psychiatry, Pitkäniemi Hospital, Nokia, Tampere University Hospital, Tampere, Finland
| | - Markus Kulmala
- Research Centre for Health Promotion, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Matthias Richter
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Mirte A G Kuipers
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Anton E Kunst
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Pirjo L Lindfors
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
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13
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Understanding Socioeconomic Status and Adolescent Behavioral health-Time to Move Beyond Simplistic Measures and Cross-sectional Data. J Adolesc Health 2021; 69:685-686. [PMID: 34688453 DOI: 10.1016/j.jadohealth.2021.08.017] [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: 08/16/2021] [Accepted: 08/18/2021] [Indexed: 11/24/2022]
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14
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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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15
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Okamoto S. Parental socioeconomic status and adolescent health in Japan. Sci Rep 2021; 11:12089. [PMID: 34103647 PMCID: PMC8187727 DOI: 10.1038/s41598-021-91715-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 05/28/2021] [Indexed: 12/02/2022] Open
Abstract
There is no consensus on which parental socioeconomic indicators should be used to define adolescents’ socioeconomic status (SES). Utilising the data for 3154 parent-adolescent pairs obtained from the sample of the Survey of Lifestyle Value of Parents and Children 2011 conducted by the Cabinet Office in Japan, the associations between adolescent’s subjective economic status, parental SES (i.e. education, occupation, and household income), and child health-related outcomes (i.e. self-rated health, dietary and oral health behaviours) were analysed using multilevel mixed-effects ordered logistic regression to investigate heterogeneity in these relationships across SES indicators and health outcome measures. Results demonstrated that income was the strongest predictor of adolescent health outcomes, suggesting that adolescents in the middle- or high-income groups tended to report better health status compared to the low-income group, have a higher frequency of having breakfast, and more likely to regularly brush their teeth by 24% (OR 1.24, 95% CI [1.06–1.46]) to 66% (OR 1.66, 95% CI [1.30–2.12]). Parental education was also related to child health-related behaviours, with higher levels of habitual healthy behaviours being observed in the middle- and high-education groups than in the low-education group by 15% (OR 1.15, 95% CI [1.01–1.32]) to 63% (OR 1.63, 95% CI [1.31–2.03]). Future studies regarding health disparities among children/adolescents should carefully choose an SES indicator, taking multiple pathways between each SES indicator and health/health behaviours into consideration.
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Affiliation(s)
- Shohei Okamoto
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, Japan. .,Institute for Global Health Policy Research, National Centre for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, Japan.
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16
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Falese L, Federico B, Kunst AE, Perelman J, Richter M, Rimpelä A, Lorant V. The association between socioeconomic position and vigorous physical activity among adolescents: a cross-sectional study in six European cities. BMC Public Health 2021; 21:866. [PMID: 33952232 PMCID: PMC8097935 DOI: 10.1186/s12889-021-10791-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 04/05/2021] [Indexed: 11/30/2022] Open
Abstract
Background The relationship between socioeconomic position (SEP) and adolescent physical activity is uncertain, as most evidence is limited to specific settings and a restricted number of SEP indicators. This study aimed to assess the magnitude of socioeconomic differences in adolescent vigorous physical activity (VPA) across various European countries using a wide range of SEP indicators, including family-based (education, family affluence, perceived social standing, parents’ employment, housing tenure) and adolescent-based (academic performance and pocket money) ones. Methods We used data from a survey among 10,510 students aged 14–17 from 50 schools in six European cities: Namur (BE), Tampere (FI), Hannover (DE), Latina (IT), Amersfoort (NL), Coimbra (PT). The questionnaire included socio-demographic characteristics and the amount of time spent in VPA. Results The mean time spent practicing VPA was 60.4 min per day, with lower values for Namur (BE) and Latina (IT), and higher values for Amersfoort (NL). In the multivariable analysis, both categories of SEP indicators (family-based and adolescent based indicators) were independently associated with VPA. For each SEP indicator, lower levels of VPA were recorded in lower socioeconomic groups. In the total sample, each additional category of low SEP was associated with a decrease in mean VPA of about 4 min per day. Conclusions This study showed that across European cities adolescent VPA is positively related to both family-based SEP and adolescents’ own SEP. When analysing socioeconomic differences in adolescent VPA, one should consider the use of multiple indicators of SEP. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10791-z.
