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Bijlani C, Vrinten C, Junghans C, Chang K, Lewis E, Mulla U, Seferidi P, Laverty AA, Vamos EP. Changes in diet and physical activity following a community-wide pilot intervention to tackle childhood obesity in a deprived inner-London ward. BMC Public Health 2024; 24:800. [PMID: 38481177 PMCID: PMC10938768 DOI: 10.1186/s12889-024-18192-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/23/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Local authorities in England have an important role in shaping healthy local environments contributing to childhood obesity. This study examined changes in diet and physical activity in primary school children following a three-year, complex, community-based intervention in Golborne ward, the second most deprived ward in London. METHODS The Go-Golborne intervention aimed to shape the local environment across multiple settings with the engagement of a large number of local government and community stakeholders in a joint approach. Activities focused on six co-created themes to make changes to local environments and reduce sugary snacks and beverage consumption, increase fruit and vegetable intake, promote healthy snacks, increase active play and travel, and reduce screen time. We analysed changes in self-reported diet and physical activity, collected annually between 2016 and 2019, from 1,650 children aged 6-11 years through six local schools, who all received the intervention. We used multilevel, linear and logistic random-slope regression models adjusted for time on study, baseline age, gender, ethnicity, deprivation quintile, school, and baseline weight status. RESULTS After three years of follow-up, there were reductions in sugar-sweetened beverage consumption (adjusted beta -0·43 occasions/day, 95% CI -0·55 to -0·32), fruit and vegetable consumption (adjusted beta -0.22 portions, 95% CI -0.44 to 0.001) and car travel to and from school (adjusted OR 0·19, 95% CI 0·06 to 0·66), while screen time increased (high versus moderate/low: OR 2·30, 95% CI 1·36 to 3·90). For other behavioural outcomes, there was no statistically significant evidence of changes. CONCLUSION Local authorities have substantial powers to make positive changes to the obesogenic environment but programmes remain under-evaluated. Results from the ambitious Go-Golborne intervention demonstrated mixed results in health behaviours following programme implementation. These results underline the importance of a coordinated and comprehensive policy response to support changes in wider environmental and social conditions as well as appropriate and holistic evaluations of initiatives to inform local actions on obesogenic environments.
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Affiliation(s)
- Charan Bijlani
- Department of Primary Care & Public Health, Public Health Policy Evaluation Unit, Imperial College London, 3rd Floor Reynolds Building, St Dunstan's Road, London, W6 8RP, UK.
- National Institute of Health Research (NIHR) School of Public Health Research (SPHR), London, UK.
| | - Charlotte Vrinten
- Department of Primary Care & Public Health, Public Health Policy Evaluation Unit, Imperial College London, 3rd Floor Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
| | - Cornelia Junghans
- Department of Primary Care & Public Health, Public Health Policy Evaluation Unit, Imperial College London, 3rd Floor Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
- National Institute for Health and Care Research Applied Research Collaboration Northwest London, London, UK
| | - Kiara Chang
- Department of Primary Care & Public Health, Public Health Policy Evaluation Unit, Imperial College London, 3rd Floor Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
| | | | - UmmeZeinab Mulla
- Department of Primary Care & Public Health, Public Health Policy Evaluation Unit, Imperial College London, 3rd Floor Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
| | - Paraskevi Seferidi
- Department of Primary Care & Public Health, Public Health Policy Evaluation Unit, Imperial College London, 3rd Floor Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
| | - Anthony A Laverty
- Department of Primary Care & Public Health, Public Health Policy Evaluation Unit, Imperial College London, 3rd Floor Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
| | - Eszter P Vamos
- Department of Primary Care & Public Health, Public Health Policy Evaluation Unit, Imperial College London, 3rd Floor Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
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Libuy N, Church D, Ploubidis G, Fitzsimons E. Fast food proximity and weight gain in childhood and adolescence: Evidence from Great Britain. HEALTH ECONOMICS 2024; 33:449-465. [PMID: 37971895 PMCID: PMC10952272 DOI: 10.1002/hec.4770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 09/08/2023] [Accepted: 09/18/2023] [Indexed: 11/19/2023]
Abstract
We study the relationship between proximity to fast food restaurants and weight gain from late childhood to early adolescence. We use the Millennium Cohort Study, a UK-wide nationally representative longitudinal study, linked with granular geocoded food outlet data to measure the presence of fast food outlets around children's homes and schools from ages 7 to 14. We find that proximity to fast food outlets is associated with increased weight (body mass index, overweight, obese, body fat, weight), but only among those with maternal education below degree level. Within this sample, those with lower levels of emotional regulation are at heightened risk of weight gain.
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Affiliation(s)
- Nicolás Libuy
- Centre for Longitudinal Studies, Social Research Institute, UCLLondonUK
| | - David Church
- Centre for Longitudinal Studies, Social Research Institute, UCLLondonUK
| | - George Ploubidis
- Centre for Longitudinal Studies, Social Research Institute, UCLLondonUK
| | - Emla Fitzsimons
- Centre for Longitudinal Studies, Social Research Institute, UCLLondonUK
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Broadbent P, Shen Y, Pearce A, Katikireddi SV. Trends in inequalities in childhood overweight and obesity prevalence: a repeat cross-sectional analysis of the Health Survey for England. Arch Dis Child 2024; 109:233-239. [PMID: 38262695 PMCID: PMC10894838 DOI: 10.1136/archdischild-2023-325844] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 11/22/2023] [Indexed: 01/25/2024]
Abstract
OBJECTIVE To examine trends in socio-economic and ethnic inequalities in childhood overweight and obesity in the England between 1995 and 2019 in survey data and to compare these to administrative data. DESIGN Observational repeated cross-sectional study using the Health Survey for England (HSE) and National Child Measurement Programme (NCMP). OUTCOME Age and sex standardised overweight, obesity and overweight including obesity. ANALYSIS Inequalities assessed by parental education, family structure, ethnicity (binary non-white vs white) and area-level Index of Multiple Deprivation. Estimates stratified by age and sex. Trends compared against NCMP data (age 4-5 and 10-11 years). RESULTS Prevalence of childhood overweight including obesity increased from 26.0% in 1995 to 31.7% in 2019, with the highest and fastest growing levels in those aged 11-15 years, rising from 29.7% to 38.0%. Despite a plateau in overall childhood obesity since 2004, differences between groups demonstrated widening inequalities over time. Inequalities widened by area-level deprivation, household educational attainment, household structure and ethnicity driven primarily by increased prevalence among socioeconomically disadvantaged children. For example, the gap between children from households with no qualifications versus degree-level qualifications increased from -1.1% to 13.2%, and the gap between single-parent households and couple households increased from 0.5% to 5.3%. HSE trends in prevalence of childhood overweight and obesity by deprivation quintile were consistent with those in NCMP. CONCLUSION Overall levels of child overweight and obesity increased between 1995 and 2004. Since then, increases in prevalence among less advantaged groups have driven widening of inequalities.
