Where a person lives as a determinant of health.
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301 to 325 of 1,190Identifying aspects of neighbourhood deprivation associated with increased incidence of schizophrenia.
Background: Several studies have found an association between area deprivation and incidence of schizophrenia. However, not all studies have concurred and definitions of deprivation have varied between studies. Relative deprivation and inequality seem to be particularly important, but which aspects of deprivation or how this effect might operate is not known.
Methods: The Lambeth Early Onset case register is a database of all cases of first episode psychosis aged 16 to 35years from the London Borough of Lambeth, a highly urban area. We identified 405 people with first onset schizophrenia who presented between 2000 and 2007. We calculated the overall incidence of first onset schizophrenia and tested for an association with area-level deprivation, using a multi-domain index of deprivation (IMD 2004). Specific analyses into associations with individual sub-domains of deprivation were then u…
matched on Residence Characteristics (mesh), area deprivation (text), neighbourhood (text)
Rossen LM (2014)MEDLINE-indexed journal, not yet read by usJournal of epidemiology and community health99 citations Neighbourhood economic deprivation explains racial/ethnic disparities in overweight and obesity among children and adolescents in the U.S.A.
Background: Low-income and some racial and ethnic subpopulations are more likely to suffer from obesity. Inequities in the physical and social environment may contribute to disparities in paediatric obesity, but there is little empirical evidence to date. This study explored whether neighbourhood-level socioeconomic factors attenuate racial and ethnic disparities in obesity among youth in the U.S.A. and whether individual-level socioeconomic status (SES) interacts with neighbourhood deprivation.
Methods: This analysis used data from 17,100 youth ages 2-18 years participating in the 2001-2010 National Health and Nutrition Examination Survey linked to census tract-level socioeconomic characteristics. Multilevel logistic regression models were used to examine neighbourhood deprivation in association with odds of obesity (age-specific and sex-specific body mass index percentile ≥95).
Results…
matched on Residence Characteristics (mesh), area deprivation (text), neighbourhood (text)
Congdon P (2012)MEDLINE-indexed journal, not yet read by usSocial psychiatry and psychiatric epidemiology20 citations Latent variable model for suicide risk in relation to social capital and socio-economic status.
Background: There is little evidence on the association between suicide outcomes (ideation, attempts, self-harm) and social capital. This paper investigates such associations using a structural equation model based on health survey data, and allowing for both individual and contextual risk factors.
Methods: Social capital and other major risk factors for suicide, namely socioeconomic status and social isolation, are modelled as latent variables that are proxied (or measured) by observed indicators or question responses for survey subjects. These latent scales predict suicide risk in the structural component of the model. Also relevant to explaining suicide risk are contextual variables, such as area deprivation and region of residence, as well as the subject's demographic status. The analysis is based on the 2007 Adult Psychiatric Morbidity Survey and includes 7,403 English subjects. A B…
matched on Residence Characteristics (mesh), area deprivation (text), neighbourhood (text)
Neighbourhood deprivation, health inequalities and service access by adults with intellectual disabilities: a cross-sectional study.
Background: Adults with intellectual disabilities (IDs) experience health inequalities and are more likely to live in deprived areas. The aim of this study was to determine whether the extent of deprivation of the area a person lives in affects their access to services, hence contributing to health inequalities.
Method: A cross-sectional study design was used. Interviews were conducted with all adults with IDs within a defined location (n = 1023), and their medical records were reviewed. The extent of area deprivation was defined by postcode, using Carstairs scores.
Results: Area deprivation did not influence access to social supports, daytime primary health-care services or hospital admissions, but people in more deprived areas made less use of secondary outpatient health care [first contacts (P = 0.0007); follow-ups (P = 0.0002)], and more use of accident and emergency care (P = 0.02).…
matched on Residence Characteristics (mesh), area deprivation (text), neighbourhood (text)
Overweight among New Zealand adolescents: associations with ethnicity and deprivation.
Objectives: The objectives of the current study are: to describe the prevalence of overweight/obesity among New Zealand adolescents and to describe the demographic characteristics, including neighbourhood deprivation, associated with overweight/obesity.
