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Woo J. How place matters for smoking cessation: Barriers to smoking cessation among low-income Black women. Health Place 2022; 78:102925. [DOI: 10.1016/j.healthplace.2022.102925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 11/04/2022]
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Breetzke GD. The Importance of Space and Time in Aggravated Assault Victimization. JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:2536-2557. [PMID: 29294717 DOI: 10.1177/0886260517704961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Interpersonal crimes such as aggravated assault greatly impacts upon an individuals' sense of personal safety and security as the crime results in a physical injury. Understanding where and when aggravated assaults are most likely to occur is therefore vital to minimize the victimization risk associated with this crime. The main aim of this study is to explore the relative importance of space and time in aggravated assault victimization. This was done using national level aggravated assault data (2008-2010) obtained from New Zealand Police and census data from Statistics New Zealand. Both the spatial and temporal distribution of aggravated assault are outlined to examine their association with aggravated assault victimization. Aggravated assault is found to cluster in space but not in time. The relationships between aggravated assault risk in space and time and a suite of social, economic, and lifestyle variables was then examined. A clear socioeconomic gradient was found between aggravated assault risk by space and all neighborhood characteristics with high-risk neighborhoods having greater residential mobility and ethnic/racial diversity, as well as being more deprived, having higher rates of unemployment, and lower median household incomes. No clear pattern emerged between aggravated assault by time and the selected neighborhood characteristics. The policy implications of these findings in terms of policing and diversity conclude.
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Carroll SJ, Dale MJ, Bailie R, Daniel M. Climatic and community sociodemographic factors associated with remote Indigenous Australian smoking rates: an ecological study of health audit data. BMJ Open 2019; 9:e032173. [PMID: 31292187 PMCID: PMC6624038 DOI: 10.1136/bmjopen-2019-032173] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
UNLABELLED Australian Indigenous smoking rates are highest in remote communities but likely vary between communities; few studies have assessed community features in relation to Indigenous smoking rates. DESIGN AND OBJECTIVE This ecological study evaluated the associations between smoking rates, and community sociodemographic and climatic characteristics for a large sample of remote Indigenous communities. SETTING AND SAMPLE Records (n=2689) from an audit of community health centres in the Northern Territory and Queensland were used to estimate smoking rates dichotomised at the median for 70 predominantly Indigenous remote communities. Community characteristics were similarly dichotomised. METHODS Cross-tabulations were used to calculate the odds of a community classified as high for a sociodemographic or climatic factor also being high for smoking rate. Additional cross-tabulations, stratified by sociodemographic, region (coastal or central) and geographic connectivity levels, were performed to assess potential confounding. RESULTS Community smoking rates ranged from 25% to 96% (median 60.2%). Moderately strong relationships were observed between community smoking rate and population size (OR 6.25,(95% CI 2.18 to 17.95)), education level (OR 3.67 (1.35-10.01)), income (2.86 (11.07-7.67)) and heat (2.86 (1.07-7.67)). CONCLUSIONS Smoking rates in Australian remote Indigenous communities are universally high. Smoking rates are associated with greater community-level socioeconomic status and size, most likely reflecting greater means of accessing tobacco with mass of smokers sufficient to sustain a normative influence. Severe heat was also associated with high smoking rates suggesting such a stressor might support smoking as a coping mechanism. Community sociodemographic and climatic factors bear consideration as context-level correlates of community smoking rates.
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Affiliation(s)
- Suzanne Jane Carroll
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Michael J Dale
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Ross Bailie
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
| | - Mark Daniel
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Canberra, Australian Capital Territory, Australia
- Department of Medicine, St. Vincent’s Hospital, The University of Melbourne, Fitzroy, Victoria, Australia
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Timmermans EJ, Veldhuizen EM, Snijder MB, Huisman M, Kunst AE. Neighbourhood safety and smoking in population subgroups: The HELIUS study. Prev Med 2018; 112:111-118. [PMID: 29654838 DOI: 10.1016/j.ypmed.2018.04.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 03/20/2018] [Accepted: 04/06/2018] [Indexed: 11/26/2022]
Abstract
This study examines the associations between neighbourhood safety and three types of smoking behaviour, and whether these associations differ by sex, age, ethnicity and individual-level socio-economic position. Baseline data (2011-2015) from the The HEalthy LIfe in an Urban Setting (HELIUS) study (Amsterdam, the Netherlands) were used. Smoking behaviour was based on self-report. Heavy smoking was defined as smoking ≥10 cigarettes per day. Nicotine dependence was assessed using the Fagerström questionnaire. Geographic Information System techniques were used to construct local residential areas and to examine neighbourhood safety for these areas using micro-scale environmental data. Multilevel logistic regression analyses with 6-digit zip code area as a second level were used to assess the association between neighbourhood safety and smoking. In our study sample of 22,728 participants (18-70 years), 24.0% were current smokers, 13.7% were heavy smokers and 8.1% were nicotine dependent individuals. Higher levels of neighbourhood safety were significantly associated with less heavy smoking (OR = 0.88, 95% CI = 0.78-0.99) and less nicotine dependence (OR = 0.81, 95% CI = 0.69-0.95), but not with less current smoking (OR = 1.01, 95% CI = 0.91-1.11). The associations between neighbourhood safety and the three types of smoking behaviour varied by ethnicity. For instance, higher levels of neighbourhood safety were associated with less current smoking in participants of African Surinamese origin (OR = 0.71, 95% CI = 0.57-0.89), but not in those of Dutch (OR = 1.13, 95% CI = 0.91-1.39), South-Asian Surinamese (OR = 1.22, 95% CI = 0.95-1.55), Turkish (OR = 1.08, 95% CI = 0.84-1.38), Moroccan (OR = 1.53, 95% CI = 1.12-2.10) or Ghanaian (OR = 1.18, 95% CI = 0.47-2.94) origin. Policies that improve neighbourhood safety potentially contribute to less heavy smoking and nicotine dependence.
