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Brunet G, Machín L, Fajardo G, Bonilla L, Costa M, González F, Bentancor S, Verdier S, Girona A, Curutchet MR, Pochellú L, Cauci A, Ares G. Coping strategies of food insecure households with children and adolescents in Uruguay, a high-income Latin American country: A qualitative study through the lens of Bourdieu's theories of capitals and practice. Appetite 2024; 198:107383. [PMID: 38685318 DOI: 10.1016/j.appet.2024.107383] [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: 12/23/2023] [Revised: 04/25/2024] [Accepted: 04/26/2024] [Indexed: 05/02/2024]
Abstract
Food insecurity has been associated with negative short, medium, and long-term health consequences, which are more detrimental for children and adolescents. These effects may depend on the coping strategies developed to deal with food shortages. The present research aimed at exploring coping strategies in food insecure households with children and adolescents in Uruguay, incorporating sociological theoretical insights from Bourdieu. A qualitative approach based on individual semi-structured interviews was used. A total of 40 interviews were conducted with adults who had parental responsibilities of children and adolescents and who received different types of food assistance, between July and December 2022, in four cities. Results showed that adults tend to develop a wide range of coping strategies aimed at: reducing food expenditure, increasing the availability of money for purchasing food, increasing food availability and/or rationing the food available in the household. Some of the strategies were implemented regardless of the severity of food insecurity, whereas others were characteristic of the moderate and severe levels of the construct. Evidence to support the mediation effect of coping strategies on health outcomes was found. Discourses suggested that lower accumulation of economic and cultural capital may be aligned with the adoption of less socially accepted mechanisms to access to food. Expressions of a specific habitus aimed at securing food were identified among participants with more deprivations. Taken together, the findings suggest that coping strategies may not be a universal or invariant sequence according to the severity of food insecurity and stress the importance of considering households' resources and local context for the development of strategies to improve access to food.
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Affiliation(s)
- Gerónimo Brunet
- Espacio Interdisciplinario, Universidad de la República, José Enrique Rodó 1843, CP, 11200, Montevideo, Uruguay.
| | - Leandro Machín
- Centro de Investigación Básica en Psicología, Facultad de Psicología, Universidad de la República, Tristán Narvaja 1674, CP, 11200, Montevideo, Uruguay
| | - Gabriela Fajardo
- Escuela de Nutrición, Universidad de la República, Av. Ricaldoni S/N, CP, 11600, Montevideo, Uruguay
| | - Luciana Bonilla
- Instituto Nacional de Alimentación, Ministerio de Desarrollo Social, Piedras 165, CP, 11000, Montevideo, Uruguay
| | - María Costa
- Instituto Nacional de Alimentación, Ministerio de Desarrollo Social, Piedras 165, CP, 11000, Montevideo, Uruguay
| | - Fernanda González
- Instituto Nacional de Alimentación, Ministerio de Desarrollo Social, Piedras 165, CP, 11000, Montevideo, Uruguay
| | - Silvia Bentancor
- Instituto Nacional de Alimentación, Ministerio de Desarrollo Social, Piedras 165, CP, 11000, Montevideo, Uruguay
| | - Sofía Verdier
- Instituto Nacional de Alimentación, Ministerio de Desarrollo Social, Piedras 165, CP, 11000, Montevideo, Uruguay
| | - Alejandra Girona
- Escuela de Nutrición, Universidad de la República, Av. Ricaldoni S/N, CP, 11600, Montevideo, Uruguay
| | - María Rosa Curutchet
- Instituto Nacional de Alimentación, Ministerio de Desarrollo Social, Piedras 165, CP, 11000, Montevideo, Uruguay
| | - Lucía Pochellú
- Instituto Nacional de Alimentación, Ministerio de Desarrollo Social, Piedras 165, CP, 11000, Montevideo, Uruguay
| | - Adriana Cauci
- Escuela de Nutrición, Universidad de la República, Av. Ricaldoni S/N, CP, 11600, Montevideo, Uruguay
| | - Gastón Ares
- Centro de Investigación Básica en Psicología, Facultad de Psicología, Universidad de la República, Tristán Narvaja 1674, CP, 11200, Montevideo, Uruguay; Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n, CP, 91000, Pando, Uruguay
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Wagner C, Jackisch J, Ortega N, Chiolero A, Cullati S, Carmeli C. Educational inequalities in multimorbidity at older ages: a multi-generational population-based study. Eur J Public Health 2024:ckae096. [PMID: 38840419 DOI: 10.1093/eurpub/ckae096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Social inequalities in multimorbidity may occur due to familial and/or individual factors and may differ between men and women. Using population-based multi-generational data, this study aimed to (1) assess the roles of parental and individual education in the risk of multimorbidity and (2) examine the potential effect modification by sex. METHODS Data were analysed from 62 060 adults aged 50+ who participated in the Survey of Health, Ageing and Retirement in Europe, comprising 14 European countries. Intergenerational educational trajectories (exposure) were High-High (reference), Low-High, High-Low and Low-Low, corresponding to parental-individual educational attainments. Multimorbidity (outcome) was ascertained between 2013 and 2020 as self-reported occurrence of ≥2 diagnosed chronic conditions. Inequalities were quantified as multimorbidity-free years lost (MFYL) between the ages of 50 and 90 and estimated via differences in the area under the standardized cumulative risk curves. Effect modification by sex was assessed via stratification. RESULTS Low individual education was associated with higher multimorbidity risk regardless of parental education. Compared to the High-High trajectory, Low-High was associated with -0.2 MFYL (95% confidence intervals: -0.5 to 0.1), High-Low with 3.0 (2.4-3.5), and Low-Low with 2.6 (2.3-2.9) MFYL. This pattern was observed for both sexes, with a greater magnitude for women. This effect modification was not observed when only diseases diagnosed independently of healthcare-seeking behaviours were examined. CONCLUSIONS Individual education was the main contributor to intergenerational inequalities in multimorbidity risk among older European adults. These findings support the importance of achieving a high education to mitigate multimorbidity risk.
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Affiliation(s)
- Cornelia Wagner
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
- Swiss School of Public Health (SSPH+), University of Fribourg, Fribourg, Switzerland
| | - Josephine Jackisch
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
- Centre for Health Equity Studies, Stockholm University, Stockholm, Sweden
| | - Natalia Ortega
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Arnaud Chiolero
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
- Swiss School of Public Health (SSPH+), University of Fribourg, Fribourg, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- School of Population and Global Health, McGill University, Montreal, Canada
| | - Stéphane Cullati
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
- Swiss School of Public Health (SSPH+), University of Fribourg, Fribourg, Switzerland
- Quality of Care Service, University Hospitals of Geneva, Geneva, Switzerland
| | - Cristian Carmeli
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
- Swiss School of Public Health (SSPH+), University of Fribourg, Fribourg, Switzerland
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Fleary SA, Joseph PL. Health literacy and health behaviors in parent-adolescent dyads: an actor-partner interdependence model approach. Psychol Health 2024; 39:803-822. [PMID: 36047615 PMCID: PMC10013691 DOI: 10.1080/08870446.2022.2117809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 07/25/2022] [Accepted: 08/22/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVE Health literacy (HL), skills for accessing, appraising and using health information in health decision-making is implicated in adolescents' health behaviors. HL skills develop through scaffolding, modeling, practice and opportunity. Therefore, adolescents' HL skills are likely closely tied to parents' HL and health behaviors. Yet, no studies have examined the dyadic interdependence of the relationship between HL and health behaviors between parents and adolescents. The purpose of this study was to determine the interdependence of adolescents' and parents' HL and health behaviors. METHODS AND MEASURES Data were collected from 300 parent-adolescent dyads via Qualtrics Panel. Dyads completed identical measures of their HL, diet, physical activity, sedentary activity, cigarette-smoking, vaping, and alcohol binge-drinking behaviors. Data were analyzed using Pearson correlations and the Actor-Partner Interdependence Model. RESULTS Within-dyad correlations were significant for HL and all health behaviors assessed. After controlling for covariates and partner effects, adolescents' HL was related to their sugar-sweetened beverage intake, sedentary activity, and substance use. After controlling for covariates and actor effects, adolescents' HL was related to parents' sedentary activity, binge-drinking, and vaping while parents' HL was related to adolescents' sedentary activity. CONCLUSION Our results suggest that there is interdependence in these relationships especially for risk behaviors.
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Affiliation(s)
- Sasha A Fleary
- Department of Community Health and Social Sciences, City University of New York Graduate School of Public Health and Health Policy, New York, NY, USA
| | - Patrece L Joseph
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
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Amaro E, Rodriguez J, Jackson D, Popovich D, Frias KM, Castañeda E. The Impact of Cultural Health Capital on Market Choice Along the Texas-Mexico Border. J Racial Ethn Health Disparities 2024; 11:1139-1151. [PMID: 37278954 DOI: 10.1007/s40615-023-01593-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/15/2023] [Accepted: 03/31/2023] [Indexed: 06/07/2023]
Abstract
Transnational cultural health capital (CHC) includes individual resources such as skills and behaviors patients use to manage healthcare exclusion and negotiate care. This study examines the impact of CHC on decisions by Hispanic people who live in El Paso, Texas, to utilize one or more markets for healthcare. We expand on the current literature and present novel findings by quantifying several aspects of CHC that may contribute to cross-border health-seeking behaviors in this vulnerable group which tends to suffer various health disparities and limited access to health insurance. Results support the hypotheses related to how the various cultural, social, and economic resources that comprise CHC affect market choices. This research has significant implications for understanding how border residents may mitigate a lack of accessibility and affordability for healthcare, developing transnational health policy, and aiding healthcare providers to understand their patients' choice(s) of healthcare markets.
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Qi Y, Reijneveld SA, Almansa J, Brouwer S, Vrooman JC. Diverging death risks: Mortality as a corollary of economic, social, cultural and person capital. SSM Popul Health 2024; 25:101644. [PMID: 38486801 PMCID: PMC10937154 DOI: 10.1016/j.ssmph.2024.101644] [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: 10/11/2023] [Revised: 02/21/2024] [Accepted: 02/22/2024] [Indexed: 03/17/2024] Open
Abstract
Introduction Diverging death risks are associated with a wide range of social factors, including not only education and income but also other economic and non-economic resources. The aim of this study was to assess the association of mortality risks with four types of resources: economic, social, cultural and person capital. Methods We used data of 2,952 participants from the Disparities in the Netherlands survey and annual mortality data from Statistics Netherlands for the period 2014 to 2021. Economic capital was measured through education, income, occupation, home equity, and liquid assets. Social capital was measured by the strength of social ties, the size of the core discussion network, and access to people in resourceful positions; cultural capital by lifestyle, digital skills, and mastery of English, and person capital by self-rated health, impediments to climbing stairs, self-confidence, self-image, people's appearance, and body mass index. To accommodate the fact that each capital was derived from several indicators, we used Partial Least Squares (PLS) Cox Regression. Results In multiple regression, higher economic, cultural, and person capital were associated with lower mortality (hazard ratio, 0.77; 95% confidence interval [CI, 0.65 to 0.90], 0.77 [0.64-0.93] and 0.80; [0.70-0.92]), adjusted for all capital measures and sex. Conclusion The finding that more economic, cultural and person capital is associated with lower mortality provides empirical support for an approach that uses a broad spectrum of capital measures - hitherto rarely included simultaneously in epidemiological research - in order to understand diverging death risks. By integrating sociological concepts, cohort data, and epidemiological research methods, our study highlights the need for further research on the interplay between different forms of resources in shaping health inequalities. In designing public health interventions, we advocate the adoption of a multidimensional capital-based framework for tackling social disparities in mortality.
