ORCID Profile
0000-0002-3576-8744
Current Organisation
RMIT University
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Publisher: Springer Science and Business Media LLC
Date: 06-12-2006
Abstract: To estimate variation between small areas in adult body mass index (BMI), and assess the importance of area level socioeconomic disadvantage in predicting BMI. We identified all census collector districts (CCDs) in the 20 innermost Local Government Areas in metropolitan Melbourne, Australia, and ranked them by the percentage of low income households (< dollar 400/week). In all, 50 CCDs were randomly selected from the least, middle and most disadvantaged septiles of the ranked list and 4913 residents (61.4% participation rate) completed one of two surveys. Multilevel linear regression was used to estimate area level variance in BMI and the importance of area level socioeconomic disadvantage in predicting BMI. There were significant variations in BMI between CCDs for women, even after adjustment for in idual and area SES (P = 0.012) significant area variation was not found for men. Living in the most versus least disadvantaged areas was associated with an average difference in BMI of 1.08 kg/m2 (95% CI: 0.48-1.68 kg/m2) for women, and of 0.93 kg/m2 (95% CI: 0.32-1.55 kg/m2) for men. Living in the mid versus least disadvantaged areas were associated with an average difference in BMI of 0.67 kg/m2 (95% CI: 0.09-1.26 kg/m2) for women, and 0.43 kg/m2 for men (95% CI: -0.16-1.01). These findings suggest that area disadvantage is an important predictor of adult BMI, and support the need to focus on improving local environments to reduce socioeconomic inequalities in overweight and obesity.
Publisher: Springer Science and Business Media LLC
Date: 12-2014
Publisher: Elsevier BV
Date: 04-2012
DOI: 10.1016/J.AMEPRE.2011.11.012
Abstract: To develop evidence-based approaches for reducing sedentary behavior, there is a need to identify the specific settings where prolonged sitting occurs, associated factors, and variations. To examine the sociodemographic and health factors associated with mid-aged adults' sitting time in three contexts and variations between weekdays and weekend days. A mail survey was sent to 17,000 adults (aged 40-65 years) in 2007 11,037 responses were received (68.5%) and 7719 were analyzed in 2010. Respondents indicated time spent sitting on a usual weekday and weekend day for watching TV, general leisure, and home computer use. Multivariate linear mixed models with area-level random intercepts were used to examine (1) associations between sociodemographic and health variables and sitting time, and (2) interaction effects of weekday/weekend day with each of gender, age, education, and employment status, on sitting time. For each context, longer sitting times were reported by those single and living alone, and those whose health restricted activity. For watching TV, longer sitting times were reported by men smokers and those with high school or lower education, not in paid employment, in poor health, and with BMI ≥25. For general leisure, longer sitting times were reported by women, smokers, and those not employed full-time. For home computer use, longer sitting times were reported by men and those aged 40-44 years, with university qualifications in the mid-income range and with BMI ≥30. Sitting times tended to be longer on weekend days than weekdays, although the extent of this differed among sociodemographic groups. Sociodemographic and health factors associated with sitting time differ by context and between weekdays and weekend days.
Publisher: Springer Science and Business Media LLC
Date: 14-09-2020
Publisher: Elsevier BV
Date: 05-2010
DOI: 10.1016/J.JADA.2010.03.007
Abstract: Cooking skills are emphasized in nutrition promotion but their distribution among population subgroups and relationship to dietary behavior is researched by few population-based studies. This study examined the relationships between confidence to cook, sociodemographic characteristics, and household vegetable purchasing. This cross-sectional study of 426 randomly selected households in Brisbane, Australia, used a validated questionnaire to assess household vegetable purchasing habits and the confidence to cook of the person who most often prepares food for these households. The mutually adjusted odds ratios (ORs) of lacking confidence to cook were assessed across a range of demographic subgroups using multiple logistic regression models. Similarly, mutually adjusted mean vegetable purchasing scores were calculated using multiple linear regression for different population groups and for respondents with varying confidence levels. Lacking confidence to cook using a variety of techniques was more common among respondents with less education (OR 3.30 95% confidence interval [CI] 1.01 to 10.75) and was less common among respondents who lived with minors (OR 0.22 95% CI 0.09 to 0.53) and other adults (OR 0.43 95% CI 0.24 to 0.78). Lack of confidence to prepare vegetables was associated with being male (OR 2.25 95% CI 1.24 to 4.08), low education (OR 6.60 95% CI 2.08 to 20.91), lower household income (OR 2.98 95% CI 1.02 to 8.72) and living with other adults (OR 0.53 95% CI 0.29 to 0.98). Households bought a greater variety of vegetables on a regular basis when the main chef was confident to prepare them (difference: 18.60 95% CI 14.66 to 22.54), older (difference: 8.69 95% CI 4.92 to 12.47), lived with at least one other adult (difference: 5.47 95% CI 2.82 to 8.12) or at least one minor (difference: 2.86 95% CI 0.17 to 5.55). Cooking skills may contribute to socioeconomic dietary differences, and may be a useful strategy for promoting fruit and vegetable consumption, particularly among socioeconomically disadvantaged groups.
Publisher: SAGE Publications
Date: 03-2011
DOI: 10.4278/AJHP.090421-QUAN-144
Abstract: Explore the role of the neighborhood environment in supporting walking. Cross-sectional study of 10,286 residents of 200 neighborhoods. Participants were selected using a stratified two-stage cluster design. Data were collected by mail survey (68.5% response rate). Brisbane City Local Government Area, Australia, 2007. Brisbane residents aged 40 to 65 years. Environmental: street connectivity, residential density, hilliness, tree coverage, bikeways, and streetlights within a 1-km circular buffer from each resident's home and network distance to nearest river or coast, public transport, shop, and park. Walking: minutes walked in the previous week: minutes, ≥30 to minutes, ≥90 to minutes, ≥150 to minutes, and ≥300 minutes. The association between each neighborhood characteristic and walking was examined using multilevel multinomial logistic regression, and the model parameters were estimated using Markov chain Monte Carlo simulation. After adjustment for in idual factors, the likelihood of walking for more than 300 minutes (relative to minutes) was highest in areas with the most connectivity (odds ratio [OR] = 1.93 99% confidence intervals [CI], 1.32–2.80), greatest residential density (OR = 1.47 99% CI, 1.02–2.12), least tree coverage (OR = 1.69 99% CI, 1.13–2.51), most bikeways (OR = 1.60 99% CI, 1.16–2.21), and most streetlights (OR = 1.50 99% CI, 1.07–2.11). The likelihood of walking for more than 300 minutes was also higher among those who lived closest to a river or the coast (OR = 2.06 99% CI, 1.41–3.02). The likelihood of meeting (and exceeding) physical activity recommendations on the basis of walking was higher in neighborhoods with greater street connectivity and residential density, more streetlights and bikeways, closer proximity to waterways, and less tree coverage. Interventions targeting these neighborhood characteristics may lead to improved environmental quality as well as lower rates of overweight and obesity and associated chromic disease. (Am J Health Promot 2011 [4]:e12–e21.)
Publisher: Human Kinetics
Date: 2023
Abstract: Aim: To examine whether changes in public open spaces (POS) were associated with leisure-time walking (LTW) between 2014 and 2021. Methods: The s le comprised a prospective cohort of in iduals living in São Paulo City, Brazil. The baseline s le was collected in 2014/2015 (4042 people aged 12 y or older) and the second wave in 2020/2021 (1431 people aged 18 y or older, 35.4% of total). Changes in POS scores in 500-m network buffers were based on household address, including positive or negative maintenance and increases or decreases in parks, public squares, and bike paths between 2015 and 2020. The International Physical Activity Questionnaire was used to evaluate LTW in the baseline and second wave. To examine the association of LTW with changes in POS, we used multilevel models in 4 levels: health administration areas, census tracts, in iduals, and observations of in iduals. The exposure was the POS tertiles, and the outcome was LTW. Results: Changes in LTW prevalence were observed in both periods and according to POS tertiles distributions. When adjusted for time (baseline/second wave), gender, education, and age, the highest POS tertile was significantly associated with a high likelihood for LTW (odds ratio = 1.44 95% confidence interval, 1.03–2.02). Conclusion: The results showed that people in São Paulo who lived within 500-m buffers with the highest access to POS were more likely to practice LTW between 2014/2015 and 2020/2021. These results have important implications for policies that were implemented in 2014, including the New Master Plan to contribute to São Paulo’s good ranking among healthy cities.
Publisher: Springer Science and Business Media LLC
Date: 24-10-2013
Publisher: Elsevier BV
Date: 12-2016
DOI: 10.1016/J.YPMED.2016.06.034
Abstract: Limitations have arisen when measuring associations between the neighbourhood social environment and physical activity, including same-source bias, and the reliability of aggregated neighbourhood-level social environment measures. This study examines cross-sectional associations between the neighbourhood social environment (perceptions of incivilities, crime, and social cohesion) and self-reported physical activity, while accounting for same-source bias and reliability of neighbourhood-level exposure measures, using data from a large population-based clustered s le. This investigation included 11,035 residents aged 40-65years from 200 neighbourhoods in Brisbane, Australia, in 2007. Respondents self-reported their physical activity and perceptions of the social environment (neighbourhood incivilities, crime and safety, and social cohesion). Models were adjusted for in idual-level education, occupation, and household income, and neighbourhood disadvantage. Exposure measures were generated via split clusters and an empirical Bayes estimation procedure. Data were analysed in 2016 using multilevel multinomial logistic regression. Residents of neighbourhoods with the highest incivilities and crime, and lowest social cohesion were reference categories. In iduals were more likely to be in the higher physical activity categories if they were in neighbourhoods with the lowest incivilities and the lowest crime. No associations were found between social cohesion and physical activity. This study provides a basis from which to gain a clearer understanding of the relationship between the neighbourhood social environment and in idual physical activity. Further work is required to explore the pathways between perceptions of the neighbourhood social environment and physical activity.
Publisher: Elsevier BV
Date: 12-2013
Publisher: Elsevier BV
Date: 06-2022
DOI: 10.1016/J.JAGING.2022.101011
Abstract: The oldest old - those aged 80 years and over - are the fastest growing sector of the Australian population and are generally assumed to be at risk of social exclusion which impedes healthy aging. The voices of those thought to be vulnerable to social exclusion are seldom heard. Informed by a critical gerontology framework, socio-ecological model of health and life-course perspectives, this research involved semi-structured in-depth interviews with a purposive s le of 13 people aged 80 and older living alone in government housing, in a socio-economically disadvantaged neighborhood in Melbourne, Australia. Interview transcripts were analyzed using thematic analysis. The findings reveal a positive picture of survival despite hardship, supportive relationships, a sense of autonomy from living independently, and contributing to society. These findings challenge ageist assumptions, which equate advanced age with social exclusion.
Publisher: Elsevier BV
Date: 06-2011
DOI: 10.1111/J.1753-6405.2010.00705.X
Abstract: To examine education differences in five-year weight change among mid-aged adults, and to ascertain if this may be due to socioeconomic differences in perceived weight status or weight control behaviours (WCBs). Data were used from the Australian Diabetes, Obesity and Lifestyle Study. Mid-aged men and women with measured weights at both baseline (1999-2000) and follow-up (2004-2005) were included. Percent weight change over the five-year interval was calculated and perceived weight status, WCBs and highest attained education were collected at baseline. Low-educated men and women were more likely to be obese at baseline compared to their high-educated counterparts. Women with a certificate-level education had a greater five-year weight gain than those with a bachelor degree or higher. Perceived weight status or WCBs did not differ by education among men and women, however participants that perceived themselves as very overweight had less weight gain than those perceiving themselves as underweight or normal weight. WCBs were not associated with five-year weight change. The higher prevalence of overweight/obesity among low-educated women may be a consequence of greater weight gain in mid-adulthood. Education inequalities in overweight/obesity among men and women made be due (in part) to overweight or obese in iduals in low-educated groups not perceiving themselves as having a weight problem.
Publisher: BMJ
Date: 30-01-2011
Abstract: Reducing disparities in cancer outcomes is a major priority for cancer-control agencies. The authors examine the relationships between geographic remoteness, area disadvantage and risk of advanced breast cancer among women. Multilevel models were used to assess the area- and in idual-level contributions to the risk of advanced breast cancer among women aged 30-79 years diagnosed as having breast cancer in Queensland, Australia between 1997 and 2006 (n=18,658). Women who resided in the most socio-economically disadvantaged areas were significantly more likely (OR 1.21, 95% CI 1.07 to 1.37) than residents of the most advantaged areas to be diagnosed as having advanced breast cancer after adjustment for in idual-level factors. When geographic remoteness and area-disadvantage (and all the in idual-level factors) were simultaneously adjusted, the rates of advanced breast cancer were significantly higher for women residing in Outer Regional areas (OR 1.13, 95% CI 1.02 to 1.24) and those who lived in the most disadvantaged areas (OR 1.16, 95% CI 1.02 to 1.32). There was no statistically significant interaction between geographic remoteness and area disadvantage. A woman's risk of being diagnosed as having advanced breast cancer depends on where she lives, separate from the in idual characteristics of the woman herself. Both the rurality and socio-economic characteristics of the geographical area in which women lived were important. The socio-economic factors contributing to advanced breast cancer, existing in both urban and rural environments, need to be investigated.
Publisher: Wiley
Date: 30-01-2013
DOI: 10.1111/ADJ.12017
Abstract: In idual-level factors influence DMFT, but little is known about the influence of community environment. This study examined associations between community-level influences and DMFT among a birth cohort of Indigenous Australians aged 16-20 years. Data were collected as part of Wave 3 of the Aboriginal Birth Cohort study. Fifteen community areas were established and the s le comprised 442 in iduals. The outcome variable was mean DMFT with explanatory variables including diet and community disadvantage (access to services, infrastructure and communications). Data were analysed using multilevel regression modelling. In a null model, 13.8% of the total variance in mean DMFT was between community areas, which increased to 14.3% after adjusting for gender, age and diet. Addition of the community disadvantage variable decreased the variance between areas by 4.8%, indicating that community disadvantage explained one-third of the area-level variance. Residents of under-resourced communities had significantly higher mean DMFT (β = 3.86, 95% CI 0.02, 7.70) after adjusting for gender, age and diet. Living in under-resourced communities was associated with greater DMFT among this disadvantaged population, indicating that policies aiming to reduce oral health-related inequalities among vulnerable groups may benefit from taking into account factors external to in idual-level influences.
Publisher: Cambridge University Press (CUP)
Date: 24-02-2015
Publisher: SAGE Publications
Date: 06-2010
DOI: 10.1177/097206341001200201
Abstract: Traditional Birth Attendants (TBA) training has been an important component of public health policy interventions to improve maternal and child health in developing countries since the 1970s. More recently, since the 1990s, the TBA training strategy has been increasingly seen as irrelevant, ineffective or, on the whole, a failure due to evidence that the maternal mortality rate (MMR) in developing countries had not reduced. Although, worldwide data show that, by choice or out of necessity, 47 percent of births in the developing world are assisted by TBAs and/or family members, funding for TBA training has been reduced and moved to providing skilled birth attendants for all births. Any shift in policy needs to be supported by appropriate evidence on TBA roles in providing maternal and infant health care service and effectiveness of the training programmes. This article reviews literature on the characteristics and role of TBAs in South Asia with an emphasis on India. The aim was to assess the contribution of TBAs in providing maternal and infant health care service at different stages of pregnancy and after-delivery and birthing practices adopted in home births. The review of role revealed that apart from TBAs, there are various other people in the community also involved in making decisions about the welfare and health of the birthing mother and new born baby. However, TBAs have changing, localised but nonetheless significant roles in delivery, postnatal and infant care in India. Certain traditional birthing practices such as bathing babies immediately after birth, not weighing babies after birth and not feeding with colostrum are adopted in home births as well as health institutions in India. There is therefore a thin precarious balance between the application of biomedical and traditional knowledge. Customary rituals and perceptions essentially affect practices in home and institutional births and hence training of TBAs need to be implemented in conjunction with community awareness programmes.
Publisher: Informa UK Limited
Date: 24-05-2016
Publisher: SAGE Publications
Date: 2013
DOI: 10.3141/2344-07
Abstract: This research identifies the impacts of residential dissonance on residential mobility behavior in transit-oriented developments (TODs) versus non-TODs in Brisbane, Australia. On the basis of the characteristics of living environments (density, ersity, connectivity, and accessibility) and the travel preferences of 4,545 in iduals, respondents in 2009 were classified into one of four categories: TOD consonants, TOD dissonants, non-TOD dissonants, and non-TOD consonants. Binary logistic regression analyses were employed to identify residential mobility behavior of groups between 2009 and 2011 while controlling for time-varying covariates. The findings show that both TOD dissonants and TOD consonants move residences at an equal rate. However, TOD dissonants are more likely to move residences to their preferred non-TOD areas. In contrast, non-TOD dissonants not only move residences at a lower rate, but their rate of mobility to their preferred TOD neighborhood is also significantly lower because of costs and other associated factors. The findings suggest that development of policies for discrete land use is required to integrate non-TOD dissonant and TOD dissonant behaviors to support TOD development in Brisbane.