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Affiliation(s)
- Erik J Timmermans
- Academic Medical Center, University of Amsterdam, Department: Public Health, Amsterdam Public Health research institute, Amsterdam, The Netherlands.
| | - Eleonore M Veldhuizen
- Department of Geography, Planning & International Development Studies, University of Amsterdam, Amsterdam, The Netherlands
| | - Marieke B Snijder
- Academic Medical Center, University of Amsterdam, Department: Public Health, Amsterdam Public Health research institute, Amsterdam, The Netherlands; Academic Medical Center, University of Amsterdam, Department: Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Martijn Huisman
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands; Department of Sociology, Faculty of Social Sciences, VU University, Amsterdam, The Netherlands
| | - Anton E Kunst
- Academic Medical Center, University of Amsterdam, Department: Public Health, Amsterdam Public Health research institute, Amsterdam, The Netherlands
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Change in Neighborhood Disadvantage and Change in Smoking Behaviors in Adults: A Longitudinal, Within-individual Study. Epidemiology 2018; 27:803-9. [PMID: 27337178 DOI: 10.1097/ede.0000000000000530] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Evidence for an association between neighborhood disadvantage and smoking is mixed and mainly based on cross-sectional studies. To shed light on the causality of this association, we examined whether change in neighborhood socioeconomic disadvantage is associated with within-individual change in smoking behaviors. METHODS The study population comprised participants of the Finnish Public Sector study who reported a change in their smoking behavior between surveys in 2008/2009 and 2012/2013. We linked participants' residential addresses to a total population database on neighborhood disadvantage with 250 × 250-m resolution. The outcome variables were changes in smoking status (being a smoker vs. not) as well as the intensity (heavy/moderate vs. light smoker). We used longitudinal case-crossover design, a method that accounts for time-invariant confounders by design. We adjusted models for time-varying covariates. RESULTS Of the 3,443 participants, 1,714 quit, while 967 began to smoke between surveys. Smoking intensity increased among 398 and decreased among 364 participants. The level of neighborhood disadvantage changed for 1,078 participants because they moved residence. Increased disadvantage was associated with increased odds of being a smoker (odds ratio of taking up smoking 1.23 [95% confidence interval: 1.2, 1.5] per 1 SD increase in standardized national disadvantage score). Odds ratio for being a heavy/moderate (vs. light) smoker was 1.14 (95% confidence interval: 0.85, 1.52) when disadvantage increased by 1 SD. CONCLUSIONS These within-individual results link an increase in neighborhood socioeconomic disadvantage, due to move in residence, with subsequent smoking behaviors.
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Mayne SL, Auchincloss AH, Moore KA, Michael YL, Tabb LP, Echeverria SE, Diez Roux AV. Cross-sectional and longitudinal associations of neighbourhood social environment and smoking behaviour: the multiethnic study of atherosclerosis. J Epidemiol Community Health 2016; 71:396-403. [PMID: 27885050 DOI: 10.1136/jech-2016-207990] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 09/18/2016] [Accepted: 11/07/2016] [Indexed: 11/03/2022]
Abstract
BACKGROUND Social features of neighbourhood environments may influence smoking by creating a stressful environment or by buffering stress through social cohesion. However, the association of the overall neighbourhood social environment (NSE) with smoking, and the association of specific neighbourhood social factors with change in smoking behaviour over time, has rarely been examined. METHODS This study included 5856 adults aged 45-84 years from the Multi-Ethnic Study of Atherosclerosis (2000-2012, average follow-up: 7.8 years). Outcomes included current smoking status and smoking intensity (average number of cigarettes smoked per day among baseline smokers). NSE was assessed as a composite score composed of aesthetic quality, safety and social cohesion scales (derived from neighbourhood surveys). Generalised linear mixed models evaluated the association of baseline NSE (composite score and individual scales) with current smoking (modified Poisson models) and smoking intensity (negative binomial models) cross-sectionally and longitudinally. RESULTS Each SD increase in baseline NSE composite score was associated with 13% lower prevalence of smoking at baseline (adjusted prevalence ratio (aPR) 0.87 (95% CI 0.78 to 0.98). Neighbourhood safety and aesthetic quality were similarly associated with lower smoking prevalence (aPR 0.87 (0.78 to 0.97) and aPR 0.87 (0.77 to 0.99), respectively) but the association with social cohesion was weaker or null. No significant associations were observed for smoking intensity among baseline smokers. Baseline NSE was not associated with changes in smoking risk or intensity over time. CONCLUSIONS Results suggest that neighbourhood social context influences whether older adults smoke, but does not promote smoking cessation or reduction over time.
