Street connectivity and obesity in Glasgow,Scotland: Impact of age,sex and socioeconomic position

This study investigated associations of street connectivity with body mass index (BMI), and whether these associations varied by sex, age and socioeconomic position, amongst adults in Glasgow, Scotland. Data on socio-demographic variables, height and weight were collected from 1062 participants in the Greater Glasgow Health and Well-being Study, and linked with neighbourhood-level census and geo-referenced data on area level deprivation and street connectivity. Results of multilevel models showed that, after adjustment for individual level covariates, street connectivity was not significantly associated with either BMI or BMI category; nor were there any significant interactions between age, sex or socioeconomic position and street connectivity.     

Child mortality,socioeconomic position,and one-parent families: independent associations and variation by age and cause of death

BACKGROUND: Although the association between child mortality and socioeconomic status is well established, it is unclear whether child mortality differences by socioeconomic position are present at all ages. The association of one-parent families with mortality, and whether any such association is due to associated low socioeconomic position, is also not clear. METHODS: In all, 480 of 693 (69%) 0-14 year old deaths during 1991-1994 were linked to 1991 census records. Analyses were weighted to adjust for potential linkage bias. RESULTS: There was approximately twofold higher mortality among the lowest compared with the highest socioeconomic categories of education, income, car access, and neighbourhood deprivation. Occupational class differences were weaker. These socioeconomic differences in mortality were strongest among infants (particularly sudden infant death syndrome [SIDS] mortality), but similar across other age groups (1-4, 5-9, and 10-14 years). The socioeconomic differences were of a similar magnitude for unintentional injury, cancer, congenital, and other deaths. Multivariable analyses demonstrated persistent independent associations of education, income, car access, and neighbourhood deprivation with mortality. Rate ratios (adjusted for age and ethnicity) for one-parent families compared with two-parent or other families were 1.2 (95% CI: 1.0, 1.5) and 1.8 (95% CI: 1.2, 2.5) for all-cause and unintentional injury mortality, respectively. Further adjustment for socioeconomic factors reduced these associations to 0.8 (95% CI: 0.6, 1.2) and 1.2 (95% CI: 0.7, 2.2), respectively. CONCLUSIONS: There does not appear to be notable variation in relative risk terms of socioeconomic differences in child mortality by age or cause of death. Any association of one-parent families with child mortality is due to associated low socioeconomic position.     

Neighborhood socioeconomic status and adherence to dietary recommendations among Finnish adults: A retrospective follow-up study

Neighborhood socioeconomic status (SES) is associated with dietary habits among the residents, but few studies have examined this association separately among long-term residents and movers. We calculated cumulative neighborhood SES score weighted by residential time in each address over 6 years for non-movers (n = 7704) and movers (n = 8818) using national grid database. Increase in average neighborhood SES was associated with higher adherence to dietary recommendations in both groups. Among the movers, an upward trajectory from low to high neighborhood SES was also associated with better adherence. Our findings suggest high SES areas might offer healthier food environments than low SES areas.     

24-h movement behaviors among autistic adults: Differences by sex,age, and level of independence

BackgroundAutistic adults have low levels of physical activity [PA], high levels of sedentary behavior [SB], and insufficient sleep. Not known is the extent to which engagement in these movement behaviors vary by sex, age, and level of independence in activities of daily living (ADLs).ObjectiveTo characterize movement behaviors in a national sample of autistic adults by sex, age, and level of independence in ADLs.MethodsA national sample of autistic adults and caregivers of autistic adults self-reported PA, SB and sleep behaviors as well as demographic variables using an electronic survey. Levels of engagement in movement behaviors were described, and compared by sex, age (young-adult versus middle-age), and level of independence in ADLs.ResultsData were collected on 361 autistic adults (60.3% male, n = 217, m^age = 30.82 years, SD = 10.24). Overall, 44% did not meet the PA guideline; PA guideline adherence was lowest among males and those who were dependent on others in ADLs. Overall, the SB guideline was not met by 43% of the sample at weekdays and 48% at weekends. SB guideline adherence was lowest among adults who were middle-aged, and those who were fully independent in ADLs. Overall, 35.2% did not meet the total sleep time (TST) guideline. Middle-aged autistic adults had the lowest adherence to the TST guideline.ConclusionsThese finding should prompt researchers to consider these demographic differences, and tailor research and programmatic efforts to account for the unique movement behavior profiles of different segments of this heterogenous population.     