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Affiliation(s)
- Philip Broadbent
- University of Glasgow MRC/CSO Social and Public Health Sciences Unit, Glasgow, UK
- NHS Education for Scotland, Edinburgh, UK
| | - Yue Shen
- University of Glasgow MRC/CSO Social and Public Health Sciences Unit, Glasgow, UK
| | - Anna Pearce
- University of Glasgow MRC/CSO Social and Public Health Sciences Unit, Glasgow, UK
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Mendez I, Fasano MV, Orden AB. Exploring factors associated with obesity in Argentinian children using structural equation modeling. CAD SAUDE PUBLICA 2023; 39:e00087822. [PMID: 37585902 PMCID: PMC10494703 DOI: 10.1590/0102-311xen087822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 03/09/2023] [Accepted: 04/20/2023] [Indexed: 08/18/2023] Open
Abstract
Habits and behaviors related to obesity risk are strongly associated with the family environment and are affected by socioeconomic factors. Structural equation modeling (SEM) allows us to hypothesize on how the relationships between these factors occur and measure their impact. This study aimed to explore the relationship between family socioeconomic indicators and childhood obesity, mediated by habits linked to energy balance, applying a SEM. A cross sectional study was performed on 861 Argentinian schoolchildren aged 6-12 years, from 2015 to 2016. The model included three latent variables: socioeconomic status, healthy habits, and obesity. Socioeconomic status indicators and healthy habits were surveyed by self-administered parental questionnaires, whereas obesity indicators were evaluated with anthropometry. The applied model showed an acceptable fit (NFI = 0.966; CFI = 0.979; RMSEA = 0.048). Socioeconomic status positively influenced parental education, health insurance, and car possession, while negatively influenced crowding (p < 0.001). Healthy habits significantly influenced physical activity, meals frequency, and sleep hours, while negatively influenced sedentary hours and mother's nutritional status (p < 0.001). Obesity factor positively influenced body mass index, body fat, and waist-to-height ratio (p < 0.001). Finally, socioeconomic status positively influenced health habits, which in turn negatively influenced obesity factor. Healthy habits (especially physical activity and mother's nutritional status) mediated the relationship between socioeconomic status and child obesity. Further research should include other indicators related to diet, eating habits, and physical activity like neighborhood characteristics.
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Affiliation(s)
- Ignacio Mendez
- Instituto de Desarrollo e Investigaciones Pediátricas, Buenos Aires, Argentina
| | - María Victoria Fasano
- Instituto de Desarrollo e Investigaciones Pediátricas, Buenos Aires, Argentina
- Centro de Matemática La Plata, Facultad de Ciencias Exactas, La Plata, Argentina
| | - Alicia B Orden
- Centro de Salud e Investigaciones Médicas, La Pampa, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
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Pérez-Muñoz C, Carretero-Bravo J, Ortega-Martín E, Ramos-Fiol B, Ferriz-Mas B, Díaz-Rodríguez M. Interventions in the first 1000 days to prevent childhood obesity: a systematic review and quantitative content analysis. BMC Public Health 2022; 22:2367. [PMID: 36527103 PMCID: PMC9758903 DOI: 10.1186/s12889-022-14701-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/22/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Childhood obesity poses a global health challenge. In recent years, there has been an increase in interventions that begin in pregnancy, putting the concept of early programming and early risk factors into practice. The present study aims to update the findings regarding interventions in the first 1000 days of life. METHODS A systematic review based on the PRISMA guidelines was carried out in PubMed, WoS, Scopus and CINAHL to obtain the articles to be analysed. We included those studies published between 2016 and 2021. Human interventions that started within the first 1000 days of life and acted on at least one programming factor were included. Once selected, coding and quantitative content analysis was carried out to obtain a profile of the interventions during the first 1000 days. RESULTS From all screened articles, 51 unique interventions, which met the selection criteria, were included. The majority of interventions (81%) took place in high-income areas. Almost all (86%) were targeted at the general population. The majority (54%) started in the second trimester of pregnancy. A clear majority (61%) ended at the time of birth. 44% of the interventions included all pregnant women. Only 48% of these interventions were focused on improving the nutritional status of the offspring in the short term. Most interventions collected the baby's weight at birth (68%). CONCLUSIONS It can be concluded that current interventions are not covering as many aspects as they should. Future research should be conducted more frequently in developing countries and target disadvantaged groups. These interventions should include all pregnant women, regardless of their nutritional status, aiming to cover as many programming factors as possible and extending through the first 1000 days of life, with body mass index or skinfolds as measures of effectiveness during this period.
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Affiliation(s)
- Celia Pérez-Muñoz
- grid.7759.c0000000103580096Facultad de Enfermería Y Fisioterapia, University of Cádiz, Ana de Viya 52, 11009 Cádiz, Spain
| | - Jesús Carretero-Bravo
- grid.7759.c0000000103580096Facultad de Enfermería Y Fisioterapia, University of Cádiz, Ana de Viya 52, 11009 Cádiz, Spain
| | - Esther Ortega-Martín
- grid.7759.c0000000103580096Facultad de Enfermería Y Fisioterapia, University of Cádiz, Ana de Viya 52, 11009 Cádiz, Spain
| | - Begoña Ramos-Fiol
- grid.7759.c0000000103580096Facultad de Enfermería Y Fisioterapia, University of Cádiz, Ana de Viya 52, 11009 Cádiz, Spain
| | | | - Mercedes Díaz-Rodríguez
- grid.7759.c0000000103580096Facultad de Enfermería Y Fisioterapia, University of Cádiz, Ana de Viya 52, 11009 Cádiz, Spain
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Holstein BE, Andersen A, Damsgaard MT, Madsen KR, Pedersen TP. Underweight among adolescents in Denmark: prevalence, trends (1998-2018), and association of underweight with socioeconomic status. Fam Pract 2022; 39:413-419. [PMID: 34718536 DOI: 10.1093/fampra/cmab134] [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] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Underweight among adolescents is an important clinical and public health issue. It is associated with adverse health outcomes throughout the life-span and may reflect food poverty, unhealthy eating habits, or some underlying health conditions. OBJECTIVE To study prevalence and trends in underweight among adolescents 1998-2018, to examine social inequality in underweight, and whether social inequality changed over time. METHODS Data were derived from 6 cross-sectional school surveys from The Health Behaviour in School-aged Children study in Denmark. The study included 11-, 13-, and 15-year-old schoolchildren in random samples of schools in 1998, 2002, 2006, 2010, 2014, and 2018 (n = 22,177). Underweight was determined by body mass index-for-age thinness grade 2-3 (the Cole and Lobstein method). Socioeconomic status was determined using occupational social class (the Danish OSC Measurement). RESULTS The overall prevalence of underweight was 3.1% among boys and 5.3% among girls (P < 0.0001) and decreased by age (P < 0.0001) among both boys and girls. The prevalence of underweight was almost stable from 1998 to 2018. There was no observed absolute or relative social inequality in the prevalence of underweight among boys or girls. CONCLUSION The prevalence of underweight in 11- to 15-year-olds was significantly higher among girls than boys. The prevalence remained stable from 1998 to 2018. There was no significant association between SES and prevalence of underweight. It is important to elucidate the underlying causes of underweight such as malnutrition, eating disorders, eating problems, loss of appetite, chronic diseases, insufficient knowledge of nutrients effects on bodily functions, and persistent pain.
