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Phu T, Doom JR. Associations between cumulative risk, childhood sleep duration, and body mass index across childhood. BMC Pediatr 2022; 22:529. [PMID: 36068546 PMCID: PMC9447344 DOI: 10.1186/s12887-022-03587-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 08/23/2022] [Indexed: 12/04/2022] Open
Abstract
Background Although associations between cumulative risk, sleep, and overweight/obesity have been demonstrated, few studies have examined relationships between these constructs longitudinally across childhood. This study investigated how cumulative risk and sleep duration are related to current and later child overweight/obesity in families across the United States sampled for high sociodemographic risk. Methods We conducted secondary analyses on 3690 families with recorded child height and weight within the Fragile Families and Child Well-Being Study. A cumulative risk composite (using nine variables indicating household/environmental, family, and sociodemographic risk) was calculated for each participant from ages 3-9 years. Path analyses were used to investigate associations between cumulative risk, parent-reported child sleep duration, and z-scored child body mass index (BMI) percentile at ages 3 through 9. Results Higher cumulative risk experienced at age 5 was associated with shorter sleep duration at year 9, b = − 0.35, p = .01, 95% CI [− 0.57, − 0.11]. At 5 years, longer sleep duration was associated with lower BMI, b = − 0.03, p = .03, 95% CI [− 0.06, − 0.01]. Higher cumulative risk at 9 years, b = − 0.34, p = .02, 95% CI [− 0.57, − 0.10], was concurrently associated with shorter sleep duration. Findings additionally differed by child sex, such that only male children showed an association between sleep duration and BMI. Conclusions Results partially supported hypothesized associations between child sleep duration, cumulative risk, and BMI emerging across childhood within a large, primarily low socioeconomic status sample. Findings suggest that reducing cumulative risk for families experiencing low income may support longer child sleep duration. Additionally, child sleep duration and BMI are concurrently related in early childhood for male children. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03587-6.
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Affiliation(s)
- Tiffany Phu
- Department of Psychology, University of Denver, 2155 South Race St, Denver, CO, 80210, USA.
| | - Jenalee R Doom
- Department of Psychology, University of Denver, 2155 South Race St, Denver, CO, 80210, USA
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Millán-Jiménez A, Herrera-Limones R, López-Escamilla Á, López-Rubio E, Torres-García M. Confinement, Comfort and Health: Analysis of the Real Influence of Lockdown on University Students during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5572. [PMID: 34071078 PMCID: PMC8197072 DOI: 10.3390/ijerph18115572] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 05/20/2021] [Indexed: 11/17/2022]
Abstract
The COVID-19 pandemic forced the population worldwide into lockdown. The purpose of this study was to assess the impact of this measure on the health and comfort of university students and the role that the characteristics of the home may have played. It is essential to differentiate between the terms comfort and health both from the medical and architectural perspectives, as there are differences between the two concepts that are, nonetheless, shared by both disciplines. An online survey was fulfilled by 188 medicine and architecture undergraduate students at the University of Seville, Spain. In terms of health, 89% suffered neuropsychiatric disorders (56% anxiety and 49% depression), 38% gained weight and 59% reported alcohol consumption. In relation to comfort, the majority rated their home positively, comfortable in terms of room temperature and noise at night, and they had a good relationship with cohabitants. However, those who did not have a balcony or terrace would have liked to have open spaces They would have also liked to increase the size of their bedroom, where they spent most of their time and where they studied. A built-up environment gave them a sense of being imprisoned, while those who enjoyed open spaces found a sense of peace. The absence of open spaces in the house, the environment and the impossibility of making the most frequently used spaces more flexible may have had negative impacts on the health and comfort of university students during confinement.
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Affiliation(s)
- Antonio Millán-Jiménez
- Faculty of Medicine, University of Seville, Avda. Sánchez Pizjuán, s/n, 41009 Seville, Spain; (A.M.-J.); (E.L.-R.)
| | - Rafael Herrera-Limones
- Institute of Architecture and Building Sciences, Superior Technical School of Architecture, University of Seville, Av. Reina Mercedes 2, 41012 Seville, Spain;
| | - Álvaro López-Escamilla
- Institute of Architecture and Building Sciences, Superior Technical School of Architecture, University of Seville, Av. Reina Mercedes 2, 41012 Seville, Spain;
| | - Emma López-Rubio
- Faculty of Medicine, University of Seville, Avda. Sánchez Pizjuán, s/n, 41009 Seville, Spain; (A.M.-J.); (E.L.-R.)