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Affiliation(s)
- Stephanie L Mayne
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Amy H Auchincloss
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Kari A Moore
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Yvonne L Michael
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Loni Philip Tabb
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Sandra E Echeverria
- Department of Community Health and Social Sciences, Graduate School of Public Health and Health Policy, City University of New York, New York, New York, USA
| | - Ana V Diez Roux
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
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Amin V, Lhila A. Decomposing racial differences in adolescent smoking in the U.S. ECONOMICS AND HUMAN BIOLOGY 2016; 22:161-176. [PMID: 27213297 DOI: 10.1016/j.ehb.2016.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 05/04/2016] [Accepted: 05/07/2016] [Indexed: 06/05/2023]
Abstract
Despite declining smoking rates in the U.S., a substantial fraction of adolescents still smoke. In addition, there are notable racial differences in adolescent smoking. We use Add Health data and apply a nonlinear decomposition method to determine the extent to which racial differences in observable characteristics account for (i) the racial smoking gaps in adolescent smoking (ages 12-18) and (ii) racial gaps in the probability of becoming a smoker in young adulthood (ages 18-24), conditional on being a non-smoker in adolescence. The model includes a host of explanatory factors, including individual, family socioeconomics, smoke exposure, school characteristics, and county crime rate. Of the 19 (9) percentage-point gap in white-black (white-Hispanic) smoking in adolescence, these factors together account for 22-28% (39-77%) of the smoking gap; and of the 18 (13) percentage-point gap in white-black (white-Hispanic) smoking up-take in young adulthood, these factors together account for 26-50% (48-100%) of the gap, depending on which set of coefficients are used for the decomposition. The biggest drivers of racial smoking gaps in adolescence are differences in friends' smoking and school peer smoking, while only school peer smoking contributes to the explained portion of racial gaps in smoking up-take in young adulthood.
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Affiliation(s)
- Vikesh Amin
- Department of Economics, Central Michigan University, Michigan, MI 48859, USA.
| | - Aparna Lhila
- Department of Economics, Central Michigan University, Michigan, MI 48859, USA.
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Ma P, Businelle MS, Balis DS, Kendzor DE. The influence of perceived neighborhood disorder on smoking cessation among urban safety net hospital patients. Drug Alcohol Depend 2015; 156:157-161. [PMID: 26386824 DOI: 10.1016/j.drugalcdep.2015.09.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 08/31/2015] [Accepted: 09/07/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Although research has shown that objective neighborhood characteristics are associated with health behaviors including smoking, little is known about the influence of perceived neighborhood characteristics on a smoking cessation attempt. METHODS Participants (N=139) enrolled in a Dallas safety-net hospital smoking cessation program were followed from 1 week pre-quit through 4 weeks post-quit. Logistic regression analyses were conducted to evaluate the impact of perceived neighborhood order and disorder on the likelihood of achieving biochemically verified point prevalence and continuous smoking abstinence 4 weeks following a scheduled quit attempt. Analyses were adjusted for demographic characteristics, cigarettes per day, intervention group, and pharmacological treatment. RESULTS Participants were primarily non-White (72.7%) and female (56.8%) with a mean age of 52.5 (SD=3.7) years. Most reported an annual household income of ≤$25,000 (86.3%). Logistic regression analyses indicated that greater neighborhood physical (p=.048) and social order (p=.039) were associated with a greater likelihood of achieving point prevalence smoking abstinence at 4 weeks post-quit. Greater perceived physical (p=.035) and social disorder (p=.039) and total neighborhood disorder (p=.014), were associated with a reduced likelihood of achieving point prevalence abstinence. Social disorder (p=.040) was associated with a reduced likelihood of achieving continuous abstinence at 4 weeks post-quit, while social order (p=.020) was associated with an increased likelihood of continuous abstinence. CONCLUSIONS Perceptions of neighborhood order and disorder were associated with the likelihood of smoking cessation among socioeconomically disadvantaged smokers making a quit attempt. Findings highlight the need to address perceptions of the neighborhood environment among disadvantaged smokers seeking treatment.
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Affiliation(s)
- Ping Ma
- University of Texas Southwestern Medical Center, Department of Clinical Sciences, Dallas, TX, United States.
| | - Michael S Businelle
- University of Texas School of Public Health, Department of Health Promotion and Behavioral Sciences, Dallas, TX, United States
| | - David S Balis
- University of Texas Southwestern Medical Center, Department of General Internal Medicine, Dallas, TX, United States
| | - Darla E Kendzor
- University of Texas School of Public Health, Department of Health Promotion and Behavioral Sciences, Dallas, TX, United States
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Frohlich KL, Shareck M, Vallée J, Abel T, Agouri R, Cantinotti M, Daniel M, Dassa C, Datta G, Gagné T, Leclerc BS, Kestens Y, O'Loughlin J, Potvin L. Cohort Profile: The Interdisciplinary Study of Inequalities in Smoking (ISIS). Int J Epidemiol 2015; 46:e4. [DOI: 10.1093/ije/dyv036] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Andrews JO, Mueller M, Newman SD, Magwood G, Ahluwalia JS, White K, Tingen MS. The association of individual and neighborhood social cohesion, stressors, and crime on smoking status among African-American women in southeastern US subsidized housing neighborhoods. J Urban Health 2014; 91:1158-74. [PMID: 25316192 PMCID: PMC4242849 DOI: 10.1007/s11524-014-9911-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The purpose of this study was to examine the associations between individual and neighborhood social contextual factors and smoking prevalence among African-American women in subsidized neighborhoods. We randomly sampled 663 adult women in 17 subsidized neighborhoods in two Southeastern US states. The smoking prevalence among participants was 37.6%, with an estimated neighborhood household prevalence ranging from 30 to 68%. Smokers were more likely to be older, have lower incomes, have lower BMI, and live with other smokers. Women with high social cohesion were less likely to smoke, although living in neighborhoods with higher social cohesion was not associated with smoking prevalence. Women with higher social cohesion were more likely to be older and had lived in the neighborhood longer. Women with high stress (related to violence and disorder) and who lived in neighborhoods with higher stress were more likely to smoke. Younger women were more likely to have higher stress than older women. There were no statistically significant associations with objective neighborhood crime data in any model. This is the first study to examine both individual and neighborhood social contextual correlates among African-American women in subsidized neighborhoods. This study extends findings about smoking behaviors and neighborhood social contexts in this high-risk, urban population. Future research is needed to explore age and residential stability differences and perceptions of social cohesion, neighborhood disorder, and perceived violence in subsidized housing. Further research is also warranted on African-American women, subsidized housing, smoking, social context, health disparities' effective strategies to address these individual and contextual factors to better inform future ecological-based multilevel prevention, and cessation intervention strategies.