Individual and household-level socioeconomic position is associated with harmful alcohol consumption behaviours among adults

Aim: To examine associations between individual‐, household‐ and neighbourhood‐level socioeconomic position (SEP) and harmful alcohol consumption. Method: 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. Individual‐, 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. Results: 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. Conclusion: 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 Implications: Socioeconomic disadvantage at the individual and household levels may be an important determinant of alcohol consumption among Australian adults.     

Dietary intakes of adults in the Netherlands by childhood and adulthood socioeconomic position

OBJECTIVE: To determine whether there are socioeconomic differences in the intakes of total fat, fatty acids and fruit among adults in the Netherlands using childhood (parental) and participant's own socioeconomic position (SEP). Furthermore, to quantify the independent effects of childhood and adulthood SEP on dietary behavior in adulthood. DESIGN: Cross-sectional study among participants in the GLOBE study. SUBJECTS: A total of 2512 men and women, aged 25-78 y, living in a region in the southeast Netherlands. METHODS: Dietary intakes were collected by an interviewer-administered quantitative food frequency questionnaire. Average daily intakes of total energy, total, saturated, monounsaturated, polyunsaturated fat and fruit were calculated. The highest educational level was used to classify the participant's adulthood SEP. Parental indicators (mother's education and father's occupation when participants were 12 y of age) were used to classify childhood SEP. RESULTS: Males with lower levels of education had moderately higher energy intakes than their more educated counterparts, but did not differ in their intakes of total fat, fatty acids and fruit. Among females, the least educated groups had marginally higher intakes of total and monounsaturated fat than the most educated group, and were less likely to consume fruit. For most of these significant differences, the participant's own education demonstrated independent effects that were consistent with chronic disease inequalities. A small residual effect of mother's education was also demonstrated for intakes of some nutrients for males and females, and for fruit consumption among females. However, the effect size of mother's education was rather small and not always consistent with disease inequalities. CONCLUSIONS: The results imply that socioeconomic disparities in intakes of some dietary factors may contribute to inequalities in chronic disease. Adulthood SEP potentially has a more direct influence on dietary intake inequalities than childhood SEP.     

Sociodemographic and socioeconomic differences in sleep duration and insomnia-related symptoms in Finnish adults

ABSTRACT: BACKGROUND: Poor sleep tends to be patterned by sociodemographic and socioeconomic factors. The aim of this study was to examine the associations of sociodemographic and socioeconomic factors with sleep duration and insomnia-related symptoms across life course. METHODS: We used cross-sectional Health 2000 Survey (2000-2001) among a total of 5,578 adult Finns, aged 30-79 years, representative of adult Finnish population. Data about sociodemographic and socioeconomic circumstances, insomnia-related symptoms over the previous month as well as average sleep duration were collected by questionnaires. Multinomial logistic regression models were adjusted first for gender and age, second for sociodemographic factors, and third for all covariates simultaneously. RESULTS: On average 70% of Finnish adults slept 7-8 hours a day. Frequent insomnia-related symptoms were more prevalent among women (14%) than men (10%). Not being married, not having children, having low education, low income, being unemployed, and being a disability retiree were associated with frequent insomnia-related symptoms. Similar factors were associated with short and long sleep duration. However, childhood socioeconomic position was mostly unrelated to sleep in adulthood except parental education had some associations with short sleep duration. CONCLUSIONS: Disadvantaged socioeconomic position in adulthood, in particular income and employment status, is associated with poorer sleep. When promoting optimal sleep duration and better sleep quality, families with low incomes, unemployed people, and disability retirees should be targeted. Key words: marital status; parental status; education; employment status; household income; residential area; insomnia-related symptoms; sleep duration; life course; self-perceived health.     