| | - Miguel Torres-García
- Energy Engineering Department, Superior Technical School of Engineering, University of Seville, Camino de los Descubrimientos s/n, 41092 Seville, Spain;
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Herrera-Limones R, Millán-Jiménez A, López-Escamilla Á, Torres-García M. Health and Habitability in the Solar Decathlon University Competitions: Statistical Quantification and Real Influence on Comfort Conditions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5926. [PMID: 32824112 PMCID: PMC7460299 DOI: 10.3390/ijerph17165926] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/07/2020] [Accepted: 08/11/2020] [Indexed: 01/12/2023]
Abstract
Medicine and architecture are disciplines with the main objectives of satisfying the fundamental needs of human beings: health, comfort, well-being, safety, and ensuring an acceptable quality of life in a sustainable habitat. In both areas of knowledge, the advances and the most innovative proposals in the fields of research and teaching are focused on transversal knowledge and the use of learning methods through problem solving (learning by doing). The student competitions called "Solar Decathlon" are focused on the development of these concepts, in which prototypes of sustainable and, as far as possible, healthy social housing are tested. In these university competitions, the design of energy-efficient and comfortable living environments that contribute to the health of the occupants are encouraged; however, the methodology for evaluating the "comfort conditions" stipulated in the competition rules considers only parameters that can be monitored by sensors. For this article, the prototypes presented by the "Solar Decathlon Team of the University of Seville" to the editions of said competition held in Latin America and Europe (in 2015 and 2019, respectively) are being studied. The present research starts from the fact that the unique consideration of measurable indices (such as temperature, humidity, etc.), is clearly insufficient when it comes to evaluating the real conditions of habitability and comfort that a domestic architectural space presents. For this reason, a theoretical-practical analysis is carried out by means of surveys, with the final objective of determining a methodology for evaluating comfort-complementary to that of the competition-which assesses other relevant issues and which, in short, takes into account the repercussion on people's health. From our analysis, we conclude that at least these two methodologies should be used to evaluate comfort because they are individually considered incomplete in terms of the data provided by each one of them. The survey-based methodology provides complementary information on comfort and health that could be taken into account in future editions of Solar Decathlon.
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Affiliation(s)
- Rafael Herrera-Limones
- University Institute of Architecture and Construction Sciences, Superior Technical School of Architecture, University of Seville, Av. Reina Mercedes 2, 41012 Seville, Spain;
| | - Antonio Millán-Jiménez
- Faculty of Medicine, University of Seville, Avda. Sánchez Pizjuán, s/n, 41009 Seville, Spain;
| | - Álvaro López-Escamilla
- University Institute of Architecture and Construction Sciences, Superior Technical School of Architecture, University of Seville, Av. Reina Mercedes 2, 41012 Seville, Spain;
| | - Miguel Torres-García
- Energy Engineering Department. Superior Technical School of Engineering, University of Seville, Camino de los Descubrimientos, s/n, 41092 Seville, Spain;
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Morishima R, Usami S, Ando S, Kiyono T, Morita M, Fujikawa S, Araki T, Kasai K. Living in temporary housing and later psychological distress after the Great East Japan Earthquake of 2011: A cross-lagged panel model. SSM Popul Health 2020; 11:100629. [PMID: 32676534 PMCID: PMC7352072 DOI: 10.1016/j.ssmph.2020.100629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 11/23/2022] Open
Abstract
Living in temporary housing is a risk factor for psychological distress after a natural disaster. As temporary housing is an essential resource for those affected by disasters, investigation of factors which potentially mediate living in temporary housing and psychological distress is needed. This is a cohort study in general population of areas affected by the Great East Japan Earthquake in 2011. Data were obtained from self-report questionnaires in annual health checks between 2014 and 2016 regarding residential situation (e.g., prefabricated or privately-rented temporary housing), psychological distress, sleep disturbances, social support, and covariates. Mediation effects of sleep disturbances and social support on the relationship between temporary housing and psychological distress were evaluated using a cross-lagged panel model during three time points. Among 3,116 participants in 2014, approximately 12% lived in prefabricated or privately-rented temporary housing. Living in prefabricated (β = 0.046, p = 0.031) and privately-rented temporary housing (β = 0.043, p = 0.042) predicted later psychological distress. There was no mediation effect by sleep disturbances (prefabricated temporary housing: β = 0.001, p = 0.620; privately-rented temporary housing: β = −0.001, p = 0.467) or social support (prefabricated temporary housing: β < 0.001, p = 0.748; privately-rented temporary housing: β < 0.001, p = 0.435). CLPM also showed no relationship between living in temporary housing and increased sleep problems or decreased social support. Mental health support may be required for residents who lived in prefabricated or privately-rented temporary housing three years after a natural disaster, whereas support focusing only on sleep disturbances or social support in residents who lived in temporary housing may not be enough to contribute to reducing psychological distress. This study investigated mediators on link temporary housing and distress following natural disaster. Living in prefabricated and privately-rented temporary housing was associated with distress. However, this link was not mediated by sleep disturbances or social support. Mental health support may be required for individuals who lived in temporary housing. Support focusing only on sleep disturbances or social support may not be enough to contribute to reducing distress.