Publisher: Elsevier BV
Date: 11-2012
DOI: 10.1016/J.HEALTHPLACE.2012.07.006
Abstract: This study examines the influence of cancer stage, distance to treatment facilities and area disadvantage on breast and colorectal cancer spatial survival inequalities. We also estimate the number of premature deaths after adjusting for cancer stage to quantify the impact of spatial survival inequalities. Population-based descriptive study of residents aged <90 years in Queensland, Australia diagnosed with primary invasive breast (25,202 females) or colorectal (14,690 males, 11,700 females) cancers during 1996-2007. Bayesian hierarchical models explored relative survival inequalities across 478 regions. Cancer stage and disadvantage explained the spatial inequalities in breast cancer survival, however spatial inequalities in colorectal cancer survival persisted after adjustment. Of the 6,019 colorectal cancer deaths within 5 years of diagnosis, 470 (8%) were associated with spatial inequalities in non-diagnostic factors, i.e. factors beyond cancer stage at diagnosis. For breast cancers, of 2,412 deaths, 170 (7%) were related to spatial inequalities in non-diagnostic factors. Quantifying premature deaths can increase incentive for action to reduce these spatial inequalities.
Publisher: BMJ
Date: 08-2007
Publisher: Elsevier BV
Date: 09-2010
Publisher: Cambridge University Press (CUP)
Date: 07-09-2012
DOI: 10.1017/S1368980011001996
Abstract: Food insecurity is the limited or uncertain availability or access to nutritionally adequate, culturally appropriate and safe foods. Food insecurity may result in inadequate dietary intakes, overweight or obesity and the development of chronic disease. Internationally, few studies have focused on the range of potential health outcomes related to food insecurity among adults residing in disadvantaged locations and no such Australian studies exist. The objective of the present study was to investigate associations between food insecurity, sociodemographic and health factors and dietary intakes among adults residing in disadvantaged urban areas. Data were collected by mail survey ( n 505, 53 % response rate), which ascertained information about food security status, demographic characteristics (such as age, gender, household income, education) fruit and vegetable intakes, takeaway and meat consumption, general health, depression and chronic disease. Disadvantaged suburbs of Brisbane city, Australia, 2009. In iduals aged ≥ 20 years. Approximately one in four households (25 %) was food insecure. Food insecurity was associated with lower household income, poorer general health, increased health-care utilisation and depression. These associations remained after adjustment for age, gender and household income. Food insecurity is prevalent in urbanised disadvantaged areas in developed countries such as Australia. Low-income households are at high risk of experiencing food insecurity. Food insecurity may result in significant health burdens among the population, and this may be concentrated in socio-economically disadvantaged suburbs.
Publisher: MDPI AG
Date: 21-03-2018
Publisher: Public Library of Science (PLoS)
Date: 23-01-2018
Publisher: Springer Science and Business Media LLC
Date: 12-2012
Publisher: Elsevier BV
Date: 12-2016
Publisher: Oxford University Press (OUP)
Date: 17-01-2018
DOI: 10.1093/AJE/KWX390
Abstract: Natural experiments, such as longitudinal observational studies that follow-up residents as they relocate, provide a strong basis to infer causation between the neighborhood environment and health. In this study, we examined whether changes in the level of neighborhood disadvantage were associated with changes in body mass index (BMI) after residential relocation. This analysis included data from 928 residents who relocated between 2007 and 2013, across 4 waves of the How Areas in Brisbane Influence Health and Activity (HABITAT) study in Brisbane, Australia. Neighborhood disadvantage was measured using a census-derived composite index. For in idual-level data, participants self-reported their height, weight, education, occupation, and household income. Data were analyzed using multilevel, hybrid linear models. Women residing in less disadvantaged neighborhoods had a lower BMI, but there was no association among men. Neighborhood disadvantage was not associated with within-in idual changes in BMI among men or women when moving to a new neighborhood. Despite a growing body of literature suggesting an association between neighborhood disadvantage and BMI, we found this association may not be causal among middle-aged and older adults. Observing associations between neighborhood socioeconomic disadvantage and BMI over the life course, including the impact of residential relocation at younger ages, remains a priority for future research.
Publisher: AMPCo
Date: 12-2011
DOI: 10.5694/MJA11.11310
Publisher: Elsevier BV
Date: 04-2016
DOI: 10.1016/J.CANEP.2015.12.009
Abstract: The survival benefits of having a partner for all cancers combined is well recognized, however its prognostic importance for in idual cancer types, including competing mortality causes, is less clear. This study was undertaken to quantify the impact of partner status on survival due to cancer-specific and competing mortality causes. Data were obtained from the population-based Queensland Cancer Registry on 176,050 incident cases of ten leading cancers diagnosed in Queensland (Australia) from 1996 to 2012. Flexible parametric competing-risks models were used to estimate cause-specific hazards and cumulative probabilities of death, adjusting for age, stage (breast, colorectal and melanoma only) and stratifying by sex. Both unpartnered males and females had higher total cumulative probability of death than their partnered counterparts for each site. For ex le, the survival disadvantage for unpartnered males ranged from 3% to 30% with higher mortality burden from both the primary cancer and competing mortality causes. The cause-specific age-adjusted hazard ratios were also consistent with patients without a partner having increased mortality risk although the specific effect varied by site, sex and cause of death. For all combined sites, unpartnered males had a 46%, 18% and 44% higher risk of cancer-specific, other cancer and non-cancer mortality respectively with similar patterns for females. The higher mortality risk persisted after adjustment for stage. It is important to better understand the mechanisms by which having a partner is beneficial following a cancer diagnosis, so that this can inform improvements in cancer management for all people with cancer.
Publisher: Elsevier BV
Date: 06-2019
Publisher: Informa UK Limited
Date: 04-05-2022
Publisher: Wiley
Date: 28-07-2011
DOI: 10.1111/J.1360-0443.2011.03510.X
Abstract: To assess the association between access to off-premises alcohol outlets and harmful alcohol consumption. Multi-level study of 2334 adults aged 18-75 years from 49 census collector districts (the smallest spatial unit in Australia at the time of survey) in metropolitan Melbourne. Alcohol outlet density was defined as the number of outlets within a 1-km road network of respondents' homes and proximity was the shortest road network distance to the closest outlet from their home. Using multi-level logistic regression we estimated the association between outlet density and proximity and four measures of harmful alcohol consumption: drinking at levels associated with short-term harm at least weekly and monthly drinking at levels associated with long-term harm and frequency of consumption. Density of alcohol outlets was associated with increased risk of drinking alcohol at levels associated with harm. The strongest association was for short-term harm at least weekly [odds ratio (OR) 1.10, 95% confidence interval (CI) 1.04-1.16]. When density was fitted as a categorical variable, the highest risk of drinking at levels associated with short-term harm was when there were eight or more outlets (short-term harm weekly: OR 2.36, 95% CI 1.22-4.54 and short-term harm monthly: OR 1.80, 95% CI 1.07-3.04). We found no evidence to support an association between proximity and harmful alcohol consumption. The number of off-premises alcohol outlets in a locality is associated with the level of harmful alcohol consumption in that area. Reducing the number of off-premises alcohol outlets could reduce levels of harmful alcohol consumption.
Publisher: Elsevier BV
Date: 12-2016
Publisher: Elsevier BV
Date: 10-2009
DOI: 10.1016/J.JADA.2009.07.006
Abstract: Cooking skills are emphasized in nutrition promotion but their distribution among population subgroups and relationship to dietary behavior is researched by few population-based studies. This study examined the relationships between confidence to cook, sociodemographic characteristics, and household vegetable purchasing. This cross-sectional study of 426 randomly selected households in Brisbane, Australia, used a validated questionnaire to assess household vegetable purchasing habits and the confidence to cook of the person who most often prepares food for these households. The mutually adjusted odds ratios (ORs) of lacking confidence to cook were assessed across a range of demographic subgroups using multiple logistic regression models. Similarly, mutually adjusted mean vegetable purchasing scores were calculated using multiple linear regression for different population groups and for respondents with varying confidence levels. Lacking confidence to cook using a variety of techniques was more common among respondents with less education (OR 3.30 95% confidence interval [CI] 1.01 to 10.75) and was less common among respondents who lived with minors (OR 0.22 95% CI 0.09 to 0.53) and other adults (OR 0.43 95% CI 0.24 to 0.78). Lack of confidence to prepare vegetables was associated with being male (OR 2.25 95% CI 1.24 to 4.08), low education (OR 6.60 95% CI 2.08 to 20.91), lower household income (OR 2.98 95% CI 1.02 to 8.72) and living with other adults (OR 0.53 95% CI 0.29 to 0.98). Households bought a greater variety of vegetables on a regular basis when the main chef was confident to prepare them (difference: 18.60 95% CI 14.66 to 22.54), older (difference: 8.69 95% CI 4.92 to 12.47), lived with at least one other adult (difference: 5.47 95% CI 2.82 to 8.12) or at least one minor (difference: 2.86 95% CI 0.17 to 5.55). Cooking skills may contribute to socioeconomic dietary differences, and may be a useful strategy for promoting fruit and vegetable consumption, particularly among socioeconomically disadvantaged groups.
Publisher: Elsevier BV
Date: 2020
Publisher: Elsevier BV
Date: 06-1997
Publisher: Springer Science and Business Media LLC
Date: 12-2009
Publisher: Elsevier BV
Date: 12-2006
DOI: 10.1016/J.HEALTHPLACE.2005.09.006
Abstract: Understanding the role environmental factors may play in the dietary behaviours of socioeconomic groups is relevant for efforts to reduce health inequalities. In contrast with international research, earlier findings from the Brisbane Food Study (BFS), Australia, found no relationship between area socioeconomic characteristics and dietary behaviours or location of food shops. This paper examines whether the price and availability of fruits and vegetables are socioeconomically patterned using data from the BFS. Fifty census collection districts were randomly s led and all local (i.e. within 2.5 km) supermarkets, greengrocers and convenience stores were observed. Little or no differences in price and availability were found on the basis of area socioeconomic characteristics.
Publisher: Elsevier BV
Date: 08-2018
Abstract: To compare prevalence estimates of food insecurity using a single-item measure, with three adaptations of the United States Department of Agriculture Food Security Survey Module (USDA-FSSM). Data were collected by postal survey, from in iduals aged ≥18 years from disadvantaged suburbs of Brisbane, Australia (n= 505, 53% response). Food security status was ascertained by the Australian single-item measure, and the 6-, 10- and 18-item versions of the USDA-FSSM. Prevalence estimates of food insecurity and different levels of severity of food insecurity estimated by each tool were determined. Data were analysed using McNemar's test, polychoric correlation and Rasch analyses. The prevalence of food insecurity was 19.5% using the single-item measure significantly less than the 24.4%, 22.8% and 21.1% identified using the 18-item, 10-item and 6-item versions of the USDA-FSSM, respectively. Rasch analyses revealed that overall the USDA-FSSM may be a valid tool for the measurement of food insecurity within the current s le. The measure of food insecurity employed in national surveys in Australia may underestimate its prevalence and public health significance. Implications for public health: Future monitoring and surveillance efforts should seek to employ a more accurate measure as the first step in recognising the right to food for all Australians.
Publisher: Public Library of Science (PLoS)
Date: 03-06-2021
DOI: 10.1371/JOURNAL.PONE.0252017
Abstract: Cross-sectional studies have found some built environmental attributes to be associated with residents’ lower levels of mobility (functional capacity to walk outside the home). However, less is known about what environmental attributes are related to mobility decline. This longitudinal study examined area-level associations of specific environmental attributes with mid-to-older aged adults’ changes in walking mobility. Data collected from 4,088 adults (aged 46–71 years at baseline) who participated in a cohort study in Brisbane, Australia were used. The outcome was the change in self-reported mobility score (SF-36) from 2013 to 2016, which were aggregated at the neighborhood (N = 156) and suburb (N = 99) levels, due to the known lack of sensitivity in SF-36 subscales to in idual changes. Linear regression analysis examined associations of mobility change with seven environmental attributes measured at baseline (residential density, intersection density, land use mix, density of walking/bike paths, park density, bus stop density, density of social incivilities), adjusting for confounding variables. Participants on average reported 4% of mobility decline during the 3-year study period. It was found that greater land use ersity was consistently associated with less decline in walking mobility, while greater density of social incivilities was associated with more decline in walking mobility. The latter finding was significant only at the neighborhood level. No consistent associations were observed for residential density, intersection density, density of walking/bike paths, park density, and bus stop density. Our findings suggest that mid-to-older aged adults who live in areas with lower land use ersity and more social incivilities may be at risk of developing mobility limitations. Recommended policies to slow residents’ mobility decline and to achieve aging in place include improving these environmental attributes where needed and advising older adults to relocate to safer, mixed-use neighborhoods.
Publisher: Wiley
Date: 10-2002
DOI: 10.1046/J.1365-277X.2002.00384.X
Abstract: The relationship between socioeconomic position (SEP) and diet has been examined mainly on the basis of food and nutrient intake. As a complement to this work, we focused on the socioeconomic patterning of food purchasing, as many educational dietary messages emphasize behaviours such as food choice when shopping. Also, the type of food people buy influences the quality of their nutrient intake. A probability s le of households in Brisbane City, Australia (n = 1003, 66.4% response rate). Data were collected using face-to-face interviews. SEP was measured using education, occupation and household income. Food purchasing was examined on the basis of grocery items (including meat and chicken) and fruit and vegetables. Significant associations were found between each socioeconomic indicator and food purchasing. Persons from socioeconomically disadvantaged backgrounds were less likely to purchase grocery foods that were comparatively high in fibre and low in fat, salt and sugar. The least educated, those employed in blue-collar (manual) occupations and residents of low income households purchased fewer types of fruit and vegetables, and less regularly, than their higher status counterparts. Health promotion efforts aimed at narrowing socioeconomic differences in food purchasing need to be designed and implemented with an understanding of, and a sensitivity to, the barriers to nutritional improvement that difficult life circumstances can impose.
Publisher: Elsevier BV
Date: 07-2013
DOI: 10.1016/J.HEALTHPLACE.2013.03.006
Abstract: This work establishes whether neighborhood disadvantage lifies the impact of socioeconomic position (SEP) on a graded measure of self-rated health (SRH). SRH data were taken from 10,932 adults recruited across 200 Brisbane neighborhoods. After adjusting for demographics, those who lived in the most disadvantaged neighborhoods were more likely to report poor SRH than those living in the least disadvantaged neighborhoods (OR=2.67). Those with the lowest SEP and lived in the most advantaged neighborhoods had a similar probability of reporting excellent SRH as those with the highest SEP living in the most disadvantaged neighborhoods. This work highlights the importance of examining SEP and neighborhood-level disadvantage simultaneously when planning communities.
Publisher: Human Kinetics
Date: 10-2004
DOI: 10.1123/JPAH.1.4.344
Abstract: This study assessed item nonresponse (INR) in a population-based mail survey of physical activity (PA). A questionnaire was mailed to a random s le, with a 57% response rate ( n = 2532). The magnitude and type of PA INR and the association with sociodemographic variables was examined using logistic regression. Among survey respondents, 28% had incomplete PA data 11% missed 1 item, 11% missed 2 items, and 5% missed all 3 items. Respondents missing 3 items tended to be female, less educated, low income, in poor health, and current smokers. The walking item was missed by 8% of respondents, and 18% and 23% missed the vigorous-intensity and moderate-intensity PA items respectively. These groups were sociodemograpically different from those without INR. Incomplete PA data was also associated with sociodemographic INR. Mail surveys may underrepresent in iduals insufficiently active for health, in particular those of low socioeconomic position.