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Ortega Hinojosa AM, Davies MM, Jarjour S, Burnett RT, Mann JK, Hughes E, Balmes JR, Turner MC, Jerrett M. Developing small-area predictions for smoking and obesity prevalence in the United States for use in Environmental Public Health Tracking. ENVIRONMENTAL RESEARCH 2014; 134:435-52. [PMID: 25261951 DOI: 10.1016/j.envres.2014.07.029] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 07/29/2014] [Accepted: 07/31/2014] [Indexed: 05/16/2023]
Abstract
BACKGROUND Globally and in the United States, smoking and obesity are leading causes of death and disability. Reliable estimates of prevalence for these risk factors are often missing variables in public health surveillance programs. This may limit the capacity of public health surveillance to target interventions or to assess associations between other environmental risk factors (e.g., air pollution) and health because smoking and obesity are often important confounders. OBJECTIVES To generate prevalence estimates of smoking and obesity rates over small areas for the United States (i.e., at the ZIP code and census tract levels). METHODS We predicted smoking and obesity prevalence using a combined approach first using a lasso-based variable selection procedure followed by a two-level random effects regression with a Poisson link clustered on state and county. We used data from the Behavioral Risk Factor Surveillance System (BRFSS) from 1991 to 2010 to estimate the model. We used 10-fold cross-validated mean squared errors and the variance of the residuals to test our model. To downscale the estimates we combined the prediction equations with 1990 and 2000 U.S. Census data for each of the four five-year time periods in this time range at the ZIP code and census tract levels. Several sensitivity analyses were conducted using models that included only basic terms, that accounted for spatial autocorrelation, and used Generalized Linear Models that did not include random effects. RESULTS The two-level random effects model produced improved estimates compared to the fixed effects-only models. Estimates were particularly improved for the two-thirds of the conterminous U.S. where BRFSS data were available to estimate the county level random effects. We downscaled the smoking and obesity rate predictions to derive ZIP code and census tract estimates. CONCLUSIONS To our knowledge these smoking and obesity predictions are the first to be developed for the entire conterminous U.S. for census tracts and ZIP codes. Our estimates could have significant utility for public health surveillance.
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Affiliation(s)
- Alberto M Ortega Hinojosa
- University of California, Berkeley, School of Public Health, Division of Environmental Health Sciences, 50 University Hall MC7360 Mail Drop, Berkeley, CA 94720-7360, United States.
| | - Molly M Davies
- University of California, Berkeley, School of Public Health, Division of Environmental Health Sciences, 50 University Hall MC7360 Mail Drop, Berkeley, CA 94720-7360, United States
| | - Sarah Jarjour
- University of California, Berkeley, School of Public Health, Division of Environmental Health Sciences, 50 University Hall MC7360 Mail Drop, Berkeley, CA 94720-7360, United States
| | - Richard T Burnett
- Health Canada, Population Studies Division, Environmental Health Sciences and Research Bureau, Environmental and Radiation Health Sciences Directorate, Healthy Environment and Consumer Safety Branch, Room 134, Environmental Health Center, 50 Columbine Driveway, Ottawa, Ontario, Canada K1A 0K9
| | - Jennifer K Mann
- University of California, Berkeley, School of Public Health, Division of Environmental Health Sciences, 50 University Hall MC7360 Mail Drop, Berkeley, CA 94720-7360, United States
| | - Edward Hughes
- Edward Hughes Consulting, 350 Queen Elizabeth Dr., #102, Ottawa, Ontario, Canada K1S 3N1
| | - John R Balmes
- University of California, Berkeley, School of Public Health, Division of Environmental Health Sciences, 50 University Hall MC7360 Mail Drop, Berkeley, CA 94720-7360, United States; University of California, San Francisco, School of Medicine, 1001 Potrero Ave, SFGH 30, San Francisco, CA 94143, United States
| | - Michelle C Turner
- McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, 1 Stewart Street, Ottawa, Ontario, Canada K1N 6N5
| | - Michael Jerrett
- University of California, Berkeley, School of Public Health, Division of Environmental Health Sciences, 50 University Hall MC7360 Mail Drop, Berkeley, CA 94720-7360, United States
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Abstract
Research suggests that immigrant enclaves positively influence health behaviors such as tobacco use through supportive social networks and informal social control mechanisms that promote healthy behavioral norms. Yet, the influence of social cohesion and control on tobacco use may depend on smoking-related norms, which can vary by gender. This study examines the influence of neighborhood Latino immigrant enclave status on smoking and cessation among Hispanic men and women. Data from the Los Angeles Family and Neighborhood Survey was combined with census data to assess the relationship between immigrant enclaves, gender, and smoking using multilevel regression. The effect of the Hispanic enclave environment on smoking differed by gender. Living in an enclave had a harmful effect on tobacco use among Hispanic men, marginally increasing the likelihood of smoking and significantly reducing cessation. This effect was independent of neighborhood socioeconomic status, nativity, and other individual demographics. Neighborhood immigrant concentration was not associated with smoking or cessation for Hispanic women. Research, interventions, and policies aimed at reducing smoking among Hispanics may need to be gender responsive to ensure effectiveness as well as health and gender equity.