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Affiliation(s)
- Ryo Morishima
- The Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Satoshi Usami
- The Graduate School of Education, University of Tokyo, Tokyo, Japan
| | - Shuntaro Ando
- The Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,The Department of Psychiatry and Behavioral Science, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Tomoki Kiyono
- The Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masaya Morita
- The Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinya Fujikawa
- The Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tsuyoshi Araki
- The Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kiyoto Kasai
- The Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Gjorgjev D, Dimovska M, Morris G, Howie J, Borota Popovska M, Topuzovska Latkovikj M. How Good Is our Place-Implementation of the Place Standard Tool in North Macedonia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010194. [PMID: 31892126 PMCID: PMC6981766 DOI: 10.3390/ijerph17010194] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 12/17/2019] [Accepted: 12/23/2019] [Indexed: 12/12/2022]
Abstract
This study describes the implementation, in North Macedonia, of a "tool", initially devised in Scotland, to generate community and stakeholder discussion about the places in which they live and notably a place's capacity to generate health wellbeing and greater equity among citizens. In this study, the "place standard tool" (PST) is viewed from the perspective of creating places which can deliver a triple win of health and wellbeing, equity, and environmental sustainability. Skopje, North Macedonia's capital, inevitably differs economically, culturally, and politically from Scotland, thus providing an opportunity to augment existing knowledge on adaptability of the tool in shaping agendas for policy and action. Тhe PST was tested through seminars with selected focus groups and an online questionnaire. Over 350 respondents were included. Information on priorities enabled the distillation of suggestions for improvement and was shared with the Mayor and municipal administration. Skopje citizens valued an approach which solicited their views in a meaningful way. Specific concerns were expressed relating to heavy traffic and related air and noise pollution, and care and maintenance of places and care services. Responses varied by geographic location. Application of the PST increased knowledge and confidence levels among citizens and enthusiasm for active involvement in decision making. Effective implementation relies heavily on: good governance and top-level support; excellent organization and good timing; careful training of interviewers and focus group moderators; and on prior knowledge of the participants/respondents.
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Affiliation(s)
- Dragan Gjorgjev
- Institute of Public Health of the Republic of North Macedonia, 1000 Skopje, North Macedonia;
- Correspondence: ; Tel.: +389-70-248-617
| | - Mirjana Dimovska
- Institute of Public Health of the Republic of North Macedonia, 1000 Skopje, North Macedonia;
| | - George Morris
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro TR1 3HD, UK;
| | - John Howie
- NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, Scotland G2 6QE, UK;
| | - Mirjana Borota Popovska
- Institute for Sociological, Political and Juridical Research, Skopje, University “Ss. Cyril and Methodius” 1000 Skopje, North Macedonia; (M.B.P.); (M.T.L.)
| | - Marija Topuzovska Latkovikj
- Institute for Sociological, Political and Juridical Research, Skopje, University “Ss. Cyril and Methodius” 1000 Skopje, North Macedonia; (M.B.P.); (M.T.L.)
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Iglesias-Rios L, Harlow SD, Burgard SA, Kiss L, Zimmerman C. Gender differences in the association of living and working conditions and the mental health of trafficking survivors. Int J Public Health 2019; 64:1015-1024. [PMID: 31243470 PMCID: PMC10506657 DOI: 10.1007/s00038-019-01269-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 06/05/2019] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES To assess the association of living and working conditions experienced during trafficking with mental health of female and male survivors. METHODS We analyzed a cross-sectional study of 1015 survivors who received post-trafficking services in Cambodia, Thailand, and Vietnam. Modified Poisson regression models were conducted by gender to estimate prevalence ratios. RESULTS For females, the elevated prevalence of anxiety, depression, and post-traumatic stress disorder (PTSD) symptoms was associated with adverse living conditions, while for males the prevalence of anxiety (PR = 2.21; 95% CI 1.24-3.96) and depression (PR = 2.63; 95% CI 1.62-4.26) more than doubled and almost tripled for PTSD (PR = 2.93; 95% CI 1.65-5.19) after adjustment. For males in particular, excessive and extreme working hours per day were associated with more than a four- and threefold greater prevalence of PTSD. Being in a detention center or jail was associated with all three mental health outcomes in males. CONCLUSIONS Providers and stakeholders need to consider the complex mental health trauma of the differential effects of living and working conditions for female and male survivors during trafficking to support treatment and recovery.
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Affiliation(s)
- Lisbeth Iglesias-Rios
- Department of Epidemiology, Center for Midlife Science, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA.