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Affiliation(s)
- Yuwei Qi
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Groningen, the Netherlands
| | - Sijmen A. Reijneveld
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Groningen, the Netherlands
| | - Josué Almansa
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Groningen, the Netherlands
| | - Sandra Brouwer
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Groningen, the Netherlands
| | - J. Cok Vrooman
- Utrecht University, Department of Sociology/ICS, Utrecht, the Netherlands
- The Netherlands Institute for Social Research|SCP, the Netherlands
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Jeong CH, Oh H, Palinkas LA, Lusenhop W. Perceptions of Health Insurance Among Self-employed Korean Immigrants From South Korea in the United States. HEALTH EDUCATION & BEHAVIOR 2024; 51:167-175. [PMID: 36495118 DOI: 10.1177/10901981221139169] [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] [Indexed: 01/12/2024]
Abstract
Korean Americans in the United States are more likely than other Asian ethnic groups to lack health insurance despite their high education and economic prosperity. According to the model of health service selection, immigrants' perceptions of the health care system and health care behaviors in their host country are affected by sociocultural referents including premigration health care experience in the country of origin. This study explored Korean immigrants' perceptions of health insurance and their intentions to purchase and maintain health insurance in the United States. We conducted in-depth interviews with 24 self-employed Korean immigrants who migrated from South Korea and were living in the Greater Los Angeles area in 2015. Participants generally had negative perceptions of U.S. health insurance in terms of cost, benefits, simplicity, and accessibility. Coupled with their positive experiences with the single-payer, universal health insurance in South Korea, respondents evaluated U.S. health insurance as not worth purchasing, and indicated they would not maintain health insurance once the individual mandate of the Affordable Care Act was abolished. On the contrary, respondents who immigrated prior to the establishment of the Korean universal health insurance in South Korea were relatively satisfied with U.S. health insurance and had maintained health insurance for substantial periods of time. Korean immigrants' premigration health care experiences appeared to influence their decisions to purchase health insurance in the United States and their intention to maintain health insurance. The study findings highlight the necessity of tailored health education that takes into account sociocultural determinants of health coverage among immigrants.
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Vrooman JC, Boelhouwer J, Gijsberts M. A contemporary class structure: Capital disparities in The Netherlands. PLoS One 2024; 19:e0296443. [PMID: 38295016 PMCID: PMC10830037 DOI: 10.1371/journal.pone.0296443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 12/13/2023] [Indexed: 02/02/2024] Open
Abstract
The academic and public debate on social inequality has recently been fuelled by large disparities in income and wealth, profound changes in the labour market, and other emerging cleavages in post-industrial societies. This article contributes to the discussion by arguing that class divisions are theoretically based on four types of capital: people's economic means, their social capital, their cultural resources, and the combination of their health and attractiveness ('person capital'). From this premise, the social structure of the Netherlands is examined. A dedicated survey was linked to microdata from the national population register, tax authorities and benefit agencies. Using latent class analysis, we assess contingencies in the distribution of the different resources, and identify a structure consisting of six capital groups. The established upper echelon (15.5% of the adult population) has the most capital, followed by the privileged younger people (12.7%), the employed middle echelon (26.9%) and the comfortable retirees (16.6%). Total capital is lowest among the insecure workers (13.5%) and the precariat (14.8%). Each social class has a distinctive mix of the four types of capital, highlighting the need to look beyond economic differences in order to comprehend structural inequality. The results of this study also indicate that resource disparities between classes coincide with other forms of social hierarchy and contrasts by age. Moreover, the contemporary class structure is associated with divergent views and experiences among the Dutch. Classes with little capital tend to rate politics, society, and their own social position more negatively. In addition, they value self-enhancement and hedonism less than today's upper classes and report lower levels of well-being.
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Affiliation(s)
- J. Cok Vrooman
- The Netherlands Institute for Social Research|SCP, The Hague, The Netherlands
| | - Jeroen Boelhouwer
- Department of Sociology, Utrecht University, Utrecht, The Netherlands
| | - Mérove Gijsberts
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
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Cui Y, He Y, Xu X, Zhou L, Nutakor JA, Zhao L. Cultural capital, the digital divide, and the health of older adults: a moderated mediation effect test. BMC Public Health 2024; 24:302. [PMID: 38273305 PMCID: PMC10811880 DOI: 10.1186/s12889-024-17831-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 01/20/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND It is of great practical significance to study the intrinsic relationship between cultural capital, digital divide, cognitive ability, and health of older adults in the dual social context of population aging and the digital era. METHODS We analyzed data from the 2020 China Family Panel Studies (CFPS) initiated by the China Center for Social Science Surveys at Peking University. Physical health, mental health, and memory health were set as indicators of older adults, and the relationship between cultural capital, digital divide, cognitive ability, and health of older adults was examined by hierarchical regression with moderated mediated effect methods. RESULTS Improvement in the health of older adults is associated with an increase in the level of cultural capital; cultural capital may bridge the digital divide faced by older adults, which in turn promotes the improvement of the health of older adults; the higher the level of cognitive ability, the stronger the effect of cultural capital on the digital divide, and at the same time, the stronger the mediating effect of the digital divide; cultural capital has a more pronounced effect on the health of older male adults living in the city. CONCLUSIONS The results of the study show that cultural capital can have a positive impact on the health of older adults, but there is urban-rural heterogeneity and gender heterogeneity, in which the digital divide plays a mediating role, and the enhancement of the cognitive ability of older adults will be conducive to the improvement of their health, so the health of older adults should be promoted by improving the level of their cultural capital and the ability of older adults to use digital technology, thus provide references for the protection of health of older adults.
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Affiliation(s)
- Yupeng Cui
- School of Management, Jiangsu University, Zhenjiang, Jiangsu Province, China
| | - Youshi He
- School of Management, Jiangsu University, Zhenjiang, Jiangsu Province, China.
| | - Xinglong Xu
- School of Management, Jiangsu University, Zhenjiang, Jiangsu Province, China
| | - Lulin Zhou
- School of Management, Jiangsu University, Zhenjiang, Jiangsu Province, China
| | | | - Lingqing Zhao
- School of Management, Jiangsu University, Zhenjiang, Jiangsu Province, China
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Gilan NR, Mohamadi J, Irankhah A, Khezeli M, Zangeneh A. Review of the effect cultural capital and subjective socioeconomic status on life satisfaction in Iran: the mediating role of health-promoting lifestyle and the moderating role of ethnicity. BMC Public Health 2023; 23:2563. [PMID: 38135873 PMCID: PMC10740275 DOI: 10.1186/s12889-023-17490-x] [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: 08/13/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION Health-promoting lifestyle can leads to improving the quality of life, life satisfaction, well-being and reducing the burden of health care in the society. This study was carried out to investigate the mediating role of health-promoting lifestyle and moderating role of ethnicity in the effect of cultural capital and subjective socioeconomic status on life satisfaction in Iran. METHODS This cross-sectional study was conducted with 800 respondents in the cities of Kermanshah with Kurdish ethnicity and Tabriz with Azeri ethnicity. The data gathering tool was a questionnaire in five section including demographic checklist, cultural capital questionnaire (2015),Diener's life satisfaction scale, and health-promoting lifestyle questionnaire (HPLP II), and socioeconomic status scale. Data were analyzed by SPSS and AMOS software. RESULTS Life satisfaction had the highest correlation with the objective dimension of cultural capital (p < 0.001 r = 0.298). The direct standardized coefficient of the path of cultural capital to health-promoting lifestyle was 0.44 (P < 0.001). Also the direct standardized coefficient of cultural capital on Life satisfaction was 0.04 that was not significant. The standard coefficient of the path of cultural capital on life satisfaction through health-promoting lifestyle was 0.27(P < 0.001). Ethnicity variable did not moderate the effect of cultural capital on life satisfaction (p > 0.05). CONCLUSION The results of this study showed that paying attention to the concept of health-promoting lifestyle is a necessity to affect life satisfaction. It can play a role as a mediator for the path of cultural capital and socio-economic status on life satisfaction. This study also showed the role of ethnicity as a moderating variable in the relationship between socio-economic status and health-promoting lifestyle.
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Affiliation(s)
- Nader Rajabi Gilan
- Sociology Department, Faculty of Humanities and Social Sciences, University of Kurdistan, sanandaj, Iran
- Social Development & Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Jamal Mohamadi
- Sociology Department, Faculty of Humanities and Social Sciences, University of Kurdistan, sanandaj, Iran.
| | - Adel Irankhah
- Sociology Department, Faculty of Humanities and Social Sciences, University of Kurdistan, sanandaj, Iran
| | - Mehdi Khezeli
- Social Development & Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Zangeneh
- Social Development & Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Mercer KH, Mollborn S. Distinction through distancing: Norm formation and enforcement during the COVID-19 pandemic. Soc Sci Med 2023; 338:116334. [PMID: 37866175 DOI: 10.1016/j.socscimed.2023.116334] [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: 04/21/2023] [Revised: 09/11/2023] [Accepted: 10/11/2023] [Indexed: 10/24/2023]
Abstract
The unequal spread of COVID-19 was accompanied by disparities in adherence to social distancing. Research is needed on social processes that facilitated widespread adherence to distancing, how they connected with existing resource access and belief systems, and how they potentially strengthened intergroup boundaries. We integrated insights from research on social norms and cultural capital to analyze early pandemic (April-August 2020) qualitative interviews with parents and their teenage children in two higher-resource communities in the United States. Our findings uncovered four interrelated processes that facilitated the rapid establishment of norms around distancing, concurrently strengthening group boundaries. Community members: 1) drew on existing cultural capital to smooth the establishment of new social norms, 2) associated social distancing with individual moral worth and community identity, 3) applied double standards that granted certain exceptions to ingroup members to maintain social cohesion, and 4) drew strong distinctions between their own and outsiders' social distancing behaviors and moral worth. Our findings articulate social processes that allowed for rapid cohesion around distancing and show how these mechanisms strengthened existing community social boundaries.
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Affiliation(s)
- Katie Holstein Mercer
- Institute of Behavioral Science and Department of Sociology, University of Colorado Boulder, UCB 483, Boulder, CO 80309-0483, USA
| | - Stefanie Mollborn
- Institute of Behavioral Science and Department of Sociology, University of Colorado Boulder, UCB 483, Boulder, CO 80309-0483, USA; Department of Sociology, Stockholm University, Stockholm, Sweden.
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Zapata-Moya AR, Freese J, Bracke P. Mechanism substitution in preventive innovations: Dissecting the reproduction of health inequalities in the United States. Soc Sci Med 2023; 337:116262. [PMID: 37898013 DOI: 10.1016/j.socscimed.2023.116262] [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: 03/18/2023] [Revised: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 10/30/2023]
Abstract
In the last three decades, numerous studies in different countries have corroborated the main postulates of the Fundamental Cause Theory (FCT), providing evidence showing how health inequalities are reproduced as society increases its capacity to control disease and/or avoid its consequences through preventive innovations. However, documenting the reproductive logic proposed by the theory requires the development of a dynamic analytical approach to consider socioeconomic disparities in the incorporation of multiple preventive innovations over time, which could act as mediating mechanisms of the durable relationship between socioeconomic status and health/mortality. This study draws on data from different waves of the National Health Interview Survey and the National Health and Nutrition Examination Survey to analyze the diffusion processes of various innovations in the U.S. The results of the study show that educational inequalities emerge, are amplified, and are reduced by the continuous diffusion of preventive innovations, supporting the meta-hypothesis of substitution of mediating mechanisms according to the interconnections of FCT and Diffusion of Innovation Theory.