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Affiliation(s)
- Bjørn E Holstein
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Anette Andersen
- Steno Diabetes Center, Aarhus University Hospital, Aarhus, Denmark
| | - Mogens Trab Damsgaard
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Katrine Rich Madsen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Trine Pagh Pedersen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Calvert SM, Dempsey RC, Povey R, Clark-Carter D. An in-school social norms approach intervention for reducing unhealthy snacking behaviours amongst 11-12-year-olds. Br J Health Psychol 2022; 27:891-914. [PMID: 35080782 DOI: 10.1111/bjhp.12581] [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: 07/02/2021] [Revised: 12/20/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Adolescents tend to overestimate the extent of peers' unhealthy snacking consumption and such misperceptions have been associated with increased personal unhealthy snacking. This study aims to test whether a Social Norms Approach (SNA) intervention which challenges these misperceptions of peers' unhealthy snacking will have a positive effect on students' personal unhealthy snacking behaviours, related attitudes, and behavioural intentions. DESIGN A quasi-experimental study tested the effectiveness of an in-school SNA intervention (n = 163) compared to a control condition (n = 95) among 11-12-year-old students. METHOD Both conditions received healthy eating information, while students in the SNA intervention received additional normative feedback (outlining the discrepancies between perceived and actual unhealthy snacking of the majority based on baseline data) delivered through an interactive poster-making session. Students completed self-reported measures of personal unhealthy snacking, related-attitudes, behavioural intentions, and normative perceptions (descriptive and injunctive) at baseline, post-intervention, and at a 3-month follow-up. RESULTS Students who received SNA feedback were significantly less likely to overestimate peers' unhealthy snacking attitudes post-intervention (F(1,232) = 16.405, p < .001), and at 3-month follow-up consumed fewer unhealthy snacks (F(1,232) = 6.133, p = .014) and had less positive attitudes towards unhealthy snacking (F(1,198) = 8.779, p = .003). The changes in personal snacking attitudes at 3-month follow-up were mediated by changes in normative misperceptions about peers' unhealthy snacking attitudes post-intervention, which indicated that the reductions in normative misperceptions following SNA messages mediated the effect of the intervention. CONCLUSION The results indicate that in-school SNA interventions which challenge normative misperceptions constitute a promising strategy for reducing unhealthy snacking in young adolescents.
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Affiliation(s)
- Sian M Calvert
- The Staffordshire Centre for Psychological Research, Staffordshire University, Stoke-on-Trent, UK
| | - Robert C Dempsey
- Department of Psychology, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, UK
| | - Rachel Povey
- The Staffordshire Centre for Psychological Research, Staffordshire University, Stoke-on-Trent, UK
| | - David Clark-Carter
- The Staffordshire Centre for Psychological Research, Staffordshire University, Stoke-on-Trent, UK
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Cobiac LJ, Scarborough P. Modelling future trajectories of obesity and body mass index in England. PLoS One 2021; 16:e0252072. [PMID: 34077469 PMCID: PMC8172072 DOI: 10.1371/journal.pone.0252072] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 05/10/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Obesity is a leading risk for poor health outcomes in England. We examined best- and worst-case scenarios for the future trajectory of the obesity epidemic. METHODS Taking the last 27 years of Health Survey for England data, we determined both position and shape of the adult body mass index (BMI) distribution and projected these parameters 20 years forward in time. For the best-case scenario, we fitted linear models, allowing for a quadratic relationship between the outcome variable and time, to reflect a potential reversal in upwards trends. For the worst-case scenario, we fitted non-linear models that applied an exponential function to reflect a potential flattening of trends over time. Best-fitting models were identified using Monte Carlo cross-validation on 1991-2014 data, and predictions of population prevalence across five BMI categories were then validated using 2015-17 data. RESULTS Both linear and non-linear models showed a close fit to observed data (mean absolute error <2%). In the best-case scenario, the proportion of the population at increased risk (BMI≥25kg/m2) is predicted to fall from 66% in 2017 to 53% (95% confidence interval: 41% to 64%) in 2035. In the worst-case scenario, this proportion is likely to remain relatively stable overall- 64% (37% to 90%) in 2035 -but with an increasing proportion of the population at highest risk (BMI≥35kg/m2). CONCLUSIONS While obesity prediction depends on chosen modelling methods, even under optimistic assumptions it is likely that the majority of the English population will still be at increased risk of disease due to their weight until at least 2035, without greater allocation of resources to effective interventions.
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Affiliation(s)
- Linda J. Cobiac
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- * E-mail:
| | - Peter Scarborough
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
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Bann D, Fitzsimons E, Johnson W. Determinants of the population health distribution: an illustration examining body mass index. Int J Epidemiol 2021; 49:731-737. [PMID: 32737506 PMCID: PMC7394943 DOI: 10.1093/ije/dyz245] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 11/22/2019] [Indexed: 01/03/2023] Open
Abstract
Most epidemiological studies examine how risk factors relate to average difference in outcomes (linear regression) or odds of a binary outcome (logistic regression); they do not explicitly examine whether risk factors are associated differentially across the distribution of the health outcome investigated. This paper documents a phenomenon found repeatedly in the minority of epidemiological studies which do this (via quantile regression): associations between a range of established risk factors and body mass index (BMI) are progressively stronger in the upper ends of the BMI distribution. In this paper, we document this finding and provide illustrative evidence of it in the 1958 British birth cohort study. Associations of low childhood socio-economic position, high maternal weight, low childhood general cognition and adult physical inactivity with higher BMI are larger at the upper end of the BMI distribution, on both absolute and relative scales. For example, effect estimates for socio-economic position and childhood cognition were around three times larger at the 90th compared with 10th quantile, while effect estimates for physical inactivity were increasingly larger from the 50th to 90th quantiles, yet null at lower quantiles. We provide potential explanations for these findings and discuss implications. Risk factors may have larger causal effects among those in worse health, and these effects may not be discovered when health is only examined in average terms. In such scenarios, population-based approaches to intervention may have larger benefits than anticipated when assuming equivalent benefit across the population. Further research is needed to understand why effect estimates differ across the BMI outcome distribution and to investigate whether differential effects exist for other physical and mental health outcomes.
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Affiliation(s)
- David Bann
- Centre for Longitudinal Studies, University College London Institute of Education, London, UK.,School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Emla Fitzsimons
- Centre for Longitudinal Studies, University College London Institute of Education, London, UK.,School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - William Johnson
- Centre for Longitudinal Studies, University College London Institute of Education, London, UK.,School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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Stewart R, Reilly JJ, Hughes A, Kelly LA, Conway DI, Young D, Sherriff A. Trends in socioeconomic inequalities in underweight and obesity in 5-year-old children, 2011-2018: a population-based, repeated cross-sectional study. BMJ Open 2021; 11:e042023. [PMID: 33741661 PMCID: PMC7986667 DOI: 10.1136/bmjopen-2020-042023] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To explore trends in prevalence and socioeconomic inequalities in underweight and obesity in 5-year-old schoolchildren in Scotland between 2011/2012 and 2017/2018. DESIGN A population-based, repeated cross-sectional study. SETTING Local authority primary schools in Scotland. PARTICIPANTS 373 189 5-year-old schoolchildren in Scotland between 2011/2012 and 2017/2018. METHODOLOGY Trends in prevalence and inequalities in underweight and obesity were examined across seven school years (2011/2012-2017/2018) for 373 189 5-year-old schoolchildren in Scotland. Body mass index SD scores were calculated, and epidemiological cut-offs relative to the UK 1990 references categorised underweight and obesity. Slope/relative indices of inequality (SII/RII) were calculated for underweight and obesity by school year using the area-based Scottish Index of Multiple Deprivation. RESULTS The prevalence of obesity rose slightly overall during the study period (9.8% in 2011/2012; 10.1% in 2017/2018). However, this masked a widening of inequalities, with children from the most deprived areas experiencing a greater risk of obesity in 2017/2018 than in 2011/2012 (risk ratio=1.14, 95% CI 1.04 to 1.25) compared with an unchanged risk in children from the least deprived areas (risk ratio=0.95, 95% CI 0.82 to 1.11). SII and RII indicate widening inequalities for obesity, with RII rising from 1.95 (95% CI 1.71 to 2.22) in 2011/2012 to 2.22 (95% CI 1.93 to 2.56) in 2017/2018. The prevalence of underweight was consistently low (compared with the UK 1990 references) and remained unchanged over the study period (1.2% in 2011/2012; 1.1% in 2017/2018), with no consistent evidence of social patterning over time. CONCLUSIONS Inequalities in obesity in schoolchildren in Scotland are large and have widened from 2011, despite only a slight rise in overall prevalence. In contrast there has been little change in underweight prevalence or inequalities during the study period. Extra resources for policy implementation and measures which do not widen inequalities and focus on reaching the most deprived children are required to tackle the high prevalence and growing inequalities in childhood obesity in Scotland.