| | - Siobán D Harlow
- Department of Epidemiology, Center for Midlife Science, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA
| | - Sarah A Burgard
- Department of Sociology, College of Literature Science, and the Arts, University of Michigan, 500 S State St, Ann Arbor, MI, 48109, USA
| | - Ligia Kiss
- Department of Global Health and Development, Gender Violence and Health Centre, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, WC1H 9SH, London, UK
| | - Cathy Zimmerman
- Department of Global Health and Development, Gender Violence and Health Centre, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, WC1H 9SH, London, UK
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Giebel C, McIntyre JC, Daras K, Gabbay M, Downing J, Pirmohamed M, Walker F, Sawicki W, Alfirevic A, Barr B. What are the social predictors of accident and emergency attendance in disadvantaged neighbourhoods? Results from a cross-sectional household health survey in the north west of England. BMJ Open 2019; 9:e022820. [PMID: 30613026 PMCID: PMC6326270 DOI: 10.1136/bmjopen-2018-022820] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The aim of this study was to identify the most important determinants of accident and emergency (A&E) attendance in disadvantaged areas. DESIGN, SETTING AND PARTICIPANTS A total of 3510 residents from 20 disadvantaged neighbourhoods in the North West Coast area in England completed a comprehensive public health survey. MAIN OUTCOME MEASURES Participants were asked to complete general background information, as well as information about their physical health, mental health, lifestyle, social issues, housing and environment, work and finances, and healthcare service usage. Only one resident per household could take part in the survey. Poisson regression analysis was employed to assess the predictors of A&E attendance frequency in the previous 12 months. RESULTS 31.6% of the sample reported having attended A&E in the previous 12 months, ranging from 1 to 95 visits. Controlling for demographic and health factors, not being in employment and living in poor quality housing increased the likelihood of attending an A&E service. Service access was also found to be predictive of A&E attendance insofar as there were an additional 18 fewer A&E attendances per 100 population for each kilometre closer a person lived to a general practitioner (GP) practice, and 3 fewer attendances per 100 population for each kilometre further a person lived from an A&E department. CONCLUSIONS This is one of the first surveys to explore a comprehensive set of socio-economic factors as well as proximity to both GP and A&E services as predictors of A&E attendance in disadvantaged areas. Findings from this study suggest the need to address both socioeconomic issues, such as employment and housing quality, as well as structural issues, such as public transport and access to primary care, to reduce the current burden on A&E departments.
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Affiliation(s)
- Clarissa Giebel
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
- NIHR Collaboration for Leadership in Applied Health Research and Care, North West Coast, UK
| | - Jason Cameron McIntyre
- School of Natural Sciences and Psychology, Liverpool John Moore's University, Liverpool, UK
| | | | - Mark Gabbay
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
- NIHR Collaboration for Leadership in Applied Health Research and Care, North West Coast, UK
| | - Jennifer Downing
- NIHR Collaboration for Leadership in Applied Health Research and Care, North West Coast, UK
- Institute of Translational Medicine, The University of Liverpool, Liverpool, UK
| | - Munir Pirmohamed
- NIHR Collaboration for Leadership in Applied Health Research and Care, North West Coast, UK
- Geographic Data Science Lab, University of Liverpool, Liverpool, UK
| | - Fran Walker
- NIHR Collaboration for Leadership in Applied Health Research and Care, North West Coast, UK
| | - Wojciech Sawicki
- Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Ana Alfirevic
- NIHR Collaboration for Leadership in Applied Health Research and Care, North West Coast, UK
- Institute of Translational Medicine, The University of Liverpool, Liverpool, UK
| | - Ben Barr
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
- NIHR Collaboration for Leadership in Applied Health Research and Care, North West Coast, UK
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Rollings KA, Wells NM. Cafeteria assessment for elementary schools (CAFES): development, reliability testing, and predictive validity analysis. BMC Public Health 2018; 18:1154. [PMID: 30285685 PMCID: PMC6171137 DOI: 10.1186/s12889-018-6032-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 09/10/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Strategies to reduce childhood obesity and improve nutrition include creating school food environments that promote healthy eating. Despite well-documented health benefits of fruit and vegetable (FV) consumption, many U.S. school-aged children, especially low-income youth, fail to meet national dietary guidelines for FV intake. The Cafeteria Assessment for Elementary Schools (CAFES) was developed to quantify physical attributes of elementary school cafeteria environments associated with students' selection and consumption of FV. CAFES procedures require observation of the cafeteria environment where preparation, serving, and eating occur; staff interviews; photography; and scoring. METHODS CAFES development included three phases. First, assessment items were identified via a literature review, expert panel review, and pilot testing. Second, reliability testing included calculating inter-item correlations, internal consistency (Kuder-Richardson-21 coefficients), and inter-rater reliability (percent agreement) based on data collected from 50 elementary schools in low-income communities and 3187 National School Lunch Program participants in four U.S. states. At least 43% of each participating school's students qualified for free- or reduced-price meals. Third, FV servings and consumption data, obtained from lunch tray photography, and multi-level modeling were used to assess the predictive validity of CAFES. RESULTS CAFES' 198 items (grouped into 108 questions) capture four environmental scales: room (50 points), table/display (133 points), plate (4 points), and food (11 points). Internal consistency (KR-21) was 0.88 (overall), 0.80 (room), 0.72 (table), 0.83 (plate), and 0.58 (food). Room subscales include ambient environment, appearance, windows, layout/visibility, healthy signage, and kitchen/serving area. Table subscales include furniture, availability, display layout/presentation, serving method, and variety. Inter-rater reliability (percent agreement) of the final CAFES tool was 90%. Predictive validity analyses indicated that the total CAFES and four measurement scale scores were significantly associated with percentage consumed of FV served (p < .05). CONCLUSIONS CAFES offers a practical and low-cost measurement tool for school staff, design and public health practitioners, and researchers to identify critical areas for intervention; suggest low- and no-cost intervention strategies; and contribute to guidelines for cafeteria design, food presentation and layout, and operations aimed at promoting healthy eating among elementary school students.
