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Timmermans EJ, Leeuwis AE, Bots ML, van Alphen JL, Biessels GJ, Brunner-La Rocca HP, Kappelle LJ, van Rossum AC, van Osch MJP, Vaartjes I. Neighbourhood walkability in relation to cognitive functioning in patients with disorders along the heart-brain axis. Health Place 2023; 79:102956. [PMID: 36525834 DOI: 10.1016/j.healthplace.2022.102956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/01/2022] [Accepted: 12/05/2022] [Indexed: 12/15/2022]
Abstract
This study examined associations of neighbourhood walkability with cognitive functioning (i.e., global cognition, memory, language, attention-psychomotor speed, and executive functioning) in participants without or with either heart failure, carotid occlusive disease, or vascular cognitive impairment. Neighbourhood walkability at baseline was positively associated with global cognition and attention-psychomotor speed. These associations were stronger in patients with vascular cognitive impairment. Individuals who live in residential areas with higher walkability levels were less likely to have impairments in language and executive functioning at two-year follow-up. These findings highlight the importance of the built environment for cognitive functioning in healthy and vulnerable groups.
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Affiliation(s)
- Erik J Timmermans
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
| | - Anna E Leeuwis
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Juliette L van Alphen
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands
| | - Geert Jan Biessels
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | - L Jaap Kappelle
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Albert C van Rossum
- Department of Cardiology, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands
| | - Matthias J P van Osch
- C.J. Gorter MRI Center, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Ilonca Vaartjes
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
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Alkouri O, Khader Y, Al-Bashaireh AM. Prevalence of Cigarettes and Waterpipe Smoking among Jordanians, Refugees, and Migrants in Jordan and Its Associated Factors: A Secondary Data Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:82. [PMID: 36612400 PMCID: PMC9819960 DOI: 10.3390/ijerph20010082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/06/2022] [Accepted: 12/09/2022] [Indexed: 06/15/2023]
Abstract
Smoking is a major public health threat resulting in increased morbidity and mortality. This study aimed to determine the prevalence of current smoking among different adult populations in Jordan, including Jordanians, refugees, and migrants and determine the factors associated with smoking. A cross-sectional survey was conducted during the period of June-September 2021 among Jordanians, Syrian refugees (both urban and camp refugees), and migrants living in four governorates in Jordan, including Amman, Zarqa, Mafraq, and Irbid. The selection of the four governorates was based on criteria related to the presence of Syrian refugees in host communities. The highest prevalence of cigarette smoking was among urban Jordanians (51.1%), followed by non-camp refugees (46.7%), while the highest prevalence for waterpipe (43.2%) and dual smoking (28.7%) was among non-camp refugees. Being male, aged 25-45 years old, unemployed, and having less than a high school education, as well as being urban Jordanians, were all associated with higher odds of cigarette smoking. Being male, unemployed, and urban Jordanians or non-camp refugees were variables associated with higher odds of waterpipe smoking. The study findings indicate that the identification of smoking prevalence in Jordan and its associated factors, including gender, educational level, employment status, regional area, migration, and exposure to traumas, should be considered by healthcare providers to formulate smoking cessation programs tailored to their needs and ultimately reduce smoking prevalence.