Publisher: Springer Science and Business Media LLC
Date: 09-12-2012
DOI: 10.1007/S10549-011-1899-Y
Abstract: A major priority for cancer control agencies is to reduce geographical inequalities in cancer outcomes. While the poorer breast cancer survival among socioeconomically disadvantaged women is well established, few studies have looked at the independent contribution that area- and in idual-level factors make to breast cancer survival. Here, we examine relationships between geographic remoteness, area-level socioeconomic disadvantage and breast cancer survival after adjustment for patients' socio-demographic characteristics and stage at diagnosis. Multilevel logistic regression and Markov chain Monte Carlo simulation were used to analyze 18,568 breast cancer cases extracted from the Queensland Cancer Registry for women aged 30-70 years diagnosed between 1997 and 2006 from 478 Statistical Local Areas in Queensland, Australia. Independent of in idual-level factors, area-level disadvantage was associated with breast cancer survival (P = 0.032). Compared to women in the least disadvantaged quintile (quintile 5), women diagnosed while resident in one of the remaining four quintiles had significantly worse survival (OR 1.23, 1.27, 1.30, 1.37 for quintiles 4, 3, 2, and 1, respectively). Geographic remoteness was not related to lower survival after multivariable adjustment. There was no evidence that the impact of area-level disadvantage varied by geographic remoteness. At the in idual-level, Indigenous status, blue collar occupations and advanced disease were important predictors of poorer survival. A woman's survival after a diagnosis of breast cancer depends on the socio-economic characteristics of the area where she lives, independently of her in idual-level characteristics. It is crucial that the underlying reasons for these inequalities be identified to appropriately target policies, resources and effective intervention strategies.
Publisher: BMJ
Date: 14-07-2009
Abstract: Takeaway consumption has been increasing and may contribute to socioeconomic inequalities in overweight/obesity and chronic disease. This study examined socioeconomic differences in takeaway consumption patterns and their contributions to dietary intake inequalities. Cross-sectional dietary intake data from adults aged between 25 and 64 years from the Australian National Nutrition Survey (n = 7319, 61% response rate). Twenty-four-hour dietary recalls ascertained intakes of takeaway food, nutrients and fruit and vegetables. Education was used as a socioeconomic indicator. Data were analysed using logistic regression and general linear models. Thirty-two per cent (n = 2327) consumed takeaway foods in the 24-hour period. Lower educated participants were less likely than their higher educated counterparts to have consumed total takeaway foods (OR 0.64 95% CI 0.52 to 0.80). Of those consuming takeaway foods, the lowest educated group was more likely to have consumed "less healthy" takeaway choices (OR 2.55 95% CI 1.73 to 3.77), and less likely to have consumed "healthy" choices (OR 0.52 95% CI 0.36 to 0.75). Takeaway foods made a greater contribution to energy, total fat, saturated fat and fibre intakes among lower than among higher educated groups. Lower likelihood of fruit and vegetable intakes were observed among "less healthy" takeaway consumers, whereas a greater likelihood of their consumption was found among "healthy" takeaway consumers. Total and the types of takeaway foods consumed may contribute to socioeconomic inequalities in intakes of energy, total and saturated fats. However, takeaway consumption is unlikely to be a factor contributing to the lower fruit and vegetable intakes among socioeconomically disadvantaged groups.
Publisher: Wiley
Date: 17-04-2012
DOI: 10.1111/J.1465-3362.2012.00452.X
Abstract: In idual smokers from disadvantaged backgrounds are less likely to quit, which contributes to widening inequalities in smoking. Residents of disadvantaged neighbourhoods are more likely to smoke, and neighbourhood inequalities in smoking may also be widening because of neighbourhood differences in rates of cessation. This study examined the association between neighbourhood disadvantage and smoking cessation and its relationship with neighbourhood inequalities in smoking. A multilevel longitudinal study of mid-aged (40-67 years) residents (n = 6915) of Brisbane, Australia, who lived in the same neighbourhoods (n = 200) in 2007 and 2009. Neighbourhood inequalities in cessation and smoking were analysed using multilevel logistic regression and Markov chain Monte Carlo simulation. After adjustment for in idual-level socioeconomic factors, the probability of quitting smoking between 2007 and 2009 was lower for residents of disadvantaged neighbourhoods (9.0-12.8%) than their counterparts in more advantaged neighbourhoods (20.7-22.5%). These inequalities in cessation manifested in widening inequalities in smoking: in 2007 the between-neighbourhood variance in rates of smoking was 0.242 (P ≤ 0.001) and in 2009 it was 0.260 (P ≤ 0.001). In 2007, residents of the most disadvantaged neighbourhoods were 88% (OR 1.88, 95% credible intervals (CrI) 1.41-2.49) more likely to smoke than residents in the least disadvantaged neighbourhoods: the corresponding difference in 2009 was 98% (OR 1.98, 95% CrI 1.48-2.66). Fundamentally, social and economic inequalities at the neighbourhood and in idual levels cause smoking and cessation inequalities. Reducing these inequalities will require comprehensive, well-funded and targeted tobacco control efforts and equity-based policies that address the social and economic determinants of smoking.
Publisher: Elsevier BV
Date: 08-2016
DOI: 10.1016/J.YPMED.2016.05.007
Abstract: Understanding associations between physical function and neighborhood disadvantage may provide insights into which interventions might best contribute to reducing socioeconomic inequalities in health. This study examines associations between neighborhood-disadvantage, in idual-level socioeconomic position (SEP) and physical function from a multilevel perspective. Data were obtained from the HABITAT multilevel longitudinal (2007-13) study of middle-aged adults, using data from the fourth wave (2013). This investigation included 6004 residents (age 46-71years) of 535 neighborhoods in Brisbane, Australia. Physical function was measured using the PF-10 (0-100), with higher scores indicating better function. The data were analyzed using multilevel linear regression and were extended to test for cross-level interactions by including interaction terms for different combinations of SEP (education, occupation, household income) and neighborhood disadvantage on physical function. Residents of the most disadvantaged neighborhoods reported significantly lower physical function (men: β -11.36 95% CI -13.74, -8.99 women: β -11.41 95% CI -13.60, -9.22). These associations remained after adjustment for in idual-level SEP. In iduals with no post-school education, those permanently unable to work, and members of the lowest household income had significantly poorer physical function. Cross-level interactions suggested that the relationship between household income and physical function is different across levels of neighborhood disadvantage for men and for education and occupation for women. Living in a disadvantaged neighborhood was negatively associated with physical function after adjustment for in idual-level SEP. These results may assist in the development of policy-relevant targeted interventions to delay the rate of physical function decline at a community-level.
Publisher: Elsevier BV
Date: 07-2019
DOI: 10.1016/J.HEALTHPLACE.2019.05.015
Abstract: This systematic review included 23 quantitative studies that estimated associations between aspects of the neighbourhood built environment and physical function among adults aged ≥45 years. Findings were analysed according to nine aspects of the neighbourhood built environment: walkability, residential density, street connectivity, land use mix, public transport, pedestrian infrastructure, aesthetics, safety and traffic. Evidence was found for a positive association of pedestrian infrastructure and aesthetics with physical function, while weaker evidence was found for land use mix, and safety from crime and traffic. There was an insufficient number of studies for walkability, residential density, street connectivity and access to public transport.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-2014
Publisher: Elsevier BV
Date: 07-2016
DOI: 10.1016/J.HEALTHPLACE.2016.04.012
Abstract: This study aims to determine if neighbourhood psychosocial characteristics contribute to inequalities in smoking among residents from neighbourhoods of differing socioeconomic disadvantage. This cross-sectional study includes 11,035 residents from 200 neighbourhoods in Brisbane, Australia in 2007. Self-reported measures were obtained for smoking and neighbourhood psychosocial characteristics (perceptions of incivilities, crime and safety, and social cohesion). Neighbourhood socioeconomic disadvantage was measured using a census-derived index. Data were analysed using multilevel logistic regression random intercept models. Smoking was associated with neighbourhood disadvantage this relationship remained after adjustment for in idual-level socioeconomic position. Area-level perceptions of crime and safety and social cohesion were not independently associated with smoking, and did not explain the higher prevalence of smoking in disadvantaged areas however, perceptions of incivilities showed an independent effect. Some neighbourhood psychosocial characteristics seem to contribute to the higher rates of smoking in disadvantaged areas.
Publisher: Elsevier BV
Date: 10-2011
DOI: 10.1016/J.JADA.2011.07.009
Abstract: Lower fruit and vegetable (F/V) intake among socioeconomically disadvantaged groups has been well documented, and may be a consequence of a higher consumption of take-out foods. This study examined whether, and to what extent, take-out food consumption mediated (explained) the association between socioeconomic position and F/V intake. A cross-sectional postal survey was conducted among 1,500 randomly selected adults aged 25 to 64 years in Brisbane, Australia, during 2009 (response rate 63.7%, N=903). A food frequency questionnaire assessed usual daily servings of F/V (0 to 6), overall take-out consumption (times per week), and the consumption of 22 specific take-out items (never to once per day or more). These specific take-out items were grouped into "less healthy" and "healthy" choices and indexes were created for each type of choice (0 to 100). Socioeconomic position was ascertained by education. The analyses were performed using linear regression, and a bootstrap res ling approach estimated the statistical significance of the mediated effects. Mean daily servings of F/V were 1.89±1.05 and 2.47±1.12, respectively. The least educated group members were more likely to consume fewer servings of fruit (β= -.39, P<0.001) and vegetables (β= -.43, P<0.001) compared with members of the highest educated group. The consumption of "less healthy" take-out food partly explained (mediated) education differences in F/V intake however, no mediating effects were observed for overall and "healthy" take-out consumption. Regular consumption of "less healthy" take-out items may contribute to socioeconomic differences in F/V intake, possibly by displacing these foods.
Publisher: Elsevier BV
Date: 02-2012
DOI: 10.1016/J.MIDW.2011.04.006
Abstract: Since the 1990s, the TBA training strategy in developing countries has been increasingly seen as ineffective and hence its funding was subsequently reallocated to providing skilled attendants during delivery. The ineffectiveness of training programmes is blamed on TBAs lower literacy, their inability to adapt knowledge from training and certain practices that may cause maternal and infant health problems. However most training impact assessments evaluate post-training TBA practices and do not assess the training strategy. There are serious deficiencies noted in information on TBA training strategy in developing countries. The design and content of the training is vital to the effectiveness of TBA training programmes. We draw on Jordan's concept of 'authoritative knowledge' to assess the extent to which there is a synthesis of both biomedical and locally practiced knowledge in the content and community involvement in the design of TBA a training programme in India. The implementation of the TBA training programme at the local level overlooks the significance of and need for a baseline study and needs assessment at the local community level from which to build a training programme that is apposite to the local mother's needs and that fits within their 'comfort zone' during an act that, for most, requires a forum in which issues of modesty can be addressed. There was also little scope for the training to be a two way process of learning between the health professionals and the TBAs with hands-on experience and knowledge. The evidence from this study shows that there is an overall 'authority' of biomedical over traditional knowledge in the planning and implementation process of the TBA training programme. Certain vital information was not covered in the training content including advice to delay bathing babies for at least six hours after birth, to refrain from applying oil on the infant, and to wash hands again before directly handling mother or infant. Information on complication management and hypothermia was not adequately covered in the local TBA training programme. The suggested improvements include the need to include a baseline study, appropriate selection criteria, improve information in the training manual to increase clarity of meaning, and to encourage beneficial traditional practices through training.
Publisher: Oxford University Press (OUP)
Date: 15-12-2020
DOI: 10.1093/IJE/DYAA175
Publisher: Elsevier BV
Date: 11-2010
DOI: 10.1016/J.JACL.2010.09.003
Abstract: The relationship between cigarette smoking and cardiovascular disease is well established, yet the underlying mechanisms remain unclear. Although smokers have a more atherogenic lipid profile, this may be mediated by other lifestyle-related factors. Analysis of lipoprotein subclasses by the use of nuclear magnetic resonance spectroscopy (NMR) may improve characterisation of lipoprotein abnormalities. We used NMR spectroscopy to investigate the relationships between smoking status, lifestyle-related risk factors, and lipoproteins in a contemporary cohort. A total of 612 participants (360 women) aged 40-69 years at baseline (1990-1994) enrolled in the Melbourne Collaborative Cohort Study had plasma lipoproteins measured with NMR. Data were analysed separately by sex. After adjusting for lifestyle-related risk factors, including alcohol and dietary intake, physical activity, and weight, mean total low-density lipoprotein (LDL) particle concentration was greater for female smokers than nonsmokers. Both medium- and small-LDL particle concentrations contributed to this difference. Total high-density lipoprotein (HDL) and large-HDL particle concentrations were lower for female smokers than nonsmokers. The proportion with low HDL particle number was greater for female smokers than nonsmokers. For men, there were few smoking-related differences in lipoprotein measures. Female smokers have a more atherogenic lipoprotein profile than nonsmokers. This difference is independent of other lifestyle-related risk factors. Lipoprotein profiles did not differ greatly between male smokers and nonsmokers.
Publisher: Oxford University Press (OUP)
Date: 10-2010
Publisher: Springer Science and Business Media LLC
Date: 25-02-2021
DOI: 10.1186/S12889-021-10458-9
Abstract: Residential environment features such as availability of supermarkets may shape dietary behaviour and thus overweight and obesity. This relationship may not be consistent between cities. This Australian national-level study examined: 1) the relationship between supermarket availability and body size and 2) whether this relationship varied by capital city. This study used 2017–18 Australian National Health Survey data including in idual-level socio-demographic information (age, sex, country of birth, education, occupation, household income), and measured body size (height and weight to derive body mass index [BMI], and waist circumference [WC]). Objectively-expressed measures of residential environments included: counts of supermarkets (major chain outlets), counts of amenities (representing walkable destinations including essential services, recreation, and entertainment), and area of public open space - each expressed within road-network buffers at 1000 m and 1500 m population density (1km 2 grid cells) and neighbourhood disadvantage (Index of Relative Socioeconomic Disadvantage) expressed within Statistical Area Level 1 units. Data for adult respondents ≥18 years residing in each of Australia’s state and territory capital cities ( n = 9649) were used in multilevel models to estimate associations between supermarket availability and body size sequentially accounting for in idual and other environment measures. An interaction term estimated city-specific differences in associations between supermarket availability and body size. Models were consequently repeated stratified by city. Body size (BMI and WC) and supermarket availability varied between cities. Initial inverse associations between supermarket availability and body size (BMI and WC) were attenuated to null with inclusion of all covariates, except for BMI in the 1000 m buffer model (beta = − 0.148, 95%CI -0.27, − 0.01, p = 0.025). In stratified analyses, the strengths of associations varied between cities, remaining statistically significant only for some cities (BMI: Melbourne, Brisbane Hobart WC: Brisbane, Hobart) in fully adjusted models. Different patterns of attenuation of associations with inclusion of covariates were evident for different cities. For Australian capital cities, greater availability of supermarkets is associated with healthful body size. Marked between-city variations in body size, supermarket availability, and relationships between supermarket availability and body size do not, however, support universal, “one-size-fits-all” solutions to change built environments to support healthful body size.
Publisher: Elsevier BV
Date: 06-2014
DOI: 10.1016/J.YPMED.2014.03.003
Abstract: Interest is growing in promoting utility cycling (i.e., for transport) as a means of incorporating daily physical activity (PA) into people's lives, but little is known about correlates of utility cycling. Our primary aim was to examine cross-sectional relationships between socio-economic characteristics, neighborhood environment perceptions and psychological disposition with utility cycling (with or without additional recreational cycling). A secondary aim was to compare these relationships with those for recreation-only cycling. Baseline survey data (2007) from 10,233 participants in HABITAT, a multilevel longitudinal study of PA, sedentary behavior, and health in Brisbane adults aged 40-65years, were analyzed using multinomial regression modeling. Greater income, habitual PA, and positive beliefs about PA were associated with utility and recreation-only cycling (p<0.05). Always having vehicle access and not in the labor force were associated with recreation-only cycling (p<0.05). Some or no vehicle access, part-time employment, and perceived environmental factors (little crime, few cul-de-sacs, nearby transport and recreational destinations) were associated with utility cycling (p<0.05). Our findings suggest differences in associations between socio-economic, neighborhood perceptions and psychological factors and utility and recreation-only cycling in Brisbane residents aged 40-65years. Tailored approaches appear to be required to promote utility and recreational cycling.