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Affiliation(s)
- Kimberly A. Rollings
- School of Architecture, University of Notre Dame, 110 Bond Hall, Notre Dame, IN 46556 USA
| | - Nancy M. Wells
- Design + Environmental Analysis, College of Human Ecology, Cornell University, 1411 Martha Van Rensselaer Hall, Ithaca, NY 14853 USA
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Shah SN, Fossa A, Steiner AS, Kane J, Levy JI, Adamkiewicz G, Bennett-Fripp WM, Reid M. Housing Quality and Mental Health: the Association between Pest Infestation and Depressive Symptoms among Public Housing Residents. J Urban Health 2018; 95:691-702. [PMID: 30141116 PMCID: PMC6181819 DOI: 10.1007/s11524-018-0298-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Housing quality, which includes structural and environmental risks, has been associated with multiple physical health outcomes including injury and asthma. Cockroach and mouse infestations can be prime manifestations of diminished housing quality. While the respiratory health effects of pest infestation are well documented, little is known about the association between infestation and mental health outcomes. To address this gap in knowledge and given the potential to intervene to reduce pest infestation, we assessed the association between household pest infestation and symptoms of depression among public housing residents. We conducted a cross-sectional study in 16 Boston Housing Authority (BHA) developments from 2012 to 2014 in Boston, Massachusetts. Household units were randomly selected and one adult (n = 461) from each unit was surveyed about depressive symptoms using the Center for Epidemiologic Study-Depression (CES-D) Scale, and about pest infestation and management practices. In addition, a home inspection for pests was performed. General linear models were used to model the association between pest infestation and high depressive symptoms. After adjusting for important covariates, individuals who lived in homes with current cockroach infestation had almost three times the odds of experiencing high depressive symptoms (adjusted OR = 2.9, 95% CI 1.9-4.4) than those without infestation. Dual infestation (cockroach and mouse) was associated with over five times the odds (adjusted odds = 5.1, 95% CI 3.0-8.5) of experiencing high depressive symptoms. Using a robust measure of cockroach and mouse infestation, and a validated depression screener, we identified associations between current infestation and depressive symptoms. Although the temporal directionality of this association remains uncertain, these findings suggest that the health impact of poor housing conditions extend beyond physical health to include mental health. The study adds important information to the growing body of evidence that housing contributes to population health and improvements in population health may not be possible without addressing deficiencies in the housing infrastructure.
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Affiliation(s)
- Snehal N. Shah
- Research and Evaluation Office, Boston Public Health Commission, 1010 Massachusetts Ave, 6th Floor, Boston, MA 02118 USA
- Department of Pediatrics, Boston University School of Medicine, 850 Harrison Ave, Boston, MA 02116 USA
- Present Address: Boston Children’s Hospital , 300 Longwood Ave, BCH 3081, Boston, MA 20115 USA
| | - Alan Fossa
- Research and Evaluation Office, Boston Public Health Commission, 1010 Massachusetts Ave, 6th Floor, Boston, MA 02118 USA
| | - Abigail S. Steiner
- Research and Evaluation Office, Boston Public Health Commission, 1010 Massachusetts Ave, 6th Floor, Boston, MA 02118 USA
- Tufts University School of Medicine, 145 Harrison Ave, Boston, MA 02111 USA
| | - John Kane
- Operations, Boston Housing Authority, 52 Chauncy Street, Boston, MA 02111 USA
| | - Jonathan I. Levy
- Department of Environmental Health, Boston University School of Public Health, 715 Albany St., Boston, MA 02118 USA
| | - Gary Adamkiewicz
- Department of Environmental Health, Landmark Center, Harvard T.H. Chan School of Public Health, Room 404K WEST, 401 Park Drive, Boston, MA 02215 USA
| | | | - Margaret Reid
- Division of Healthy Homes and Community Support, Boston Public Health Commission, 1010 Massachusetts Ave, 2nd Floor, Boston, MA 02118 USA
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de Vries E, Rincon CJ, Tamayo Martínez N, Rodriguez N, Tiemeier H, Mackenbach JP, Gómez-Restrepo C, Guarnizo-Herreño CC. Housing index, urbanisation level and lifetime prevalence of depressive and anxiety disorders: a cross-sectional analysis of the Colombian national mental health survey. BMJ Open 2018; 8:e019065. [PMID: 29880561 PMCID: PMC6009503 DOI: 10.1136/bmjopen-2017-019065] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES To study socioeconomic inequalities in mental health in rural and urban Colombia, a country with a history of internal conflict and large socioeconomic inequalities. Recent survey data are available to study this understudied topic in a middle-income country. METHODS Using data from 9656 respondents from the 2015 Colombian Mental Health survey, we investigated the association between lifetime prevalence of depressive and anxiety disorders and quality of dwellings and access to public services housing score (HS). We calculated the relative index of inequality (RII) and slope index of inequality (SII) for HS in urban and rural areas, adjusting for potential confounders and mediating factors. OUTCOMES The lifetime prevalence of anxiety and depression (combined) was 9.6% in urban versus 6.9% in rural areas (p<0.001). HS was not associated with prevalence of anxiety and depression in urban settings, whereas a higher HS (poorer housing quality) was associated with fewer mental disorders in rural areas in both univariate and multivariate models (multivariate RIIurban0.96 (95% CI 0.51 to 1.81); RIIrural0.11 (95% CI 0.04 to 0.32)). In rural areas, the prevalence of mental health problems was 12% points lower in persons living in the poorest quality dwellings than in those living in high-quality dwellings (SII -0.12 (95% CI -0.18 to -0.06)). Interestingly, within rural areas, persons living in 'populated centres' (small towns, villages) had a higher lifetime prevalence of any mental health disorder (9.8% (95% CI 6.9 to 13.6)) compared with those living in more isolated, dispersed areas (6.0% (95% CI 4.6 to 7.7)). INTERPRETATION In rural Colombia, those living in the poorest houses and in dispersed areas had a lower prevalence of mental health problems. Further understanding of this phenomenon of a seemingly inverse association of prevalence of mental disorders with poverty and/or urbanisation in rural areas is needed. Particularly, considering the progressive urbanisation process in Colombia, it is important to monitor mental health in populations migrating to the cities.