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Affiliation(s)
- Angel R Zapata-Moya
- Universidad Pablo de Olavide, Department of Anthropology, Basic Psychology and Public Health, Seville, Spain; Centre for Sociology and Urban Policies - The Urban Governance Lab, Universidad Pablo de Olavide, Seville, Spain.
| | - Jeremy Freese
- Stanford University, Department of Sociology, United States.
| | - Piet Bracke
- Ghent University, Department of Sociology, Health and Demographic Research, Ghent, Belgium.
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Luo Y, Zhao H, Chen H, Xiao M. Association between cultural capital and health literacy during the COVID-19 pandemic among community residents in China: the mediating effect of social capital. Front Public Health 2023; 11:1199941. [PMID: 38026294 PMCID: PMC10647931 DOI: 10.3389/fpubh.2023.1199941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 09/25/2023] [Indexed: 12/01/2023] Open
Abstract
Background Health literacy is crucial for managing pandemics such as COVID-19 and maintaining the health of the population; our goal was to investigate the impact of cultural capital on health literacy during the COVID-19 pandemic among community residents and to further examine the mediating role of social capital in the relationship between cultural capital and health literacy. Methods A cross-sectional study was conducted among 1,600 community residents selected in Chongqing, China using a stratified random sampling method. Data were gathered through a questionnaire survey, including sociodemographic characteristics, cultural capital, social capital, and health literacy. Chi-square analysis, one-way ANOVA, t-test, and hierarchical linear regression were used to analyze the level of health literacy among community residents and the related elements; the structural equation model (SEM) was used to explore the influential mechanisms of health literacy and explore whether social capital acted as a mediator in the relationship between cultural capital and health literacy. Results Cultural capital, community participation, community trust, reciprocity, and cognitive social capital had a significant positive effect on health literacy. In addition, the results of SEM indicated that cultural capital not only directly influences health literacy (β = 0.383, 95% CI = 0.265-0.648), but also indirectly influences health literacy through three types of social capital (β = 0.175, 95% CI = 0.117-0.465; β = 0.191, 95% CI = 0.111-0.406; β = 0.028, 95% CI = 0.031-0.174); its mediating effect accounting for 50.7% of the overall effect. Conclusions Our results highlight the empirical link between cultural capital and health literacy, and suggest that social capital mediates this connection. These findings suggest that governments and communities should focus on the construction of community cultural capital and provide residents with better social capital to improve their health literacy to prepare for future pandemics.
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Affiliation(s)
| | | | | | - Mimi Xiao
- School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
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13
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Bae M, Kim Y, Hong I. Factors of Capital on Depression in Older Adulthood: A Comparison of Urban and Rural Regions in Korea. Healthcare (Basel) 2023; 11:2850. [PMID: 37957995 PMCID: PMC10650468 DOI: 10.3390/healthcare11212850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 11/15/2023] Open
Abstract
This study analyses old-age capital in its economic, cultural, and social components, in terms of how it impacts on depression in the elderly, comparing urban and rural regions. Our comparative analysis in urban and rural areas focuses on South Korea, using the Korean Welfare Panel Data from 2012 to 2020. Time-series trends and variables measuring capital and depression in older adults were examined in panel data analyses. Depression among the Korean elderly was at a similar level in urban and rural areas, whereas satisfaction regarding income levels, leisure life, and social relationships was higher for older adults in rural areas. We also found that the higher the economic capital, the higher the leisure life satisfaction (cultural capital), and the higher the social relationship satisfaction (social capital), the lower the rates of depression. Finally, depression among the urban elderly did not decrease as house prices increased as a component of economic capital, and depression decreased among groups participating in volunteer activities as part of the social capital of the rural elderly. In accordance with the socioemotional selectivity theory, older adults in rural areas in Korea have an advantage in terms of cultural capital due to their environment, whereas the psychosocial environment theory is relevant to urban elderly people experiencing relative deprivation in terms of economic capital.
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Affiliation(s)
- MinYoung Bae
- Department of Social Welfare, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - YunYoung Kim
- Department of Social Welfare, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - Ijin Hong
- Graduate Institute of National Development, National Taiwan University, Taipei 106216, Taiwan;
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14
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Oosterwegel SL, Boderie NW, van Lenthe FJ. Is the association between financial scarcity and health behaviours moderated by cultural capital? The GLOBE study. Eur J Public Health 2023; 33:771-777. [PMID: 37533281 PMCID: PMC10567241 DOI: 10.1093/eurpub/ckad126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Experiencing financial scarcity taxes cognitive bandwidth. This leaves less capacity to withhold temptations and makes relying on easiest default options more likely. Whether this default option is (un)healthy may depend on the amount of cultural capital acquired during life course. This study examined whether the association between financial scarcity and health behaviours is moderated by cultural capital. METHODS Self-reported data were used from Dutch adults of the 2014-survey of the GLOBE study (N = 2466). Using linear regression analysis, financial strain (no, some, great) and cultural capital (institutionalized, objectivized, incorporated) were related to body mass index (BMI), alcohol intake, sports participation, cycling and walking, fruit intake and vegetable consumption. The interaction between financial strain and cultural capital was used to assess moderation. RESULTS Experiencing some financial strain was associated with a higher BMI (0.7 kg/m2) and less sport participation (-31.8 min/week). Great financial strain was associated with less sport participation (-41.4 min/week). Being in the lowest tertile of cultural capital was associated with a higher BMI (1.3 kg/m2), drinking less alcohol (-10.0 units/week), less sport participation (-31.5 min/week) and consuming less fruit (-2.9 pieces/week). Cultural capital had no significant moderating effect on the relationship between financial strain and these health behaviours. CONCLUSION Financial strain and cultural capital seem associated with different health behaviours. Cultural capital had no moderating effect on the relationship between financial strain and different health behaviours. While financial strain and cultural capital could both be entry points for interventions to improve health behaviour, underlying mechanisms require further attention.
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Affiliation(s)
- Sigrid L Oosterwegel
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Nienke W Boderie
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Frank J van Lenthe
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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15
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Walker ES, Fancourt D, Bu F, McMunn A. A Bourdieusian Latent Class Analysis of Cultural, Arts, Heritage and Sports Activities in the UK Representative Understanding Society Dataset. SOCIOLOGY 2023; 57:843-864. [PMID: 37927966 PMCID: PMC10623679 DOI: 10.1177/00380385221130163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
To Bourdieu, interaction with culture has symbolic power and drives the manifestation of social stratification. Many have adapted his theory and methodology, developing new models of cultural engagement. Here, to further integrate these theoretical and methodological approaches, Bourdieu's tools were used to operationalise and interpret a Latent Class Analysis of cultural engagement in the Understanding Society dataset. Six classes of increasing engagement were established, and were increasingly correlated with youth, capital and social advantage. However, some qualitative differences in engagement were also seen. The classes also varied by which characteristics correlated with membership. For example, economic capital was associated with sports engagement, while advantaged social position was associated with broad-scale engagement. Overall, this analysis combined Bourdieusian theory with contemporary methodology in the largest representative UK dataset and highlights the broader relevance of cultural engagement patterns in indicating (and possibly generating) status, identity, capital and social position.
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16
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Mudd AL, Oude Groeniger J, Bal M, Verra SE, van Lenthe FJ, Kamphuis CB. Testing conditionality with Bourdieu's capital theory: How economic, social, and embodied cultural capital are associated with diet and physical activity in the Netherlands. SSM Popul Health 2023; 22:101401. [PMID: 37123560 PMCID: PMC10139966 DOI: 10.1016/j.ssmph.2023.101401] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 04/05/2023] [Accepted: 04/09/2023] [Indexed: 05/02/2023] Open
Abstract
Although Bourdieu's capital theory emphasized that economic, social, and embodied cultural capital interact to shape health behavior, existing empirical research mainly considered separate associations of the three forms of capital. Our aim was to investigate if and how economic, social, and embodied cultural capital are conditional on each other in their associations with adults' diet and physical activity. Cross-sectional, self-reported data from the 2014 GLOBE survey of 2812 adults aged between 25 and 75 years residing in Eindhoven, the Netherlands were used. Step-wise multiple logistic regression models included economic, social, and embodied cultural capital and adjustment for potential confounders. The models estimated odds ratios of main effects and two-way interactions of the forms of capital with fruit consumption, vegetable consumption, sports participation, and leisure time walking or cycling. In the main effects models, embodied cultural capital was consistently positively associated with all outcomes. Social capital was positively associated with sports participation, fruit consumption, and vegetable consumption, and economic capital was positively associated with sports participation and vegetable consumption. In the two-way interaction models, having specific higher levels of both economic and social capital strengthened their positive association with sports participation. No other combinations of capital were conditional on each other. Economic and social capital were conditional on each other in their association with sports participation, so interventions that provide both economic and social support may be especially effective for increasing this type of physical activity. As its association was strong with all outcomes but not conditional on other forms of capital, embodied cultural capital may operate distinctly from economic and social resources. Policy that takes differences in embodied cultural capital into account or changes to the environment that dampen the importance of embodied cultural resources for health behavior may help improve both diet and physical activity.
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Affiliation(s)
- Andrea L. Mudd
- Department of Interdisciplinary Social Science- Social Policy and Public Health, Utrecht University, PO Box 80140, 3508, TC, Utrecht, the Netherlands
- Corresponding author.
| | - Joost Oude Groeniger
- Department of Public Health, Erasmus University Medical Centre, PO Box 2040, 3000, CA, Rotterdam, the Netherlands
| | - Michèlle Bal
- Department of Interdisciplinary Social Science- Social Policy and Public Health, Utrecht University, PO Box 80140, 3508, TC, Utrecht, the Netherlands
| | - Sanne E. Verra
- Department of Interdisciplinary Social Science- Social Policy and Public Health, Utrecht University, PO Box 80140, 3508, TC, Utrecht, the Netherlands
| | - Frank J. van Lenthe
- Department of Public Health, Erasmus University Medical Centre, PO Box 2040, 3000, CA, Rotterdam, the Netherlands
- Department of Human Geography and Spatial Planning, Utrecht University, PO Box 80140, 3508, TC, Utrecht, the Netherlands
| | - Carlijn B.M. Kamphuis
- Department of Interdisciplinary Social Science- Social Policy and Public Health, Utrecht University, PO Box 80140, 3508, TC, Utrecht, the Netherlands
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Cavazza M, Vecchio MD, Fattore G, Fenech L. Geographical variation in the use of private health insurance in a predominantly publicly-funded system. Health Policy 2023; 130:104720. [PMID: 36801610 DOI: 10.1016/j.healthpol.2023.104720] [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: 09/25/2020] [Revised: 12/03/2022] [Accepted: 02/01/2023] [Indexed: 02/05/2023]
Abstract
We provide evidence of geographical variations in the use of private health insurance (PHI) in Italy. Our study offers an original contribution, using a 2016 dataset on the use of PHI amongst a population of more than 200,000 employees of a major company. The average claim per enrolee was €925, representing approximately 50% of public health expenditure per capita, primarily for dental care (27.2%), specialist outpatient services (26.3%) and inpatient care (25.2%). Residents in northern regions and metropolitan areas respectively claimed reimbursements for €164 and €483 more than those in southern regions and in non-metropolitan areas. Both supply and demand factors can explain these large geographical differences. The study suggests the urgency for policymakers to address the considerable disparities in the Italian healthcare system, revealing the overall social, cultural and economic conditions that shape the demand for healthcare.