Publisher: Springer Science and Business Media LLC
Date: 28-09-2011
Publisher: Elsevier BV
Date: 07-2021
Publisher: Environmental Health Perspectives
Date: 21-05-2018
DOI: 10.1289/EHP2080
Publisher: Elsevier BV
Date: 2021
Publisher: Springer Science and Business Media LLC
Date: 09-04-2014
Publisher: Springer Science and Business Media LLC
Date: 05-03-2009
Publisher: Elsevier BV
Date: 09-2018
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.YPMED.2017.09.017
Abstract: Despite a body of evidence on the relationship between neighborhood socioeconomic disadvantage and body mass index (BMI), few studies have examined this relationship over time among ageing populations. This study examined associations between level of neighborhood socioeconomic disadvantage and the rate of change in BMI over time. The s le included 11,035 participants aged between 40 and 65years at baseline from the HABITAT study, residing in 200 neighborhoods in Brisbane, Australia. Data were collected biennially over four waves from 2007 to 2013. Self-reported height and weight were used to calculate BMI, while neighborhood disadvantage was measured using a census-based composite index. All models were adjusted for age, education, occupation, and household income. Analyses were conducted using multilevel linear regression models. BMI increased over time at a rate of 0.08kg/m
Publisher: BMJ
Date: 03-2004
Abstract: To examine the association between area and in idual level socioeconomic status (SES) and food purchasing behaviour. The s le comprised 1000 households and 50 small areas. Data were collected by face to face interview (66.4% response rate). SES was measured using a composite area index of disadvantage (mean 1026.8, SD = 95.2) and household income. Purchasing behaviour was scored as continuous indices ranging from 0 to 100 for three food types: fruits (mean 50.5, SD = 17.8), vegetables (61.8, 15.2), and grocery items (51.4, 17.6), with higher scores indicating purchasing patterns more consistent with dietary guideline recommendations. Brisbane, Australia, 2000. Persons responsible for their household's food purchasing. Controlling for age, gender, and household income, a two standard deviation increase on the area SES measure was associated with a 2.01 unit increase on the fruit purchasing index (95% CI -0.49 to 4.50). The corresponding associations for vegetables and grocery foods were 0.60 (-1.36 to 2.56) and 0.94 (-1.35 to 3.23). Before controlling for household income, significant area level differences were found for each food, suggesting that clustering of household income within areas (a composition effect) accounted for the purchasing variability between them. Living in a socioeconomically advantaged area was associated with a tendency to purchase healthier food, however, the association was small in magnitude and the 95% CI for area SES included the null. Although urban areas in Brisbane are differentiated on the basis of their socioeconomic characteristics, it seems unlikely that where you live shapes your procurement of food over and above your personal characteristics.
Publisher: SAGE Publications
Date: 05-06-2019
Abstract: Interrelationships between neighborhood walkability, area disadvantage, and crime may contribute to the inconsistent associations between crime and walking. We examined associations between crime and walking, and tested for differences by neighborhood disadvantage while addressing these additional complexities. Participants ( n = 6,680) from 200 neighborhoods spanning the most and least disadvantaged in Brisbane, Australia, completed a questionnaire and objective measures were generated for the in idual-level 1,000-m neighborhood. Multilevel models examined associations between crime (perceived and objective) and walking (recreational and transport), and interactions tested for differences by neighborhood disadvantage. High perceived crime was associated with reduced odds of transport walking, whereas high objective crime was associated with increased odds of transport walking. Patterns did not differ by neighborhood disadvantage. In disadvantaged neighborhoods, the “negative” criminogenic attributes were insufficient to outweigh the “positive” walkability attributes, producing similar walking patterns to advantaged neighborhoods where residents were dislocated from local destinations but buffered from crime.
Publisher: Elsevier BV
Date: 02-2014
Publisher: BMJ
Date: 02-05-2011
Abstract: The aim of this study was to examine the association between time spent in sedentary leisure and physical activity level in mid-aged men and women. Data were from the 2007 HABITAT study in Brisbane, Australia. A mail survey sent to 17 000 adults (40-65 years) provided 11 037 responses (68.5%), and 9121 (82.6%) were analysed. Sedentary leisure was quantified as hours/day spent sitting watching television, in home computer use, in general leisure, and overall, on a usual week and weekend day. Physical activity level (no activity, low, recommended, high, very high) included walking, moderate and vigorous activity combined into a measure of MET.min/week. Data were analysed separately for men and women using multilevel multinomial logistic regression with adjustment for sociodemographic and health variables. The only significant negative associations were between watching television on a week day and high activity in men (0.91 0.83-0.98), and home computer use on a weekend day and very high activity in men (0.89 0.81-0.98). For both men and women, there were significant positive associations between overall sedentary leisure time on a week day and very high activity (men: 1.07, 1.02-1.13 women: 1.10, 1.04-1.16), home computer use on a week day and very high activity (men: 1.11, 1.01-1.22 women: 1.15, 1.04-1.27) and general leisure on a week day and most activity levels. Sedentary leisure is mainly independent of physical activity and does not preclude meeting physical activity recommendations.
Publisher: SAGE Publications
Date: 03-1993
DOI: 10.1177/144078339302900105
Abstract: The residents' rights movement has a relatively recent history in Australia, although it is well established in the United States. The recent Ronalds consultancy (1988-1989) established a national policy agenda for the residents' rights movement in Australia, including a Charter of Residents' Rights and Responsibilities, a Resident/Proprietor Agreement, independent advocacy services and complaints units with the Department of Health, Housing and Community Services. A less well publicised aspect of recent reforms to the aged care system also converges significantly on the issue of residents' rights. In 1987, a new and sophisticated system of nursing home regulation was introduced by the Australian government. The standards monitoring program, which is at the forefront of international developments in this field, is resident centred and outcome oriented. The data presented here suggest that the program has contributed toward the development of residents' rights in nursing homes, via improved commitment amongst management, and greater participation by residents. Yet overall progress in residents' rights remains precarious. Several conflicts of interest and sources of constraint are identified.
Publisher: Elsevier BV
Date: 2013
DOI: 10.1016/J.HEALTHPLACE.2012.10.008
Abstract: Residents of socioeconomically disadvantaged neighbourhoods are more likely to walk for transport than their counterparts in advantaged neighbourhoods however, the reasons for higher rates of transport walking in poorer neighbourhoods remain unclear. We investigated this issue using data from the HABITAT study of physical activity among 11,037 mid-aged residents of 200 neighbourhoods in Brisbane, Australia. Using a five-step mediation analysis and multilevel regression, we found that higher levels of walking for transport in disadvantaged neighbourhoods was associated with living in a built environment more conducive to walking (i.e. greater street connectivity and land use mix) and residents of these neighbourhoods having more limited access to a motor vehicle. The health benefits that accrue to residents of disadvantaged neighbourhoods as a result of their higher levels of walking for transport might help offset the negative effects of less healthy behaviours (e.g. smoking, poor diet), thus serving to contain or reduce neighbourhood inequalities in chronic disease.
Publisher: Cambridge University Press (CUP)
Date: 12-2002
DOI: 10.1079/PHN2002339
Abstract: To determine whether socio-economic groups differ in their fruit and vegetable consumption, and the variety eaten, and whether socio-economic differences are similar for adolescents and adults. The study also examined whether socio-economic groups vary in their reported desire to increase the amount of fruit and vegetables consumed, and the perceived barriers to achieving this. Design, setting and subjects: The 1995 Australian National Nutrition Survey collected fruit and vegetable intake data from adolescents aged 13–17 years (n = 654) and adults 18–64 years (n = 7695) using a 24-hour dietary recall. Gross annual household income was used to measure socio-economic position. Approximately 44% of males and 34% of females did not consume fruit in the 24 hours preceding the survey, and 20% of males and 17% of females did not consume vegetables. Among adolescents and adults, fruit and vegetable consumption was positively related to income. The only exception was vegetable consumption among adolescent males, which did not vary by income Lower-income adults consumed a smaller variety of fruits and vegetables than their higher-income counterparts. Fruit and vegetable variety did not vary by income among adolescents. Lower-income adults expressed less desire to increase their fruit and vegetable consumption, and were more likely to report that price and storage were barriers to doing so. Socio-economic differences in consumption and variety were more apparent for adults than for adolescents. In addition to increasing the consumption of fruits and vegetables among the general population, nutrition interventions, programmes and policy aiming to improve diet should target adolescents and adults from low socio-economic groups. Strategies should address price and storage barriers.
Publisher: Elsevier BV
Date: 2014
Publisher: MDPI AG
Date: 19-11-2016
Publisher: BMJ
Date: 03-2000
Abstract: To determine whether, in the context of a face to face interview, socioeconomic groups differ in their propensity to provide details about the amount of their personal income, and to discuss the likely consequences of any differences for studies that use income based measures of socioeconomic position. The study used data from the 1995 Australian Health Survey. The s le was selected using a stratified multi-stage area design that covered urban and rural areas across all States and Territories and included non-institutionalised residents of private and non-private dwellings. The response rate was 91.5% for selected dwellings and 97.0% for persons within dwellings. Data were collected using face to face interviews. Income response, the dependent measure, was binary coded (0 if income was reported and 1 for refusals, "don't knows" and insufficient information). Socioeconomic position was measured using employment status, occupation, education and main income source. The socioeconomic characteristics of income non-reporters were initially examined using sex specific age adjusted proportions with 95% confidence intervals. Multivariate analysis was performed using logistic regression. Persons aged 15-64 (n = 33,434) who were reportedly in receipt of an income from one or more sources during the data collection reference period. The overall rate of income non-response was 9.8%. Propensity to not report income increased with age (15-29 years 5.8%, 30-49 10.6%, 50-64 13.8%). No gender differences were found (men 10.2%, women 9.3%). Income non-response was not strongly nor consistently related to education or occupation for men, although there was a suggested association among these variables for women, with highly educated women and those in professional occupations being less likely to report their income. Strong associations were evident between income non-response, labour force status and main income source. Rates were highest among the employed and those in receipt of an income from their own business or partnership, and lowest among the unemployed and those in receipt of a government pension or benefit (which excluded the unemployed). Given that differences in income non-reporting were small to moderate across levels of the education and occupation variables, and that propensity to not report income was greater among higher socioeconomic groups, estimates of the relation between income and health are unlikely to be affected by socioeconomic variability in income non-response. Probability estimates from a logistic regression suggested that higher rates of income non-reporting among employed persons who received their income from a business or partnership were not attributable to socio-economic factors. Rather, it is proposed that these higher rates were attributable to recall effects, or concerns about having one's income information disclosed to taxation authorities. Future studies need to replicate this analysis to determine whether the results can be inferred to other survey and data collection contexts. The analysis should also be extended to include an examination of the relation between socio-economic position and accuracy of income reporting. Little is known about this issue, yet it represents a potential source of bias that may have important implications for studies that investigate the association between income and health.
Publisher: Wiley
Date: 06-07-2006
DOI: 10.1111/J.1600-0528.2006.00286.X
Abstract: The nature of the relationship between status and health has theoretical and applied significance. To compare the shape of the socioeconomic -oral health relationship using a measure of relative social status (MacArthur Scale of Subjective Social Status) and a measure of absolute material resource (equivalised household income) to investigate the contribution of behaviour in attenuating the socioeconomic gradient in oral health status and to comment on three hypothesised explanatory mechanisms for this relationship (material, psychosocial, behavioural). In 2003, cross-sectional self-report data were collected from 2,915 adults aged 43-57 years in Adelaide, Australia using a stratified cluster design. Oral conditions were (1) < 24 teeth, (2) 1+ impact/s reported fairly often or very often on the 14-item Oral Health Impact Profile (3) fair or poor self-rated oral health, and (4) low satisfaction with chewing ability. Prevalence ratios and 95% confidence intervals (PR, 95%CI) were calculated from a logistic regression model. Covariates were age, sex, country of birth, smoking, alcohol use, body mass index, frequencies of toothbrushing and interdental cleaning. There was an approximately linear relationship of decreasing prevalence for each oral condition across quintiles of increasing relative social status. In the fully adjusted model the gradient was steepest for low satisfaction with chewing (PR = 4.1, 95%CI = 3.0-5.4). Using equivalised household income, the shape more closely resembled a threshold effect, with an approximate halving of the prevalence ratio between the first and second social status quintiles for the adverse impact of oral conditions and fair or poor self-rated oral health. Adjustment for covariates did not attenuate the magnitude of PRs. The nature of the relationship between social status and oral conditions differed according to the measure used to index social status. Perception of relative social standing followed an approximately straight-line relationship. In contrast, there was a discrete threshold of income below which oral health deteriorated, suggesting that the benefit to oral health of material resources occurs mostly at the lower end of the across the full socioeconomic distribution.
Publisher: Human Kinetics
Date: 04-2005
DOI: 10.1123/JPAH.2.2.181
Abstract: This study assessed the relative contributions of psychological, social, and environmental variables to walking, moderate- and vigorous-intensity physical activity. A questionnaire was mailed to a random s le (57% response rate). Analyses used a backwards elimination logistic regression model, removing and replacing in idual variables, and adjusting for age, gender, household composition, and education ( N = 1827). The sociodemographic and correlate variables collectively accounted for 43% of the variation in total activity, 26% of walking, 22% of moderate-intensity activity and 45% of vigorous-intensity activity (Nagelkerke R 2 ). In idually, the correlates accounted for 0.0 to 4.0% of unique variation, with habit, efficacy, and support having higher values. Physical health, discouragement, competition, and time management contributed more to vigorous-intensity activity. Anticipated benefits of social interactions and weight management contributed more to moderate-intensity activity. Neighborhood aesthetics contributed more to walking. Walking, moderate- and vigorous-intensity activity might be associated with different correlates.
Publisher: Cambridge University Press (CUP)
Date: 07-08-2014
DOI: 10.1017/S1368980013002036
Abstract: To assess socio-economic differences in three components of nutrition knowledge, i.e. knowledge of (i) the relationship between diet and disease, (ii) the nutrient content of foods and (iii) dietary guideline recommendations furthermore, to determine if socio-economic differences in nutrition knowledge contribute to inequalities in food purchasing choices. The cross-sectional study considered household food purchasing, nutrition knowledge, socio-economic and demographic information. Household food purchasing choices were summarised by three indices, based on self-reported purchasing of sixteen groceries, nineteen fruits and twenty-one vegetables. Socio-economic position (SEP) was measured by household income and education. Associations between SEP, nutrition knowledge and food purchasing were examined using general linear models adjusted for age, gender, household type and household size. Brisbane, Australia in 2000. Main household food shoppers ( n 1003, response rate 66·4 %), located in fifty small areas (Census Collectors Districts). Shoppers in households of low SEP made food purchasing choices that were less consistent with dietary guideline recommendations: they were more likely to purchase grocery foods comparatively higher in salt, sugar and fat, and lower in fibre, and they purchased a narrower range of fruits and vegetables. Those of higher SEP had greater nutrition knowledge and this factor attenuated most associations between SEP and food purchasing choices. Among nutrition knowledge factors, knowledge of the relationship between diet and disease made the greatest and most consistent contribution to explaining socio-economic differences in food purchasing. Addressing inequalities in nutrition knowledge is likely to reduce socio-economic differences in compliance with dietary guidelines. Improving knowledge of the relationship between diet and disease appears to be a particularly relevant focus for health promotion aimed to reduce socio-economic differences in diet and related health inequalities.
Publisher: MDPI AG
Date: 23-05-2017
Publisher: Springer Science and Business Media LLC
Date: 04-10-2014
Publisher: SAGE Publications
Date: 10-2008
DOI: 10.1177/154405910808701006
Abstract: The effect of neighborhood on health may vary according to the characteristics of the residents. We tested the hypothesis that, in affluent neighborhoods, low-income adults retain more teeth than their income-equivalent peers in poor neighborhoods. In 2003, the Adelaide Small Area Dental Study collected sociodemographic and tooth retention information from 2860 adults in 60 neighborhoods. Neighborhood socio-economic position was a census-based composite measure. Using multilevel modelling, we fitted a series of two-level random intercept variance component models. Findings revealed significant main effects for in idual and neighborhood predictors and a significant interaction between neighborhood disadvantage and low income. In affluent areas, disparities in tooth retention were negligible, but in poor neighborhoods, substantial variation in tooth retention between in iduals was found based on their level of income. Low-income adults appeared to benefit from living in affluent areas, while wealthier adults living in poor neighborhoods did not lose their oral health advantage.
Publisher: Elsevier BV
Date: 02-2007
DOI: 10.1111/J.1753-6405.2007.00008.X
Abstract: Many of the self-administered scales for measuring physical activity (PA) influences were originally developed for vigorous-intensity exercise, focus on only one domain of influence, and have not been evaluated for both reliability and validity using population-based s les. This study describes the factorial validity and internal reliability of scales for measuring in idual-level psychological, social, and environmental influences on leisure-time PA among adults in the general population. Constructs were identified from a literature review and formative research with a socio-economically erse s le. Items were generated using previously developed scales and interview data. New items were pre-tested using reliability and principal components analyses, with data collected from a mail survey sent to a randomly selected population-based s le. Qualitative feedback was obtained from a convenience s le and expert panel. A second mail survey provided data for principal components and reliability analyses. Twenty-eight scales were factorially derived and 24 had acceptable or marginally acceptable levels of internal consistency with Cronbach's alpha values ranging from 0.65 to 0.91. The 24 scales are suitable for researchers and practitioners interested in measuring in idual-level influences on PA that are consistent with Social Cognitive Theory. More research is required to assess predictive validity, sensitivity to change and test/re-test reliability.