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Affiliation(s)
- Esther de Vries
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Carlos Javier Rincon
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Nathalie Tamayo Martínez
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Nelcy Rodriguez
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Henning Tiemeier
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Johan P Mackenbach
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Carlos Gómez-Restrepo
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia
- Department of Psychiatry and Mental Health, Hospital Universitario San Ignacio, Bogota, Colombia
| | - Carol C Guarnizo-Herreño
- Departamento de Salud Colectiva, Facultad de Odontología, Universidad Nacional de Colombia, Bogota, Colombia
- Department of Epidemiology and Public Health, University College London, London, UK
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Exploring the Relationship between Housing and Health for Refugees and Asylum Seekers in South Australia: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14091036. [PMID: 28885594 PMCID: PMC5615573 DOI: 10.3390/ijerph14091036] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 08/30/2017] [Accepted: 09/05/2017] [Indexed: 02/08/2023]
Abstract
Housing is an important social determinant of health; however, little is known about the impact of housing experiences on health and wellbeing for people from refugee and asylum-seeking backgrounds. In this paper, we outline a qualitative component of a study in South Australia examining these links. Specifically, interviews were conducted with 50 refugees and asylum seekers who were purposively sampled according to gender, continent and visa status, from a broader survey. Interviews were analysed thematically. The results indicated that housing was of central importance to health and wellbeing and impacted on health through a range of pathways including affordability, the suitability of housing in relation to physical aspects such as condition and layout, and social aspects such as safety and belonging and issues around security of tenure. Asylum seekers in particular reported that living in housing in poor condition negatively affected their health. Our research reinforces the importance of housing for both the physical and mental health for asylum seekers and refugees living in resettlement countries. Improving housing quality, affordability and tenure security all have the potential to lead to more positive health outcomes.
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Mora DC, Quandt SA, Chen H, Arcury TA. Associations of Poor Housing with Mental Health Among North Carolina Latino Migrant Farmworkers. J Agromedicine 2016; 21:327-34. [PMID: 27409300 PMCID: PMC5019947 DOI: 10.1080/1059924x.2016.1211053] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This analysis examines the associations of housing conditions with mental health among migrant farmworkers. Data are from a 2010 cross-sectional study conducted in 16 North Carolina counties. Interviews and housing inspections were completed with 371 farmworkers in 186 camps. Mental health measures included depression (Center for Epidemiologic Studies Depression Scale, CES-D), anxiety (Personality Assessment Inventory, PAI), and alcohol misuse (Alcohol Use Disorders Identification Test, AUDIT-C). Housing measures were number of people per sleeping room, perceived security of self and belongings, having a key to dwelling's door, having bedroom storage, toilet privacy issues, and number of housing regulation violations. Sixty (16.7%) participants had substantial depressive symptoms (CES-D ≥10), 31 (8.8%) had substantial anxiety (PAI ≥27), and 185 (50.1%) had the potential for alcohol misuse (AUDIT-C ≥4). Those with 5+ persons sleeping per room were more likely to have a depression score ≥10 (31.5% vs. 13-14%, P = .01) and an anxiety scores ≥27 (19.6% vs. 5-9%, P = .02). Those who did not feel they or their belongings were secure were more likely to have a depression score ≥10 (19.4% vs. 9.1%, P = .01). Those without a key were more likely to have an anxiety score ≥27 (11.5% vs. 5.1%, P = .04). Those with no bedroom storage were more likely to have a depression score ≥10 (28.9% vs. 14.9%, P = .03). This article suggests links between poor housing and farmworkers' mental health. These results inform regulations surrounding farmworker housing and inform health care providers on how to prevent and treat poor mental health among migrant farmworkers.