Socioeconomic inequality in cigarette smoking: trends by gender, age, and socioeconomic position in South Korea, 1989-2003

OBJECTIVE: The aim of this study was to examine trends of socioeconomic differentials in smoking rates by gender, age, and socioeconomic position in South Korea. METHODS: We used data from five Social Statistical Surveys of Korea National Statistical Office from 1989 to 2003. This study included 344,969 men and women aged 20 or over. Socioeconomic position indicators were education and occupation. RESULTS: Age-standardized smoking rates decreased in all age groups of men and women aged 45+ between 1989 and 2003, while smoking rates among women aged 20-44 did not decrease. Education was inversely associated with smoking in both genders. Those with manual occupations had greater smoking rates than those who performed non-manual labor. Based on the relative index of inequality, unfavorable inequality trends toward low education were detected in both genders aged 20-44. However, these trends were not found at ages 45-64. For occupational class, the relative inequality in smoking measured by odds ratios remained stable among men and women between 1995 and 2003. CONCLUSIONS: Continuous and progressive anti-smoking policy measures should be directed toward South Korean men whose smoking rates are still high. Policy efforts to reduce socioeconomic inequality in smoking, especially among young adult men and women, should be exercised. In addition, additional anti-smoking policy measures toward young women's smoking habits need to be developed in South Korea.     

The effects of a psychosocial dimension of socioeconomic position on survival: occupational prestige and mortality among US working adults

The association between education or income and mortality has been explored in great detail. These measures capture both the effects of material disadvantage on health and the psychosocial impacts of a low socioeconomic position on health. When explored independently of educational attainment and income, occupational prestige – a purely perceptual measure – serves as a measure of the impact of a psychosocial phenomenon on health. For instance, a fire‐fighter, academician or schoolteacher may carry the social benefits of a higher social status without actually having the income (in all cases) or the educational credentials (in the case of the fire‐fighter) to match. We explored the independent influence of occupational prestige on mortality. We applied Cox proportional hazards models to a nationally representative sample of over 380,000 US workers who had worked at any time between 1986 and 1994 with mortality follow up through 2002. We found that occupational prestige is associated with a decrease in the risk of all‐cause, cancer, cardiovascular and respiratory‐related mortality after controlling for household income and educational attainment. We further investigated the question of whether the effects of prestige are moderated by sex and broader occupational groupings. Prestige effects operate in white‐collar occupations for men only and within service occupations for all workers.     

Multiple roles and health among British and Finnish women: the influence of socioeconomic circumstances

Two contrasting hypotheses have been presented to predict women's health variations. The Multiple burden hypothesis predicts that combining a paid job, being married, and having children is likely to be detrimental to women's health. The multiple attachment hypothesis predicts that multiple roles provide attachment to the community, which is likely to be beneficial to women's health. These hypotheses are examined in Britain and Finland, which have different patterns of women's employment participation. Lone mothers form a critical case, since they have fewer attachments and greater burdens, and therefore are expected to have poorer health. The socioeconomic position of lone mothers differs in Britain and Finland, but in both societies they are likely to have fewer attachments. We assess the extent to which health variations between women with different family and parental role combinations are because of the differences in their socioeconomic status and material circumstances. Comparable surveys from Britain and Finland from 1994 were used. Perceived general health and limiting long-standing illness were analysed for working age women (20-49 years) by family type and employment status. as well as other socioeconomic variables. In both countries, women living in two parent families and having children had better health than women living in other family types or on their own. Lone mothers form a disadvantaged group and showed overall worse health in both countries. Adjusting for employment status. education and household income weakened the association between family type and poor health. The findings are broadly in accordance with the multiple attachment hypothesis. Despite the more generous welfare state and high full-time employment among Finnish women, single lone mothers report poorer health than other women in Finland as well as in Britain. However, in Britain the disadvantaged social position of lone mothers accounts for a greater proportion of their poor health than in Finland.     