Publisher: Elsevier BV
Date: 04-2006
DOI: 10.1016/J.BRAINRESBULL.2006.01.003
Abstract: Huntington's disease (HD) is a hereditary neurodegenerative disorder caused by a CAG repeat expansion in the HD gene. Excitotoxic cell damage by excessive stimulation of glutamate receptors has been hypothesized to contribute to the pathogenesis of HD. Transgenic mouse models of HD have shown variable sensitivity to excitotoxicity. The models differ in the genetic background, the type and length of the promoter driving the transgene expression, the CAG repeat length and/or the HD gene construct length. Furthermore, one has to differentiate whether transgenic or knock-in models have been used. All these factors may be involved in determining the responsiveness to an excitotoxic insult. Here, we explored the responsiveness to excitotoxic damage using a transgenic HD rat model carrying 22% of the rat HD gene which is driven by the rat HD promoter and which harbors 51 CAG repeats. 3 and 18 months old transgenic HD rats and their wild-type littermates received unilateral intrastriatal injections of the glutamate analogue quinolinic acid. Lesion size was assessed 7 days later using the degenerative stain Fluoro-Jade and by immunohistochemistry for the neuronal protein NeuN. No difference in susceptibility to excitotoxicity was found between the groups. Our study supports mouse data showing maintained susceptibility to excitotoxicity with the expression of around 25% of the full HD gene. Differences in sensitivity to excitotoxicity between genetic animal models of HD may be dependent on the length of the expressed HD gene although additional factors are also likely to be important.
Publisher: Wiley
Date: 10-2002
DOI: 10.1046/J.1365-277X.2002.00387.X
Abstract: To determine whether socioeconomic groups differ in their food intakes for fruit and vegetables, their consumption of fruit and vegetables dense in vitamin A, folate and vitamin C, and their nutrient intakes of vitamin C, folate and vitamin A. The 1995 Australian National Nutrition Survey collected food intake data from 8883 adults aged 18-64 years using a 24-h dietary recall. Fruit and vegetables were measured as amount (g) consumed. Intakes of nutrients were estimated from the 24-h dietary recall data. Participants were categorized by whether or not they consumed fruit or vegetables high in vitamin A, folate and vitamin C. Gross annual household income was used to measure socioeconomic position. Participants from low-income households consumed a smaller quantity of fruit and vegetables. They were also less likely to consume fruit and vegetables high in vitamin C, folate and vitamin A. Consistent with these findings, men and women from disadvantaged socioeconomic groups had lower intakes of vitamin C and folate compared with their more affluent counterparts. These differences were small to moderate in magnitude. Vitamin A intakes were not significantly related to income. As well as promoting healthy dietary practices, nutrition-promotion strategies should target the nutrient intakes of lower socioeconomic groups. These programmes should focus on improving the quantity and choice of fruit and vegetables consumed by people from low-income households.
Publisher: Elsevier BV
Date: 03-2019
DOI: 10.1016/J.HEALTHPLACE.2019.01.020
Abstract: Residents of disadvantaged neighbourhoods have poorer physical function than their advantaged counterparts, although the reasons for this remain largely unknown. We examined the moderating effects of walkability in the relationship between neighbourhood disadvantage and physical function using 2013 cross-sectional data from 5115 in iduals aged 46-72 living in 200 neighbourhoods in Brisbane, Australia. The relationship between neighbourhood disadvantage and physical function differed by levels of walkability: positive associations as levels of walkability increased for those living in more disadvantaged neighbourhoods, and no difference for those living in more advantaged neighbourhoods. Further work is required to better understand the underlying mechanisms.
Publisher: BMJ
Date: 11-2005
Publisher: Elsevier BV
Date: 12-2013
Publisher: Cambridge University Press (CUP)
Date: 11-07-2011
DOI: 10.1017/S136898001100139X
Abstract: To examine socio-economic differences in the frequency and types of takeaway foods consumed. A cross-sectional postal survey. Participants were asked about their usual consumption of overall takeaway food ( times/month or ≥4 times/month) and of twenty-two specific takeaway food items ( time/month or ≥1 time/month) these latter foods were grouped into ‘healthy’ and ‘less healthy’ choices. Socio-economic position was measured on the basis of educational level and equivalised household income, and differences in takeaway food consumption were assessed by calculating prevalence ratios using log binomial regression. Adults aged 25–64 years from Brisbane, Australia, were randomly selected from the electoral roll ( n 903 63·7 % response rate). Compared with their more educated counterparts, the least educated were more regular consumers of overall takeaway food and fruit or vegetable juice and less regular consumers of sushi. For the ‘less healthy’ items, the least educated more regularly consumed potato chips, savoury pies, fried chicken and non-diet soft drinks however, the least educated were less likely to consume curry. Household income was not associated with overall takeaway consumption. The lowest-income group was a more regular consumer of fruit or vegetable juice compared with the highest-income group. Among the ‘less healthy’ items, the lowest-income group was a more regular consumer of fried fish, ice cream and milk shakes, whereas curry was consumed less regularly. The frequency and types of takeaway foods consumed by socio-economically disadvantaged groups may contribute to inequalities in overweight or obesity and to chronic disease.
Publisher: Elsevier BV
Date: 07-1997
Publisher: Elsevier BV
Date: 10-2018
DOI: 10.1016/J.MATURITAS.2018.08.006
Abstract: There are few prospective data on temporal trends in overall sitting time for different domains of sitting. This study examined time trends over 6 years in total and domain-specific sitting time in mid-age Australian men and women. Self-report data from 5246 participants in four survey waves (2007, 2009, 2011, 2013) of the HABITAT study in Brisbane, Australia, were analysed. Overall trends in 'high' total sitting time (>8 h/day sitting) and five domains were examined: a) >5 h/day for TV b) >2 h/day for travel c) >2 h/day for home computer use d) >2 h/day for leisure and e) >6 h/day for work. Sitting to watch TV and sitting at work accounted for more than half of total sitting time. The proportions who reported high sitting for computer use at home increased from 25% in 2007 to 37% in 2013 in men and from 19% to 29% over the same period in women. High TV sitting time was reported by 11.8% of men and 10.2% of women. These estimates increased to 16.5% and 13.2% respectively over the six years. In conclusion, although overall total sitting time remained fairly stable, there were significant increases in sitting time in some domains (home computer use and TV viewing) and in some sub-groups (such as women, and the employed). These increases were countered by declines in work-related sitting due to retirement.
Publisher: Elsevier BV
Date: 11-2017
DOI: 10.1016/J.HEALTHPLACE.2017.08.010
Abstract: The relationship between features of the neighbourhood built environment and early child development was investigated using area-level data from the Australian Early Development Census. Overall 9.0% of children were developmentally vulnerable on the Physical Health and Well-being domain, 8.1% on the Social Competence domain and 8.1% on the Emotional Maturity domain. After adjustment for socio-demographic factors, Local Communities with the highest quintile of home yard space had significantly lower odds of developmental vulnerability on the Emotional Maturity domain. Residing in a Local Community with fewer main roads was associated with a decrease in the proportion of children developmentally vulnerable on the Social Competence domain. Overall, sociodemographic factors were more important than aspects of the neighbourhood physical environment for explaining variation between Local Communities in the developmental vulnerability of children.
Publisher: The Sax Institute
Date: 11-2014
DOI: 10.17061/PHRP2511405
Abstract: Liveable communities create the conditions to optimise health and wellbeing outcomes in residents by influencing various social determinants of health - for ex le, neighbourhood walkability and access to public transport, public open space, local amenities, and social and community facilities. This study will develop national liveability indicators that are (a) aligned with state and federal urban policy, (b) developed using national data (where available), (c) standard and consistent over time, (d) suitable for monitoring progress towards creating more liveable, equitable and sustainable communities, (e) validated against selected noncommunicable disease risk behaviours and/or health outcomes, and (f) practical for measuring local, national and federal built environment interventions. Protocol. Over two years, the National Liveability Study, funded through The Australian Prevention Partnership Centre (TAPPC), will develop and validate a national set of spatially derived built environment liveability indicators related to noncommunicable disease risk behaviours and/or health outcomes, informed by a review of relevant policies in selected Australian state and territory governments. To create national indicators, we will compare measures developed using national data with finer-grained state-level data, which have been validated against a range of outcomes. Finally, we will explore the creation of a national database of built environment spatial indicators. A national advisory group comprising stakeholders in state and federal government, federal nongovernment organisations and state-based technical working groups located in the ACT, Victoria, NSW, Queensland and WA has been established a policy analysis is under way and work programs are being prepared. This project seeks to build the capacity for built environment and health systems research by developing national indicators to monitor progress towards creating healthy and liveable communities. This ambition requires multisector engagement and an interdisciplinary research team.
Publisher: Cambridge University Press (CUP)
Date: 05-2006
DOI: 10.1079/PHN2006850
Publisher: BMJ
Date: 06-2006
Publisher: Elsevier BV
Date: 08-2015
Publisher: Public Library of Science (PLoS)
Date: 30-09-2014
Publisher: Informa UK Limited
Date: 02-2012
Publisher: SAGE Publications
Date: 04-2003
Abstract: This qualitative study explored how influences on recreational physical activity (RPA) were patterned by socioeconomic position. Face-to-face interviews were conducted with 10 males and 10 females in three socioeconomic groups ( N = 60). Influences salient across all groups included previous opportunities, physical health, social assistance, safety, environmental aesthetics and urban design, physical and health benefits, and barriers of self-consciousness, low skill, and weather/time of year. Influences more salient to the high socioeconomic group included social benefits, achieving a balanced lifestyle, and the barrier of an unpredictable lifestyle. Influences more salient to the high and mid socioeconomic groups included efficacy, perceived need, activity demands, affiliation, emotional benefits, and the barrier of competing demands. Influences more salient to the low socioeconomic group included poor health and barriers of inconvenient access and low personal functioning. Data suggest that efforts to increase RPA in the population should include both general and socioeconomically targeted strategies.
Publisher: Springer International Publishing
Date: 2018
Publisher: AMPCo
Date: 09-2011
DOI: 10.5694/MJA10.11204
Abstract: To determine whether an association exists between distance from radiotherapy facilities and survival outcomes of people diagnosed with rectal cancer. Descriptive population-based study using data from the Queensland Cancer Registry. All patients aged 20-79 years (n = 6848) diagnosed with invasive rectal cancer between 1 January 1996 and 31 December 2006. Cause-specific survival. The 5-year cause-specific survival was 62% (95% CI, 61%-64%) it was strongly influenced by stage at diagnosis (American Joint Committee on Cancer, Stages I-IV), ranging from 86% (Stage I) to 9% (Stage IV). After adjusting for age, sex, and stage at diagnosis, patients who lived 100-199 km, 200-399 km and 400 km or more from a radiotherapy facility were 16%, 30%, and 25%, respectively, more likely to die from rectal cancer than patients living within 50 km of such a facility. On average, there was a 6% increase in mortality risk (95% CI, 3%-8% P < 0.001) for each 100 km increment in distance from the nearest radiotherapy facility. Shared frailty models showed that this association persisted after adjusting for the correlation between in idual cancer patients living in the same remoteness or area-level socioeconomic status categories. While centralisation of cancer treatment services has merit, our study provides evidence of a shorter survival for people with rectal cancer who live relatively far from radiotherapy facilities. It remains a priority to develop and implement policy, cultural and clinical measures to reduce the burden faced by rural and remote patients with rectal cancer.
Publisher: Elsevier BV
Date: 05-2000
DOI: 10.1016/S0277-9536(99)00300-7
Abstract: This study uses small-area data for the period 1985-89 to examine the relationship between socioeconomic status and infant mortality in each of the mainland State capital cities of Australia. An unweighted OLS regression analysis based on 195 Statistical Local Areas (SLAs) that recorded five or more deaths over the reference period shows that standardised infant mortality ratios were significantly higher in areas with greater concentrations of low income families. This relationship was independent of the effects of low birthweight, Aboriginality, ethnicity and variability between each of the capital cities. To test for the robustness of this result a sensitivity analysis was undertaken. This involved (a) performing a Principal Components Analysis on a wide range of sociodemographic variables to derive factor scales that were subsequently included in a regression analysis, (b) using weighted least-squares regression and a Poisson generalised linear model and (c) including in the analysis all SLAs irrespective of the number of infant deaths. The sensitivity analysis supported the results of this study, thus validating the observed association between the socioeconomic characteristics of urban areas and their rate of infant mortality. Despite marked reductions in overall rates of infant mortality over the last century in Australia. socioeconomic disparities were still evident during the mid-to-late 1980s. Whether and to what extent this situation persisted during the early-to-mid 1990s will be known in the near future when the next collection of area-based data are publicly released. The results of this study, therefore, represent an important baseline against which more contemporary national trends can be monitored.
Publisher: Springer Science and Business Media LLC
Date: 14-03-2022
DOI: 10.1186/S12889-022-12905-7
Abstract: Socioeconomic disadvantage is associated with mental illness, yet its relationship with mental well-being is unclear. Mental well-being is defined as feeling good and functioning well. Benefits of mental well-being include reduced mortality, improved immune functioning and pain tolerance, and increased physical function, pro-social behaviour, and academic and job performance. This study aimed to explore the relationship between in idual socioeconomic position (SEP), neighbourhood disadvantage and mental well-being in mid-age adults. Multilevel modelling was used to analyse data collected from 7866 participants from the second (2009) wave of HABITAT (How Areas in Brisbane Influence healTh and activiTy), a longitudinal study (2007–2016) of adults aged 40–65 years living in Brisbane, Australia. Mental well-being was measured using the Warwick Edinburgh Mental Well-Being Scale (WEMWBS). Exposure measures were education, occupation, household income, and neighbourhood socioeconomic disadvantage. The lowest MWB scores were observed for the least educated (β = − 1.22, 95%CI = − 1.74, − 0.71), those permanently unable to work (β = − 5.50, 95%CI = − 6.90, − 4.10), the unemployed (β = − 2.62, 95%CI = − 4.12, − 1.13), and members of low-income households (β = − 3.77, 95%CI = − 4.59, − 2.94). Residents of the most disadvantaged neighbourhoods had lower MWB scores than those living in the least disadvantaged neighbourhoods, after adjustment for in idual-level SEP (β = − 0.96, 95%CI = − 1.66, − 0.28). Both in idual-level SEP and neighbourhood disadvantage are associated with mental well-being although the association is stronger for in idual-level SEP. This research highlights the need to address in idual and neighbourhood-level socioeconomic determinants of mental well-being.
Publisher: SAGE Publications
Date: 12-2007
DOI: 10.1177/154405910708601205
Abstract: It is unclear which theoretical dimension of psychological stress affects health status. We hypothesized that both distress and coping mediate the relationship between socio-economic position and tooth loss. Cross-sectional data from 2915 middle-aged adults evaluated retention of 20 teeth, behaviors, psychological stress, and sociodemographic characteristics. Principal components analysis of the Perceived Stress Scale (PSS) extracted ’distress’ (a = 0.85) and ’coping’ (a =0.83) factors, consistent with theory. Hierarchical entry of explanatory variables into age- and sex-adjusted logistic regression models estimated odds ratios (OR) and 95% confidence intervals [95% CI] for retention of 20 teeth. Analysis of the separate contributions of distress and coping revealed a significant main effect of coping (OR = 0.7 [95% CI = 0.7–0.8]), but no effect for distress (OR = 1.0 [95% CI = 0.9–1.1]) or for the interaction of coping and distress. Behavior and psychological stress only modestly attenuated socio-economic inequality in retention of 20 teeth, providing evidence to support a mediating role of coping.
Publisher: Elsevier BV
Date: 09-2021
Publisher: Oxford University Press (OUP)
Date: 31-03-2011
DOI: 10.1093/AJE/KWR007
Abstract: The authors investigated the health consequences of marital separation and whether the partners who initiated the separation had better health than those who did not. The data came from the Households, Income and Labour Dynamics in Australia (HILDA) panel study (2001-2007), comprising an analytic s le of 1,786 men and 2,068 women who were in their first marriages in 2001. For participants who separated, the authors distinguished between self-initiated, partner-initiated, and jointly initiated separations. Using linear random-intercept models, they examined scores on the 8 physical and mental health dimensions of Short Form 36, with scale scores ranging from 0 to 100. The results indicated that in general, men who separated had a decline in health, although this was more pronounced for mental dimensions than for physical dimensions. Among separated men, those whose partner initiated the separation had poorer mental health than those for whom the separation was self-initiated or jointly initiated (-4.61). Women's physical health improved with separation, but their mental health declined. For separated women, those whose partner initiated the separation had lower scores on the general health (-5.39), role-emotional (-11.08), and mental health (-7.18) scales than women who self-initiated separation. The health consequences of separation were less severe for self- or jointly initiated separations, suggesting that not all marital dissolutions are equally bad for health.