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Affiliation(s)
- Jennifer Cantrell
- Research & Evaluation Department at the American Legacy Foundation, Washington, DC, USA,
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Auluck A, Walker BB, Hislop G, Lear SA, Schuurman N, Rosin M. Population-based incidence trends of oropharyngeal and oral cavity cancers by sex among the poorest and underprivileged populations. BMC Cancer 2014; 14:316. [PMID: 24886308 PMCID: PMC4022437 DOI: 10.1186/1471-2407-14-316] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 04/22/2014] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Oral cancer is an important health issue, with changing incidence in many countries. Oropharyngeal cancer (OPC, in tonsil and oropharygeal areas) is increasing, while oral cavity cancer (OCC, other sites in the mouth) is decreasing. There is the need to identify high risk groups and communities for further study and intervention. The objective of this study was to determine how the incidence of OPC and OCC varied by neighbourhood socioeconomic status (SES) in British Columbia (BC), including the magnitude of any inequalities and temporal trends. METHODS ICDO-3 codes were used to identify OPC and OCC cases in the BC Cancer Registry from 1981-2010. Cases were categorized by postal codes into SES quintiles (q1-q5) using VANDIX, which is a census-based, multivariate weighted index based on neighbourhood average household income, housing tenure, educational attainment, employment and family structure. Age-standardized incidence rates were determined for OPC and OCC by sex and SES quintiles and temporal trends were then examined. RESULTS Incidence rates are increasing in both men and women for OPC, and decreasing in men and increasing in women for OCC. This change is not linear or proportionate between different SES quintiles, for there is a sharp and dramatic increase in incidence according to the deprivation status of the neighbourhood. The highest incidence rates in men for both OPC and OCC were observed in the most deprived SES quintile (q5), at 1.7 times and 2.2 times higher, respectively, than men in the least deprived quintile (q1). For OPC, the age-adjusted incidence rates significantly increased in all SES quintiles with the highest increase observed in the most deprived quintile (q5). Likewise, the highest incidence rates for both OPC and OCC in women were observed in the most deprived SES quintile (q5), at 2.1 times and 1.8 times higher, respectively, than women in the least deprived quintile (q1). CONCLUSION We report on SES disparities in oral cancer, emphasizing the need for community-based interventions that address access to medical care and the distribution of educational and health promotion resources among the most SES deprived communities in British Columbia.
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Affiliation(s)
- Ajit Auluck
- Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, Canada
- Cancer Control Research Department, BC Cancer Agency, Research Centre, 675 W. 10th Ave, 3rd Floor, Room 119, V5Z1L3 Vancouver, B.C, Canada
| | | | - Greg Hislop
- Cancer Control Research Department, BC Cancer Agency, Research Centre, 675 W. 10th Ave, 3rd Floor, Room 119, V5Z1L3 Vancouver, B.C, Canada
| | - Scott A Lear
- Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
- Division of Cardiology, Providence Health Care, St. Paul’s Hospital, Vancouver, Canada
| | - Nadine Schuurman
- Department of Geography, Simon Fraser University, Burnaby, BC, Canada
| | - Miriam Rosin
- Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, Canada
- Cancer Control Research Department, BC Cancer Agency, Research Centre, 675 W. 10th Ave, 3rd Floor, Room 119, V5Z1L3 Vancouver, B.C, Canada
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14
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Halonen JI, Vahtera J, Kivimäki M, Pentti J, Kawachi I, Subramanian SV. Adverse experiences in childhood, adulthood neighbourhood disadvantage and health behaviours. J Epidemiol Community Health 2014; 68:741-6. [PMID: 24764352 DOI: 10.1136/jech-2013-203441] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Early life adversities may play a role in the associations observed between neighbourhood contextual factors and health behaviours. METHODS We examined whether self-reported adverse experiences in childhood (parental divorce, long-term financial difficulties, serious conflicts, serious/chronic illness or alcohol problem in the family, and frequent fear of a family member) explain the association between adulthood neighbourhood disadvantage and co-occurrence of behavioural risk factors (smoking, moderate/heavy alcohol use, physical inactivity). Study population consisted of 31 271 public sector employees from Finland. The cross-sectional associations were analysed using two-level cumulative logistic regression models. RESULTS Childhood adverse experiences were associated with the sum of risk factors (cumulative OR 1.32 (95% CI 1.25 to 1.40) among those reporting 3-6 vs 0 adversities). Adverse experiences did not attenuate the association between neighbourhood disadvantage and risk factors; this cumulative OR was 1.52 (95% CI 1.43 to 1.62) in the highest versus lowest quartile of neighbourhood disadvantage when not including adversities, and 1.50 (95% CI 1.40 to 1.60) when adjusted for childhood adversities. In adversity-stratified analyses those reporting 3-6 adversities had 1.60-fold (95% CI 1.42 to 1.80) likelihood of risk factors if living in the neighbourhood of the highest disadvantage, while in those with fewer adversities this likelihood was 1.09-1.34-fold (95% CI 0.98 to 1.53) (p interaction 0.07). CONCLUSIONS Childhood adverse experiences and adulthood neighbourhood disadvantage were associated with behavioural risk factors. Childhood experiences did not explain associations between neighbourhood disadvantage and the risk factors. However, those with more adverse experiences may be susceptible for the socioeconomic conditions of neighbourhoods.