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Affiliation(s)
- Marianna Cavazza
- Centre for Research on Health and Social Care Management (Cergas), SDA Bocconi School of Management, Observatory on Privately Financed Health Consumption (OCPS), Via Sarfatti 10, Milan 20136, Italy.
| | - Mario Del Vecchio
- Centre for Research on Health and Social Care Management (Cergas), SDA Bocconi School of Management, Observatory on Privately Financed Health Consumption (OCPS), Via Sarfatti 10, Milan 20136, Italy; Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla, 3, Florence 50134, Italy
| | - Giovanni Fattore
- Centre for Research on Health and Social Care Management (Cergas), SDA Bocconi School of Management, Observatory on Privately Financed Health Consumption (OCPS), Via Sarfatti 10, Milan 20136, Italy; Social and Political Sciences Department, Bocconi University, Via Roentgen 1, Milan 20136, Italy
| | - Lorenzo Fenech
- Centre for Research on Health and Social Care Management (Cergas), SDA Bocconi School of Management, Observatory on Privately Financed Health Consumption (OCPS), Via Sarfatti 10, Milan 20136, Italy
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18
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Oude Groeniger J, Houweling TAJ, Jansen PW, Horoz N, Buil JM, van Lier PAC, van Lenthe FJ. Social inequalities in child development: the role of differential exposure and susceptibility to stressful family conditions. J Epidemiol Community Health 2023; 77:74-80. [PMID: 36428086 PMCID: PMC9872228 DOI: 10.1136/jech-2022-219548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/07/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Stressful family conditions may contribute to inequalities in child development because they are more common among disadvantaged groups (ie, differential exposure) and/or because their negative effects are stronger among disadvantaged groups (ie, differential impact/susceptibility). We used counterfactual mediation analysis to investigate to what extent stressful family conditions contribute to inequalities in child development via differential exposure and susceptibility. METHODS We used data from the Generation R Study, a population-based birth cohort in the Netherlands (n=6842). Mother's education was used as the exposure. Developmental outcomes, measured at age 13 years, were emotional and behavioural problems (Youth Self-Report), cognitive development (Wechsler Intelligence Scale for Children) and secondary education entry level. Financial and social stress at age 9 years were the putative mediators. RESULTS Differential exposure to financial stress caused a 0.07 (95% CI -0.12 to -0.01) SD worse emotional and behavioural problem -score, a 0.05 (95% CI -0.08 to -0.02) SD lower intelligence score and a 0.05 (95% CI -0.05 to -0.01) SD lower secondary educational level, respectively, among children of less-educated mothers compared with children of more-educated mothers. This corresponds to a relative contribution of 54%, 9% and 6% of the total effect of mother's education on these outcomes, respectively. Estimates for differential exposure to social stress, and differential susceptibility to financial or social stress, were much less pronounced. CONCLUSION Among children of less-educated mothers, higher exposure to financial stress in the family substantially contributes to inequalities in socioemotional development, but less so for cognitive development and educational attainment.
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Affiliation(s)
- Joost Oude Groeniger
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands .,Department of Public Administration and Sociology, Erasmus University, Rotterdam, Netherlands
| | - Tanja AJ Houweling
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Pauline W Jansen
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands,Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Nil Horoz
- Dept of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands,Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - J. Marieke Buil
- Dept of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands,Amsterdam Public Health Research Institute, Amsterdam, Netherlands,Research Centre Urban Talent, Rotterdam University of Applied Sciences, Rotterdam, Netherlands
| | - Pol AC van Lier
- Dept of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands,Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Frank J van Lenthe
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
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19
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Childhood dental caries experience in northern Spain: a cross-sectional study. Eur Arch Paediatr Dent 2023; 24:95-103. [PMID: 36264453 PMCID: PMC9992230 DOI: 10.1007/s40368-022-00762-2] [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: 12/04/2021] [Accepted: 10/03/2022] [Indexed: 10/24/2022]
Abstract
PURPOSE This study aimed to describe the caries experience in primary and permanent dentition of schoolchildren from a sample taken in public schools in Bilbao, to identify the most vulnerable child population, and compare them with the findings obtained by the Children's Dental Care Programme in the region of the Basque Country (Spain). METHODS A cross-sectional study was conducted using a representative sample (n = 1682) of children from 5-year-old early childhood education classes and the first- and second-year elementary classes in public schools in Bilbao. The dependent variable was the caries experience determined through oral examinations carried out by a single dentist. On the other hand, independent variables were measured through questionnaires completed by families, with help from teachers as appropriate. In the statistical analysis, Mann-Whitney and Kruskal-Wallis nonparametric tests, as well as two logistic regressions, were performed, and the significance level was set at α = 0.05 for decision making. RESULTS The mean (SD) values of dft, DMFT, DMFS and DMFT of first permanent molars scores were 1.25 ± 2.20, 0.16 ± 0.61, 0.20 ± 0.90 and 0.15 ± 0.57, respectively. Compared to the findings in the most recent PADI report, the schoolchildren in our sample had slightly greater experience of dental caries in primary dentition and much greater experience in permanent dentition. CONCLUSION The dft index of the primary dentition for the current sample is 1.25, while the DMFT index for the permanent dentition is 0.16. Among pupils in early childhood and elementary education in public schools in Bilbao, children from families with low socioeconomic status and educational attainment are most vulnerable to developing caries.
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Glenn LE, Thurlow CB, Enriquez M. The "Ups and Downs" of Living With Type 2 Diabetes Among Working Adults in the Rural South. J Prim Care Community Health 2022; 13:21501319221143715. [PMID: 36564892 PMCID: PMC9793025 DOI: 10.1177/21501319221143715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The purpose of this qualitative study was to gain a better understanding of the spheres of influence on engagement in recommended diabetes preventive health services among rural, working adults. Additionally, this study sought to understand the unique factors that influence diabetes self-management among rural, working adult populations. The sample included mostly African-American, low-income females with self-reported diabetes, who scored low on the Patient Activation Measure (PAM-10). Semi-structured interviews (N = 20) revealed that most participants struggled with the "ups and downs" of living with diabetes. Four major themes emerged from the data: "the struggle," "doing things together," "diabetes is not the priority," and "we're lucky to have what we have." Most participants were developing individual responsibility and motivation for a healthy future, but were overwhelmed by inconsistency in self-management, diabetes distress, lack of effective coping strategies, and lack of social and economic capital. The findings of this study indicate the need to further address psychological well-being among rural, working adults, yet rural populations often lack sufficient access to mental health care and formalized psychological support. Psychological support and resources are essential to facilitate engagement in diabetes self-management and preventive health services for rural, working adults.
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Affiliation(s)
- Lynn E. Glenn
- Augusta University, Augusta, GA,
USA,Lynn E. Glenn, College of Nursing, Augusta
University, 1120 15th Street EC 4338, Augusta, GA 30912, USA.
| | | | - Maithe Enriquez
- Research College of Nursing, Kansas
City, MO, USA,University of Missouri, Columbia, MO,
USA
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21
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Tutt M, Begay C, George S, Dickerson C, Kahn C, Bauer M, Teufel-Shone N. Diné teachings and public health students informing peers and relatives about vaccine education: Providing Diné (Navajo)-centered COVID-19 education materials using student health messengers. Front Public Health 2022; 10:1046634. [PMID: 36589984 PMCID: PMC9794580 DOI: 10.3389/fpubh.2022.1046634] [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: 09/28/2022] [Accepted: 11/08/2022] [Indexed: 01/03/2023] Open
Abstract
Introduction/background On 9 April 2021, the Centers for Disease Control and Prevention (CDC) reported that only 19. 9% of United States (US) adults were fully vaccinated against COVID-19. In that same week, the Navajo Nation (NN) reported that 37.4% of residents were fully vaccinated, making the NN a leader in the uptake of COVID-19 vaccines. Despite high vaccination rates, vaccine hesitancy exists within the NN. The Diné (Navajo) Teachings and Public Health Students Informing Peers and Relatives about Vaccine Education (RAVE) intervention was designed to utilize trusted health messengers as an effective means to address adults' vaccine concerns and hesitancy. Methods The research team used COVID-19 vaccine materials developed in a previous collaboration with non-Navajo tribal communities and publicly available materials. Diné Traditional Knowledge Holders (TKHs) were interviewed to develop and incorporate Diné-specific information on individual and collective health behaviors into the RAVE materials. These drafted health education materials were presented to NN community health representatives (CHRs) and Diné public health students using a consensus panel approach. NN residents who participated in the intervention completed a 16-element retrospective pretest. Results The adaptation and tailoring process of materials yielded 4 health education materials. The students recruited 46 adults for health education sessions. These participants then completed the retrospective pretest. Changes in the 16 elements were in the desired direction, although only six were significant: four related to attitudes and two concerned with vaccination intention. Participants were more likely to consider vaccination and to try to get vaccinated after the education session. Discussion Trusted messengers and culturally centered materials have been identified as effective means of health behavior education with Native American audiences. RAVE applied these intervention elements by (1) training Diné College public health students to leverage their cultural knowledge and social relationships (cultural and social capital) to recruit vaccine-hesitant adults and provide education; (2) building on previous understanding of Native American communities' vaccine concerns; and (3) integrating Diné perspectives on individual and collective health into the adaptation of materials designed for general audiences; this knowledge was gained from interviews with TKHs.
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Affiliation(s)
- Marissa Tutt
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, United States,*Correspondence: Marissa Tutt
| | - Chassity Begay
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, United States
| | - Shawndeena George
- Diné College, School of Science, Technology, Engineering and Math, Shiprock, NM, United States
| | - Christopher Dickerson
- Diné College, School of Science, Technology, Engineering and Math, Shiprock, NM, United States
| | - Carmella Kahn
- Diné College, School of Science, Technology, Engineering and Math, Shiprock, NM, United States
| | - Mark Bauer
- Diné College, School of Science, Technology, Engineering and Math, Shiprock, NM, United States
| | - Nicolette Teufel-Shone
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, United States
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22
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Qi Y, Vrooman JC, Almansa J, Ots P, Brouwer S, Reijneveld SA. A capital-based approach to better understand health inequalities: Theoretical and empirical explorations. SSM Popul Health 2022; 21:101309. [PMID: 36561918 PMCID: PMC9763943 DOI: 10.1016/j.ssmph.2022.101309] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
Background The persistence of health inequalities may be driven by differences in education and income, but also by other economic and non-economic factors. Our aim was to explore how the association between single-dimensional health and socioeconomic status (SES) changes when including health-related person capital, economic capital, social capital, cultural capital and attractiveness and personality capital. Methods We used a capital-based approach to understand health inequalities. It presumes intertwined relationships between broadly measured health ('health-related person capital') and embodied resources ('attractiveness and personality capital') on the one hand, and ESC capital, i.e., economic, social, and cultural resources on the other. We used cross-sectional data on 152,592 participants from the Dutch Lifelines cohort study and estimated correlations using partial least squares structural equation modelling. Results The correlation between SES and health-related person capital (r = 0.15) was stronger than the correlations between SES and single-dimensional health (physical and mental health; r = 0.12 and r = 0.04, respectively). ESC capital, combining economic, social and cultural capital, showed a correlation of 0.34 with health-related person capital. This was stronger than the correlation between health-related person capital and economic capital alone (r = 0.19). Lastly, the correlation between health-related person capital and ESC capital increased when health related, attractiveness and personality resources were combined into a single person capital construct (from r = 0.34 to r = 0.49). Conclusions This exploratory study shows the empirical interconnectedness of various types of resources, and their potential role in the persistence of health inequalities. Our findings corroborate the idea of considering health as a multidimensional concept, and to extend conventional SES indicators to a broader measurement of economic and non-economic resources.