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Affiliation(s)
- Ryan Stewart
- School of Dentistry, Medicine and Nursing, College of MVLS, University of Glasgow, Glasgow, UK
| | - John J Reilly
- School of Psychological Science and Health, University of Strathclyde, Glasgow, UK
| | - Adrienne Hughes
- School of Psychological Science and Health, University of Strathclyde, Glasgow, UK
| | - Louise A Kelly
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - David I Conway
- School of Dentistry, Medicine and Nursing, College of MVLS, University of Glasgow, Glasgow, UK
| | - David Young
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - Andrea Sherriff
- School of Dentistry, Medicine and Nursing, College of MVLS, University of Glasgow, Glasgow, UK
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Reversal of the Upward Trend of Obesity in Boys, but Not in Girls, in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041842. [PMID: 33672817 PMCID: PMC7918759 DOI: 10.3390/ijerph18041842] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/06/2021] [Accepted: 02/11/2021] [Indexed: 01/22/2023]
Abstract
(1) Background: To compare the prevalence of overweight and obesity in boys and girls and to estimate socioeconomic differences associated with obesity in Spain in 1997, 2007, and 2017. (2) Methods: Data were drawn from national health interview surveys. For each year of study, the prevalence of overweight and obesity was measured, and these results were compared by gender (boy/girl) and socioeconomic status (low/high education). (3) Results: The prevalence of overweight and obesity rose from 1997 to 2007 but then fell in 2017 in all subgroups except in girls aged 10 to 15 years. In this group, there was a steady increase in the prevalence of both overweight (1997, 14.6%; 2007, 17.7%; 2017, 19.6%) and obesity (1.1, 3.2, and 3.7%, respectively). The decrease in prevalence of overweight in both sexes and of obesity in boys, along with the increase in prevalence of obesity in girls, was of a higher magnitude in children whose parents had a lower educational level. (4) Conclusions: The apparent turnaround in the obesity epidemic in Spain should be interpreted with caution. Children’s body weight is influenced by both gender and socioeconomic status—considerations that should be kept in mind when designing health promotion interventions.
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Oztumer CA, Chaudhry RM, Alrubaiy L. Association between behavioural risk factors for chronic liver disease and transient elastography measurements across the UK: a cross-sectional study. BMJ Open Gastroenterol 2020; 7:bmjgast-2020-000524. [PMID: 33214232 PMCID: PMC7678228 DOI: 10.1136/bmjgast-2020-000524] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 10/13/2020] [Accepted: 10/27/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Chronic liver disease (CLD) is a largely preventable condition with increasing burden on National Health Service resources. We aimed to determine the prevalence of behavioural risk factors for CLD and their association with liver stiffness and socioeconomic status in the UK. DESIGN In this cross-sectional study, adults aged ≥18 years were invited to complete a liver health screener and have a liver stiffness measurement (LSM) by transient elastography (TA) to screen for alcohol intake, obesity and viral hepatitis risk across different areas in the UK. Index of Multiple Deprivation (IMD) scores were used as a measure of socioeconomic status. We performed binary logistic regression, adjusting for age, gender, alcohol consumption, body mass index, diet and viral hepatitis risk to determine the factors associated with LSM and IMD. RESULTS We analysed the data from 2150 individuals across 25 UK areas. Of those, 24.1% had high-risk alcohol consumption, 29.6% had high-risk diets, 24.7% were obese and 32.7% had risk factors for viral hepatitis. LSMs were available for 1043 participants, of which 16.2% were ≥7 kPa. Independent predictors of an LSM≥7 kPa were an age≥40 years (OR, 1.986; 95% CI, 1.280 to 3.081), male gender (OR, 1.599; 95% CI, 1.128 to 2.266), obesity (OR, 2.526; 95% CI, 1.383 to 4.614) and high-risk diet (OR, 2.197; 95% CI, 1.000 to 4.826). Five-unit increases in IMD score were an independent predictor of obesity (OR, 1.110; 95% CI, 1.028 to 1.200), but not high-risk alcohol consumption (p=0.88) or viral hepatitis risk (p=0.05). CONCLUSIONS We identified a high prevalence of risk factors for CLD, most of which are addressable through raising public awareness to inculcate healthy habits. More studies are needed to assess longitudinal outcomes of liver screening using TA, accounting for societal factors and comorbidities, to help inform resource allocation and policy-making in the future.
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Affiliation(s)
- Ceyhun Aksel Oztumer
- Department of Gastroenterology and Hepatology, Imperial College London, London, UK.,Department of Medicine, Brighton and Sussex Medical School, Brighton, UK
| | | | - Laith Alrubaiy
- Department of Gastroenterology, St Mark's Hospital and Academic Institute, London, UK
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13
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Mears M, Brindley P, Baxter I, Maheswaran R, Jorgensen A. Neighbourhood greenspace influences on childhood obesity in Sheffield, UK. Pediatr Obes 2020; 15:e12629. [PMID: 32130792 DOI: 10.1111/ijpo.12629] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 02/10/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND One cause of childhood obesity is a reduction in the amount of unstructured time spent outdoors, resulting in less physical activity. Greenspaces have the potential to increase children's physical activity levels, so it is desirable to understand how to create spaces that promote visitation and activity. OBJECTIVES We investigate the relationship between rates of obesity at ages 4 to 5 and 10 to 11 in small-area census geographies, and indicators of the neighbourhood greenspace environment, in the northern English city of Sheffield. METHODS To capture the environment at scales relevant to children, we test the importance of overall green cover; garden size; tree density around residential addresses; and accessibility within 300 m of any greenspace, greenspaces that meet quality criteria, and greenspaces with play facilities. We use a multimodel inference approach to improve robustness. RESULTS The density of trees around addresses is significant at both ages, indicating the importance of the greenspace environment in the immediate vicinity of houses. For 10 to 11 year olds, accessibility of greenspaces meeting quality criteria is also significant, highlighting that the wider environment becomes important with age and independence. CONCLUSIONS More attention should be given to children's requirements of greenspace when considering interventions to increase physical activity or planning new residential areas.