Methods: Data for the current study were collected as part of Youth'07, a national survey of the health and well-being of 9 107 New Zealand secondary school students (approximate ages 13 to 17 years). Students answered a comprehensive, multimedia survey about their health and wellbeing and were weighed and measured for height. Small area deprivation was measured by the New Zealand Deprivation Index, based on the student's residential address.
Results: One in ten adolescents was obese and an additional 24% were overweight. Body size was significantly associated with small area deprivation (p<0.001) and ethnicity (p<0.001). Furthermore, the…
matched on Residence Characteristics (mesh), area deprivation (text), neighbourhood (text)
The impact of regional and neighbourhood deprivation on physical health in Germany: a multilevel study.
Background: There is increasing evidence that individual health is at least partly determined by neighbourhood and regional factors. Mechanisms, however, remain poorly understood, and evidence from Germany is scant. This study explores whether regional as well as neighbourhood deprivation are associated with physical health and to what extent this association can be explained by specific neighbourhood exposures.
Methods: Using 2004 data from the German Socio-Economic Panel Study (SOEP) merged with regional and neighbourhood characteristics, we fitted multilevel linear regression models with subjective physical health, as measured by the SF-12, as the dependent variable. The models include regional and neighbourhood proxies of deprivation (i.e. regional unemployment quota, average purchasing power of the street section) as well as specific neighbourhood exposures (i.e. perceived air pollu…
matched on Residence Characteristics (mesh), area deprivation (text), neighbourhood (text)
Neighbourhood deprivation and access to alcohol outlets: a national study.
People living in poor areas suffer higher mortality than those in wealthy areas. Environmental factors partly explain this association, including exposure to pollutants and accessibility of healthcare. We sought to determine whether proximity to alcohol outlets varied by area deprivation in New Zealand. Roadway travel distance from each census unit to the nearest alcohol outlet was summarised according to socioeconomic deprivation for each area. Analyses were conducted by license type (pubs/bars, clubs, restaurants, off-licenses) and community urban-rural status. Strong associations were found between proximity to the nearest alcohol outlet and deprivation, there being greater access to outlets in more-deprived urban areas.
matched on Residence Characteristics (mesh), area deprivation (text), neighbourhood (text)
A multilevel analysis of state and regional disparities in childhood and adolescent obesity in the United States.
This study examines state- and regional disparities in obesity prevalence among 46,707 US children and adolescents aged 10-17 years before and after adjusting for individual socioeconomic and behavioral characteristics and area deprivation measures. The 2003 National Survey of Children's Health was used to calculate obesity prevalence in nine geographic regions and in the 50 states and the District of Columbia (DC). Logistic regression was used to estimate odds of obesity and adjusted prevalence. OLS regression was used to determine the amount of variance explained by income inequality, poverty, and violent crime rates. The prevalence of childhood obesity varied substantially across geographic areas, with the Southcentral regions of the US having the highest prevalence (> or =18%) and the Mountain region the lowest prevalence (11.4%). Children in West Virginia, Kentucky, Texas, Tennessee…
matched on Residence Characteristics (mesh), area deprivation (text), neighborhood (text)
Do poorer people have poorer access to local resources and facilities? The distribution of local resources by area deprivation in Glasgow, Scotland.
It has commonly been suggested that in modern cities individual or household deprivation (for example, low income or education) is amplified by area level deprivation (for example, lack of jobs or good schools), in ways which damage the health of the poorest and increase health inequalities. The aim of this study was to determine the location of a range of resources and exposures by deprivation in a UK city. We examined the location of 42 resources in Glasgow City, Scotland, in 2005-2006, by quintile of small area deprivation. Measures included number per 1000 population, network distance to nearest resource, and percentage of data zones containing at least one of each type of resource. Twelve resources had higher density in, and/or were closer to or more common in, more deprived neighbourhoods: public nurseries, public primary schools, police stations, pharmacies, credit unions, post of…
matched on Residence Characteristics (mesh), area deprivation (text), neighbourhood (text)
Social risks for disabling pain in older people: a prospective study of individual and area characteristics.