Optimism, dietary habits, body mass index and smoking among young Finnish adults

The association between optimism and health habits was evaluated among 31-year-old men and women (n=8690) born in Northern Finland in 1966. Both women and men above the upper quartile for optimism more often ate fresh vegetables and salads (women 76%/men 57%), berries (23%/9%), fruit (67%/42%), low-fat cheese (25%/16%) and salad dressing (15%/17%) than those below the lower quartile (56%/31%, 14%/5%, 52%/26%, 18%/10% and 10%/5%, respectively) with women in higher proportion than in men in each case. Pessimism was associated with infrequent consumption of foods rich in fiber and salad dressing and the proportions of high consumers of alcohol. Proportion of subjects with BMI of 30.0 kg/m2 and above and that of current smokers were higher among the pessimists than among the optimists. Thus lack of optimism is associated with a cluster of unhealthy dietary and other habits. This may at least partly explain the positive association of optimism with health found in previous studies.     

Road traffic injuries among young car drivers by country of origin and socioeconomic position

Summary Objectives: The study examines the relationship between country of birth, socioeconomic position, and the risk of being injured as a young car driver. Methods: The study consists of a nationwide follow-up of young people in Sweden in which individual census records on country of birth and household socioeconomic position were linked to the Hospital Discharge Register so as to identify subjects’ road traffic injuries (RTIs) as car drivers. Multivariate analyses were conducted using Cox regression, with hospital admission due to RTI as car driver as the dependent variable. Results: There are no significant differences in injury risks between foreign-born and Swedish-born drivers, but clear socioeconomic differences were found. Young drivers from manual worker families have 80% higher risk for RTIs compared to drivers in families with salaried employee parents (RR 1.83, CI 1.63-2.05). Conclusions: The results do not support the idea that type of country of origin constitutes a significant marker of risk level for RTI as novice car driver. On the other hand, the results reconfirm that, in Sweden, the risk of RTI among young drivers from different socioeconomic backgrounds varies. Submitted: 4 July 2006; Revised: 1 June, 16 September 2007; Accepted 21 November 2007     

Municipal socioeconomic status and mortality in Japan: sex and age differences, and trends in 1973-1998

The purpose of this study was to examine the sex and age differences and the time trends in the association between municipal socioeconomic status (SES) and all-cause mortality across Japan from 1973 to 1998. Sex-specific mortality of municipalities (N=3319 in 1995) by age groups (total, under 75-year, and over 75-year populations) was linked to municipal SES indicators related to income, education, unemployment and living space, and two SES composite indices formulated by principle component analysis (Index 1 related to lower income and education, and Index 2 related to unemployment and overcrowding). The relation was assessed using mortality gradients by SES quintiles and Bayesian hierarchical Poisson regression. The results showed that a lower SES was related to higher mortality for all SES indicators and composite indices. The mortality gradient was steeper for the under 75-year population than the total and over 75-year populations, and the relation between mortality and income- and education-related indicators/index was stronger for males than for females. The time trend showed an increase in the relation for Index 2, while a decrease for Index 1. This study demonstrated that lower municipal SES had an adverse influence on population health, and the influence was marked for males and premature death. Although a substantial health disadvantage still remained in lower SES areas, the impact of SES factors on geographical health variation changed over time; the association with mortality has weakened for income and education, while it has strengthened for unemployment and living space.     

Age and sex differences in variation of nutrient intakes among U.S. adults.

Studies assessing associations of diet with health frequently use multi-day dietary records to estimate usual dietary intakes. We examined variation in intakes of 13 nutrients for 13,388 U.S. adults using 3 days of dietary data from the 1977-1978 Nationwide Food Consumption Survey. Ratios of within-person variability to between-person variability in intakes were large and would result in attenuated linear regression estimates of diet-health associations. For many nutrients, the magnitude of the attenuation decreased with age for both sexes but particularly for men, implying that fewer days of dietary intake per person would correctly assess diet-health associations among older adults than have been suggested for younger adults.     