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Affiliation(s)
- Meghann Mears
- Department of Landscape Architecture, University of Sheffield, Sheffield, UK
| | - Paul Brindley
- Department of Landscape Architecture, University of Sheffield, Sheffield, UK
| | - Ian Baxter
- Performance & Intelligence Team, Policy, Performance & Communications, Sheffield, UK
| | - Ravi Maheswaran
- Public Health GIS Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Anna Jorgensen
- Department of Landscape Architecture, University of Sheffield, Sheffield, UK
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14
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Díaz-Rodríguez M, Pérez-Muñoz C, Lendínez-de la Cruz JM, Fernández-Gutiérrez M, Bas-Sarmiento P, Ferriz-Mas BC. Effectiveness of a Multifactorial Intervention in the First 1000 Days of Life to Prevent Obesity and Overweight in Childhood: Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072239. [PMID: 32225027 PMCID: PMC7177794 DOI: 10.3390/ijerph17072239] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/16/2020] [Accepted: 03/24/2020] [Indexed: 12/13/2022]
Abstract
(1) Background: Obesity is a global health problem, and its prevention must be a priority goal of public health, especially considering the seriousness of the problem among children. It is known that fetal and early postnatal environments may favor the appearance of obesity in later life. In recent years, the impact of the programs to prevent obesity in childhood has been scarce. The aim of this research is to evaluate the effectiveness of an intervention based on the concept of early programming. (2) Methods: Non-randomized controlled trial design. Inclusion criteria are: two-year-old infants whose gestational period begins in the 14 months following the start of the intervention, and whose mothers have made the complete follow-up of their pregnancy in the same clinical unit of the study. The intervention will be developed over all the known factors that affect early programming, during pregnancy up to 2 years of life. Data will be collected through a data collection sheet by the paediatricians. A unibivariate and multivariate analysis of the data will be carried out. (3) Ethics and dissemination: The trial does not involve any risk to participants and their offspring. Signed informed consent is obtained from all participants. Ethical approval has been obtained. (4) Results: It is expected that this study will provide evidence on the importance of the prevention of obesity from the critical period of the first 1000 days of life, being able to establish this as a standard intervention in primary care.
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Affiliation(s)
- Mercedes Díaz-Rodríguez
- Department of Nursing and Physiotherapy, University of Cádiz, 11009 Andalusia, Spain; (M.D.-R.); (M.F.-G.); (P.B.-S.)
| | - Celia Pérez-Muñoz
- Department of Nursing and Physiotherapy, University of Cádiz, 11009 Andalusia, Spain; (M.D.-R.); (M.F.-G.); (P.B.-S.)
| | - José Manuel Lendínez-de la Cruz
- Ribera del Muelle Health Centre, Clinic Management Unit (CMU) Puerto Real, Cádiz, Andalusian Health System, 11510 Andalusia, Spain;
| | - Martina Fernández-Gutiérrez
- Department of Nursing and Physiotherapy, University of Cádiz, 11009 Andalusia, Spain; (M.D.-R.); (M.F.-G.); (P.B.-S.)
| | - Pilar Bas-Sarmiento
- Department of Nursing and Physiotherapy, University of Cádiz, 11009 Andalusia, Spain; (M.D.-R.); (M.F.-G.); (P.B.-S.)
| | - Bernardo C. Ferriz-Mas
- Río San Pedro Health Centre, Clinic Management Unit (CMU) Puerto Real, Cádiz, Andalusian Health System, 11519 Andalusia, Spain
- Correspondence:
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15
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Assari S. Understanding America: Unequal Economic Returns of Years of Schooling in Whites and Blacks. WORLD JOURNAL OF EDUCATIONAL RESEARCH (LOS ANGELES, CALIF.) 2020; 7:78-92. [PMID: 32582861 PMCID: PMC7314384 DOI: 10.22158/wjer.v7n2p78] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Higher schooling is associated with higher economic wellbeing. Marginalization-related Diminished Returns (MDRs) framework, however, refers to smaller returns of schooling for non-Hispanic Blacks (NHBs) compared to non-Hispanic Whites (NHWs). AIM Using a national sample of American adults, the current study compared NHBs and NHWs for the effects of each incremental increase in the years of schooling (gradient of educational level) on economic wellbeing of American adults. METHODS Data came from the Understanding America Study (UAS), a national online survey with a nationally representative sample. A total of 5715 adults (18+ years old) were included. From this number, 4,826 (84.4%) were NHWs, and 889 (15.6%) were NHBs. Years of schooling was the independent variable. Economic wellbeing was the main outcome. Age and gender were the covariates. Race was the moderator. RESULTS Overall, each additional year of schooling was associated with higher economic wellbeing, net of age, and gender. A statistically significant interaction was found between race and years of schooling on the outcome, indicating a smaller boosting effect of any incremental increase in the years of education on the economic wellbeing of NHBs compared to NHWs. CONCLUSION In line with MDRs, highly educated Black people experience low economic wellbeing. The MDRs of education on economic wellbeing may be why highly educated, and middle-class Black Americans still report poor health. Policy solutions should address multi-level causes of MDR-related health disparities.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA
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16
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Iguacel I, Chung A, Gearon E, Moreno LA, Peeters A, Backholer K. Influence of early-life risk factors on socioeconomic inequalities in weight gain. J Public Health (Oxf) 2019; 40:e447-e455. [PMID: 29608712 DOI: 10.1093/pubmed/fdy056] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 03/05/2018] [Indexed: 11/14/2022] Open
Abstract
Background Previous research has examined the role of early-life risk factors on childhood weight gain.The extent to which these factors drive socioeconomic differences in weight is unclear. We aimed to quantify the influence of early-life risk factors on the development of socioeconomic inequalities in children's body mass index (BMI) z-score at 10-11 years. Methods Overall, 2186 children from the Longitudinal Study of Australian Children were examined. Socioeconomic position (SEP) was measured as a continuous composite of parent's education, occupation and income. The Product of Coefficients mediation method was used to quantify the contribution of maternal smoking during pregnancy, gestational diabetes, prematurity, caesarean section, birthweight, not being breastfed, early introduction of solid food, maternal BMI and paternal BMI to the relationship between SEP and BMI z-score. Results Each increasing decile of SEP (higher SEP) was associated with a 0.05 unit lower (95% CI: -0.06, -0.03) BMI z-score at 10-11 years. In total, 83.5% of these differences in BMI z-score could be explained by socioeconomic differences in maternal smoking during pregnancy (26.9%), maternal BMI (39.6%) and paternal BMI (17.0%). Conclusions Interventions to reduce socioeconomic inequalities in excess weight gain during childhood should support the attainment of a healthy parental weight and prevent smoking during pregnancy.