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Affiliation(s)
| | - Jussi Vahtera
- Finnish Institute of Occupational Health, Helsinki, Finland Department of Public Health, University of Turku, and Turku University Hospital, Turku, Finland
| | - Mika Kivimäki
- Finnish Institute of Occupational Health, Helsinki, Finland Department of Epidemiology and Public Health, University College London Medical School, London, UK
| | - Jaana Pentti
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, USA
| | - S V Subramanian
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, USA
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Shaw RJ, Pickett KE. The health benefits of Hispanic communities for non-Hispanic mothers and infants: another Hispanic paradox. Am J Public Health 2013; 103:1052-7. [PMID: 23597369 DOI: 10.2105/ajph.2012.300985] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES In the United States, Hispanic mothers have birth outcomes comparable to those of White mothers despite lower socioeconomic status. The contextual effects of Hispanic neighborhoods may partially explain this "Hispanic paradox." We investigated whether this benefit extends to other ethnic groups. METHODS We used multilevel logistic regression to investigate whether the county-level percentage of Hispanic residents is associated with infant mortality, low birth weight, preterm delivery, and smoking during pregnancy in 581,151 Black and 2,274,247 White non-Hispanic mothers from the US Linked Birth and Infant Death Data Set, 2000. RESULTS For White and Black mothers, relative to living in counties with 0.00%-0.99% of Hispanic residents, living in counties with 50.00% or more of Hispanic residents was associated with an 80.00% reduction in the odds of smoking, an infant mortality reduction of approximately one third, and a modest reduction in the risks of preterm delivery and low birth weight. CONCLUSIONS The health benefits of living in Hispanic areas appear to bridge ethnic divides, resulting in better birth outcomes even for those of non-Hispanic origin.
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Affiliation(s)
- Richard J Shaw
- Department of Health Sciences, University of York, York, UK
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Halonen JI, Kivimäki M, Pentti J, Kawachi I, Virtanen M, Martikainen P, Subramanian SV, Vahtera J. Quantifying neighbourhood socioeconomic effects in clustering of behaviour-related risk factors: a multilevel analysis. PLoS One 2012; 7:e32937. [PMID: 22427912 PMCID: PMC3299718 DOI: 10.1371/journal.pone.0032937] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2011] [Accepted: 02/01/2012] [Indexed: 11/30/2022] Open
Abstract
Background The extent to which neighbourhood characteristics explain accumulation of health behaviours is poorly understood. We examined whether neighbourhood disadvantage was associated with co-occurrence of behaviour-related risk factors, and how much of the neighbourhood differences in the co-occurrence can be explained by individual and neighbourhood level covariates. Methods The study population consisted of 60 694 Finnish Public Sector Study participants in 2004 and 2008. Neighbourhood disadvantage was determined using small-area level information on household income, education attainment, and unemployment rate, and linked with individual data using Global Positioning System-coordinates. Associations between neighbourhood disadvantage and co-occurrence of three behaviour-related risk factors (smoking, heavy alcohol use, and physical inactivity), and the extent to which individual and neighbourhood level covariates explain neighbourhood differences in co-occurrence of risk factors were determined with multilevel cumulative logistic regression. Results After adjusting for age, sex, marital status, and population density we found a dose-response relationship between neighbourhood disadvantage and co-occurrence of risk factors within each level of individual socioeconomic status. The cumulative odds ratios for the sum of health risks comparing the most to the least disadvantaged neighbourhoods ranged between 1.13 (95% confidence interval (CI): 1.03–1.24) and 1.75 (95% CI, 1.54–1.98). Individual socioeconomic characteristics explained 35%, and neighbourhood disadvantage and population density 17% of the neighbourhood differences in the co-occurrence of risk factors. Conclusions Co-occurrence of poor health behaviours associated with neighbourhood disadvantage over and above individual's own socioeconomic status. Neighbourhood differences cannot be captured using individual socioeconomic factors alone, but neighbourhood level characteristics should also be considered.
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Affiliation(s)
- Jaana I Halonen
- Finnish Institute of Occupational Health, Helsinki, Finland.
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Acquavita SP, Deforge BR, Burry CL, Boyd SJ. Individual and community predictors of maternal smoking in the city of Baltimore: what can be learned from a predominantly minority case controlled study? SOCIAL WORK IN HEALTH CARE 2012; 51:197-212. [PMID: 22443401 DOI: 10.1080/00981389.2011.617665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This case control study of 1,000 birth certificates examined what individual and community factors predicted maternal smoking in Baltimore, Maryland. Conditional multinomial logistic regression results indicated women who were White were more likely to start smoking at a young age, but as they got older, they were less likely to smoke. Minority women were more likely to start smoking at a later age. Also, White women were more likely to smoke as the rate of poverty increased, while for minority women, smoking was unrelated to whether they lived in higher or lower poverty areas. Medical assistance status, community education level, and crime rate were not found to be related to smoking status.
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Affiliation(s)
- Shauna P Acquavita
- School of Social Work, University of Cincinnati, Cincinnati, Ohio 45221-0108, USA.
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18
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Shareck M, Ellaway A. Neighbourhood crime and smoking: the role of objective and perceived crime measures. BMC Public Health 2011; 11:930. [PMID: 22168151 PMCID: PMC3267705 DOI: 10.1186/1471-2458-11-930] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Accepted: 12/14/2011] [Indexed: 11/14/2022] Open
Abstract
Background Smoking is a major public health problem worldwide. Research has shown that neighbourhood of residence is independently associated with the likelihood of individuals' smoking. However, a fine comprehension of which neighbourhood characteristics are involved and how remains limited. In this study we examine the relative contribution of objective (police-recorded) and subjective (resident-perceived) measures of neighbourhood crime on residents' smoking behaviours. Methods Data from 2,418 men and women participating in the 2007/8 sweep of the West of Scotland Twenty-07 Study were analyzed. Smoking status and perceived crime were collected through face-to-face interviews with participants. Police-recorded crime rates were obtained from the Scottish Neighbourhood Statistics website at the datazone scale. Adjusted odds ratios and 95% confidence intervals were estimated for the likelihood of current smoking using logistic regression models. Adjusted mean daily amount smoked and F statistics were calculated using general linear models. Analyses were conducted for all respondents and stratified by sex and age cohort. Results Compared to individuals living in low crime areas, those residing in an area characterized by high police-recorded crime rates or those perceiving high crime in their neighbourhood were more likely to be current smokers, after controlling for individual characteristics. The association with smoking was somewhat stronger for police-recorded crime than for perceived crime. Associations were only slightly attenuated when adjusting for either the objective or subjective crime measures, suggesting that these indicators may exert an independent influence on the risk of smoking. Stronger effects were observed for women compared to men. Police-recorded crime rates were more strongly related to smoking status among older respondents than among the younger cohort, whereas the strongest effect for perceived crime was observed among younger participants. Conclusions Our findings highlight the relevance of paying attention to both objective and perceived neighbourhood crime measures when aiming to prevent smoking.