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Affiliation(s)
- Yuwei Qi
- University Medical Center Groningen, University of Groningen, Department of Health Sciences, Groningen, the Netherlands
- Corresponding author. Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30001, FA10, 9700 RB, Groningen, the Netherlands.
| | - J. Cok Vrooman
- Department of Sociology/ICS, Utrecht University, the Netherlands
- The Netherlands Institute for Social Research|SCP, the Netherlands
| | - Josué Almansa
- University Medical Center Groningen, University of Groningen, Department of Health Sciences, Groningen, the Netherlands
| | - Patricia Ots
- University Medical Center Groningen, University of Groningen, Department of Health Sciences, Groningen, the Netherlands
| | - Sandra Brouwer
- University Medical Center Groningen, University of Groningen, Department of Health Sciences, Groningen, the Netherlands
| | - Sijmen A. Reijneveld
- University Medical Center Groningen, University of Groningen, Department of Health Sciences, Groningen, the Netherlands
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23
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Intergenerational educational trajectories and premature mortality from chronic diseases: A registry population-based study. SSM Popul Health 2022; 20:101282. [DOI: 10.1016/j.ssmph.2022.101282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022] Open
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Djojosoeparto SK, Kamphuis CBM, Harrington JM, Løvhaug AL, Roos G, Sawyer ADM, Stronks K, Terragni L, Torheim LE, Vandevijvere S, Poelman MP, van Lenthe FJ. How theory can help to understand the potential impact of food environment policies on socioeconomic inequalities in diet: an application of Bourdieu's capital theory and the scarcity theory. Eur J Public Health 2022; 32:iv66-iv70. [PMID: 36444101 PMCID: PMC9706114 DOI: 10.1093/eurpub/ckac052] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Government policies that promote healthy food environments are considered promising to reduce socioeconomic inequalities in diet. Empirical evidence of effects on these inequalities, however, is relatively scarce and, with a few exceptions, tends to be inconclusive. We use two contemporary theories that help to understand socioeconomic inequalities in health and health-related behaviours (Bourdieu's capital theory and Mullainathan and Shafir's scarcity theory) to reason how policies influencing food environments may differentially impact lower and higher socioeconomic groups. In essence, these theories enable us to understand how specific elements of broader daily living conditions (e.g. social practices that lead to habitus formation, material conditions that shape experiences of scarcity) may lead to a greater benefit of certain food environment policies for the healthfulness of diets of lower or higher socioeconomic groups. We conclude that the application of theories on the mechanisms underlying socioeconomic inequalities in health can help to guide future empirical studies in testing theory-based hypotheses on differential effects of policies, and thereby enhance the development of effective policies tackling socioeconomic inequalities in dietary intakes.
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Affiliation(s)
- Sanne K Djojosoeparto
- Correspondence: Sanne K. Djojosoeparto, Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Vening Meinesz Building A, Princetonlaan 8a, Utrecht 3584 CB, The Netherlands, e-mail:
| | - Carlijn B M Kamphuis
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands
| | | | - Anne Lene Løvhaug
- Department of Nursing and Health Promotion, OsloMet—Oslo Metropolitan University, Oslo, Norway
| | - Gun Roos
- Consumption Research Norway (SIFO), OsloMet—Oslo Metropolitan University, Oslo, Norway
| | - Alexia D M Sawyer
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Karien Stronks
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Laura Terragni
- Department of Nursing and Health Promotion, OsloMet—Oslo Metropolitan University, Oslo, Norway
| | - Liv Elin Torheim
- Department of Nursing and Health Promotion, OsloMet—Oslo Metropolitan University, Oslo, Norway,Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Maartje P Poelman
- Chair Group Consumption and Healthy Lifestyles, Department of Social Sciences, Wageningen University & Research, Wageningen, The Netherlands
| | - Frank J van Lenthe
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, The Netherlands,Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
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25
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Nisar M, Uddin R, Kolbe-Alexander T, Khan A. The prevalence of chronic diseases in international immigrants: a systematic review and meta-analysis. Scand J Public Health 2022:14034948221116219. [DOI: 10.1177/14034948221116219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Aims: The purpose of this study is systematically to review and synthesise available prevalence data of major chronic diseases in international immigrants. Methods: Four electronic databases were searched to retrieve peer-reviewed original articles published in English between January 2000 and December 2020. Cross-sectional, cohort, or longitudinal studies that reported the prevalence of cardiovascular disease, any type of cancer, chronic obstructive pulmonary disease, and type 2 diabetes among immigrant adults were included. We calculated pooled prevalence using random-effects meta-analyses. Results: Of 13,363 articles retrieved, 24 met the eligibility criteria. The pooled prevalence of diabetes was 9.0% (95% confidence interval (CI) 7.6–10.4) with a higher prevalence in North American countries 11.1% (95% CI 8.0–14.1) than in the other destination countries: 6.6% (95% CI 5.1–8.1) including Italy, Sweden, The Netherlands, Australia, and Israel. The pooled prevalence of cardiovascular diseases and respiratory diseases was 7.7% (95% CI 5.7–9.6) and 6.5% (95% CI 2.3–10.7), respectively. Only two articles reported the prevalence of cancers (2.7% and 3.8%). We found high heterogeneity among all studies regardless of the disease. Conclusions: The prevalence of diabetes was higher than other chronic diseases in international immigrants. There is a strong need to enhance health information systems to understand the magnitude of chronic diseases among different immigrant subgroups.
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Affiliation(s)
- Mehwish Nisar
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Riaz Uddin
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Australia
| | - Tracy Kolbe-Alexander
- School of Health and Wellbeing, University of Southern Queensland, Ipswich, Australia
| | - Asaduzzaman Khan
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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26
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Chatelan A, Khalatbari-Soltani S. Evaluating and rethinking public health for the 21st century: Toward vulnerable population interventions. Front Public Health 2022; 10:1033270. [PMID: 36388343 PMCID: PMC9650281 DOI: 10.3389/fpubh.2022.1033270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/07/2022] [Indexed: 01/29/2023] Open
Affiliation(s)
- Angeline Chatelan
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland,Geneva School of Health Sciences, University of Applied Sciences and Arts Western Switzerland (HES-SO), Geneva, Switzerland,*Correspondence: Angeline Chatelan
| | - Saman Khalatbari-Soltani
- Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, NSW, Australia,ARC Centre of Excellence in Population Aging Research (CEPAR), University of Sydney, Sydney, NSW, Australia
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27
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Settels J, Leist AK. The Role of Country-Level Availability and Generosity of Healthcare Services, and Old-Age Ageism for Missed Healthcare during the COVID-19 Pandemic Control Measures in Europe. J Aging Health 2022; 34:1016-1036. [PMID: 35465763 PMCID: PMC9482934 DOI: 10.1177/08982643221087097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Objectives: The effects of the COVID-19 outbreak on non-COVID-19-related healthcare need further investigation. Methods: Using the Survey of Health, Ageing and Retirement in Europe's COVID-19 module (2020) (N = 57,025), country-level data from the European Social Survey (2008) and OECD (2020), and logistic regressions, this study examines predictors of older Europeans' forgone, postponed, and denied healthcare during the pandemic. Results: Country-level availability of physicians, healthcare systems' generosity, and beliefs that older persons burden healthcare systems all increased forgone healthcare. Healthcare system generosity increased postponed and denied healthcare. Greater medical resources decreased denied healthcare. Furthermore, missed healthcare varied by individual-level gender (higher rates among women), age, education, and health. Discussion: This study reveals predictors of missed healthcare during the pandemic. To decrease unintended health consequences of a pandemic, both individual-level determinants, such as gender and health, and contextual-level determinants, such as healthcare systems' characteristics, should be considered in research and practice.
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Affiliation(s)
- Jason Settels
- University of Luxembourg, Institute for Research on Socio-Economic Inequality,
Esch-sur-Alzette, Luxembourg
| | - Anja K. Leist
- University of Luxembourg, Institute for Research on Socio-Economic Inequality,
Esch-sur-Alzette, Luxembourg
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28
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Kleppang AL, Skille EÅ. Leisure-Time Activities in Different Contexts and Depressive Symptoms in Norwegian Adolescents: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710769. [PMID: 36078483 PMCID: PMC9518453 DOI: 10.3390/ijerph191710769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 08/23/2022] [Accepted: 08/25/2022] [Indexed: 06/10/2023]
Abstract
The purpose of this study was to examine the association between physical activity organised in sports clubs, non-organised physical activity, other organised leisure-time activities, and depressive symptoms among adolescents. This study was based on cross-sectional data from the Ungdata survey conducted between 2017 and 2019. The sample comprised 7656 adolescents (aged 13-16 years). Binominal logistic regression was used to analyse the association between the three different leisure-time activities and depressive symptoms. All models were adjusted for gender, family economy, parents' higher education, having friends, alcohol intoxication, and smoking. The odds for symptoms of depression were higher for those who were less physically active in a sports club (OR: 1.34, 95% CI: 1.15-1.57) and in non-organised physical activities (OR: 1.50, 95% CI: 1.29-1.74) and lower for those who participated less in other organised leisure-time activities (OR: 0.79, 95% CI: 0.68-0.92) compared with those who were physically active (sports club and non-organised) and those who participated in other organised leisure-time activities. Our findings suggested that being physically active, both in a sports club and in non-organised activities, was associated with lower odds of depressive symptoms among adolescents. Additional research is needed to confirm a possible causal relationship.
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Abstract
Health literacy research is growing rapidly and broadly; however, conceptual advances in critical health literacy (CHL) seem hampered by a lack of a clear definition. In this paper, we refer to key features of the concept as identified in earlier works, offer a new definition of CHL and briefly discuss its theoretical roots. Reflection and action are suggested as the two constituent components of CHL. Consequences for future research are also discussed.