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Affiliation(s)
- Isabel Iguacel
- Deakin University, Geelong, Global Obesity Centre (GLOBE), World Health Organization Collaborating Centre for Obesity Prevention, Centre for Population Health Research School of Health & Social Development, Burwood, Australia.,Growth, Exercise, NUtrition and Development (GENUD) Research Group, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IIS Aragón) and Centro de Investigación Biomédica en Red de Fisiopatología de la Nutrición y la Obesidad (CIBEROBN), Zaragoza, Spain
| | - Alexandra Chung
- Deakin University, Geelong, Global Obesity Centre (GLOBE), World Health Organization Collaborating Centre for Obesity Prevention, Centre for Population Health Research School of Health & Social Development, Burwood, Australia.,School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Emma Gearon
- Deakin University, Geelong, Global Obesity Centre (GLOBE), World Health Organization Collaborating Centre for Obesity Prevention, Centre for Population Health Research School of Health & Social Development, Burwood, Australia.,School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Luis A Moreno
- Growth, Exercise, NUtrition and Development (GENUD) Research Group, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IIS Aragón) and Centro de Investigación Biomédica en Red de Fisiopatología de la Nutrición y la Obesidad (CIBEROBN), Zaragoza, Spain
| | - Anna Peeters
- Deakin University, Geelong, Global Obesity Centre (GLOBE), World Health Organization Collaborating Centre for Obesity Prevention, Centre for Population Health Research School of Health & Social Development, Burwood, Australia
| | - Kathryn Backholer
- Deakin University, Geelong, Global Obesity Centre (GLOBE), World Health Organization Collaborating Centre for Obesity Prevention, Centre for Population Health Research School of Health & Social Development, Burwood, Australia
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17
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Burghel GJ, Khan U, Lin WY, Whittaker W, Banka S. Presence of pathogenic copy number variants (CNVs) is correlated with socioeconomic status. J Med Genet 2019; 57:70-72. [DOI: 10.1136/jmedgenet-2019-106292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/18/2019] [Accepted: 07/24/2019] [Indexed: 11/03/2022]
Abstract
Socioeconomic status (SES) is a major determinant of health. We studied the Index of Multiple Deprivation Rank of 473 families with individuals with pathogenic autosomal copy number variants (CNVs) and known inheritance status. The IMDR distribution of families with pathogenic CNVs was significantly different from the general population. Families with inherited CNVs were significantly more likely to be living in areas of higher deprivation when compared with families that had individuals with de novo CNVs. These results provide unique insights into biological determinants of SES. As CNVs are relatively frequent in the general population, these results have important medical and policy consequences.
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18
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McCrory C, Leahy S, Ribeiro AI, Fraga S, Barros H, Avendano M, Vineis P, Layte R, Baglietto L, Bartley M, Bellone M, Berger E, Bochud M, Candiani G, Carmeli C, Carra L, Castagne R, Chadeau‐Hyam M, Cima S, Costa G, Courtin E, Delpierre C, D'Errico A, Donkin A, Dugué P, Elliott P, Fagherazzi G, Fiorito G, Gandini M, Gares V, Gerbouin‐Rerrolle P, Giles G, Goldberg M, Greco D, Guida F, Hodge A, Karimi M, Karisola P, Kelly M, Kivimaki M, Laine J, Lang T, Laurent A, Lepage B, Lorsch D, Machell G, Mackenbach J, Marmot M, Milne R, Muennig P, Nusselder W, Petrovic D, Polidoro S, Preisig M, Recalcati P, Reinhard E, Ricceri F, Robinson O, Jose Rubio Valverde, Severi G, Simmons T, Stringhini S, Terhi V, Than J, Vergnaud A, Vigna‐Taglianti F, Vollenweider P, Zins M. Maternal educational inequalities in measured body mass index trajectories in three European countries. Paediatr Perinat Epidemiol 2019; 33:226-237. [PMID: 31090081 DOI: 10.1111/ppe.12552] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 03/05/2019] [Accepted: 03/16/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Social inequalities in the prevalence of childhood overweight and obesity are well-established, but less is known about when the social gradient first emerges and how it evolves across childhood and adolescence. OBJECTIVE This study examines maternal education differentials in children's body mass trajectories in infancy, childhood and adolescence using data from four contemporary European child cohorts. METHODS Prospective data on children's body mass index (BMI) were obtained from four cohort studies-Generation XXI (G21-Portugal), Growing Up in Ireland (GUI) infant and child cohorts, and the Millennium Cohort Study (MCS-UK)-involving a total sample of 41,399 children and 120,140 observations. Children's BMI trajectories were modelled by maternal education level using mixed-effect models. RESULTS Maternal educational inequalities in children's BMI were evident as early as three years of age. Children from lower maternal educational backgrounds were characterised by accelerated BMI growth, and the extent of the disparity was such that boys from primary-educated backgrounds measured 0.42 kg/m2 (95% CI 0.24, 0.60) heavier at 7 years of age in G21, 0.90 kg/m2 (95% CI 0.60, 1.19) heavier at 13 years of age in GUI and 0.75 kg/m2 (95% CI 0.52, 0.97) heavier in MCS at 14 years of age. The corresponding figures for girls were 0.71 kg/m2 (95% CI 0.50, 0.91), 1.31 kg/m2 (95% CI 1.00, 1.62) and 0.76 kg/m2 (95% CI 0.53, 1.00) in G21, GUI and MCS, respectively. CONCLUSIONS Maternal education is a strong predictor of BMI across European nations. Socio-economic differentials emerge early and widen across childhood, highlighting the need for early intervention.
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Affiliation(s)
- Cathal McCrory
- Department of Medical Gerontology, The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
| | - Siobhan Leahy
- Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Ana Isabel Ribeiro
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Silvia Fraga
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Henrique Barros
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Mauricio Avendano
- Department of Social Science, Health and Medicine, Kings College London, London, UK
| | - Paolo Vineis
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Richard Layte
- Department of Sociology, Trinity College Dublin, Dublin, Ireland
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Nyasani E, Munir I, Perez M, Payne K, Khan S. Linking obesity-induced leptin-signaling pathways to common endocrine-related cancers in women. Endocrine 2019; 63:3-17. [PMID: 30218381 DOI: 10.1007/s12020-018-1748-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 09/04/2018] [Indexed: 12/13/2022]
Abstract
Obesity is related to many major diseases and cancers. Women have higher rates of obesity and obesity is linked to commonly occurring cancers in women. However, there is a lack of knowledge of the unique mechanism(s) involved in each type of cancer. The objective of this review is to highlight the need for novel experimental approaches and a better understanding of the common and unique pathways to resolve controversies regarding the role of obesity in cancer. In women, there is a link between hormones and obesity-associated genes in cancer development. Leptin is an obesity-associated gene that has been studied extensively in cancers; however, whether the defect is in the leptin gene or in its signaling pathways remains unclear. Both leptin and its receptor have been positively correlated with cancer progression in some endocrine-related cancers in women. This review offers an up-to-date and cohesive review of both upstream and downstream pathways of leptin signaling in cancer and a comprehensive picture of cancer pathogenesis in light of current evidence of leptin effects in several major types of cancer. This work is intended to aid in the design of better therapeutic strategies for obese/overweight women with cancer.
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Affiliation(s)
- Eunice Nyasani
- Center for Health Disparities & Molecular Medicine, Loma Linda, CA, USA
| | - Iqbal Munir
- Riverside University Health System, Moreno Valley, CA, USA
| | - Mia Perez
- Department of Pathology & Human Anatomy, Loma Linda, USA
| | - Kimberly Payne
- Department of Pathology & Human Anatomy, Loma Linda, USA
| | - Salma Khan
- Center for Health Disparities & Molecular Medicine, Loma Linda, CA, USA.
- Division of Biochemistry, Loma Linda University, Loma Linda, CA, USA.