Publisher: Elsevier BV
Date: 08-2011
DOI: 10.1016/J.EVALPROGPLAN.2011.02.012
Abstract: Training birth attendants (TBAs) provide essential maternal and infant health care services during delivery and ongoing community care in developing countries. Despite inadequate evidence of relevance and effectiveness of TBA training programmes, there has been a policy shift since the 1990s in that many donor agencies funding TBA training programmes redirected funds to providing skilled attendants during delivery. This study aimed to assess the ways in which a TBA training programme in India has been successful in disseminating evidence-based knowledge on birthing practices. TBAs practicing within 16 villages targeted by training programme initiatives were administered with structured questionnaires. The post training birthing practices of trained (24) and untrained (14) TBAs was compared and birthing practices adopted by women assisted by trained (16) and untrained (9) TBAs was analysed. Positive post training practices were hand washing, use of a clean blade for cutting the cord, immediate breastfeeding and weighing of babies. Nevertheless, the training could be further improved with up to date and evidence-based information and more comprehensive instructions. The findings suggest an integration of local and evidence-based knowledge is needed to improve the training. Raising community awareness of public health measures related to maternal and child health is also recommended.
Publisher: Oxford University Press (OUP)
Date: 28-02-2006
DOI: 10.1093/IJE/DYL010
Abstract: Material circumstances and collective psychosocial processes have been invoked as potential explanations for socioeconomic inequalities in health and, linking social capital has been proposed as a way of reconciling these apparently opposing explanations. We conducted multilevel logistic regression of self-rated health (fair or poor vs excellent, very good, or good) on 14 495 in iduals living within 41 statistical local areas who were respondents to the 1998 Tasmanian Healthy Communities Study. We modelled the effects of area-level socioeconomic disadvantage and social capital (neighbourhood integration, neighbourhood alienation, neighbourhood safety, social trust, trust in public rivate institutions, and political participation), and adjusted for the effects of in idual characteristics. Area-level socioeconomic disadvantage was associated with poor self-rated health (beta = 0.0937, P < 0.001) an effect that was attenuated, but remained significant, after adjusting for in idual characteristics (beta = 0.0419, P < 0.001). Social trust was associated with a reduction in poor self-rated health (beta = -0.0501, p = 0.008) and remained significant when in idual characteristics (beta = -0.0398, P = 0.005) were included. Political participation was non-significant in the unadjusted model but became significant when adjusted for in idual characteristics (beta = -0.2557, P = 0.045). The effects of social trust and political participation were attenuated and became non-significant when area-level socioeconomic disadvantage was included. Area-based socioeconomic disadvantage is a determinant of self-rated health in Tasmania, but we did not find an independent effect of area-level social capital. These findings suggest that in Tasmania investments in improving the material circumstances in which people live are likely to lead to greater improvements in population health than attempts to increase area-level social capital.
Publisher: Springer Science and Business Media LLC
Date: 28-01-2010
Publisher: Elsevier BV
Date: 05-2019
Publisher: SAGE Publications
Date: 12-2011
Abstract: Children in food-insecure households may be at risk of poor health, developmental or behavioural problems. This study investigated the associations between food insecurity, potential determinants and health and developmental outcomes among children. Data on household food security, socio-demographic characteristics and children's weight, health and behaviour were collected from households with children aged 3-17 years in socioeconomically disadvantaged suburbs by mail survey using proxy-parental reports (185 households). Data were analysed using logistic regression. Approximately one-in-three households (34%) were food insecure. Low household income was associated with an increased risk of food insecurity [odds ratio (OR), 16.20 95% confidence interval (CI), 3.52-74.47]. Children with a parent born outside of Australia were less likely to experience food insecurity (OR, 0.42 95% CI, 0.19-0.93). Children in food-insecure households were more likely to miss days from school or activities (OR, 3.52 95% CI, 1.46-8.54) and were more likely to have borderline or atypical emotional symptoms (OR, 2.44 95% CI, 1.11-5.38) or behavioural difficulties (OR, 2.35 95% CI, 1.04-5.33). Food insecurity may be prevalent among socioeconomically disadvantaged households with children. The potential developmental consequences of food insecurity during childhood may result in serious adverse health and social implications.
Publisher: BMJ
Date: 20-01-2020
Abstract: Identification of features of the neighbourhood physical environment that have a causal association with positive child development is important for promoting long-term developmental health. Previous research on these associations have been conducted at the neighbourhood level, and do not account for in idual variation in exposure to these features. This cross-sectional study utilised de-identified linked administrative data. Neighbourhood features were measured with Geographic Information Systems and identified within a 1600 m service area around the child’s home address. The study population included a random selection of 5024 Western Australian children who participated in the 2012 Australian Early Development Census (AEDC median age 5 years, 5 months). Multi-level logistic regressions modelled the odds of children scoring in the bottom 10% on the physical, social or emotional AEDC domains as an outcome of neighbourhood features. After adjustment for in idual and neighbourhood sociodemographic factors, lower odds of physical vulnerability were associated with increased neighbourhood residential density, presence of railway station, and higher counts of playgroups and kindergartens. Larger areas of neighbourhood home-yard space were associated with increased odds of physical and social vulnerability. Presence of high-quality green spaces was associated with lower odds of social vulnerability. Increased road traffic exposure was associated with higher odds of social and emotional vulnerability. The neighbourhood physical environment has a weak but significant association with early childhood development. Future research should consider the interplay between the neighbourhood environment and proximal influences, including parenting attributes and socioeconomic status, and how they influence early child development.
Publisher: Elsevier BV
Date: 12-2000
Publisher: BMJ
Date: 24-01-2018
Abstract: Few studies have examined the causal relationship between transport mode and body mass index (BMI). We examined between-person differences and within-person changes in BMI by transport mode over four time points between 2007 and 2013. Data were from the How Areas in Brisbane Influence HealTh and AcTivity project, a population-representative study of persons aged 40–65 in 2007 (baseline) residing in 200 neighbourhoods in Brisbane, Australia. The analytic s le comprised 9931 respondents who reported on their main transport for all travel purposes (work-related and non-work-related). Transport mode was measured as private motor vehicle (PMV), public transport, walking and cycling. Self-reported height and weight were used to derive BMI. Sex-specific analyses were conducted using multilevel hybrid regression before and after adjustment for time-varying and time-invariant confounders. Independent of transport mode and after adjustment for confounders, average BMI increased significantly and linearly across the four time points for both men and women. Men and women who walked or cycled had a significantly lower BMI than their counterparts who used a PMV. BMI was nearly always lower during the time men and women walked or cycled than when they used a PMV however, few statistically significant differences were observed. For women, BMI was significantly higher during the time they used public transport than when using a PMV. The findings suggest a causal association between transport mode and BMI and support calls from health authorities to promote walking and cycling for transport as a way of incorporating physical activity into everyday life to reduce the risk of chronic disease.
Publisher: Elsevier BV
Date: 03-2018
Publisher: MDPI AG
Date: 28-08-2019
Abstract: We conducted a systematic review to describe and summarize possible associations between the walkability index, overweight, and obesity. Systematic searches using seven electronic databases and reference lists were conducted to identify papers published until December 2017. Observational studies, describing associations using regression-based statistical methods, published in English and Portuguese, reporting markers of overweight and obesity, and involving adults (≥18 years) were included. Of the 2469 references initially retrieved, ten were used for the descriptive synthesis. Seven studies showed significant inverse associations between walkability and overweight and obesity, however, all were cross-sectional studies. High risk of bias scores were observed in “selection bias” and “withdrawals and dropouts”. All studies were published in high-income countries with s le sizes ranging among 75 to 649,513 participants. Weight and height as measures for determining BMI tended to be self-reported. Indicators of walkability, such as land-use mix, street connectivity and residential density were used as components of the indices. Based on this review, more studies should be conducted in low, middle, and middle-high income countries, using longitudinal designs that control neighborhood self-selection other indicators of the neighborhood environment, such as food access, physical activity facilities, sidewalks, and safety and crime prevention should be considered.
Publisher: Springer Science and Business Media LLC
Date: 09-2011
DOI: 10.1038/BJC.2011.356
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-08-2019
Abstract: Population densities of many cities are increasing rapidly, with the potential for impacts on cardiovascular health. This longitudinal study examined the potential impact of population‐density increases in urban areas (urban densification) on cardiovascular risk markers among Australian adults. Data were from the Australian Diabetes, Obesity and Lifestyle Study, in which adult participants’ cardiovascular risk markers were collected in 3 waves (in 1999–2000, 2004–2005, and 2011–2012). We included 2354 participants with a mean age of 51 years at baseline who did not change their residence during the study period. Outcomes were 12‐year changes in waist circumference, weight, systolic and diastolic blood pressure, fasting and 2‐hour postload plasma glucose, high‐density lipoprotein cholesterol, and triglycerides. The exposure was neighborhood population densification, defined as 12‐year change in population density within a 1‐km radius buffer around the participant’s home. Multilevel linear growth models, adjusting for potential confounders, were used to examine the relationships. Each 1% annual increase in population density was related with smaller increases in waist circumference (b=−0.043 cm/y 95% CI, −0.065 to −0.021 [ P .001]), weight (b=−0.019 kg/y 95% CI, −0.039 to 0.001 [ P =0.07]), and high‐density lipoprotein cholesterol (b=−0.035 mg/ dL per year 95% CI , −0.067 to −0.002 [ P =0.04]), and greater increases in diastolic blood pressure (b=0.032 mm Hg/y 95% CI , −0.004 to 0.069 [ P =0.08]). Our findings suggest that, at least in the context of Australia, urban densification may be protective against obesity risk but may have adverse effects on blood lipids and blood pressure. Further research is needed to understand the mechanisms through which urban densification influences cardiovascular health.
Publisher: Elsevier BV
Date: 12-2017
Publisher: Elsevier BV
Date: 02-2016
DOI: 10.1016/J.ANNEPIDEM.2015.11.008
Abstract: This study examines associations between neighborhood socioeconomic disadvantage and self-reported type 2 diabetes and heart disease, occurring separately and concurrently at a single time point (comorbidity). This study included 11,035 residents from 200 neighborhoods in Brisbane, Australia. Respondents self-reported type 2 diabetes and heart disease as long-term health conditions. Neighborhood socioeconomic disadvantage was measured using a census-derived composite index. In idual socioeconomic position was measured using education, occupation, and household income. Data were analyzed using multilevel multinomial mixed-effects logistic regression using Markov chain Monte Carlo simulation. Compared with the most advantaged neighborhoods, residents of the most-disadvantaged neighborhoods were more likely to report type 2 diabetes (odds ratio [OR] = 2.21, 95% credible interval [CrI] = 1.55-3.15), heart disease (OR = 1.72, 95% CrI = 1.25-2.38), and comorbidity (OR = 4.38, 95% CrI = 2.27-8.66). This relationship attenuated after adjustment for in idual-level socioeconomic position, but remained statistically significant for type 2 diabetes (OR = 1.81, 95% CrI = 1.15-2.83) and comorbidity (OR = 3.00, 95% CrI = 1.49-6.13). Studies of neighborhood disadvantage that fail to include in idual-level socioeconomic measures may inflate associations. Establishing why residents of disadvantaged neighborhoods are more likely to experience the co-occurrence of heart disease and type 2 diabetes independent of their in idual socioeconomic position warrants further investigation.
Publisher: Wiley
Date: 21-05-2007
DOI: 10.1111/J.1600-0528.2006.00311.X
Abstract: To examine the association between neighborhood disadvantage and in idual-level socioeconomic position (SEP) and self-reported oral health. A population-based cross-sectional study conducted in 2003 among males and females aged 43-57 years. The s le comprised 2915 in iduals and 60 neighborhoods and was selected using a stratified two-stage cluster design. Data were collected using a mail survey (69.4% response rate). Neighborhood disadvantage was measured using a census-based composite index, and in idual-level SEP was measured using education and household income. Oral health was indicated by self-reports of the impact of oral conditions on quality of life (0 = none or minor, 1 = severe), self-rated oral health (0 = excellent-good, 1 = fair oor) and missing teeth (measured as a quantitative outcome). Data were analyzed using multilevel modeling. After adjusting for age, sex, education, and household income, residents of socioeconomically disadvantaged neighborhoods were significantly more likely than those in more advantaged neighborhoods to indicate negative impacts of oral conditions on quality of life, to assess their oral health as fair or poor, and to report greater tooth loss. In addition, respondents with low levels of education and those from a low income household reported poorer oral health for each outcome independent of neighborhood disadvantage. The socioeconomic characteristics of neighborhoods are important for oral health over and above the socioeconomic characteristics of the people living in those neighborhoods. Policies and interventions to improve population oral health should be directed at the social, physical and infrastructural characteristics of places as well as in iduals (i.e. the traditional target of intervention efforts).
Publisher: BMJ
Date: 21-10-2012
Abstract: To investigate the impact of transitions out of marriage (separation, widowhood) on the self reported mental health of men and women, and examine whether perceptions of social support play an intervening role. The analysis used six waves (2001-06) of an Australian population based panel study, with an analytical s le of 3017 men and 3225 women. Mental health was measured using the MHI-5 scale scored 0-100 (α=0.97), with a higher score indicating better mental health. Perceptions of social support were measured using a 10-item scale ranging from 10 to 70 (α=0.79), with a higher score indicating higher perceived social support. A linear mixed model for longitudinal data was used, with lags for marital status, mental health and social support. After adjustment for social characteristics there was a decline in mental health for men who separated (-5.79 points) or widowed (-7.63 points), compared to men who remained married. Similar declines in mental health were found for women who separated (-6.65 points) or became widowed (-9.28 points). The inclusion of perceived social support in the models suggested a small mediation effect of social support for mental health with marital loss. Interactions between perceived social support and marital transitions showed a strong moderating effect for men who became widowed. No significant interactions were found for women. Marital loss significantly decreased mental health. Increasing, or maintaining, high levels of social support has the potential to improve widowed men's mental health immediately after the death of their spouse.
Publisher: BMJ
Date: 10-2017
DOI: 10.1136/BMJOPEN-2017-017284
Abstract: To examine whether respondents to a survey of health and physical activity and potential determinants could be grouped according to the questions they missed, known as ‘item missing’. Observational study of longitudinal data. Residents of Brisbane, Australia. 6901 people aged 40–65 years in 2007. We used a latent class model with a mixture of multinomial distributions and chose the number of classes using the Bayesian information criterion. We used logistic regression to examine if participants’ characteristics were associated with their modal latent class. We used logistic regression to examine whether the amount of item missing in a survey predicted wave missing in the following survey. Four per cent of participants missed almost one-fifth of the questions, and this group missed more questions in the middle of the survey. Eighty-three per cent of participants completed almost every question, but had a relatively high missing probability for a question on sleep time, a question which had an inconsistent presentation compared with the rest of the survey. Participants who completed almost every question were generally younger and more educated. Participants who completed more questions were less likely to miss the next longitudinal wave. Examining patterns in item missing data has improved our understanding of how missing data were generated and has informed future survey design to help reduce missing data.
Publisher: Springer Science and Business Media LLC
Date: 12-02-2021
DOI: 10.1186/S12889-020-10123-7
Abstract: Sedentary behavior is influenced by contextual, social, and in idual factors, including the built environment. However, associations between the built environment and sitting time have not been extensively investigated in countries with economies in transition such as Brazil. The objective of this study is to examine the relationship between sitting-time and access to a mix of destinations for adults from Sao Paulo city, Brazil. This study uses data from the Health Survey of Sao Paulo. Sedentary behavior was assessed by a questionnaire using two questions: total sitting time in minutes on a usual weekday and on a usual weekend day. The mix of destinations was measured by summing the number of facilities (comprising bus stops, train/subway stations, parks, squares, public recreation centres, bike paths, primary health care units, supermarkets, food stores, bakeries, and coffee-shops) within 500 m of each participant’s residence. Minutes of sitting time in a typical weekday and weekend day were the outcomes and the mix of destinations score in 500 m buffers was the exposure variable. Associations between the mix of destinations and sitting time were examined using multilevel linear regression: these models accounted for clustering within census tracts and households and adjusted for environmental, sociodemographic, and health-related factors. After adjustment for covariates, the mix of destinations was inversely associated with minutes of sitting time on a weekday (β=− 8.8, p =0.001) and weekend day (β=− 6.1, p =0.022). People who lived in areas with a greater mix of destinations had shorter average sitting times. Greater mix of destinations within 500 m of peoples’ residences was inversely associated with sitting time on a typical weekday and weekend day. In Latin American cities like Sao Paulo built environments more favorable for walking may contribute to reducing sedentary behavior and prevent associated chronic disease.