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Affiliation(s)
- L Falese
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, via S. Angelo (Folcara), 03043, Cassino, FR, Italy.
| | - B Federico
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, via S. Angelo (Folcara), 03043, Cassino, FR, Italy
| | - A E Kunst
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - J Perelman
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - M Richter
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - A Rimpelä
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland.,Department of Adolescent Psychiatry, Tampere University Hospital, Nokia, Finland
| | - V Lorant
- Institute of Health and Society, Université Catholique de Louvain, Bruxelles, Belgium
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17
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Davison J, Stewart-Knox B, Connolly P, Lloyd K, Dunne L, Bunting B. Exploring the association between mental wellbeing, health-related quality of life, family affluence and food choice in adolescents. Appetite 2020; 158:105020. [PMID: 33171225 DOI: 10.1016/j.appet.2020.105020] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 09/24/2020] [Accepted: 11/03/2020] [Indexed: 10/23/2022]
Abstract
Young people choose energy-dense, nutrient-poor diets, yet understanding of potential determinants is limited. Associations between food choices, mental wellbeing, health-related quality of life (HRQoL) and family affluence were explored to identify targets for intervention to promote dietary health and wellbeing in young people. Adolescents were recruited via post-primary schools in the UK and surveyed at two time-points when aged 13-14 years and 15-16 years. The questionnaire enquired about mental wellbeing using the Short Warwick-Edinburgh Mental Wellbeing Scale, HRQoL using the KIDSCREEN-10, socio-economic status using the Family Affluence Scale and food choice by Food Frequency Questionnaire (FFQ). With missing and anomalous cases excluded, the sample comprised 1208 cases. Factor analysis on the FFQ indicated five food choice factors: 'Junk Food'; 'Meat'; 'Healthy Protein'; 'Fruit/Vegetables'; 'Bread/Dairy'. Multivariate regression analysis indicated that frequent consumption of Junk Food was associated with being male and lower mental wellbeing. Frequent Meat intake was associated with being male and with lower HRQoL. Frequent choice of Bread/Dairy foods was more common among males and associated with higher wellbeing and greater affluence. Those who consumed Fruit/Vegetables frequently were more likely to be female, have higher HRQoL, higher mental wellbeing, and greater family affluence. These direct associations endured between time points. The dietary factors were not mutually exclusive. Those who frequently chose Junk Food were less likely to choose Fruit/Vegetables. Frequent choice of Meat was associated with more frequent choice of Junk Food and Healthy Protein. Intervention to improve dietary and psychological health in young people should target males, those in less affluent households, seek to reduce consumption of 'junk' food, and increase fruit and vegetable intake.
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Affiliation(s)
- Jenny Davison
- Psychology Research Institute, Ulster University, Cromore Road, Coleraine, Northern Ireland, BT52 1SA, UK.
| | - Barbara Stewart-Knox
- Division of Psychology, University of Bradford, Bradford, West Yorkshire, BD7 1DP, UK
| | - Paul Connolly
- Faculty of Arts and Social Sciences, Lancaster University, FASS Building, Lancaster, LA1 4YL, UK
| | - Katrina Lloyd
- Centre for Evidence and Social Innovation, Queens University Belfast, University Road, Belfast, Northern Ireland, BT7 1NN, UK
| | - Laura Dunne
- Centre for Evidence and Social Innovation, Queens University Belfast, University Road, Belfast, Northern Ireland, BT7 1NN, UK
| | - Brendan Bunting
- Psychology Research Institute, Ulster University, Cromore Road, Coleraine, Northern Ireland, BT52 1SA, UK
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18
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Piola TS, PacÍfico AB, Campos JG, Ribeiro AG, Bacil ED, Silva MP, Campos W. Cell phone use is associated with alcohol and tobacco consumption in insufficiently active adolescents. J Sports Med Phys Fitness 2020; 61:444-451. [PMID: 33092329 DOI: 10.23736/s0022-4707.20.11356-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this study was to estimate the prevalence of alcohol and tobacco experimentation by adolescents and to verify the association between cell phone use with alcohol and tobacco consumption in adolescents with different physical activity levels. METHODS This work is a cross-sectional study with a representative sample of 772 adolescents (52.6% girls; age: 16.63±0.70 years old). Self-reported questionnaires were assessed to verify the cell phone use, physical activity level, alcohol and tobacco consumption. Logistic regressions tested the associations obtaining odds ratios with 95% confidence intervals. RESULTS Alcohol and tobacco consumption prevalence reached 43.4% and 7.8% of adolescents, respectively. Insufficiently active adolescents who reported using cell phones more than and 2 hours a day were more likely to use alcohol (OR: 1.58; 95% CI: 1.14 - 2.19) and tobacco (OR: 2.46; 95% CI: 1.23 - 4.96). CONCLUSIONS We found a high prevalence of cell phone use and a worrying prevalence of alcohol and tobacco consumption by adolescents. The use of the cell phone for more than two hours a day seemed to be a risk factor for alcohol and tobacco consumption in insufficiently active adolescents.