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Affiliation(s)
- Dana C. Mora
- Department of Family and Community Medicine, Wake Forest School of Medicine
| | - Sara A. Quandt
- Center for Worker Health, Wake Forest School of Medicine
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine
| | - Haiying Chen
- Center for Worker Health, Wake Forest School of Medicine
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine
| | - Thomas A. Arcury
- Department of Family and Community Medicine, Wake Forest School of Medicine
- Center for Worker Health, Wake Forest School of Medicine
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13
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Evans GW, Swain JE, King AP, Wang X, Javanbakht A, Ho SS, Angstadt M, Phan KL, Xie H, Liberzon I. Childhood Cumulative Risk Exposure and Adult Amygdala Volume and Function. J Neurosci Res 2015; 94:535-43. [PMID: 26469872 DOI: 10.1002/jnr.23681] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 09/13/2015] [Accepted: 09/28/2015] [Indexed: 01/29/2023]
Abstract
Considerable work indicates that early cumulative risk exposure is aversive to human development, but very little research has examined the neurological underpinnings of these robust findings. This study investigates amygdala volume and reactivity to facial stimuli among adults (mean 23.7 years of age, n = 54) as a function of cumulative risk exposure during childhood (9 and 13 years of age). In addition, we test to determine whether expected cumulative risk elevations in amygdala volume would mediate functional reactivity of the amygdala during socioemotional processing. Risks included substandard housing quality, noise, crowding, family turmoil, child separation from family, and violence. Total and left hemisphere adult amygdala volumes were positively related to cumulative risk exposure during childhood. The links between childhood cumulative risk exposure and elevated amygdala responses to emotionally neutral facial stimuli in adulthood were mediated by the corresponding amygdala volumes. Cumulative risk exposure in later adolescence (17 years of age), however, was unrelated to subsequent adult amygdala volume or function. Physical and socioemotional risk exposures early in life appear to alter amygdala development, rendering adults more reactive to ambiguous stimuli such as neutral faces. These stress-related differences in childhood amygdala development might contribute to the well-documented psychological distress as a function of early risk exposure.
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Affiliation(s)
- Gary W Evans
- Departments of Design and Environmental Analysis and of Human Development, Bronfenbrenner Center for Translational Research, Cornell University, Ithaca, New York
| | - James E Swain
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.,Yale Child Study Center, Yale University, New Haven, Connecticut
| | - Anthony P King
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Xin Wang
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Arash Javanbakht
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.,Department of Psychiatry and Neuroscience, Wayne State University, Detroit, Michigan
| | - S Shaun Ho
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Michael Angstadt
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - K Luan Phan
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois
| | - Hong Xie
- Department of Neuroscience, University of Toledo, Toledo, Ohio
| | - Israel Liberzon
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
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Arcury TA, Trejo G, Suerken CK, Grzywacz JG, Ip EH, Quandt SA. Housing and Neighborhood Characteristics and Latino Farmworker Family Well-Being. J Immigr Minor Health 2015; 17:1458-67. [PMID: 25367531 PMCID: PMC4418958 DOI: 10.1007/s10903-014-0126-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Housing quality and neighborhood characteristics affect individual health and family well-being. This analysis describes characteristics of farmworker housing and neighborhoods and delineates the associations of housing and local neighborhood with indicators of family well-being. Mothers in North Carolina farmworker families (n = 248) completed interviews in 2011-2012. Family well-being measures included stress, family conflict, and outward orientation. Housing measures included ownership and facilities, and neighborhood measures included heavy traffic and driving time to grocery stores. Families experienced elevated stress and conflict, and limited outward orientation. Few owned their homes, which were generally crowded. Few had enclosed play spaces for their children. For many, traffic made it difficult to walk on the street. Housing and neighborhood characteristics were related to increased stress and limited outward orientation. Housing and neighborhood characteristics are important for research on the health of families in vulnerable populations, such as farmworker families.
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Affiliation(s)
- Thomas A Arcury
- Department of Family and Community Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA,
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15
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Yarlagadda S, Maughan D, Lingwood S, Davison P. Sustainable psychiatry in the UK. PSYCHIATRIC BULLETIN 2014; 38:285-90. [PMID: 25505629 PMCID: PMC4248165 DOI: 10.1192/pb.bp.113.045054] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 01/24/2014] [Accepted: 02/11/2014] [Indexed: 12/18/2022]
Abstract
Demands on our mental health services are growing as financial pressures increase. In addition, there are regular changes to service design and commissioning. The current political mantra is 'more and more, of better quality, for less and less, please'. We suggest that mental health services need to actively respond to these constraints and that clinical transformation is needed to move towards a more sustainable system of healthcare. Emphasis on prevention, patient empowerment and leaner, greener services is required alongside more extensive use of technologies. Focusing on these areas will make mental health services more responsive to the challenges we face and serve to future-proof psychiatry in the UK. Services need to be delivered to provide maximum benefit to the health of our patients, but also to our society and the environment.