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Affiliation(s)
- Martine Shareck
- Département de médecine sociale et préventive, Université de Montréal, Canada
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de Castro AB, Gee GC, Takeuchi DT. Examining alternative measures of social disadvantage among Asian Americans: the relevance of economic opportunity, subjective social status, and financial strain for health. J Immigr Minor Health 2010; 12:659-71. [PMID: 19434494 PMCID: PMC2891922 DOI: 10.1007/s10903-009-9258-3] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Socioeconomic position is often operationalized as education, occupation, and income. However, these measures may not fully capture the process of socioeconomic disadvantage that may be related to morbidity. Economic opportunity, subjective social status, and financial strain may also place individuals at risk for poor health outcomes. Data come from the Asian subsample of the 2003 National Latino and Asian American Study (n = 2095). Regression models were used to examine the associations between economic opportunity, subjective social status, and financial strain and the outcomes of self-rated health, body mass index, and smoking status. Education, occupation, and income were also investigated as correlates of these outcomes. Low correlations were observed between all measures of socioeconomic status. Economic opportunity was robustly negatively associated with poor self-rated health, higher body mass index, and smoking, followed by financial strain, then subjective social status. Findings show that markers of socioeconomic position beyond education, occupation, and income are related to morbidity among Asian Americans. This suggests that potential contributions of social disadvantage to poor health may be understated if only conventional measures are considered among immigrant and minority populations.
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Affiliation(s)
- A B de Castro
- School of Nursing, University of Washington, Seattle, WA 98195-7263, USA.
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20
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Sapag JC, Poblete FC, Eicher C, Aracena M, Caneo C, Vera G, Martínez M, Hoyos R, Villarroel L, Bradford E. Tobacco smoking in urban neighborhoods: exploring social capital as a protective factor in Santiago, Chile. Nicotine Tob Res 2010; 12:927-36. [PMID: 20693233 DOI: 10.1093/ntr/ntq117] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Research examining the relationship between social capital and health in Latin America has been limited. The aim of this study is to evaluate the association between social capital and tobacco use in four low-income neighborhoods in Santiago, Chile. METHODS A multistage probability sample was used to select households in 4 of the 10 poorest neighborhoods in the district of Puente Alto, in Santiago, Chile. A cross-sectional survey of 781 participants (81.2% response rate for households) included sociodemographic variables, questions pertaining to neighborhood social capital, and questions pertaining to tobacco. Main analyses were carried out at the individual level by performing a multiple logistic regression of individual tobacco use on individual perceptions of community social capital. RESULTS The prevalence of smoking was 43.9% of the surveyed population. A five-factor structure for social capital was identified, including "perceived trust in neighbors," "perceived trust in organizations," "reciprocity within the neighborhood," "neighborhood integration," and "social participation." An inverse relationship between trust in neighbors and tobacco smoking was statistically significantly with an adjusted odds ratio of 0.95 (95% CI: 0.91-0.99). Trust in neighbors was also significantly inversely associated with the number of cigarettes smoked. DISCUSSION Tobacco control remains a significant challenge in global health, requiring innovative strategies that address changing social contexts as well as the changing epidemiological profile of developing regions.
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Affiliation(s)
- Jaime C Sapag
- Department of Family Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
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21
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Unemployment and self-rated health: Neighborhood influence. Soc Sci Med 2010; 71:815-23. [DOI: 10.1016/j.socscimed.2010.05.021] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2009] [Revised: 03/10/2010] [Accepted: 05/20/2010] [Indexed: 11/19/2022]
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Virtanen P, Vahtera J, Nygård CH. Locality differences of sickness absence in the context of health and social conditions of the inhabitants. Scand J Public Health 2010; 38:309-16. [PMID: 20435618 DOI: 10.1177/1403494809364561] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIM Earlier research has suggested that local communities develop different sickness absence practices, expressed in variation in the absence figures. This study aimed to test the hypothesis that the work places residing in a locality share similar sickness absence practice. METHODS Register data from the major public sector employers and from private industrial employers were used to compare the absence in two localities. RESULTS There were significant differences by locality in both branches and both in short and in long sickness absences. Population-level statistics showed a corresponding locality difference in recipients of sickness allowance benefits and in primary healthcare visits, but not in indicators of mortality and morbidity. Social problems were more common in the locality with high rate of absence. CONCLUSION Area-specific practice, or habitus, as an independent determinant of sickness absence is discussed and an explicitly sociological context is recommended for debates about ''best sickness absence practices'' and corresponding intervention measures.
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Affiliation(s)
- Pekka Virtanen
- Tampere School of Public Health, University of Tampere, Tampere, Finland.