Multiple dimensions of socioeconomic position and obesity among employees: The Helsinki Health Study

OBJECTIVE: To examine socioeconomic differences in obesity using several different socioeconomic indicators, ranging from childhood socioeconomic environment and adult socioeconomic status to material resources and economic satisfaction. RESEARCH METHODS AND PROCEDURES: The data derived from the Helsinki Health Study baseline surveys in 2000 and 2001. Respondents to postal surveys were middle-aged employees of the City of Helsinki (4,975 women and 1,252 men, response rate 68%). Associations between eight socioeconomic indicators and obesity (BMI > or = 30 kg/m(2)), calculated from self-reported data, were examined by fitting a series of logistic regression models. RESULTS: In women, all socioeconomic indicators except household income and economic satisfaction were associated with obesity. Parental education and childhood economic difficulties, i.e., socioeconomic conditions in childhood, remained associated with obesity after adjusting for all indicators of current socioeconomic position. Indicators of adult socioeconomic status, own education and occupational class, were no longer associated with obesity when childhood socioeconomic conditions were adjusted for. Home ownership and economic difficulties were associated with obesity after full adjustments. In men, the findings paralleled those among women, but few associations reached statistical significance. DISCUSSION: Obesity was associated with several dimensions of socioeconomic position. Childhood socioeconomic disadvantage was associated with obesity independently of the various indicators of current socioeconomic position. Associations between obesity and both educational level and occupational class disappeared after adjustment for other indicators of socioeconomic position. This suggests that the variation observed in the prevalence of obesity by these key socioeconomic indicators may reflect differences in the related material resources.     

Colorectal cancer incidence among Chinese in North America and the People's Republic of China: variation with sex, age and anatomical site

Age-specific incidence rates for cancers of the colon and rectum are presented for Chinese in the western United States and Canada (high risk area), and in Shanghai, the People's Republic of China (low risk area). These rates are compared to those among North American whites. Among Chinese, rate differences between high and low risk areas are greater for colon cancer than rectal cancer, are greater for men than women, and increase with age. The most striking finding is the high colon cancer incidence among older Chinese-American men, compared to Chinese-American women. Colon cancer rates among elderly Chinese-American men equal those of whites, which are seven times the corresponding rates in China. By contrast, colon cancer rates among older Chinese-American women are intermediate between those of whites and those in China, and are only three to four times the rates in China. Rectal cancer rate differences for Chinese men also exceed those for Chinese women. However, they are less dramatic than for colon cancer, with elderly Chinese-American men having roughly double the rates in China, and with women exhibiting little variation between continents or ethnic groups. Male:female (M:F) rate ratios increase with age for both continents, both ethnic groups, and both colon and rectum. The colon cancer M:F ratios among Chinese-Americans exceed the others, reaching two in the older age groups. These observations suggest sex-specific aetiological exposures, or sex-specific susceptibilities to common exposures, among Chinese-Americans.(ABSTRACT TRUNCATED AT 250 WORDS)     

Hysterectomy and socioeconomic position in Rome,Italy

STUDY OBJECTIVE: There exists conflicting evidence regarding the higher risk of hysterectomy among women of a lower educational and economic level. This study aims to assess whether in Italy socioeconomic level is related to hysterectomy undertaken for different medical reasons. DESIGN: An area based index was used to assign socieconomic status (SES; four levels defined) to 3141 women (aged 35 years or older) who underwent a hysterectomy in 1997 and were residing in Rome. Data were taken from hospital discharge records. Direct age standardised hospitalisation rates by SES level were calculated for overall hysterectomies and for those performed for either malignant or non-malignant causes. Statistical differences were detected using the ratios of standardised rates and the test for linear trend. MAIN RESULTS: The hysterectomy rate was 36.7 per 10 000 women aged 35 years or more. Hysterectomy for uterine leiomyoma accounted for 41% of all operations and was more frequent among women aged 35-49 years than for those aged 50 years or more (crude rates: 28.6 and 7.7 per 10 000, respectively). The risk of hysterectomy was 35% higher for the lowest SES group, compared with the highest group. No association was found between SES and hysterectomy rates for malignant causes, although less affluent women in age group 35-49 years had 87% higher risk of hysterectomy compared with most affluent women. The inverse association between SES and hysterectomy rates attributable to non-malignant causes was statistically significant for women aged 35-49 years but not for those aged 50 years or more. CONCLUSIONS: The inverse relation between hysterectomy and SES is largely attributable to benign disorders of the uterus, namely leiomyoma and prolapse. More affluent women may have a greater uptake of less invasive techniques for removing uterine leiomyoma compared with less affluent women, who are more likely to undergo unnecessary hysterectomies irrespective of their reproductive age.