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Affiliation(s)
- Thiago S Piola
- Research Center on Physical Activity and Health, Department of Physical Education, Federal University of Parana, Curitiba, Brazil -
| | - Ana B PacÍfico
- Research Center on Physical Activity and Health, Department of Physical Education, Federal University of Parana, Curitiba, Brazil
| | - Jhonatan G Campos
- Research Center on Physical Activity and Health, Department of Physical Education, Federal University of Parana, Curitiba, Brazil
| | - Anelize G Ribeiro
- Research Center on Physical Activity and Health, Department of Physical Education, Federal University of Parana, Curitiba, Brazil
| | - Eliane D Bacil
- Research Center on Physical Activity and Health, Department of Physical Education, Federal University of Parana, Curitiba, Brazil
| | - Michael P Silva
- School of Medicine, Federal University of Rio Grande, Rio Grande, Brazil
| | - Wagner Campos
- Research Center on Physical Activity and Health, Department of Physical Education, Federal University of Parana, Curitiba, Brazil
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Leal-López E, Moreno-Maldonado C, Inchley J, Deforche B, Van Havere T, Van Damme J, Buijs T, Sánchez-Queija I, Currie D, Vieno A, De Clercq B. Association of alcohol control policies with adolescent alcohol consumption and with social inequality in adolescent alcohol consumption: A multilevel study in 33 countries and regions. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 84:102854. [PMID: 32717703 PMCID: PMC7762782 DOI: 10.1016/j.drugpo.2020.102854] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/28/2020] [Accepted: 07/03/2020] [Indexed: 10/26/2022]
Abstract
Background Previous research found inconsistent associations between alcohol control policies and socioeconomic inequality with adolescent drinking outcomes. This study expands the focus beyond individual associations to examine whether a combination of policies is related to socioeconomic inequality in adolescent drinking outcomes and whether this relationship varies across survey years. Methods Multilevel modelling of 4 waves of repeat cross-sectional survey data (2001/02, 2005/06, 2009/10, and 2013/14) from the Health Behaviour in School-aged Children (HBSC) study was carried out. The sample was composed of 671,084 adolescents (51% girls) aged 11, 13, and 15 (mean age=13.58; SD=1.65) from 33 European and North American countries/regions. The dependent variables were lifetime alcohol consumption, weekly alcohol consumption, and lifetime drunkenness. Independent variables were of three types: individual-level variables (age, sex, Family Affluence Scale, and the Perceived Family Wealth), time-level variable (survey year), and context-level variables (minimum legal drinking age, physical availability, advertising restrictions, a total alcohol policy index, and affordability of alcohol). Results The total alcohol policy index showed a negative relationship with both lifetime and weekly consumption. Higher affordability of alcohol was related to higher lifetime and weekly consumption and higher lifetime drunkenness. Family Affluence Scale was positively related to all three alcohol measures and Perceived Family Wealth was negatively related to lifetime drunkenness, with these associations increasing across survey years. The total alcohol policy index buffered the associations of Family Affluence Scale and Perceived Family Wealth with adolescent drinking outcomes. Conclusion A combination of alcohol control policies is more effective in reducing adolescent drinking outcomes than single policy measures. Reducing the affordability of alcohol stood out as the most successful single measure. Socioeconomic inequalities (i.e. higher alcohol consumption and drunkenness in adolescents with higher family affluence and higher drunkenness in adolescents perceiving their families to be poor) have persisted and even increased across survey years. A combined alcohol control policy can help in tackling them.