Publisher: Elsevier BV
Date: 03-2014
DOI: 10.1016/J.APPET.2013.12.007
Abstract: The aim of this study was to examine whether takeaway food consumption mediated (explained) the association between socioeconomic position and body mass index (BMI). A postal-survey was conducted among 1500 randomly selected adults aged between 25 and 64years in Brisbane, Australia during 2009 (response rate 63.7%, N=903). BMI was calculated using self-reported weight and height. Participants reported usual takeaway food consumption, and these takeaway items were categorised into "healthy" and "less healthy" choices. Socioeconomic position was ascertained by education, household income, and occupation. The mean BMI was 27.1kg/m(2) for men and 25.7kg/m(2) for women. Among men, none of the socioeconomic measures were associated with BMI. In contrast, women with diploma/vocational education (β=2.12) and high school only (β=2.60), and those who were white-collar (β=1.55) and blue-collar employees (β=2.83) had significantly greater BMI compared with their more advantaged counterparts. However, household income was not associated with BMI. Among women, the consumption of "less healthy" takeaway food mediated BMI differences between the least and most educated, and between those employed in blue collar occupations and their higher status counterparts. Decreasing the consumption of "less healthy" takeaway options may reduce socioeconomic inequalities in overweight and obesity among women but not men.
Publisher: Human Kinetics
Date: 08-2018
Abstract: Residents of more socioeconomically disadvantaged neighborhoods are more likely to report poorer physical function, although the reasons for this remain unknown. It is possible that neighborhood-level perceptions of safety from crime contribute to this relationship through its association with walking for recreation. Data were obtained from the fourth wave (collected in 2013) of the HABITAT (How Areas in Brisbane Influence HealTh and AcTivity) multilevel longitudinal study of middle- to older-aged adults (46-74 y) residing in 200 neighborhoods in Brisbane, Australia. The data were analyzed separately for men (n = 2190) and women (n = 2977) using multilevel models. Residents of the most disadvantaged neighborhoods had poorer physical function, perceived their neighborhoods to be less safe from crime, and do less walking for recreation. These factors accounted for differences in physical function between disadvantaged and advantaged neighborhoods (24% for men and 25% for women). This study highlights the importance of contextual characteristics, through their associations with behaviors, that can have in explaining the relationship between neighborhood disadvantage and physical function. Interventions aimed at improving neighborhood safety integrated with supportive environments for physical activity may have positive impact on physical function among all socioeconomic groups.
Publisher: Elsevier BV
Date: 12-2019
Publisher: Springer Science and Business Media LLC
Date: 30-10-2016
Publisher: Elsevier BV
Date: 11-2015
DOI: 10.1016/J.HEALTHPLACE.2015.10.004
Abstract: This study examined associations between objective environmental attributes and, separately, transport (TC) and recreational cycling (RC). Environmental attributes were more strongly associated with TC than RC. Distances to areas with the best bicycle infrastructure and urban amenities may be key environmental attributes influencing TC but not RC. Government investments in bicycle infrastructure within inner Brisbane appear to have resulted in more TC than in outer areas and to appeal to residents of both the most and least disadvantaged neighbourhoods. Extending this infrastructure to residents living in disadvantaged and advantaged neighbourhoods outside the CBD could expand TC participation.
Publisher: Elsevier BV
Date: 09-2019
Publisher: Elsevier BV
Date: 03-2018
DOI: 10.1016/J.ANNEPIDEM.2018.01.006
Abstract: Increasing global migration, high obesity in developed countries, and ethnic health inequalities are compelling reasons to monitor immigrant obesity trends. Longitudinal studies of ethnicity, length of residence, and adiposity in contexts outside of the United States are lacking. Nine waves (2006-2014) of the Household Income and Labour Dynamics in Australia survey were analyzed (n = 20,934 52% women 101,717 person-year observations) using random effects modeling to assess average annual change in body mass index (BMI) by ethnic group. A second analysis used an immigrant only cohort (n = 4583 52% women 22,301 person-year observations) to examine BMI change by length of residence. Over 9 years, mean BMI increased significantly in all ethnic and Australian-born groups, and by the final wave, mean BMI exceeded 25 kg m Immigrants to Australia, regardless of ethnicity, are at risk of obesity over time. Obesity prevention policy should prioritize immigrants in the early-mid settlement period.
Publisher: Elsevier BV
Date: 06-2011
DOI: 10.1111/J.1753-6405.2011.00683.X
Abstract: To examine associations between in idual-, household- and neighbourhood-level socioeconomic position (SEP) and harmful alcohol consumption. Adults aged 18-76 residing in 50 neighbourhoods in Melbourne completed a postal questionnaire (n= 2349, 58.7% response rate). Alcohol-related behaviours were classified by risk of short- and long-term harm. In idual-, household- and neighbourhood-level SEP were ascertained by education, household income and proportion of low-income households, respectively. The association were examined by multi-level logistic regression. Participants lower education or household income were less likely to consume alcohol frequently compared to their more-advantaged counterparts. Lower-educated men were more likely to be at risk of short-term harm [OR 1.75 (1.23 - 2.48)]. Low-income women were less likely to be at risk of short-term harm [OR 0.44 (0.23 - 0.81)]. Neighbourhood disadvantage was not associated with alcohol consumption. Men and women from socioeconomically advantaged backgrounds were more frequent consumers of alcohol, whereas their disadvantaged counterparts drank less frequently but in greater quantities on each drinking occasion. Socioeconomic disadvantage at the in idual and household levels may be an important determinant of alcohol consumption among Australian adults.
Publisher: Wiley
Date: 14-10-2001
DOI: 10.1046/J.1440-1754.2001.00697.X
Abstract: To describe the reported prevalence, comorbidity and socioeconomic status (SES) of children with speech disorders. Data from the 1995 Australian Health Survey were used. Information relating to the health of 12 388 children aged 0-14 years was collected via face-to-face interviews with a responsible adult. Speech disorders were recorded if children had reported difficulty talking, producing speech sounds, or who stuttered. The prevalence of childhood speech disorders (CSD) was 1.7% (n = 209). Of this group, 25.8% (n = 54) had a developmental delay or intellectual impairment when these were excluded, the prevalence of CSD was reduced to 1.3% (n = 155). Among males, the peak prevalence occurred at age 5 (6.5%), for females the highest rates were for 3-4-year-olds (1.8%). Children with a speech disorder had a greater number of additional health problems. No relationship was found between SES and CSD. Children with speech disorders often have complex health and developmental needs. Developing effective prevention programs with a view to improving the long-term health and social outcomes of these children will require a mix of in idual (clinical) and population-based (public-health) strategies.
Publisher: American Public Health Association
Date: 10-2014
Abstract: We developed a theoretical framework to organize obesity prevention interventions by their likely impact on the socioeconomic gradient of weight. The degree to which an intervention involves in idual agency versus structural change influences socioeconomic inequalities in weight. Agentic interventions, such as standalone social marketing, increase socioeconomic inequalities. Structural interventions, such as food procurement policies and restrictions on unhealthy foods in schools, show equal or greater benefit for lower socioeconomic groups. Many obesity prevention interventions belong to the agento–structural types of interventions, and account for the environment in which health behaviors occur, but they require a level of in idual agency for behavioral change, including workplace design to encourage exercise and fiscal regulation of unhealthy foods or beverages. Obesity prevention interventions differ in their effectiveness across socioeconomic groups. Limiting further increases in socioeconomic inequalities in obesity requires implementation of structural interventions. Further empirical evaluation, especially of agento–structural type interventions, remains crucial.
Publisher: Elsevier BV
Date: 05-2020
DOI: 10.1016/J.HEALTHPLACE.2020.102308
Abstract: Studies of parks and physical activity rarely identify the actual spaces participants use. Using data from the HABITAT project, a longitudinal cohort of mid-to older-aged (40-70 years) respondents (n = 11,036) living in Brisbane Australia, this study examined (1) the demographic characteristics of users and non-users of parks (2) the park used and the characteristics and features of the most popular reported spaces and (3) the level of physical activity undertaken in the reported parks and whether users had higher total physical activity levels than non-users. Park use was significantly higher (p < 0.01) among dog walkers, couples (over 40) living with children, and those living in least disadvantaged areas. Regular park use was significantly higher among users of larger-sized neighbourhood and district-catchment parks. Park users were 35% more likely to meet the physical activity guidelines (OR = 1.35, 95%CI 1.21-1.50, p < 0.001) compared with those who indicated they did nto regularly use a park. The size of the park used was positively associated with participation in physical activity. Users of larger-sized parks spent more time doing vigorous activity and engaged in more activity sessions than non-users. Future data obtained from large populations, including spatial examination of the actual parks used and their characteristics, are essential to facilitate planning for park provision, optimising the use of these spaces for recreation and physical activity by mid-to older-aged adults, and creating healthy communities.
Publisher: Springer Science and Business Media LLC
Date: 20-11-2007
Publisher: Oxford University Press (OUP)
Date: 03-2004
DOI: 10.1093/AJE/KWH057
Abstract: Links between low socioeconomic position and poor health are well established. Most previous research, however, has focused on middle-aged males and has relied on limited socioeconomic data, usually measured at one point over the life course. This paper examines all-cause, cardiovascular, and noncardiovascular mortality in women in relation to socioeconomic position at different stages of the life course. Information was collected in 1965, 1974, 1983, and 1994 and included recalled father's occupation and education as a measure of childhood socioeconomic position and the respondent's household income, education and occupation, and spouse's occupation from a s le of 3,087 women participating in the Alameda County Study. Cox regression models were used to estimate hazard ratios for risk of death. Lower childhood socioeconomic position was associated with an increased mortality due to cardiovascular disease (hazard ratio (HR) = 1.29, 95% confidence interval (CI): 1.09, 1.54) but was unrelated to death due to other causes (HR = 0.97, 95% CI: 0.82, 1.15). Overall mortality was higher among women reporting the lowest level of education (HR = 1.17, 95% CI: 0.99, 1.39), but education was most strongly related to noncardiovascular disease-related deaths (HR = 1.41, 95% CI: 1.10, 1.81). Low household income was also associated with higher mortality, for both cardiovascular disease-related (HR = 1.47, 95% CI: 1.14, 1.91) and noncardiovascular disease-related (HR = 1.30, 95% CI: 1.03, 1.63) deaths. Both early and later life indicators of socioeconomic position contribute to increased mortality risk among socioeconomically disadvantaged women, but these effects appear stronger for cardiovascular mortality.
Publisher: BMJ
Date: 10-2008
Abstract: To examine whether compositional and/or contextual area characteristics are associated with area socioeconomic inequalities and between-area differences in recreational cycling. The city of Melbourne, Australia. 2349 men and women residing in 50 areas (58.7% response rate). Cycling for recreational purposes (at least once a month vs never). In a cross-sectional survey participants reported their frequency of recreational cycling. Objective area characteristics were collected for their residential area by environmental audits or calculated with Geographic Information Systems software. Multilevel logistic regression models were performed to examine associations between recreational cycling, area socioeconomic level, compositional characteristics (age, sex, education, occupation) and area characteristics (design, safety, destinations or aesthetics). After adjustment for compositional characteristics, residents of deprived areas were less likely to cycle for recreation (OR 0.66 95% CI 0.43 to 1.00), and significant between-area differences in recreational cycling were found (median odds ratio 1.48 (95% credibility interval 1.24 to 1.78). Aesthetic characteristics tended to be worse in deprived areas and were the only group of area characteristics that explained some of the area deprivation differences. Safety characteristics explained the largest proportion of between-area variation in recreational cycling. Creating supportive environments with respect to safety and aesthetic area characteristics may decrease between-area differences and area deprivation inequalities in recreational cycling, respectively.
Publisher: Cambridge University Press (CUP)
Date: 04-05-2011
DOI: 10.1017/S1368980011000644
Abstract: To examine socio-economic differences in weight-control behaviours (WCB) and barriers to weight control. A cross-sectional study. Data were obtained by means of a postal questionnaire. A total of 1013 men and women aged 45–60 years residing in Brisbane, Australia (69·8 % response rate). Binary and multinomial logistic regression analyses were performed, adjusted for age, gender and BMI. Socio-economically disadvantaged groups were less likely to engage in weight control (OR for lowest income quartile = 0·60, 95 % CI 0·39, 0·94) among those who engaged in weight control, the disadvantaged group had a likelihood of 0·52 (95 % CI 0·30, 0·90) of adopting exercise strategies, including moderate (OR = 0·56, 95 % CI 0·33, 0·96) and vigorous (OR = 0·47, 95 % CI 0·25, 0·89) physical activities, compared with their more-advantaged counterparts. However, lower socio-economic groups were more likely to decrease their sitting time to control their weight compared with their advantaged counterparts (OR for secondary school or lower education = 1·78, 95 % CI 1·11, 2·84). They were also more likely to believe that losing weight was expensive, not of high priority, required a lot of cooking skills and involved eating differently from others in the household. Marked socio-economic inequalities existed with regard to engaging in WCB, the type of weight-control strategies used and the perceived barriers to weight control these differences are consistent with socio-economic gradients in weight status. These factors may need to be included in health promotion strategies that address socio-economic inequalities in weight status, as well as inequalities in weight-related health outcomes.
Publisher: BMJ
Date: 2007
Publisher: Human Kinetics
Date: 2018
Abstract: Background: There is growing urgency for higher quality evidence to inform policy. This study developed geographic information system spatial measures based on land use and transport policies currently used in selected Australian states to assess which, if any, of these measures were associated with walking for transport. Methods: Overall, 6901 participants from 570 neighborhoods in Brisbane, Australia, were included. Participants reported their minutes of walking for transport in the previous week. After a review of state-level land use and transport policies relevant to walking for transport across Australia, 7 geographic information system measures were developed and tested based on 9 relevant policies. Data were analyzed using multilevel multinomial logistic regression. Results: Greater levels of walking for transport were associated with more highly connected street networks, the presence of public transport stops, and having at least 2 public transport services per hour. Conversely, neighborhoods with shorter cul-de-sac lengths had lower levels of walking for transport. There was no evidence of associations between walking for transport and street block lengths less than 240 m or traffic volumes. Conclusions: These findings highlight the need for urban design and transport policies developed by governments to be assessed for their impact on transport-related physical activity.
Publisher: BMJ
Date: 04-08-2015
Abstract: Understanding how different socioeconomic indicators are associated with transport modes provide insight into which interventions might contribute to reducing socioeconomic inequalities in health. The purpose of this study was to examine associations between neighbourhood-level socioeconomic disadvantage, in idual-level socioeconomic position (SEP), and usual transport mode. This investigation included 11,036 residents from 200 neighbourhoods in Brisbane, Australia. Respondents self-reported their usual transport mode (car or motorbike, public transport, walking or cycling). Indicators for in idual-level SEP were education, occupation and household income and neighbourhood disadvantage was measured using a census-derived index. Data were analysed using multilevel multinomial logistic regression. High SEP respondents and residents of the most advantaged neighbourhoods who used a private motor vehicle as their usual form of transport was the reference category. Compared with driving a motor vehicle, the odds of using public transport were higher for white collar employees (OR 1.68, 95% CrI 1.41-2.01), members of lower income households (OR 1.71 95% CrI 1.25-2.30) and residents of more disadvantaged neighbourhoods (OR 1.93, 95% CrI 1.46-2.54) and lower for respondents with a certificate-level education (OR 0.60, 95% CrI 0.49-0.74) and blue collar workers (OR 0.63, 95% CrI 0.50-0.81). The odds of walking for transport were higher for the least educated (OR 1.58, 95% CrI 1.18-2.11), those not in the labour force (OR 1.94, 95% CrI 1.38-2.72), members of lower income households (OR 2.10, 95% CrI 1.23-3.64) and residents of more disadvantaged neighbourhoods (OR 2.73, 95% CrI 1.46-5.24). The odds of cycling were lower among less educated groups (OR 0.31, 95% CrI 0.19-0.48). The relationships between socioeconomic characteristics and transport modes are complex, and provide challenges for those attempting to encourage active forms of transportation. Further work is required exploring the in idual-level and neighbourhood-level mechanisms behind choice of transport mode, and what factors might influence in iduals from different socioeconomic backgrounds to change to more active transport modes.