Pain is common in adult life, and the extent to which pain interferes with daily activities rises with age. Little is known about the social factors associated with disabling pain. The objective was to determine the individual and neighbourhood social factors that predict pain that interferes with daily activities. This was a prospective cohort study set within the North Staffordshire Osteoarthritis Project (NorStOP). People aged 50 and over registered with six general practices were sent baseline and 3-year questionnaires. Individual predictors of the onset of pain interference were determined through multilevel modelling. Neighbourhood impact was examined using measures of deprivation taken from the UK Index of Multiple Deprivation 2004. 19% of the 3644 people without pain interference at baseline reported it at follow-up. Baseline social factors were weaker predictors than baseline ag…
matched on Residence Characteristics (mesh), area deprivation (text), neighbourhood (text)
Pathways to obesity: identifying local, modifiable determinants of physical activity and diet.
Many studies document small area inequalities in morbidity and mortality and show associations between area deprivation and health. However, few studies unpack the "black box" of area deprivation to show which specific local social and physical environmental characteristics impact upon health, and might be amenable to modification. We theorised a model of the potential causal pathways to obesity and employed path analysis using a rich data set from national studies in England and Scotland to test the model empirically. Significant associations between obesity and neighbourhood disorder and access to local high street facilities (local shops, financial services and health-related stores found in a typical small UK town) were found. There was a tendency for lower levels of obesity in areas with more swimming pools and supermarkets. In turn, policing levels, physical dereliction and recorde…
matched on Residence Characteristics (mesh), area deprivation (text), neighbourhood (text)
Measuring the neighbourhood using UK benefits data: a multilevel analysis of mental health status.
Background: Evidence from multilevel research investigating whether the places where people live influence their mental health remains inconclusive. The objectives of this study are to derive small area-level, or contextual, measures of the local social environment using benefits data from the Department of Work and Pensions (DWP) and to investigate whether (1) the mental health status of individuals is associated with contextual measures of low income, economic inactivity, and disability, after adjusting for personal risk factors for poor mental health, (2) the associations between mental health and context vary significantly between different population sub-groups, and (3) to compare the effect of the contextual benefits measures with the Townsend area deprivation score.
Methods: Data from the Welsh Health Survey 1998 were analysed in Normal response multilevel models of 24,975 individ…
matched on Residence Characteristics (mesh), area deprivation (text), neighbourhood (text)
Barriers and facilitators to cancer care in the Northeast region, India: A scoping review.
Background and objectives Cancer is a major health issue globally, and in India's Northeast Region (NER), it is experiencing the highest incidence, particularly among rural and tribal communities. However, screening rates are low, awareness is limited, and access to care is challenged by isolation, poor infrastructure, financial constraints, and dependence on traditional medicine. To address these gaps, this scoping review aimed to synthesise evidence on the multidimensional barriers to cancer care in the NER, examine how socioeconomic, cultural, health system, logistical, and geographical factors influence care-seeking behaviour, and identify facilitators that could improve access to screening, diagnosis, and treatment. Methods A scoping review was conducted following the Arksey and O'Malley framework and reported in accordance with PRISMA-ScR guidelines. PubMed, Scopus, Web of Science,…
matched on Rural Population (mesh)
Implementation of Physical Activity Interventions in Rural, Remote, and Northern Communities: A Scoping Review.
Compared with urban centers, rural, remote, and northern communities face substantial health inequities and increased rates of noncommunicable disease fuelled, in part, by decreased participation in physical activity. Understanding how the unique sociocultural and environmental factors in rural, remote, and northern communities contribute to implementation of physical activity interventions can help guide health promotion policy and practice. A scoping review was conducted to map literature describing the implementation of physical activity interventions in rural, remote, and/or northern communities. Databases MEDLINE, PsycINFO, EMBASE, CINAHL, and SPORTDiscus were searched using a predetermined search strategy. Outcomes of interest included community demographics, program characteristics, intervention results, measures of implementation, and facilitators or barriers to implementation. A…
matched on Rural Population (mesh)
Epidemiology and Implementation of Cancer Prevention in Disparate Populations and Settings.
Successful cancer prevention strategies must be tailored to support usability. In this article, we will focus on cancer prevention strategies in populations that differ by race and ethnicity, place and location, sexual orientation and gender identity, and age by providing examples of effective approaches. An individual may belong to none of these categories, to all of these categories, or to some. This intersectionality of belonging characterizes individuals and shapes their experiences. Even within a category, broad diversity exists. Effective cancer prevention strategies comprehensively engage the community at multiple levels of influence and may effectively include lay health workers and faith-based cancer education interventions. Health system efforts that integrate cancer health with other health promotion activities show promise. At the individual physician level, culturally litera…
matched on Rural Population (mesh)
Nature-Based Social Prescribing in Urban Settings to Improve Social Connectedness and Mental Well-being: a Review.