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Social Capital, Women's Autonomy and Smoking Among Married Women in Low-Income Urban Neighborhoods of Beirut, Lebanon. Womens Health Issues 2010; 20:156-67. [DOI: 10.1016/j.whi.2009.12.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2009] [Revised: 10/09/2009] [Accepted: 12/27/2009] [Indexed: 11/18/2022]
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Kandula NR, Wen M, Jacobs EA, Lauderdale DS. Association between neighborhood context and smoking prevalence among Asian Americans. Am J Public Health 2009; 99:885-92. [PMID: 19299683 DOI: 10.2105/ajph.2007.131854] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To study neighborhood-level determinants of smoking among Asian Americans, we examined 3 neighborhood factors (ethnic enclave, socioeconomics, and perceived social cohesion) and smoking prevalence in a population-based sample. METHODS We linked data from the 2003 California Health Interview Survey to tract-level data from the 2000 Census. We used multivariate logistic regression models to estimate the associations between smoking and neighborhood-level factors, independent of individual factors. RESULTS Twenty-two percent of 1693 Asian men and 6% of 2174 Asian women reported current smoking. Women living in an Asian enclave were less likely to smoke (adjusted odds ratio [AOR] = 0.27; 95% confidence interval [CI] = 0.08, 0.88). Among men, higher levels of perceived neighborhood social cohesion were associated with lower odds of smoking (AOR = 0.74; 95% CI = 0.61, 0.91). CONCLUSIONS The association between contextual factors and smoking differed for men and women. For women, living in an Asian enclave may represent cultural behavioral norms. For men, neighborhood trust and cohesiveness may buffer stress. Smoking prevention and cessation interventions among Asian Americans may be more effective if they address contextual factors.
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Affiliation(s)
- Namratha R Kandula
- Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, 750 North Lakeshore Dr, 10th floor, Chicago, IL 60611, USA.
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Tarlov E, Zenk SN, Campbell RT, Warnecke RB, Block R. Characteristics of mammography facility locations and stage of breast cancer at diagnosis in Chicago. J Urban Health 2009; 86:196-213. [PMID: 18972211 PMCID: PMC2648885 DOI: 10.1007/s11524-008-9320-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2008] [Accepted: 08/28/2008] [Indexed: 10/21/2022]
Abstract
In the United States, despite substantial investment in public health initiatives to promote early detection of breast cancer through screening mammography, the proportion of female breast cancers that have advanced beyond the localized stage by the time of diagnosis remains high. Our objective in this exploratory study was to investigate whether stage of breast cancer at diagnosis among Chicago residents is associated with characteristics of the neighborhoods in which proximate mammography facilities are located. Those characteristics may influence likelihood of utilizing the service routinely and partly explain differences in stage at diagnosis. We used a retrospective cohort design and combined 3 years of data from the Illinois State Cancer Registry (ISCR) with information on locations of mammography facilities, public transportation service, crime, and area demographic and economic characteristics. Using a Geographic Information System (GIS), we identified the five facilities located nearest to each case's residence. Estimates of the association between characteristics of mammography facility locations and breast cancer stage at diagnosis were obtained using the partial proportional odds regression model. We found that the number of homicides in areas in which the nearest mammography facilities were located was associated with increased odds of later stage diagnosis. This effect was independent of age, race, and residential area education and income. We found no effect on stage of distance, public transportation service, or measures of neighborhood social similarity. The "spatial dynamics" of health may involve geographies beyond the immediate neighborhood. The results of our study suggest that areas in which the nearest mammography facilities are located may be one such geography. We hope that this study will spark research interest in the impact of health service locations on utilization.
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Affiliation(s)
- Elizabeth Tarlov
- VA Information Resource Center, Edward Hines, Jr. VA Hospital, Hines, IL, USA.
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Barnett R, Pearce J, Moon G. Community inequality and smoking cessation in New Zealand, 1981–2006. Soc Sci Med 2009; 68:876-84. [DOI: 10.1016/j.socscimed.2008.12.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2007] [Indexed: 10/21/2022]
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Smoking in context - a multilevel approach to smoking among females in Helsinki. BMC Public Health 2008; 8:134. [PMID: 18435839 PMCID: PMC2377262 DOI: 10.1186/1471-2458-8-134] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2007] [Accepted: 04/24/2008] [Indexed: 11/25/2022] Open
Abstract
Background Smoking is associated with disadvantage. As people with lower social status reside in less privileged areas, the extent of contextual influences for smoking remains unclear. The aims were to examine the spatial patterning of daily smoking within the city of Helsinki, to analyse whether contextual variation can be observed and which spatial factors associate with current daily smoking in the employed female population. Methods Data from a cross-sectional questionnaire were collected for municipal employees of Helsinki (aged 40–60 years). The response rate was 69%. As almost 4/5 of the employees are females, the analyses were restricted to women (n = 5028). Measures included smoking status, individual level socio-demographic characteristics (age, occupational social class, education, family type) and statistical data describing areas in terms of social structure (unemployment rate, proportion of manual workers) and social cohesion (proportions of single parents and single households). Logistic multilevel analysis was used to analyse data. Results After adjusting for the individual-level composition, smoking was significantly more prevalent according to all social structural and social cohesion indicators apart from the proportion of manual workers. For example, high unemployment in the area of domicile increased the risk of smoking by almost a half. The largest observed area difference in smoking – 8 percentage points – was found according to the proportion of single households. Conclusion The large variation in smoking rates between areas appears mainly to result from variation in the characteristics of residents within areas. Yet, living in an area with a high level of unemployment appears to be an additional risk for smoking that cannot be fully accounted for by individual level characteristics even in a cohort of female municipal employees.
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Stephens C. Social capital in its place: Using social theory to understand social capital and inequalities in health. Soc Sci Med 2008; 66:1174-84. [DOI: 10.1016/j.socscimed.2007.11.026] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2006] [Indexed: 11/26/2022]
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