Publisher: Springer Science and Business Media LLC
Date: 15-10-2019
DOI: 10.1186/S12966-019-0849-7
Abstract: Living in walkable neighborhoods may provide long-term cardio-metabolic health benefits to residents. Little empirical research has examined the behavioral mechanisms in this relationship. In this longitudinal study, we examined the potential mediating role of physical activity (baseline and 12-year change) in the relationships of neighborhood walkability with 12-year changes in cardio-metabolic risk markers. The Australian Diabetes, Obesity and Lifestyle study collected data from adults, initially aged 25+ years, in 1999–2000, 2004–05, and 2011–12. We used 12-year follow-up data from 2023 participants who did not change their address during the study period. Outcomes were 12-year changes in waist circumference, weight, systolic and diastolic blood pressure, fasting and 2-h postload plasma glucose, high-density lipoprotein cholesterol, and triglycerides. A walkability index was calculated, using dwelling density, intersection density, and destination density, within 1 km street-network buffers around participants’ homes. Spatial data for calculating these measures were sourced around the second follow-up period. Physical activity was assessed by self-reported time spent in moderate-to-vigorous physical activity (including walking). Multilevel models, adjusting for potential confounders, were used to examine the total and indirect relationships. The joint-significance test was used to assess mediation. There was evidence for relationships of higher walkability with smaller increases in weight ( P = 0.020), systolic blood pressure ( P 0.001), and high-density lipoprotein cholesterol ( P = 0.002) and, for relationships of higher walkability with higher baseline physical activity ( P = 0.020), which, in turn, related to smaller increases in waist circumference ( P = 0.006), weight ( P = 0.020), and a greater increase in high-density lipoprotein cholesterol ( P = 0.005). There was no evidence for a relationship of a higher walkability with a change in physical activity during the study period ( P = 0.590). Our mediation analysis has shown that the protective effects of walkable neighborhoods against obesity risk may be in part attributable to higher baseline physical activity levels. However, there was no evidence of mediation by increases in physical activity during the study period. Further research is needed to understand other behavioral pathways between walkability and cardio-metabolic health, and to investigate any effects of changes in walkability.
Publisher: Elsevier BV
Date: 03-2010
DOI: 10.1016/J.ANNEPIDEM.2009.11.004
Abstract: To examine the association between neighborhood disadvantage and physical activity (PA). We use data from the HABITAT multilevel longitudinal study of PA among middle-aged (40-65 years) men and women (N = 11,037, 68.5% response rate) living in 200 neighborhoods in Brisbane, Australia. PA was measured using three questions from the Active Australia Survey (general walking, moderate, and vigorous activity), one indicator of total activity, and two questions about walking and cycling for transport. The PA measures were operationalized by using multiple categories based on time and estimated energy expenditure that were interpretable with reference to the latest PA recommendations. The association between neighborhood disadvantage and PA was examined with the use of multilevel multinomial logistic regression and Markov chain Monte Carlo simulation. The contribution of neighborhood disadvantage to between-neighborhood variation in PA was assessed using the 80% interval odds ratio. After adjustment for sex, age, living arrangement, education, occupation, and household income, reported participation in all measures and levels of PA varied significantly across Brisbane's neighborhoods, and neighborhood disadvantage accounted for some of this variation. Residents of advantaged neighborhoods reported significantly higher levels of total activity, general walking, moderate, and vigorous activity however, they were less likely to walk for transport. There was no statistically significant association between neighborhood disadvantage and cycling for transport. In terms of total PA, residents of advantaged neighborhoods were more likely to exceed PA recommendations. Neighborhoods may exert a contextual effect on the likelihood of residents participating in PA. The greater propensity of residents in advantaged neighborhoods to do high levels of total PA may contribute to lower rates of cardiovascular disease and obesity in these areas.
Publisher: Elsevier BV
Date: 03-2018
Publisher: Elsevier BV
Date: 06-2021
Publisher: Elsevier BV
Date: 03-2017
Publisher: Cambridge University Press (CUP)
Date: 26-02-2009
DOI: 10.1017/S1368980009004911
Abstract: The present study examined the association between area socio-economic status (SES) and food purchasing behaviour. Data were collected by mail survey (64·2 % response rate). Area SES was indicated by the proportion of households in each area earning less than $AUS 400 per week, and in idual-level socio-economic position was measured using education, occupation and household income. Food purchasing was measured on the basis of compliance with dietary guideline recommendations (for grocery foods) and variety of fruit and vegetable purchase. Multilevel regression analysis examined the association between area SES and food purchase after adjustment for in idual-level demographic (age, sex, household composition) and socio-economic factors. Melbourne city, Australia, 2003. Residents of 2564 households located in fifty small areas. Residents of low-SES areas were significantly less likely than their counterparts in advantaged areas to purchase grocery foods that were high in fibre and low in fat, salt and sugar and they purchased a smaller variety of fruits. There was no evidence of an association between area SES and vegetable variety. In Melbourne, area SES was associated with some food purchasing behaviours independent of in idual-level factors, suggesting that areas in this city may be differentiated on the basis of food availability, accessibility and affordability, making the purchase of some types of foods more difficult in disadvantaged areas.
Publisher: Wiley
Date: 04-1998
Publisher: Elsevier BV
Date: 2019
Publisher: Elsevier BV
Date: 09-2006
Publisher: Cambridge University Press (CUP)
Date: 04-2003
DOI: 10.1079/PHN2002415
Abstract: To undertake an assessment of survey participation and non-response error in a population-based study that examined the relationship between socio-economic position and food purchasing behaviour. The study was conducted in Brisbane City (Australia) in 2000. The s le was selected using a stratified two-stage cluster design. Respondents were recruited using a range of strategies that attempted to maximise the involvement of persons from disadvantaged backgrounds: respondents were contacted by personal visit and data were collected using home-based face-to-face interviews multiple call-backs on different days and at different times were used and a financial gratuity was provided. Non-institutionalised residents of private dwellings ( n = 1003), located in 50 small areas that differed in their socio-economic characteristics. Rates of survey participation – measured by non-contacts, exclusions, dropped cases, response rates and completions – were similar across areas, suggesting that residents of socio-economically advantaged and disadvantaged areas were equally likely to be recruited. In idual-level analysis, however, showed that respondents and non-respondents differed significantly in their sociodemographic and food purchasing characteristics: non-respondents were older, less educated and exhibited different purchasing behaviours. Misclassification bias probably accounted for the inconsistent pattern of association between the area- and in idual-level results. Estimates of bias due to non-response indicated that although respondents and non-respondents were qualitatively different, the magnitude of error associated with this differential was minimal. Socio-economic position measured at the in idual level is a strong and consistent predictor of survey non-participation. Future studies that set out to examine the relationship between socio-economic position and diet need to adopt s ling strategies and data collection methods that maximise the likelihood of recruiting participants from all points on the socio-economic spectrum, and particularly persons from disadvantaged backgrounds. Study designs that are not sensitive to the difficulties associated with recruiting a socio-economically representative s le are likely to produce biased estimates (underestimates) of socio-economic differences in the dietary outcome being investigated.
Publisher: Elsevier BV
Date: 03-2019
Publisher: Cambridge University Press (CUP)
Date: 04-2003
DOI: 10.1079/PHN2002416
Abstract: To examine the association between socio-economic position (SEP) and diet, by assessing the unadjusted and simultaneously adjusted (independent) contributions of education, occupation and household income to food purchasing behaviour The s le was randomly selected using a stratified two-stage cluster design, and the response rate was 66.4%. Data were collected by face-to-face interview. Food purchasing was examined on the basis of three composite indices that reflected a household's choice of grocery items (including meat and chicken), fruit and vegetables Brisbane City, Australia, 2000 Non-institutionalised residents of private dwellings ( n = 1003), located in 50 small areas (Census Collectors Districts) When shopping, respondents in lower socio-economic groups were less likely to purchase grocery foods that were high in fibre and low in fat, salt and sugar. Disadvantaged groups purchased fewer types of fresh fruits and vegetables, and less often, than their counterparts from more advantaged backgrounds. When the relationship between SEP and food purchasing was examined using each indicator separately, education and household income made an unadjusted contribution to purchasing behaviour for all three food indices however, occupation was significantly related only with the purchase of grocery foods. When education and occupation were simultaneously adjusted for each other, the socio-economic patterning with food purchase remained largely unchanged, although the strength of the associations was attenuated. When household income was introduced into the analysis, the association between education, occupation and food purchasing behaviour was diminished or became non-significant income, however, showed a strong, graded association with food choice The food purchasing behaviours of socio-economically disadvantaged groups were least in accord with dietary guideline recommendations, and hence are more consistent with greater risk for the development of diet-related disease. The use of separate indicators for education, occupation and household income each adds something unique to our understanding of how socio-economic position is related to diet: each indicator reflects a different underlying social process and hence they are not interchangeable, and do not serve as adequate proxies for one another
Publisher: BMJ
Date: 10-01-2014
DOI: 10.1136/BJSPORTS-2013-093107
Abstract: The time that children and adults spend sedentary-put simply, doing too much sitting as distinct from doing too little physical activity-has recently been proposed as a population-wide, ubiquitous influence on health outcomes. It has been argued that sedentary time is likely to be additional to the risks associated with insufficient moderate-to-vigorous physical activity. New evidence identifies relationships of too much sitting with overweight and obesity, type 2 diabetes, cardiovascular disease, some cancers and other adverse health outcomes. There is a need for a broader base of evidence on the likely health benefits of changing the relevant sedentary behaviours, particularly gathering evidence on underlying mechanisms and dose-response relationships. However, as remains the case for physical activity, there is a research agenda to be pursued in order to identify the potentially modifiable environmental and social determinants of sedentary behaviour. Such evidence is required so as to understand what might need to be changed in order to influence sedentary behaviours and to work towards population-wide impacts on prolonged sitting time. In this context, the research agenda needs to focus particularly on what can inform broad, evidence-based environmental and policy initiatives. We consider what has been learned from research on relationships of environmental and social attributes and physical activity provide an overview of recent-emerging evidence on relationships of environmental attributes with sedentary behaviour argue for the importance of conducting international comparative studies and addressing life-stage issues and socioeconomic inequalities and we propose a conceptual model within which this research agenda may be addressed.
Publisher: Springer Science and Business Media LLC
Date: 05-09-2016
Publisher: Springer Science and Business Media LLC
Date: 08-04-2011
Publisher: Elsevier BV
Date: 07-2008
DOI: 10.1016/J.APPET.2007.12.002
Abstract: This study examined relationships between in idual-level socioeconomic position, area-level disadvantage, characteristics of the takeaway food environment, and the purchase of takeaway food. 'Takeaway' is conceptualised as foods or meals that are prepared and purchased outside of the home, and ready for immediate consumption either at the place of purchase or elsewhere. The analytic s le comprised 1001 households and 50 small areas in Brisbane, Australia. Takeaway food was purchased more regularly by high-income householders and those with higher levels of education. Residents of advantaged areas purchased takeaway food more regularly, although area differences attenuated to the null after adjustment for in idual-level compositional factors. Number of takeaway shops in the local food environment, and road distance to the closest takeaway shop, were largely unrelated to the purchase of takeaway food. We conclude that there is little evidence that takeaway food purchasing in Brisbane is influenced by area-level socioeconomic disadvantage or features of the takeaway food environment. Rather, it seems that what matters most in terms of influencing the decision or capacity of Brisbane residents to purchase takeaway food are the socioeconomic characteristics of in iduals and their households. The findings of this and previous analyses of the Brisbane Food Study data suggest that policy and health promotion aimed at improving the diets of residents and reducing dietary inequalities between socioeconomic groups should focus on people more so than places.
Publisher: Elsevier BV
Date: 10-2013
DOI: 10.1016/J.IJCARD.2013.01.219
Abstract: Our goal was to study associations between childhood socioeconomic position (SEP), adulthood SEP, adulthood risk factors and cardiovascular disease (CVD) mortality, by investigating the critical period and pathway models. The prospective GLOBE study in the Netherlands, with baseline data from 1991, was linked with cause of death register data from Statistics Netherlands in 2007. At baseline, respondents reported information on childhood SEP (i.e. occupational level of respondent's father), adulthood SEP (educational level), and adulthood risk factors (health behaviours, material circumstances, and psychosocial factors). Analyses included 4894 men and 5572 women. Data were analysed by Cox proportional hazard ratios (HR) with CVD mortality as the outcome. Childhood SEP was associated with CVD mortality among men with the lowest childhood SEP only (HR 1.32, 95% CI 1.00-1.74), and not among women. The majority of childhood SEP inequalities in CVD mortality among men (88%) were explained by material, behavioural and psychosocial risk factors in adulthood, and adulthood SEP. This was mostly due to the association of childhood SEP with adulthood SEP, and the interrelations of adulthood SEP with risk factors, and partly via the direct association of childhood SEP with adulthood risk factors, independent of adulthood SEP. This study supports the pathway model for men, but found no evidence that socioeconomic conditions in childhood are critical for CVD mortality in later life independent of adulthood conditions. Developing effective methods to reduce material and behavioural risk factors among lower socioeconomic groups should be a top priority in cardiovascular disease prevention.
Publisher: Human Kinetics
Date: 08-2019
Abstract: To examine associations between perceived destination accessibility within different distances from home and self-reported overall amounts of walking for different purposes among older adults (aged ≥ 65 years) in Brisbane, Australia ( N = 793) and Hong Kong, China ( N = 484). Perceived neighborhood destination accessibility types were derived from latent class analysis using comparable measures of perceived distance to 12 destinations from epidemiological studies in the two cities. Associations of perceived destination accessibility with measures of within-neighborhood walking were also estimated in Hong Kong participants. Better perceived destination accessibility was positively associated with the likelihood of walking in Brisbane participants only. Perceived destination accessibility within a short distance from home (5-min walk) was negatively related to the amount of within-neighborhood walking for transport in Hong Kong residents who walked. Our findings suggest that providing moderate-to-high, but not extreme, levels of destination accessibility may be optimal for the promotion of walking in older community dwellers.
Publisher: Wiley
Date: 12-02-2010
DOI: 10.1111/J.1753-6405.1995.TB00396.X
Abstract: Australian researchers examining the relationship between socioeconomic status and food-related behaviour have often selected their s les from the electoral roll and then collected their data using a mail-survey method. These studies have generally found statistically significant associations between socioeconomic status and behaviour, although these relationships are usually only weak-to-moderate in strength. Given the consistent and strong pattern of association between socioeconomic status and mortality, and diet and mortality, there is a possibility that these studies may have used a research design that underestimates the magnitude of the association. To assess this possibility, results obtained using an electoral-roll s le and mail-survey method were compared with findings obtained by administering the same questionnaire directly to a s le of indigent clients contacted through a welfare agency. The comparison suggests that studies that draw their s les from electoral rolls and then collect data using a mail-survey questionnaire may greatly understate the level of socioeconomic inequality in food-related behaviour in the wider community.
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.BREAST.2017.09.005
Abstract: Reducing geographical inequalities in breast cancer stage remains a key focus of public health policy. We explored whether patterns of advanced breast cancer by residential accessibility and disadvantage in Queensland, Australia, have changed over time. Population-based cancer registry study of 38,706 women aged at least 30 years diagnosed with a first primary invasive breast cancer of known stage between 1997 and 2014. Multilevel logistic regression was used to examine temporal changes in associations of area-level factors with odds of advanced disease after adjustment for in idual-level factors. Overall 19,401 (50%) women had advanced breast cancer. Women from the most disadvantaged areas had higher adjusted odds (OR = 1.23 [95%CI 1.13, 1.32]) of advanced disease than those from least disadvantaged areas, with no evidence this association had changed over time (interaction p = 0.197). Living in less accessible areas independently increased the adjusted odds (OR = 1.18 [1.09, 1.28]) of advanced disease, with some evidence that the geographical inequality had reduced over time (p = 0.045). Sensitivity analyses for un-staged cases showed that the original associations remained, regardless of assumptions made about the true stage distribution. Both geographical and residential socioeconomic inequalities in advanced stage diagnoses persist, potentially reflecting barriers in accessing diagnostic services. Given the role of screening mammography in early detection of breast cancer, the lack of population-based data on private screening limits our ability to determine overall participation rates by residential characteristics. Without such data, the efficacy of strategies to reduce inequalities in breast cancer stage will remain compromised.
Publisher: Duke University Press
Date: 17-05-2016
DOI: 10.1007/S13524-016-0478-6
Abstract: Life course perspectives suggest that later-life health reflects long-term social patterns over an in idual's life: in particular, the occurrence and timing of key roles and transitions. Such social patterns have been demonstrated empirically for multiple aspects of fertility and partnership histories, including timing of births and marriage, parity, and the presence and timing of a marital disruption. Most previous studies have, however, addressed particular aspects of fertility or partnership histories singly. We build on this research by examining how a holistic classification of family life course trajectories from ages 18 to 50, incorporating both fertility and partnership histories, is linked to later-life physical health for a s le of Australian residents. Our results indicate that long-term family life course trajectories are strongly linked to later-life health for men but only minimally for women. For men, family trajectories characterized by early family formation, no family formation, an early marital disruption, or high fertility are associated with poorer physical health. Among women, only those who experienced both a disrupted marital history and a high level of fertility were found to be in poorer health.
Start Date: 2005
End Date: 2008
Funder: Australian Research Council
View Funded ActivityStart Date: 2009
End Date: 2011
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2013
End Date: 2017
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2010
End Date: 2012
Funder: Australian Research Council
View Funded ActivityStart Date: 2013
End Date: 2018
Funder: National Health and Medical Research Council
View Funded Activity