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Affiliation(s)
- E Leal-López
- Department of Developmental and Educational Psychology. University of Seville. C/Camilo José Cela, s/n. 41018, Sevilla, Spain.
| | - C Moreno-Maldonado
- Department of Developmental and Educational Psychology. University of Seville. C/Camilo José Cela, s/n. 41018, Sevilla, Spain
| | - J Inchley
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. 200 Renfield St, Glasgow G2 3AX, UK; School of Medicine, University of St Andrews. North Haugh, St Andrews, KY16 9TF, UK
| | - B Deforche
- Department of Public Health and Primary Care, Ghent University. Academical Hospital, 4K3. Corneel Heymanslaan, 10, B-9000 Ghent, Belgium; Physical Activity, Nutrition and Health Research Unit, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium
| | - T Van Havere
- School of Social Welfare, University of Applied Sciences of Ghent. Hoogpoort 15, 9000, Ghent, Belgium
| | - J Van Damme
- Flemish Expertise Centre on Alcohol and other Drugs, Vanderlindenstraat 15, 1030, Brussels, Belgium
| | - T Buijs
- Department of Public Health and Primary Care, Ghent University. Academical Hospital, 4K3. Corneel Heymanslaan, 10, B-9000 Ghent, Belgium
| | - I Sánchez-Queija
- Department of Developmental and Educational Psychology. University of Seville. C/Camilo José Cela, s/n. 41018, Sevilla, Spain
| | - D Currie
- School of Medicine, University of St Andrews. North Haugh, St Andrews, KY16 9TF, UK
| | - A Vieno
- Department of Developmental and Social Psychology, University of Padova. Via Venezia, 8 35131 - Padova, Italy
| | - B De Clercq
- Department of Public Health and Primary Care, Ghent University. Academical Hospital, 4K3. Corneel Heymanslaan, 10, B-9000 Ghent, Belgium
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Navarro-Carrillo G, Alonso-Ferres M, Moya M, Valor-Segura I. Socioeconomic Status and Psychological Well-Being: Revisiting the Role of Subjective Socioeconomic Status. Front Psychol 2020; 11:1303. [PMID: 32587560 PMCID: PMC7298147 DOI: 10.3389/fpsyg.2020.01303] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 05/18/2020] [Indexed: 11/22/2022] Open
Abstract
Socioeconomic status (SES) is a complex and multidimensional construct, encompassing both independent objective characteristics (e.g., income or education) and subjective people's ratings of their placement in the socioeconomic spectrum. Within the growing literature on subjective SES belongingness and psychological well-being, subjective indices of SES have tended to center on the use of pictorial rank-related social ladders where individuals place themselves relative to others by simultaneously considering their income, educational level, and occupation. This approach, albeit consistent with the idea of these social ladders as summative or cognitive SES markers, might potentially constrain individuals' conceptions of their SES. This research (N = 368; M age = 39.67, SD = 13.40) is intended to expand prior investigations on SES and psychological well-being by revisiting the role of subjective SES. In particular, it (a) proposes an innovative adaptation of the traditional MacArthur Scale of subjective SES to income, education, and occupation, thus resulting in three separate social ladders; and (b) tests the empirical contribution of such three social ladders to psychological well-being. Overall, our findings showed that the novel education and occupation ladders (excluding the income ladder) are predictive of a significant part of the variance levels of psychological well-being that is not due to canonical objective metrics of SES (i.e., income, education, and occupation), or to the conventional MacArthur Scale of subjective SES. Although preliminary, these results underscore the need to further reconsider (subjective) SES-related conceptualization and measurement strategies to gather a more comprehensive understanding of the SES-psychological well-being link.
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Affiliation(s)
| | - María Alonso-Ferres
- Department of Social Psychology, Faculty of Psychology, Mind, Brain and Behavior Research Center, University of Granada, Granada, Spain
| | - Miguel Moya
- Department of Social Psychology, Faculty of Psychology, Mind, Brain and Behavior Research Center, University of Granada, Granada, Spain
| | - Inmaculada Valor-Segura
- Department of Social Psychology, Faculty of Psychology, Mind, Brain and Behavior Research Center, University of Granada, Granada, Spain
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Abstract
PURPOSE OF REVIEW This review presents findings from recent studies investigating the role of socioeconomic status (SES) in child development. Studies on associations between SES and different parameters of physical and psychological health, on interventions and possible resilience factors are reviewed. RECENT FINDINGS Several cross-sectional and longitudinal studies demonstrate social disparities in child behavior and health. They underline the detrimental effects of low SES on child development. Some studies also highlight the potentially adverse effects of early diseases or vulnerabilities on later career and social position. Whereas most studies applied parent-based measures of SES, some studies emphasize the significance of child-based (e.g. perceived social position) and area-level indicators of SES (e.g. area deprivation). With respect to intervention, study findings suggest positive effects of programs aiming to improve specific neighborhood characteristics and psychosocial functioning of individuals. SUMMARY The relation between SES and health is bidirectional and stable, and the effects of interventions aiming at changing behaviors of children and families with low SES are small. There is a need for further center-based and area-level interventions and studies evaluating the effects of these interventions.
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