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Affiliation(s)
- Thomas Abel
- Institute of Social and Preventive Medicine University of Bern, Bern, Switzerland
| | - Richard Benkert
- Institute of Social and Preventive Medicine University of Bern, Bern, Switzerland
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30
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Yu B, Kelly S. Does artistic activity help kids avoid obesity? Emergent considerations in the ecology of childhood BMI. Prev Med 2022; 161:107120. [PMID: 35750262 DOI: 10.1016/j.ypmed.2022.107120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 05/07/2022] [Accepted: 06/15/2022] [Indexed: 11/29/2022]
Abstract
Although the positive relationship between arts engagement and mental health is well documented, arts participation may be an emergent factor in the ecology of childhood obesity. Prior research hypothesized several potential health benefits of arts participation including healthy diet and lifestyles, but the available evidence is mainly limited to cross-sectional covariate-adjustment models for the adult population. We employed a newly released panel of the Early Childhood Longitudinal Study kindergarten cohort (ECLS-K: 2011), which is a nationally representative sample of American children who entered kindergarten in 2010-2011 (n = 15,820). We applied both dynamic panel models with Maximum Likelihood estimation as well as difference-in-differences models to address unobserved heterogeneity. Our results showed that childhood arts activity is significantly associated with reduced weight status in elementary schooling. In particular, arts participation in elementary schooling reduced the risk of being overweight on a year-to-year basis; the effect size was between 12% and 23% of a SD of BMI for all children. Arts participation at kindergarten also had a significant relationship with cumulative changes in BMI over the course of elementary schooling, especially for female and White female children (about 22% and 32% of a SD of BMI). There are considerable arts participation gaps between families and regions, and these early artistic experiences appear to affect the risk of being overweight. This suggests the possibility of a larger social reproduction process via an ecological pathway that might be easily overlooked-the accumulation of arts experience and concurrent health inequalities in childhood.
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Affiliation(s)
- Baeksan Yu
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway; PROMENTA Research Center, Department of Psychology, University of Oslo, Norway.
| | - Sean Kelly
- Department of Educational Foundations, Organizations, and Policy, University of Pittsburgh, PA, USA
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31
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Suggested explanations for the (in)effectiveness of nutrition information interventions among adults with a low socioeconomic status: a scoping review. J Nutr Sci 2022; 11:e50. [PMID: 35836699 PMCID: PMC9241061 DOI: 10.1017/jns.2022.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 05/12/2022] [Accepted: 05/13/2022] [Indexed: 11/15/2022] Open
Abstract
Unhealthy diets are a major threat to population health and are especially prevalent among those with a low socioeconomic status (SES). Health promotion initiatives often rely on nutrition information interventions (NIIs), but are usually less effective among adults with a low SES than in their high-SES counterparts. Explanations for this lower effectiveness are set out in extant studies. These have been conducted across a wide range of disciplines and subject fields and using a variety of methodological approaches. We have therefore conducted a scoping review to identify and synthesise the following: (1) explanations suggested in studies carried out in high-income countries for why NIIs are (in)effective among adults with a low SES and (2) whether these suggested explanations were studied empirically. Eight databases were searched for relevant studies published since 2009 across various disciplines. This identified 4951 papers, 27 of which were included in our review after screening. Only fifteen of these proposed an explanation for the (in)effectiveness of NIIs among adults with a low SES. The following four main themes were uncovered: health literacy, economic resources, social resources and convenience. Ten studies tested their explanations empirically, but the results were inconsistent. The reasons why NIIs are (in)effective among low-SES adults are therefore still largely unclear. Also, current literature predominantly relies on individualistic explanations, most notably focusing on psychological and economic attributes. Consequently, if the effectiveness of NIIs among low-SES populations is to be improved, future studies should examine a wider range of explanations and test them systematically and empirically.
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32
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Joseph PL. Managing health in inequitable contexts: Health capacities as integral to life course health development. New Dir Child Adolesc Dev 2022; 2022:145-168. [PMID: 35653299 DOI: 10.1002/cad.20464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Health behavior models are widely used in prevention research with children and adolescents; yet, many of these models were developed based on adult experiences and fail to consider the development of health constructs. The concept of health capacity development is a theoretical model of how health capacities, the health-related developmental sociocultural resources individuals use to regulate their coactions with their environments to sustain health, develop. Health capacities are formed through person-environment transactions and thus, are informed by, and help individuals manage, the opportunities and constraints situated in their environments. The extent to which health capacities support long-term adaptive health development varies; yet, health capacities may be leveraged for adaptative functioning. Grounded in the Life Course Health Development (LCHD) framework and the principles of Relational Developmental Systems (RDS) metatheory, the development of three health capacities, their role in managing person-environment coactions, and their potential for facilitating displays of resilient functioning in inequitable contexts are described. Implications of the model, its limitations, and avenues for future research are discussed.
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Affiliation(s)
- Patrece L Joseph
- Eliot-Pearson Department of Child Study and Human Development, Tufts University, Medford, Massachusetts, USA
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33
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[School from the spirit of public health? : Health promotion in schools from a sociology of education perspective]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2022; 65:768-775. [PMID: 35648160 PMCID: PMC9232413 DOI: 10.1007/s00103-022-03547-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 04/28/2022] [Indexed: 11/06/2022]
Abstract
Im Rahmen der Gesundheitsförderung im Sinne der Ottawa-Charta wird der Schule eine Reihe von Aufgaben und Funktionen zugeschrieben, die unter anderem zur Reduktion von gesundheitlichen und sozialen Ungleichheiten beitragen sollen. Dabei finden allerdings in der Public-Health-Diskussion zur schulischen Gesundheitsförderung wichtige theoretische Überlegungen und empirische Erkenntnisse aus der Bildungssoziologie, die Schule als eine hierarchisierende, segregierende, Ungleichheiten produzierende und reproduzierende Institution analysiert, kaum Platz. In diesem Diskussionsbeitrag werden einige bildungssoziologische Positionen und die normative Rahmung der schulischen Gesundheitsförderung vorgestellt. Ferner wird auf die Widersprüche zwischen den Zielen der Gesundheitsförderung und den aktuellen schulischen Bedingungen eingegangen. Zum Schluss werden konzeptionelle Überlegungen für eine Perspektive vorgestellt, die Bildung aus dem Geist der Gesundheitsförderung entwickelt, dabei werden Verbindungen zu Inklusion, Demokratiebildung sowie Menschenrechten hergestellt.
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34
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Philip J, Newman J, Bifelt J, Brooks C, Rivkin I. Role of social, cultural and symbolic capital for youth and community wellbeing in a rural Alaska Native community. CHILDREN AND YOUTH SERVICES REVIEW 2022; 137:106459. [PMID: 35422537 PMCID: PMC9004681 DOI: 10.1016/j.childyouth.2022.106459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Health promotion programs by and for Indigenous Peoples increasingly use strength-based Indigenous approaches aimed at reinforcing protective factors rooted in their cultures and traditions. These protective factors can counteract the deleterious effects induced by the rapid social changes related to colonization. Western social scientists defined cultural, social and symbolic capital as assets akin to social strengths that can promote health. It is important to understand Indigenous perspectives on these social and cultural capitals, and the ways their interplay can promote wellness. Using the qualitative methods photovoice and digital storytelling, we elicited the perspectives of Athabascan middle and high school students participating in the Frank Attla Youth and Sled Dog Care-Mushing Program in their home community of Huslia in Interior Alaska. Subsequently, we disseminated the stories and preliminary findings in Huslia, and conducted focus groups with adults to triangulate with the youth perspectives. Deductive and inductive thematic content analysis of youth stories and photos revealed the impacts of the program on them and their community. Youth reported gains in cultural, social and symbolic capital and shared what these forms of capital mean in their cultural context. Cultural capital gains were mostly in its embodied form, e.g. in work ethics, perseverance and the value of cultural traditions; social capital gains revolved around relations with peers, adults and Elders, nature and animals, as well as social cohesion and sense of belonging in Huslia; Symbolic capital was reflected through pride and spirituality. The students' stories also illustrated their perspectives on how the program affected their wellbeing, through physical activity, healing relations with dogs, increased self-esteem and visions of a bright future. Adults corroborated youth perspectives and shared their observations of program impacts on discipline, academic and life skills and resilience. These findings could be used to guide development and assessment of culturally-based wellbeing promoting interventions.
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Affiliation(s)
- Jacques Philip
- Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, AK, United States of America
- Corresponding author: Jacques B. Philip, MD, Institute of Arctic Biology, University of Alaska Fairbanks, 311 Irving I Building, Fairbanks, AK 99775, (907) 474 6127 (phone) (907) 474 5700 (fax),
| | - Janessa Newman
- One Health Masters Student, University of Alaska Fairbanks, Fairbanks, AK, United States of America
| | - Joe Bifelt
- 3-4 grade teacher, Yukon Koyukuk School District, Huslia, AK, United States of America
| | - Cathy Brooks
- Department of Alaska Native Studies and Rural Development, University of Alaska Fairbanks, Fairbanks, AK, United States of America
| | - Inna Rivkin
- Department of Psychology and Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, AK, United States of America
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35
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Kamphuis CBM, Oude Groeniger J, Beenackers MA, Van Lenthe FJ. A wake-up call for social epidemiologists studying health inequalities: Response to Dijkstra & Horstman. Soc Sci Med 2022; 303:115020. [PMID: 35569234 DOI: 10.1016/j.socscimed.2022.115020] [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: 04/19/2022] [Accepted: 05/05/2022] [Indexed: 11/16/2022]
Abstract
In their paper, published in this journal, Dijkstra & Horstman critically reflect on a selection of social epidemiological articles and examine how low socioeconomic status populations are constructed in these articles. They identify four components which they argue represent the "dominant thought style" of this literature: 1) proliferation, 2) generalization, 3) problematization and 4) individualization. We largely agree with their first two points, but strongly disagree with the other two, and explain why in our reply. All in all, we believe that their analysis is a wake-up call for social epidemiologists, rightly pointing to the risk that the relevance and moral origins of the use and study of categories, like 'low socioeconomic status', can easily become less visible, and therefore should be articulated and explained every time.
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Affiliation(s)
- Carlijn B M Kamphuis
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, the Netherlands.
| | - Joost Oude Groeniger
- Department of Public Health, Erasmus MC, Rotterdam, the Netherlands; Department of Public Administration and Sociology, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | | | - Frank J Van Lenthe
- Department of Public Health, Erasmus MC, Rotterdam, the Netherlands; Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, the Netherlands
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36
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Ren H, Liu W. The Effect and Mechanism of Cultural Capital on Chinese Residents' Participation in Physical Activities. Front Psychol 2022; 13:848530. [PMID: 35529567 PMCID: PMC9069810 DOI: 10.3389/fpsyg.2022.848530] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 03/28/2022] [Indexed: 12/02/2022] Open
Abstract
Background Using Bourdieu’s cultural capital theory, this paper discusses the inequality of Chinese urban residents’ participation in physical activities caused by cultural capital and explores the relationship and role of residents’ income and self-rated health in cultural capital and physical activity participation. Methods Using Chinese social survey data (2017), the proposed assumptions were tested and analyzed by using a linear regression model. Results Cultural capital can promote the participation of Chinese urban residents in physical activities, and personal income and health self-assessment play an intermediary role in promoting residents’ participation in physical activities. Conclusion Promoting Chinese residents’ participation in physical activities can be realized not only through traditional publicity and sports venue construction but also by increasing residents’ educational level, art appreciation level and health awareness.