Purpose of review: Recent reports of a "loneliness epidemic" in the USA are growing along with a robust evidence base that suggests that loneliness and social isolation can compromise physical and psychological health. Screening for social isolation among at-risk populations and referring them to nature-based community services, resources, and activities through a social prescribing (SP) program may provide a way to connect vulnerable populations with the broader community and increase their sense of connectedness and belonging. In this review, we explore opportunities for social prescribing to be used as a tool to address connectedness through nature-based interventions.
Recent findings: Social prescribing can include a variety of activities linked with voluntary and community sector organizations (e.g., walking and park prescriptions, community gardening, farmers' market vouchers). The…
matched on Urban Population (mesh)
Women's health promotion in the rural church: a Canadian perspective.
The rural church may be an effective health resource for rural Canadian women who have compromised access to health resources. The purpose of this paper is to explore the relevance of the Christian church and faith community nurses in promoting the health of rural Canadian women in the evolving rural context. The findings from an extensive literature search reveal that religion and spirituality often influence the health beliefs, behaviors, and decisions of rural Canadian women. The church and faith community nurses may therefore be a significant health resource for rural Canadian women, although this phenomenon has been significantly understudied.
matched on Rural Population (mesh)
Stability and change in rural youths' educational outcomes through the middle and high school years.
There is a dearth of literature that examines rural youths' school transition and adaptation over the middle and high school years. Given rural education challenges, this study examines rural youths' developmental trajectories of self-reported grades and affective and behavioral educational outcomes (i.e., school belonging, value of education, school misbehavior, and extracurricular activity participation). The cohort-sequential study consisted of 3,312 African American and White youth (50% female) who were surveyed over three and a half years, including the transition to high school. The results reveal significant changes in the outcomes from sixth to twelfth grade. For example, on average, school misbehavior increased over time while perceived school belonging decreased over time. Gender and race differences emerged; African American youth reported placing higher importance on educatio…
matched on Rural Population (mesh)
Persisting inequalities in birth outcomes related to neighbourhood deprivation.
Introduction: Health inequalities can be observed in early life as unfavourable birth outcomes. Evidence indicates that neighbourhood socioeconomic circumstances influence health. However, studies looking into temporal trends in inequalities in birth outcomes including neighbourhood socioeconomic conditions are scarce. The aim of this work was to study how inequalities in three different key birth outcomes have changed over time across different strata of neighbourhood deprivation.
Methods: Nationwide time trends ecological study with area-level deprivation in quintiles as exposure. The study population consisted of registered singleton births in the Netherlands 2003-2017 between 24 and 41 weeks of gestation. Outcomes used were perinatal mortality, premature birth and small for gestational age (SGA). Absolute rates for all birth outcomes were calculated per deprivation quintile. Time tre…
matched on Residence Characteristics (mesh), Poverty Areas (mesh), neighbourhood (text)
Deprivation matters: understanding associations between neighbourhood deprivation, unhealthy food outlets, unhealthy dietary behaviours and child body size using structural equation modelling.
Background: Children residing in neighbourhoods of high deprivation are more likely to have poorer health, including excess body size. While the availability of unhealthy food outlets are increasingly considered important for excess child body size, less is known about how neighbourhood deprivation, unhealthy food outlets and unhealthy dietary behaviours are interlinked.
Methods: This study involves children aged 8-13 years (n=1029) and resided in Auckland, New Zealand. Unhealthy dietary behaviours (frequency of consumption of unhealthy snacks and drinks) and food purchasing behaviour on the route to and from school were self-reported. Height and waist circumference were measured to calculate waist-to-height ratio (WtHR). Geographic Information Systems mapped neighbourhood deprivation and unhealthy food outlets within individual, child-specific neighbourhood buffer boundaries (800 m arou…
matched on Residence Characteristics (mesh), Poverty Areas (mesh), neighbourhood (text)
Adverse impact of neighbourhood socioeconomic deprivation on psychological treatment outcomes: the role of area-level income and crime.