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20
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Shackleton N, Milne BJ, Audas R, Derraik JGB, Zhu T, Taylor RW, Morton SMB, Glover M, Cutfield WS, Taylor B. Improving rates of overweight, obesity and extreme obesity in New Zealand 4-year-old children in 2010-2016. Pediatr Obes 2018; 13:766-777. [PMID: 29271074 PMCID: PMC6585814 DOI: 10.1111/ijpo.12260] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 09/25/2017] [Accepted: 10/31/2017] [Indexed: 01/20/2023]
Abstract
BACKGROUND Prevalence of childhood obesity is high in developed countries, and there is a growing concern regarding increasing socio-economic disparities. OBJECTIVES To assess trends in the prevalence of overweight, obesity and extreme obesity among New Zealand 4-year olds, and whether these differ by socio-economic and ethnic groupings. METHODS A national screening programme, the B4 School Check, collected height and weight data for 75-92% of New Zealand 4-year-old children (n = 317 298) between July 2010 and June 2016. Children at, or above, the 85th, 95th and 99.7th percentile for age and sex adjusted body mass index (according to World Health Organization standards) were classified as overweight, obese and extremely obese, respectively. Prevalence rates across 6 years (2010/11 to 2015/16) were examined by sex, across quintiles of socio-economic deprivation, and by ethnicity. RESULTS The prevalence of overweight, obesity and extreme obesity decreased by 2.2 [95% CI, 1.8-2.5], 2.0 [1.8-2.2] and 0.6 [0.4-0.6] percentage points, respectively, between 2010/2011 and 2015/2016. The downward trends in overweight, obesity and extreme obesity in the population persisted after adjustment for sex, ethnicity, deprivation and urban/rural residence. Downward trends were also observed across sex, ethnicity and deprivation groups. CONCLUSIONS The prevalence of obesity appears to be declining in 4-year-old children in New Zealand across all socio-economic and ethnic groups.
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Affiliation(s)
- N. Shackleton
- A Better Start – National Science ChallengeUniversity of AucklandAucklandNew Zealand,Centre of Methods and Policy Application in the Social SciencesUniversity of AucklandAucklandNew Zealand
| | - B. J. Milne
- A Better Start – National Science ChallengeUniversity of AucklandAucklandNew Zealand,Centre of Methods and Policy Application in the Social SciencesUniversity of AucklandAucklandNew Zealand
| | - R. Audas
- A Better Start – National Science ChallengeUniversity of AucklandAucklandNew Zealand,Dunedin School of MedicineUniversity of OtagoDunedinNew Zealand
| | - J. G. B. Derraik
- A Better Start – National Science ChallengeUniversity of AucklandAucklandNew Zealand,Liggins InstituteUniversity of AucklandAucklandNew Zealand,Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| | - T. Zhu
- A Better Start – National Science ChallengeUniversity of AucklandAucklandNew Zealand,Centre of Methods and Policy Application in the Social SciencesUniversity of AucklandAucklandNew Zealand
| | - R. W. Taylor
- A Better Start – National Science ChallengeUniversity of AucklandAucklandNew Zealand,Dunedin School of MedicineUniversity of OtagoDunedinNew Zealand
| | - S. M. B. Morton
- A Better Start – National Science ChallengeUniversity of AucklandAucklandNew Zealand,Centre for Longitudinal Research–He Ara ki MuaThe University of AucklandNew Zealand,School of Population HealthThe University of AucklandAucklandNew Zealand
| | - M. Glover
- A Better Start – National Science ChallengeUniversity of AucklandAucklandNew Zealand,School of Public Health, College of HealthMassey UniversityAucklandNew Zealand
| | - W. S. Cutfield
- A Better Start – National Science ChallengeUniversity of AucklandAucklandNew Zealand,Liggins InstituteUniversity of AucklandAucklandNew Zealand
| | - B. Taylor
- A Better Start – National Science ChallengeUniversity of AucklandAucklandNew Zealand,Dunedin School of MedicineUniversity of OtagoDunedinNew Zealand
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Prevalence of Childhood Overweight and Obesity in Liverpool between 2006 and 2012: Evidence of Widening Socioeconomic Inequalities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122612. [PMID: 30469490 PMCID: PMC6313599 DOI: 10.3390/ijerph15122612] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 11/12/2018] [Accepted: 11/19/2018] [Indexed: 12/28/2022]
Abstract
The primary aim of this study was to describe the prevalence of childhood overweight and obesity in Liverpool between 2006 and 2012. A secondary aim was to examine the extent to which socioeconomic inequalities relating to childhood overweight and obesity in Liverpool changed during this six-year period. A sample of 50,125 children was created using data from the National Child Measurement Program (NCMP) in Liverpool. The prevalence of overweight and obesity was calculated for Reception and Year 6 aged children in Liverpool for each time period by gender and compared against published averages for England. Logistic regression analyses examined the likelihood of children in Liverpool being classified as overweight and obese based on deprivation level for each time period. Analyses were conducted separately for Reception and Year 6 aged children and were adjusted for gender. The prevalence of overweight and obesity among Reception and Year 6 aged children in Liverpool increased between 2006 and 2012. During the same period, socioeconomic disparities in overweight and obesity prevalence between children living in the most deprived communities in Liverpool and those living in less deprived communities in Liverpool, widened. This study evidences rising rates of overweight and obesity among Liverpool children and widening socioeconomic health inequalities within Liverpool, England’s most deprived city between 2006 and 2012.
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22
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Changes in socio-economic level and their impact on nutritional status: a follow-up study among young Chilean adults. Public Health Nutr 2018; 21:2402-2408. [DOI: 10.1017/s1368980018001003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractObjectiveTo verify the association between changes in socio-economic level (SEL) and nutritional status of Chilean adults over a 10-year period.DesignConcurrent cohort study.Setting/SubjectsIndividuals born from 1974 to 1978 in the Valparaíso Region of Chile were evaluated between 2000 and 2002 (n 1232) and again between 2010 and 2012 (n 796). SEL was characterized according to the occupation and educational level of the head of household. Nutritional status was based on measurement of BMI and waist circumference (WC).ResultsBetween the first and second evaluation there was a 13 % reduction in the number of individuals classified as poor and a 12 % increase in those classified in the medium high SEL. Increases in BMI were found among women who remained in the low SEL (β=2·2, 95 % CI 0·16, 2·87) compared with women who maintained the same SEL (and whose SEL was above low over the 10-year period). Women who remained in the low SEL increased their WC (β=4·10, 95 % CI 0·27, 7·93). There were no associations between nutritional status and SEL among males.ConclusionsIn the period studied, the SEL of the study population improved between the third and fourth decade of life, but BMI and WC also increased among women, with the lowest socio-economic group experiencing the greatest changes. Meanwhile, among males we found no association between anthropometric measurements and changes in SEL.