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Affiliation(s)
- Huitao Ren
- Sport and Health College, Wenzhou University, Wenzhou, China.,Physical Education College, Quanzhou Normal University, Quanzhou, China
| | - Wei Liu
- Key Research Base of Humanities and Social Sciences in Colleges and Universities in Anhui Province-Quality Education Research Center for College Students of Anhui Xinhua University, Hefei, China.,Department of Physical Education, Anhui Vocational and Technical College of Sports, Hefei, China
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37
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Dierckens M, Richter M, Moor I, Elgar FJ, Clays E, Deforche B, De Clercq B. Trends in material and non-material inequalities in adolescent health and health behaviours: A 12-year study in 23 European countries. Prev Med 2022; 157:107018. [PMID: 35283161 DOI: 10.1016/j.ypmed.2022.107018] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 12/29/2021] [Accepted: 03/06/2022] [Indexed: 11/18/2022]
Abstract
Information on trends in adolescent health inequalities is scarce but the available evidence suggests that inequalities are increasing. Prior studies describe associations between material resources of socioeconomic status (SES) and health, while information on non-material SES resources and inequalities in health behaviours is lacking. To improve current understandings of evolutions in adolescent health inequalities, we examined how material and non-material SES resources were associated with changes in selected health outcomes (life satisfaction, physical and psychological symptoms) and health behaviours (physical activity, screen time, breakfast, fruit, vegetables, sweets and soft drinks consumption and alcohol and tobacco use) over a 12-year period. Repeated cross-sectional data came from the 2002, 2006, 2010 and 2014 waves of the Health Behaviour in School-aged Children (HBSC) survey from 23 European countries (n = 480,386). Measures of family affluence and occupational social class were used as indicators of material and non-material SES resources respectively. Regression-based slope indices of inequality indicated that absolute material and non-material inequalities remained stable from 2002 to 2014 in all health outcomes, except for life satisfaction for which a decrease in material inequalities was found between the highest and lowest affluence group (0.81 to 0.68 difference; p < 0.001). In terms of health behaviours, material inequalities decreased in screen time between highest and lowest affluence groups (0.53 to 0.34 h/day difference; p < 0.001), fruit (odds ratio [OR] 1.89 to 1.72 lower odds; p = 0.0088) and soft drinks consumption (OR 1.36 to 1.13 lower odds; p < 0.001) and remained stable in all others. Non-material inequalities increased in all health behaviours (except for sweets consumption) between highest and lowest occupational social class groups: physical activity (0.16 to 0.24 h/day difference; p = 0.0071), screen time (-0.41 to -0.58 h/day difference; p < 0.001), breakfast (0.21 to 0.51 day/week difference; p < 0.001), fruit (OR 1.23 to 1.48 higher odds; p < 0.001), vegetables (OR 1.39 to 1.74 higher odds; p < 0.001) and soft drinks consumption (OR 0.59 to 0.43 lower odds; p < 0.001) and alcohol (OR 0.99 to 0.85 lower odds; p = 0.0420) and tobacco use (OR 0.71 to 0.59 lower odds; p = 0.0183). In summary, non-material inequalities in most health behaviours increased, whereas material inequalities in adolescent health and health behaviours remain stable or decreased. Policies and interventions may consider non-material SES components as these can help in reducing future health inequalities.
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Affiliation(s)
- Maxim Dierckens
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, B-9000 Ghent, Belgium.
| | - Matthias Richter
- Institute of Medical Sociology, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112 Halle (Saale), Germany
| | - Irene Moor
- Institute of Medical Sociology, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112 Halle (Saale), Germany
| | - Frank J Elgar
- Institute for Health and Social Policy, McGill University, 2001 McGill College Avenue, Suite 1200, Montreal, Quebec, Canada
| | - Els Clays
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, B-9000 Ghent, Belgium
| | - Benedicte Deforche
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, B-9000 Ghent, Belgium; Movement and Nutrition for Health and Performance Research Group, Department of Movement and Sports Sciences, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium
| | - Bart De Clercq
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, B-9000 Ghent, Belgium
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38
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Refaeli T, Achdut N. Perceived poverty, perceived income adequacy and loneliness in Israeli young adults: Are social capital and neighbourhood capital resilience factors? HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:668-684. [PMID: 32959947 DOI: 10.1111/hsc.13177] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 07/26/2020] [Accepted: 08/25/2020] [Indexed: 06/11/2023]
Abstract
Loneliness is a severe risk factor that has been linked to diminished health outcomes and low quality of life across ages. Young adults have been identified as a high-risk group for experiencing loneliness, but only a few studies have explored the economic and social determinants of loneliness in this age group. Taking a social inequality approach to health, with loneliness as a focus, this study examined: (a) the associations between the following factors - subjective social status (SSS) indicators (perceived poverty and perceived income adequacy), offline and online social capital, and neighbourhood capital - and loneliness; and (2) whether social and neighbourhood capital were moderators in the association between SSS and loneliness. Cross-sectional data for individuals aged 20-29 were taken from the 2017 Israeli Social Survey (N = 1,508). Employing multinomial logit models, we found that perceived poverty was a strong predictor of loneliness. Greater social and neighbourhood capital decreased loneliness, whereas a higher use of online social networks increased loneliness. Neighbourhood capital and perceived trust were moderators, whereas trust was a resilience factor, neighbourhood capital strengthened the negative effect of perceived poverty on loneliness. To reduce the prevalence of loneliness in young adults, policymakers should examine various means of enhancing social and neighbourhood capital along with moderating the use of online social networks. However, they should be aware that interventions of this kind can do little to buffer the strong effect of perceived poverty on loneliness, as in most cases the effect of perceived poverty on the probability of loneliness is not ameliorated by improved social or neighbourhood resources.
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Affiliation(s)
- Tehila Refaeli
- The Charlotte Jack Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Netta Achdut
- The Charlotte Jack Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Saville C, Mann R. Cross-level group density interactions on mental health for cultural, but not economic, components of social class. Soc Sci Med 2022; 296:114790. [DOI: 10.1016/j.socscimed.2022.114790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/08/2021] [Accepted: 02/05/2022] [Indexed: 10/19/2022]
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Burgess A, Cavanagh K, Strauss C, Oliver BR. Headspace for parents: qualitative report investigating the use of a mindfulness-based app for managing parents' stress during COVID-19. BJPsych Open 2022; 8:e15. [PMID: 34956647 PMCID: PMC8692845 DOI: 10.1192/bjo.2021.1070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 09/24/2021] [Accepted: 11/19/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Stress can compromise parental well-being and may contribute to harsh and critical parenting styles, which are in turn associated with children's conduct problems. Coronavirus disease 2019 (COVID-19)-related restrictions are likely to have exacerbated parental stress as, for many, UK-based family life was altered considerably. Mindfulness has been demonstrated to improve stress management and emotion regulation when delivered to parents in person, however, more accessible online interventions are under-researched. AIMS To provide preliminary data on family well-being and parent-child relationships as well as the acceptability and usability of the Headspace app - a self-delivered mindfulness-based intervention - for parents in low-risk families during the early days of the COVID-19 pandemic. METHOD We provided 12 parents with access to Headspace, and collected qualitative data (semi-structured interviews and 5 minute speech samples) immediately following the initial COVID-19 lockdown in the UK. The resulting transcripts were thematically analysed. RESULTS Most parents reported Headspace to be acceptable and useful - improvements in parents' own sleep were particularly noted - and there was high adherence to the intervention. However, difficulties related to family well-being and parent-child relationships following the lockdown were also reported. CONCLUSIONS As a result of the confounding impact of COVID-19 restrictions, and varied access to app content, we were unable to determine any outcomes to be a result of practising mindfulness specifically. However, COVID-19 has had a profound impact on many UK-based families, including those previously at low risk, and our results demonstrate that Headspace may have beneficial effects for parents. There is a need to more rigorously test this tool with a broader range of families.
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Mollborn S, Modile A. "Dedicated to being healthy": Young adults' deployments of health-focused cultural capital. Soc Sci Med 2022; 293:114648. [PMID: 34906829 PMCID: PMC8810689 DOI: 10.1016/j.socscimed.2021.114648] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/01/2021] [Accepted: 12/07/2021] [Indexed: 01/03/2023]
Abstract
Performances of "health" through diet, exercise, and body size are an increasingly important form of cultural capital transmitted to children. Yet less is known about how socioeconomically privileged young people internalize and deploy that capital or how those less privileged manage their relative lack of capital. How does health-focused cultural capital acquired in childhood shape socioeconomic inequalities, health behaviors, and understandings of health in young adulthood? Our analysis of 113 interviews found that health-focused cultural capital acquired in early life reinforced young adults' socioeconomic and health advantages by helping them claim discipline and morality on the basis of their health behaviors and body size. Two key phenomena tended to be present among our many socioeconomically privileged but not our fewer less privileged participants: family socialization into classed diet- and exercise-related health behaviors resulting in a classed appearance of health (despite less-than-ideal behaviors), and cohesive life course narratives linking these behaviors to hard work and moral worth. Less socioeconomically privileged participants' understandings of health and healthy behaviors were different, rarely linking health to worthiness and discipline. To understand the intergenerational transmission of socioeconomic attainment and health in US society, we must consider how behaviors and group-based norms, identities, and understandings of health coalesce in classed health lifestyles that convey cultural capital.
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Affiliation(s)
- Stefanie Mollborn
- Department of Sociology, Stockholm University, 106 91, Stockholm, Sweden; Institute of Behavioral Science and Department of Sociology, University of Colorado Boulder, UCB 483, Boulder, CO, 80309, USA.
| | - Adenife Modile
- Institute of Behavioral Science and Department of Sociology, University of Colorado Boulder, UCB 483, Boulder, CO, 80309, USA
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Refaeli T, Krumer-Nevo M. Mental Distress during the Coronavirus Pandemic in Israel: Who Are the Most Vulnerable? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:124. [PMID: 35010378 PMCID: PMC8750296 DOI: 10.3390/ijerph19010124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/18/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
Based on Pearlin's stress process model and the social inequality approach to health, this study used a social lens to explore the role of socioeconomic inequities in mental distress during the COVID-19 pandemic in Israel. Specifically, we examined people's pre-pandemic sociodemographic characteristics and economic situation, and the economic effects of the pandemic itself on mental distress. A real-time survey was conducted in May 2020 among 273 adults (ages 20-68), and hierarchical linear models were employed. Findings indicated that groups vulnerable to mental distress in routine times (e.g., women, people with economic difficulties) showed the same pattern during the pandemic. Not only was unemployment related to mental distress, so too was a reduction in work hours. The pandemic's economic effects (e.g., needing to take out loans, having a worsening financial situation) were also associated with increased mental distress. This study is one of very few studies to explore a wide range of socioeconomic factors and their association with mental distress during the current crisis. The findings call for broader interventions to alleviate the economic distress caused by the pandemic to promote mental health, especially for groups that were vulnerable before the crisis and those most affected economically following the pandemic.