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Affiliation(s)
- Osama Alkouri
- Faculty of Nursing, Yarmouk University, Irbid 2116, Jordan
| | - Yousef Khader
- Department of Public Health, Community Medicine, Jordan University of Science and Technology, Irbid 21163, Jordan
| | - Ahmad M. Al-Bashaireh
- Faculty of Health Science, Higher Colleges of Technology, Fujairah 23036, United Arab Emirates
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Chen Q, Ma X, Geng Y, Liao J, Ma L. Association between smoking and hypertension under different PM 2.5 and green space exposure: A nationwide cross-sectional study. Front Public Health 2022; 10:1026648. [PMID: 36466446 PMCID: PMC9712966 DOI: 10.3389/fpubh.2022.1026648] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 10/24/2022] [Indexed: 11/19/2022] Open
Abstract
Background Smoking has been widely reported to have a significant relationship with hypertension, but the past description of this relationship has not been uniform. In addition, there has been a lack of research to discuss the impact of environmental exposure on the relationship between smoking and hypertension. Therefore, this study estimates the association between smoking and hypertension in middle aged and elderly people in China under different PM2.5 (fine particulate matter) concentrations and the green space exposure conditions. Methods Individual sample data from the China Health and Retirement Longitudinal Study in 2018 and the long-term average exposure concentration of fine particles and green space exposure for all participants were used with a multilevel binary logistic mixed effects model. Adjustments were made for sociodemographic characteristics and other health behaviors including drinking, physical activity, and social activity. The normalized difference vegetation index (NDVI) and PM2.5 concentration stratification were assigned with the median of the population exposure concentration as the dividing line, and the dual environmental factor stratification was assigned in combination with the two types of environmental exposure. The analysis was also stratified using age groups. Results A total of 10,600 participants over the age of 45 were included in the study. The effects of smoking on hypertension were diverse under different environmental exposure conditions. There was a significant relationship between smoking behavior and hypertension in the Low-NDVI group, and the effect value of this relationship was significantly different from that in the High-NDVI group. Furthermore, for respondents exposed to low green spaces and high PM2.5 environments at the same time (Low-NDVI/High-PM2.5 group), their smoking behavior may lead to an increase in the risk of hypertension. In addition, the risk of hypertension caused by smoking in the middle-aged (45-64) was significant under low green space exposure, but the effect difference between the different age groups was not significant. Conclusions The relationship between smoking and hypertension was different under different environmental exposure conditions. Exposure to low green spaces may strengthen the association between smoking and hypertension risk. When participants were exposed to both low green spaces and high PM2.5 concentrations, the risk of hypertension caused by smoking was significantly higher than that of those who were exposed to high green spaces and low PM2.5 concentrations.
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Affiliation(s)
- Qihao Chen
- Department of Biostatistics, School of Public Health, Wuhan University, Wuhan, China
| | - Xuxi Ma
- Department of Global Health, School of Public Health, Wuhan University, Wuhan, China
| | - Yan Geng
- Department of Global Health, School of Public Health, Wuhan University, Wuhan, China
| | - Jingling Liao
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China
| | - Lu Ma
- Department of Biostatistics, School of Public Health, Wuhan University, Wuhan, China,*Correspondence: Lu Ma
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Zelenina A, Shalnova S, Maksimov S, Drapkina O. Classification of Deprivation Indices That Applied to Detect Health Inequality: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10063. [PMID: 36011694 PMCID: PMC9408665 DOI: 10.3390/ijerph191610063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Many studies around the world are undertaken to establish the association between deprivation and public health indicators. Both separate indicators (e.g., income, education, occupation, public security and social support) and complex models (indices) include several indicators. Deprivation indices are actively used in public health since the mid 1980s. There is currently no clear classification of indices. METHODS In the current review, data related to deprivation indices are combined and analyzed in order to create a taxonomy of indices based on the results obtained. The search was carried out using two bibliographic databases. After conducting a full-text review of the articles and searching and adding relevant articles from the bibliography, and articles that were already known to the authors, sixty studies describing the use of sixty deprivation indices in seventeen countries were included in the narrative synthesis, resulting in development of a taxonomy of indices. When creating the taxonomy, an integrative approach was used that allows integrating new classes and sub-classes in the event that new information appears. RESULTS In the review, 68% (41/60) of indices were classified as socio-economic, 7% (4/60) of indices as material deprivation, 5% (3/60) of indices as environmental deprivation and 20% (12/60) as multidimensional indices. CONCLUSIONS The data stimulates the use of a competent approach, and will help researchers and public health specialist in resolving conflicts or inconsistencies that arise during the construction and use of indices.