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Bann D, Johnson W, Li L, Kuh D, Hardy R. Socioeconomic inequalities in childhood and adolescent body-mass index, weight, and height from 1953 to 2015: an analysis of four longitudinal, observational, British birth cohort studies. Lancet Public Health 2018; 3:e194-e203. [PMID: 29571937 PMCID: PMC5887082 DOI: 10.1016/s2468-2667(18)30045-8] [Citation(s) in RCA: 125] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 02/20/2018] [Accepted: 02/26/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND Socioeconomic inequalities in childhood body-mass index (BMI) have been documented in high-income countries; however, uncertainty exists with regard to how they have changed over time, how inequalities in the composite parts (ie, weight and height) of BMI have changed, and whether inequalities differ in magnitude across the outcome distribution. Therefore, we aimed to investigate how socioeconomic inequalities in childhood and adolescent weight, height, and BMI have changed over time in Britain. METHODS We used data from four British longitudinal, observational, birth cohort studies: the 1946 Medical Research Council National Survey of Health and Development (1946 NSHD), 1958 National Child Development Study (1958 NCDS), 1970 British Cohort Study (1970 BCS), and 2001 Millennium Cohort Study (2001 MCS). BMI (kg/m2) was derived in each study from measured weight and height. Childhood socioeconomic position was indicated by the father's occupational social class, measured at the ages of 10-11 years. We examined associations between childhood socioeconomic position and anthropometric outcomes at age 7 years, 11 years, and 15 years to assess socioeconomic inequalities in each cohort using gender-adjusted linear regression models. We also used multilevel models to examine whether these inequalities widened or narrowed from childhood to adolescence, and quantile regression was used to examine whether the magnitude of inequalities differed across the outcome distribution. FINDINGS In England, Scotland, and Wales, 5362 singleton births were enrolled in 1946, 17 202 in 1958, 17 290 in 1970, and 16 404 in 2001. Low socioeconomic position was associated with lower weight at childhood and adolescent in the earlier-born cohorts (1946-70), but with higher weight in the 2001 MCS cohort. Weight disparities became larger from childhood to adolescence in the 2001 MCS but not the earlier-born cohorts (pinteraction=0·001). Low socioeconomic position was also associated with shorter height in all cohorts, yet the absolute magnitude of this difference narrowed across generations. These disparities widened with age in the 2001 MCS (pinteraction=0·002) but not in the earlier-born cohorts. There was little inequality in childhood BMI in the 1946-70 cohorts, whereas inequalities were present in the 2001 cohort and widened from childhood to adolescence in the 1958-2001 cohorts (pinteraction<0·05 in the later three cohorts but not the 1946 NSHD). BMI and weight disparities were larger in the 2001 cohort than in the earlier-born cohorts, and systematically larger at higher quantiles-eg, in the 2001 MCS at age 11 years, a difference of 0·98 kg/m2 (95% CI 0·63-1·33) in the 50th BMI percentile and 2·54 kg/m2 (1·85-3·22) difference at the 90th BMI percentile were observed. INTERPRETATION Over the studied period (1953-2015), socioeconomic-associated inequalities in weight reversed and those in height narrowed, whereas differences in BMI and obesity emerged and widened. These substantial changes highlight the impact of societal changes on child and adolescent growth and the insufficiency of previous policies in preventing obesity and its socioeconomic inequality. As such, new and effective policies are required to reduce BMI inequalities in childhood and adolescence. FUNDING UK Economic and Social Research Council, Medical Research Council, and Academy of Medical Sciences/the Wellcome Trust.
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Affiliation(s)
- David Bann
- Centre for Longitudinal Studies, University College London (UCL) Institute of Education, UCL, London, UK.
| | - William Johnson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Leah Li
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, UCL, London, UK
| | - Diana Kuh
- Medical Research Council Unit for Lifelong Health and Ageing at UCL, UCL, London, UK
| | - Rebecca Hardy
- Medical Research Council Unit for Lifelong Health and Ageing at UCL, UCL, London, UK
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Gebremariam MK, Arah OA, Lien N, Naess O, Ariansen I, Kjollesdal MK. Change in BMI Distribution over a 24-Year Period and Associated Socioeconomic Gradients: A Quantile Regression Analysis. Obesity (Silver Spring) 2018; 26:769-775. [PMID: 29498224 DOI: 10.1002/oby.22133] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 01/12/2018] [Accepted: 01/21/2018] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study assessed the change in body mass index (BMI) distribution among 18- or 19-year-olds over 24 years. It also investigated parallel changes in the distribution of birth weight and in the association between birth weight and later risk of overweight and/or obesity. Parental educational variations in the trends and associations were explored. METHODS The study used data on 606,832 male military conscripts enlisted between 1985 and 2008. Quantile regression was used to assess the temporal change in BMI and birth weight distribution. The association between birth weight and overweight and/or obesity at age 18 or 19 years was quantified by using logistic regression. RESULTS Increases in BMI over time were found namely in the 90th, 95th, 97th, and 99th percentiles. Socioeconomic differences in this increase were documented in the 75th to 97th percentiles. The distribution of birth weight and the association between birth weight and the risk of overweight and/or obesity at age 18 or 19 years remained stable over time. CONCLUSIONS The difference in the increase in BMI between low and high percentiles indicates the limited role of mean BMI in reflecting population changes. The results suggest a need to focus on those with low socioeconomic position in the upper ends of the BMI distribution to combat increasing disparities in obesity-related outcomes.
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Affiliation(s)
- Mekdes K Gebremariam
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Onyebuchi A Arah
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
- UCLA Center for Health Policy Research, University of California, Los Angeles, Los Angeles, California, USA
- California Center for Population Research, University of California, Los Angeles, Los Angeles, California, USA
| | - Nanna Lien
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Oyvind Naess
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
- Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Inger Ariansen
- Division for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Marte K Kjollesdal
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
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25
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Iguacel I, Escartín L, Fernández-Alvira JM, Iglesia I, Labayen I, Moreno LA, Samper MP, Rodríguez G. Early life risk factors and their cumulative effects as predictors of overweight in Spanish children. Int J Public Health 2018; 63:501-512. [DOI: 10.1007/s00038-018-1090-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Revised: 03/05/2018] [Accepted: 03/07/2018] [Indexed: 12/19/2022] Open
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26
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Black M, Joseph V, Mott L, Maheswaran R. Increasing inequality in childhood obesity in primary schools in a northern English town. Public Health 2018. [PMID: 29524611 DOI: 10.1016/j.puhe.2018.01.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To undertake an analysis of National Child Measurement Programme (NCMP) data to quantify the obesity prevalence gap over time between children in primary schools in the most and least deprived areas of Doncaster. STUDY DESIGN The research design for this study was retrospective quantitative analysis of secondary data. METHODS The study undertook secondary analysis of NCMP data on obesity prevalence in children in Reception Year and Year 6 in primary schools in Doncaster for the period 2006-2007 to 2014-2015. Data were combined into three 3-year periods (2006-2007 to 2008-2009; 2009-2010 to 2011-2012; and 2012-2013 to 2014-2015), and schools were grouped by deprivation based on the national Indices of Multiple Deprivation 2015. Analysis was undertaken to assess whether there is a difference in obesity prevalence for Reception Year and Year 6 children in schools in the most deprived areas compared with the least deprived (prevalence gap), over time. RESULTS The difference in obesity prevalence between children attending schools in the most and least deprived areas has increased over time. For Reception Year children, the prevalence gap has widened from a difference of 1.01% higher in the most deprived schools in 2006-2007 to 2008-2009 to 3.64% higher in 2012-2013 to 2014-2015. In the same time periods, for Year 6 children, the obesity prevalence gap has also increased over time from 2.82% to 5.08%. CONCLUSIONS There is inequality in relation to obesity in primary school children in Doncaster with those in schools in the most deprived areas carrying the greatest burden. Research is needed to understand why the plateau seen nationally is not reaching the most deprived children.
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Affiliation(s)
- M Black
- School of Health and Related Research, The University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK.
| | - V Joseph
- Doncaster Metropolitan Borough Council, Civic Office, Waterdale, Doncaster DN1 3BU, UK.
| | - L Mott
- Doncaster Metropolitan Borough Council, Civic Office, Waterdale, Doncaster DN1 3BU, UK.
| | - R Maheswaran
- Public Health GIS Unit, School of Health and Related Research, The University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK.
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