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Osteopathic ableism: A critical disability view of traditional osteopathic theory in modern practice. INT J OSTEOPATH MED 2021. [DOI: 10.1016/j.ijosm.2021.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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44
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Pedersen LH, Erdmann F, Aalborg GL, Hjalgrim LL, Larsen HB, Schmiegelow K, Winther JF, Dalton SO. Socioeconomic position and prediagnostic health care contacts in children with cancer in Denmark: a nationwide register study. BMC Cancer 2021; 21:1104. [PMID: 34649500 PMCID: PMC8518314 DOI: 10.1186/s12885-021-08837-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 09/30/2021] [Indexed: 11/28/2022] Open
Abstract
Background While underlying mechanisms and pathways of social inequalities in cancer survival have been extensively examined in adults, this is less so for children with cancer. Hypothesized mechanisms include prediagnostic utilization of and navigation through the health care system, which may differ by socioeconomic resources of the families. In this nationwide register-based study we investigated the association between measures of family socioeconomic position in relation to prediagnostic health care contacts and stage of disease at diagnosis in children with cancer in Denmark. Methods We identified all children diagnosed with a cancer at ages 0–15 years in 1998–2016 (N = 3043) from the Danish Childhood Cancer Registry. We obtained comprehensive information on measures of socioeconomic position, parental health and prediagnostic contacts to both general practitioners and hospitals 24 months prior to diagnosis from various national registries. We fitted multivariable conditional logistic regression models for the association of family socioeconomic and health-related variables with firstly, frequent health care contacts and secondly, advanced stage. Results We found higher odds ratios (OR) of frequent both overall and emergency health care contacts in the last 3 months before diagnosis in children from households with short parental education and mixed affiliation to work market, when compared to children with high family socioeconomic position. Further, children of parents with depression or of non-Western origin, respectively, had higher OR for frequent overall and emergency contacts. We found no association between socioeconomic position, parental health and stage of disease. Conclusion Families with socioeconomic disadvantage, non-Western origin or depression more frequently utilize prediagnostic health care services, both generally and in the acute setting, indicating that some disadvantaged families may struggle to navigate the health care system when their child is sick. Reassuringly, this was not reflected in disparities in stage at diagnosis. In order to improve the diagnostic process and potentially reduce health care contacts, attention and support should be given to families with a high number of health care contacts over a short period of time. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08837-x.
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Affiliation(s)
- Line Hjøllund Pedersen
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark. .,Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark.
| | - Friederike Erdmann
- Division of Childhood Cancer Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics (IMBEI), Johannes Gutenberg University Mainz, Mainz, Germany
| | - Gitte Lerche Aalborg
- Statistics and Data Analysis, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Lisa Lyngsie Hjalgrim
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark
| | - Hanne Bækgaard Larsen
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kjeld Schmiegelow
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Susanne Oksbjerg Dalton
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Oncology & Palliative Care, Zealand University Hospital, Naestved, Denmark
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45
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Miner SA. Cultural health capital and the stratification of reproduction in Czech and Spanish egg donation markets. SOCIOLOGY OF HEALTH & ILLNESS 2021; 43:1887-1902. [PMID: 34453321 DOI: 10.1111/1467-9566.13363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 07/31/2021] [Accepted: 08/03/2021] [Indexed: 06/13/2023]
Abstract
This article explores the ways that fertility clinics in the Czech Republic and Spain attract international fertility clients for fertility treatment involving egg donation. I draw upon a content analysis of 18 fertility clinics' advertising materials and 31 in-depth interviews with fertility professionals in the Czech Republic and Spain, and Canadian fertility travellers to show how clinics use cultural health capital (CHC) to persist as popular destination sites for fertility travellers. I argue that the use of evidence-based medicine and patient-centred care combined with bioracial discourses are strategies by which clinics create a culture of fertility care that is legible to white, middle-class, hetero travellers. My interviews with fertility patients who travelled to these sites show the ways in which CHC is interactional-I document how fertility travellers desire these specific practices that are both created for and marketed to them. By expanding the definition of CHC to show how fertility clinics market and fertility travellers expect a particular culture of fertility medicine, I elucidate the interactions between clinics and professionals that reinforce ideals of white motherhood and the stratification of reproduction.
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Affiliation(s)
- Skye A Miner
- Department of Sociology, McGill University, Montreal, QC, Canada
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46
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Mollborn S, Lawrence EM, Onge JMS. Contributions and Challenges in Health Lifestyles Research. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2021; 62:388-403. [PMID: 34528487 PMCID: PMC8792463 DOI: 10.1177/0022146521997813] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The concept of health lifestyles is moving scholarship beyond individual health behaviors to integrated bundles of behaviors undergirded by group-based identities and norms. Health lifestyles research merges structure with agency, individual-level processes with group-level processes, and multifaceted behaviors with norms and identities, shedding light on why health behaviors persist or change and on the reproduction of health disparities and other social inequalities. Recent contributions have applied new methods and life course perspectives, articulating health lifestyles's dynamic relationships to social contexts and demonstrating their implications for health and development. Culturally focused work has shown how health lifestyles function as signals for status and identity and perpetuate inequalities. We synthesize literature to articulate recent advances and challenges and demonstrate how health lifestyles research can strengthen health policies and inform scholarship on inequalities. Future work emphasizing health lifestyles's collective nature and attending to upstream social structures will further elucidate complex social processes.
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Affiliation(s)
- Stefanie Mollborn
- Institute of Behavioral Science and Department of Sociology, University of Colorado Boulder, UCB 483, 1440 15 St, Boulder, CO 80309-0483, USA
| | - Elizabeth M. Lawrence
- Department of Sociology, University of Nevada-Las Vegas, 4505 S. Maryland Pkwy, Las Vegas, NV 89154
| | - Jarron M. Saint Onge
- Departments of Sociology and Health Policy and Management, University of Kansas, 716 Fraser Hall, Lawrence, KS 66045-7556
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47
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Dai X, Li W. Impact of Education, Medical Services, and Living Conditions on Health: Evidence from China Health and Nutrition Survey. Healthcare (Basel) 2021; 9:healthcare9091122. [PMID: 34574896 PMCID: PMC8466347 DOI: 10.3390/healthcare9091122] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/26/2021] [Accepted: 08/26/2021] [Indexed: 11/19/2022] Open
Abstract
Education, medical services, and living conditions can influence individual health and health literacy. We used the 2015 China Health and Nutrition Survey data to analyze the impact of education, medical services, and living conditions on individual health by extending the Grossman model. As a result, using the instrumental variable (read, write, and draw) two-stage least square method, we found that education, medical services, and living conditions have a positive impact on individual health, both physical health and psychological health. Among them, medical services have the largest influence, followed by living conditions and education. In addition, the results are robust. However, individual characteristics, family income, and working status also affect individual health. Moreover, we observed heterogeneity in age, sex, and residence in the impact of education, medical services, and living conditions on individual health. In particular, the health of the rural elderly and elderly women is more sensitive to education, the medical services of middle-aged women and young men have a greater impact on their health, and the living conditions of the rural elderly and youth have a greater impact on their health. All the findings are helpful for optimizing the path of the Healthy China program.
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Affiliation(s)
- Xianhua Dai
- School of Public Administration, Central China Normal University, Wuhan 430079, China;
- Center for Labor and Social Security Research, Central China Normal University, Wuhan 430079, China
- Correspondence: or
| | - Wenchao Li
- School of Public Administration, Central China Normal University, Wuhan 430079, China;
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48
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Mollborn S, Rigles B, Pace JA. "Healthier Than Just Healthy": Families Transmitting Health as Cultural Capital. SOCIAL PROBLEMS 2021; 68:574-590. [PMID: 34381314 PMCID: PMC8341485 DOI: 10.1093/socpro/spaa015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
As the relationship between social class and health strengthens and socioeconomic and health inequalities widen, understanding how parents' socioeconomic advantage translates into health and class advantages in the next generation is increasingly important. Our analyses illustrate how a classed performance of "health" is a fundamental component of transmitting cultural capital in families and communities. Socially advantaged parents' health and class goals for children are often met simultaneously by building children's cultural capital in community-specific ways. This study uses observational, interview, and focus group data from families in two middle-class communities to illustrate how health-focused cultural capital acquisition plays out in everyday life. As parents manage children's lives to ensure future advantages, they often focus on health-related behaviors and performances as symbols of class-based distinction for their children. The synergy between family and community cultural capital is strengthening class and health advantages for some children, even as health-focused cultural capital often has drawbacks for stress and well-being. The intensification of and value placed on "health" in cultural capital may have long-term implications for health, socioeconomic attainment, and inequalities. If health-focused cultural capital continues to become increasingly salient for status attainment, its importance could grow, widening these gaps and reducing intergenerational mobility.
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49
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Shiri Mohammadabad H, Afshani SA. Women's Participation in Self-Care and the Importance of Paying Attention to Cultural Capital: A Cross-Sectional Study among Women in Yazd (Iran). INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2021:272684X211033463. [PMID: 34256633 DOI: 10.1177/0272684x211033463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The present study aimed to investigate the relationship between women's cultural capital and self-care. A survey was employed with a sample size of 737 women living in the marginal, middle, and upper areas of Yazd in terms of socioeconomic characteristics. Data were analyzed using structural equation modelling by SPSS and Amos version 24. The results revealed that the effect of cultural capital on self-care was positive and significant (β = 0.46, p < 0.001). The effectiveness rates of cultural capital on women's self-care in the marginal, middle, and upper areas were 0.44, 0.32 and 0.45, respectively (p < 0.001). Besides, there was no significant difference between the intensity of the relationship between cultural capital and self-care in the three areas (CR < 1.96). The fit indices also indicated that the model had a good fit (CMIN/DF = 2.560, NFI = 0.916, RMSEA = 0.033, CFI = 0.946, TLI = 0.922, GFI = 0.963, IFI = 0.947).
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Affiliation(s)
| | - Seyed Alireza Afshani
- Department of Cooperative and Social Welfare, Faculty of Social science, Yazd University, Iran
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50
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Murakami K, Ishikuro M, Ueno F, Noda A, Onuma T, Matsuzaki F, Metoki H, Obara T, Kuriyama S. Associations of education and income with hazardous drinking among postpartum women in Japan: results from the TMM BirThree Cohort Study. Environ Health Prev Med 2021; 26:70. [PMID: 34217215 PMCID: PMC8254918 DOI: 10.1186/s12199-021-00991-9] [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: 03/29/2021] [Accepted: 06/20/2021] [Indexed: 11/30/2022] Open
Abstract
Background Although the postpartum period is suggested to provide an ideal opportunity for interventions to prevent hazardous drinking, evidence on the associations of education and income with hazardous drinking during this period is limited, including in Japan. Methods We analyzed data from 11,031 women who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study in Japan. Hazardous drinking was defined as ethanol intake of ≥20 g/day 1 year after delivery. We conducted multiple logistic regression analyses to examine whether educational attainment or equivalent household income was associated with hazardous drinking, adjusting for age, parity, drinking status during pregnancy, work status, postpartum depression, breastfeeding, and income/education. We also conducted stratified analyses by income and education groups. Results The prevalence of hazardous drinking 1 year after delivery was 3.6%. Lower education was associated with hazardous drinking; the odds ratio (95% confidence interval) of high school education or lower compared with university education or higher was 2.17 (1.59–2.98). Lower income was also associated with hazardous drinking, but this association disappeared after further adjustments for education; the odds ratios (95% confidence intervals) of the lowest compared with highest level of income were 1.42 (1.04–1.94) and 1.12 (0.81–1.54), respectively. A significant interaction was detected; lower education and lower income were associated with increased risks of hazardous drinking only in a lower income group and lower education group, respectively. Conclusions Postpartum women with lower education and lower income had higher risks of hazardous drinking in Japan. Supplementary Information The online version contains supplementary material available at 10.1186/s12199-021-00991-9.
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Affiliation(s)
- Keiko Murakami
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan. .,Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
| | - Mami Ishikuro
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Fumihiko Ueno
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Aoi Noda
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.,Department of Pharmaceutical Sciences, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Tomomi Onuma
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
| | - Fumiko Matsuzaki
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
| | - Hirohito Metoki
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8536, Japan
| | - Taku Obara
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.,Department of Pharmaceutical Sciences, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Shinichi Kuriyama
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.,Department of Disaster Public Health, International Research Institute of Disaster Science, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
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