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van Nieuwenhuizen BP, Sekercan A, Tan HL, Blom MT, Lok A, van den Born BJH, Kunst AE, van Valkengoed IGM. Is the Association Between Education and Sympathovagal Balance Mediated by Chronic Stressors? Int J Behav Med 2021; 29:426-437. [PMID: 34580830 PMCID: PMC9338002 DOI: 10.1007/s12529-021-10027-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2021] [Indexed: 11/25/2022]
Abstract
Background This study investigated whether raised chronic stress in low education groups contributes to education differences in cardiovascular disease by altering sympathovagal balance. Methods This study included cross-sectional data of 10,202 participants from the multi-ethnic, population-based HELIUS-study. Sympathovagal balance was measured by baroreflex sensitivity (BRS), the standard deviation of the inter-beat interval (SDNN) and the root mean square of successive differences between normal heartbeats (RMSSD). The associations between chronic stressors (work, home, psychiatric, financial, negative life events, lack of job control and perceived discrimination) in a variety of domains and BRS, SDNN and RMSSD were assessed using linear regression, adjusted for age, ethnicity, waist-to-hip ratio and pack-years smoked. Mediation analysis was used to assess the contribution of chronic stress to the association between education and sympathovagal balance. Results Modest but significant associations were observed between financial stress and BRS and SDNN in women, but not in RMSSD nor for any outcome measure in men. Women with the highest category of financial stress had 0.55% lower BRS (ms/mmHg; β = -0.055; CI = -0.098, -0.011) and 0.61% lower SDNN (ms; β = -0.061; CI = -0.099, -0.024) than those in the lowest category. Financial stress in women contributed 7.1% to the association between education and BRS, and 13.8% to the association between education and SDNN. Conclusion No evidence was found for the hypothesized pathway in which sympathovagal balance is altered by chronic stress, except for a small contribution of financial stress in women. Supplementary Information The online version contains supplementary material available at 10.1007/s12529-021-10027-9.
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Affiliation(s)
| | - Aydin Sekercan
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Department of Surgery, OLVG, Amsterdam, The Netherlands
| | - Hanno L Tan
- Department of Clinical and Experimental Cardiology Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Netherlands Heart Institute, Utrecht, The Netherlands
| | - Marieke T Blom
- Department of Clinical and Experimental Cardiology Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Anja Lok
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Bert-Jan H van den Born
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Anton E Kunst
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Singh A, Arora M, Bentley R, Spittal MJ, Do LG, Grills N, English DR. Geographic variation in tobacco use in India: a population-based multilevel cross-sectional study. BMJ Open 2020; 10:e033178. [PMID: 32565446 PMCID: PMC7307551 DOI: 10.1136/bmjopen-2019-033178] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE This study aims to quantify the extent to which people's use of tobacco products varies by local areas (city ward and village) across India and the variation in this clustering by tobacco products. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS Data on 73 954 adults across 2547 city wards and villages were available for analysis from 30 states and 2 union territories in India. PRIMARY AND SECONDARY OUTCOME MEASURES We included as primary outcomes self-reported any tobacco use, current cigarette smoking, current bidi smoking, current smokeless tobacco use and a derived variable for dual use describing respondents who engaged in both smoking and smokeless tobacco use. RESULTS The median risk of an individual using tobacco was 1.64 times greater if a person hypothetically moved from an area of low to high risk of tobacco use (95% CI: 1.60 to 1.69). Area-level partitioning of variation differed by tobacco product used. Median ORs ranged from 1.77 for smokeless tobacco use to 2.53 for dual use. CONCLUSIONS Tobacco use is highly clustered geographically in India. To be effective in India, policy interventions should be directed to influence specific local contextual factors on adult tobacco use. Where people live in India influences their use of tobacco, and this association may be greater than has been observed in other settings. Tailoring tobacco control policies for local areas in India may, therefore, provide substantial public health benefits.
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Affiliation(s)
- Ankur Singh
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Monika Arora
- Health Promotion Division, Public Health Foundation of India, Gurugram, Haryana, India
| | - Rebecca Bentley
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Matthew J Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Loc G Do
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Nathan Grills
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Australia India Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Dallas R English
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Cancer Council Victoria, Melbourne, Victoria, Australia
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Timmermans EJ, Veldhuizen EM, Mäki-Opas T, Snijder MB, Lakerveld J, Kunst AE. Associations of neighbourhood safety with leisure-time walking and cycling in population subgroups: The HELIUS study. Spat Spatiotemporal Epidemiol 2019; 31:100300. [PMID: 31677765 DOI: 10.1016/j.sste.2019.100300] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 06/21/2019] [Accepted: 08/06/2019] [Indexed: 10/26/2022]
Abstract
To create neighbourhood environments that encourage physical activity, it is important to know which neighbourhood characteristics are most influential. We examined the association of neighbourhood safety with leisure-time walking and cycling in the population at large, as well as in some subgroups in terms of sex, age, ethnicity and socio-economic position. We used data of 19,914 participants (18-70 years) from a study in Amsterdam, the Netherlands. Leisure-time walking and cycling in minutes/week were assessed with standard questionnaire. Geographic Information System techniques were used to examine neighbourhood safety (range = 1-10). Multilevel linear regression analyses showed positive associations between safety and walking (B = 7.9, 95% CI = -6.2-21.9) and cycling (B = 14.8, 95% CI = 2.5-27.1), but only the association with cycling was statistically significant. Higher safety levels were significantly associated with more cycling in women and individuals of Turkish and Moroccan origin. Stronger evidence is needed to inform policies to stimulate walking and cycling by improving neighbourhood safety.