Aim: Socioeconomic deprivation is known to be associated with depression and anxiety symptoms. This study aimed to investigate the influence of several domains of neighbourhood deprivation on psychological treatment outcomes. Method: Healthcare records from 44805 patients who accessed psychological treatment were analyzed. Patient-level depression (PHQ-9) and anxiety (GAD-7) outcome measures were linked to their neighbourhood statistics, including area-level indices of income, unemployment, education, health and disability, crime, housing quality, and quality of the local environment. Linear regressions were applied to examine associations between these domains and post-treatment symptom severity after controlling for patient-level and service-level variables. Results: Neighbourhood income and crime rates were associated with depression and anxiety symptoms after controlling for covariat…
matched on Residence Characteristics (mesh), Poverty Areas (mesh), neighbourhood (text)
Macdonald L (2019)MEDLINE-indexed journal, not yet read by usInternational journal of health geographics20 citations Associations between spatial access to physical activity facilities and frequency of physical activity; how do home and workplace neighbourhoods in West Central Scotland compare?
Background: Over a third of the Scottish population do not meet physical activity (PA) recommendations, with a greater proportion of those from disadvantaged areas not meeting recommended levels. There is a great need for detailed understanding of why some people are active while others are not. It has been established that features within home neighbourhoods are important for promoting PA, and although around 60% of time spent in exercise daily is undertaken outside the residential environment, relatively little research includes both home and workplace neighbourhood contexts. This study utilised an existing west central Scotland survey and spatial data on PA facilities to examine whether, for working adults, there are links between access to facilities, within home and workplace neighbourhoods, and frequency of PA, and whether such associations differ by socio-economic group.
Methods: …
matched on Residence Characteristics (mesh), Environment Design (mesh), neighbourhood (text)
Stressed out? An investigation of whether allostatic load mediates associations between neighbourhood deprivation and health.
Deprived neighbourhoods have long been associated with poorer health outcomes. However, many quantitative studies have not evidenced the mechanisms through which place 'gets under the skin' to influence health. The increasing prevalence of biosocial data provides new opportunities to explore these mechanisms and incorporate them into models of contextual effects. The stress pathway is a key biosocial mechanism; however, few studies have explicitly tested it in neighbourhood associations. This paper addresses this gap by investigating whether allostatic load, a biological response to chronic stress, mediates relationships of neighbourhood deprivation to physical and mental health. Data from UK Understanding Society is used to undertaken a multilevel mediation analysis. Allostatic load is found to mediate the association between neighbourhood deprivation and health, substantiating the biol…
matched on Residence Characteristics (mesh), Poverty Areas (mesh), neighbourhood (text)
Associations between perceived stress, socioeconomic status, and health-risk behaviour in deprived neighbourhoods in Denmark: a cross-sectional study.
Background: Previous studies have found that residents of deprived neighbourhoods have an increased risk of perceived stress compared to residents with similar sociodemographic and socioeconomic characteristics in non-deprived neighbourhoods. While stress may provide an explanatory pathway linking neighbourhood deprivation to health-risk behaviour, only limited research has been undertaken on whether perceived stress influences health-risk behaviour in deprived neighbourhoods. Moreover, it is uncertain whether perceived stress has a negative effect on the associations between socioeconomic status and health-risk behaviours in deprived neighbourhoods. The overall aim of this study was to compare perceived stress in deprived neighbourhood with that in the general population, and to examine whether perceived stress was associated with health-risk behaviours (including their co-occurrence) i…
matched on Residence Characteristics (mesh), Poverty Areas (mesh), neighbourhood (text)
Obesity and caries in four-to-six year old English children: a cross-sectional study.
Background: Obesity and caries are common conditions in childhood and can have significant implications on children's wellbeing. Evidence into their association remains conflicting. Furthermore, studies examining the ssociation between obesity and caries commonly focus on individual-level determinants. The present study aimed to examine the association between obesity and caries in young English children and to determine the impact of deprivation and area-level characteristics on the distribution of the two conditions.
Methods: This was a cross-sectional study among children in Plymouth city aged four-to-six years. Anthropometric measurements included weight and height (converted to Body Mass Index centiles and z-scores), and waist circumference. Caries was assessed by using the sum of the number of teeth that were decayed, missing or filled. A questionnaire was used to obtain informatio…
matched on Residence Characteristics (mesh), Poverty Areas (mesh), neighbourhood (text)