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Affiliation(s)
- Erik J Timmermans
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Department of Epidemiology and Biostatistics, Amsterdam UMC, VU University medical center, Amsterdam Public Health research institute, Amsterdam, the Netherlands.
| | - Eleonore M Veldhuizen
- Department of Geography, Planning & International Development Studies, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Tomi Mäki-Opas
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; University of Eastern Finland (UEF), Department of Social Sciences, Kuopio, Finland
| | - Marieke B Snijder
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Jeroen Lakerveld
- Department of Epidemiology and Biostatistics, Amsterdam UMC, VU University medical center, Amsterdam Public Health research institute, Amsterdam, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; Global Geo Health Data Center, Utrecht University, Utrecht, the Netherlands
| | - Anton E Kunst
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
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Smoking in the temple of the holy spirit? Geographic location matters. Health Place 2019; 58:102139. [PMID: 31154161 DOI: 10.1016/j.healthplace.2019.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 05/03/2019] [Accepted: 05/20/2019] [Indexed: 11/23/2022]
Abstract
Smoking at a young age poses significant risks to one's health and is linked with a wide range of deviant conducts. While prior research has looked into the ways in which individual religious characteristics may influence smoking, much less is known about how the overall religious context in which individuals are embedded may affect smoking during adolescence and early adulthood. In this study, multilevel regression analyses were used on nationally representative panel data to explore this understudied area. The results suggest that when a county has higher population share of conservative Protestants, youth living there are more likely to smoke. A similar robust relationship is also found for county-level mainline Protestant population share and smoking. By simultaneously examining both the individual and contextual religious effects on smoking, this study contributes to a renewed, more comprehensive understanding of an important public health and youth deviance issue.
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Chen Y, Chen H, Li Z. Effect of characteristics and life in cities in China on residents' smoking behaviour. J Int Med Res 2018; 46:4226-4234. [PMID: 30111202 PMCID: PMC6166327 DOI: 10.1177/0300060518791702] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Objective This study aimed to identify the relationship between city-level economic
development and smoking behaviour. Methods Using multilevel mixed-effects logistic methods, we examined the relationship
between smoking/passive smoking and respondents’ lifestyles in the city. Results We found that respondents living in cities with higher per capita gross
domestic product (GDP) were less likely to smoke than those living in cities
with lower per capita GDP (odds ratio [OR] = 0.977, 95% confidence interval
[CI]: 0.958–0.997). Further, respondents with higher levels of life
satisfaction and subjective social status were less likely to smoke than
those with lower levels of these variables (OR = 0.942, 95% CI: 0.893–0.994;
OR = 0.955, 95% CI: 0.928–0.983, respectively). In terms of passive smoking,
respondents with higher levels of subjective social status in their cities
were less likely to smoke than those with lower levels (OR = 0.972, 95% CI:
0.948–0.996). Smoking and exposure to second-hand smoke were more common
among those with lower socioeconomic status. Conclusions Smoking is one of the most serious public health hazards in China. People’s
smoking behaviour is significantly related to characteristics of their
cities and their socioeconomic status. Improved smoking-prevention measures
are urgently required in China.
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Affiliation(s)
- Yang Chen
- 1 School of Architecture, Southeast University, Xuanwu District, Nanjing, China
| | - Hongsheng Chen
- 1 School of Architecture, Southeast University, Xuanwu District, Nanjing, China
| | - Zhigang Li
- 2 School of Urban Design, Wuhan University, Wuhan, China
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