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Affiliation(s)
| | - Daniel Maughan
- Royal College of Psychiatrists, London ; Oxford Health NHS Foundation Trust, Oxford
| | - Susie Lingwood
- Barnet, Enfield and Haringey Mental Health Trust, London
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Development and initial validation of the Observer-Rated Housing Quality Scale (OHQS) in a multisite trial of housing first. J Urban Health 2014; 91:242-55. [PMID: 24477427 PMCID: PMC3978156 DOI: 10.1007/s11524-013-9851-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Quality of housing has been shown to be related to health outcomes, including mental health and well-being, yet "objective" or observer-rated housing quality is rarely measured in housing intervention research. This may be due to a lack of standardized, reliable, and valid housing quality instruments. The objective of this research was to develop and validate the Observer-Rated Housing Quality Scale (OHQS) for use in a multisite trial of a "housing first" intervention for homeless individuals with mental illness. A list of 79 housing unit, building, and neighborhood characteristics was generated from a review of the relevant literature and three focus groups with consumers and housing service providers. The characteristics were then ranked by 47 researchers, consumers, and service providers on perceived importance, generalizability, universality of value, and evidence base. Items were then drafted, scaled (five points, half values allowed), and pretested in seven housing units and with seven raters using cognitive interviewing techniques. The draft scale was piloted in 55 housing units in Toronto and Winnipeg, Canada. Items were rated independently in each unit by two trained research assistants and a housing expert. Data were analyzed using classical psychometric approaches and intraclass correlation coefficients (ICC) for inter-rater reliability. The draft scale consisted of 34 items assessing three domains: the unit, the building, and the neighborhood. Five of 18 unit items and 3 of 7 building items displayed ceiling or floor effects and were adjusted accordingly. Internal consistency was very good (Cronbach's alpha = 0.90 for the unit items, 0.80 for the building items, and 0.92 total (unit and building)). Percent agreement ranged from 89 to 100 % within one response scale value and 67 to 91 % within one half scale value. Inter-rater reliability was also good (ICCs were 0.87 for the unit, 0.85 for the building, and 0.93 for the total scale). Three neighborhood items (e.g., distance to transit) were found to be most efficiently rated using publicly available information. The physical quality of housing can be reliably rated by trained but nonexpert raters using the OHQS. The tool has potential for improved measurement in housing-related health research, including addressing the limitations of self-report, and may also enable documenting the quality of housing that is provided by publicly funded housing programs.
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17
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Affiliation(s)
- Robert Gifford
- Department of Psychology, University of Victoria, Victoria V8W 3P5, Canada;
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18
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Ciaccio CE, DiDonna AC, Kennedy K, Barnes CS, Portnoy JM, Rosenwasser LJ. Association of tobacco smoke exposure and atopic sensitization. Ann Allergy Asthma Immunol 2013; 111:387-90. [PMID: 24125146 PMCID: PMC3869197 DOI: 10.1016/j.anai.2013.07.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 07/18/2013] [Accepted: 07/18/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND Forty million children are regularly exposed to environmental tobacco smoke (ETS) each year, increasing their risk for premature death and middle ear and acute respiratory infections. Early life exposure to ETS also is clearly associated with wheezing. However, there is no clear understanding of the influence of ETS on the development of allergic sensitization. OBJECTIVE To determine the association of combined exposure to ETS and indoor allergens on IgE sensitization to aeroallergens in children. METHODS This case-control study enrolled 116 cases and 121 controls from low-income families from Kansas City, Missouri. The adjusted odds ratio was calculated using a logistic model to assess the association between ETS and allergic sensitization using dust allergen levels as a covariate. RESULTS Thirty-six percent of atopic children and 39% of controls were exposed to ETS (P < .05). Unadjusted analyses showed no significant influence of ETS on IgE sensitization to indoor allergens. Logistic regression analyses also showed no significant influence of ETS on sensitization when adjusted for levels of allergens in the home dust and family history of allergic rhinitis. CONCLUSION These data suggest that ETS exposure was not associated with IgE sensitization to indoor allergens, even when home allergen levels were taken into consideration. Further understanding of how components of tobacco smoke influence the immune response is necessary to interpret the disparate findings across studies.
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Sarkar C, Gallacher J, Webster C. Urban built environment configuration and psychological distress in older men: results from the Caerphilly study. BMC Public Health 2013; 13:695. [PMID: 23898839 PMCID: PMC3735426 DOI: 10.1186/1471-2458-13-695] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Accepted: 07/04/2013] [Indexed: 11/10/2022] Open
Abstract
Background Few studies have examined the impact of the built environment configuration upon mental health. The study examines the impact of objectively assessed land use and street network configuration upon psychological distress and whether this association is moderated by the natural environment and area-level deprivation. Methods In a community sample of 687 older men from the Caerphilly Prospective Study, built environment morphological metrics (morphometrics) were related to differences in psychological distress as measured by the General Health Questionnaire. Cross-sectional data were taken from the most recent (5th) phase. A multi-level analysis with individuals nested within census-defined neighbourhoods was conducted. Environmental measures comprised GIS-constructed land use and street network metrics, slope variability and a satellite derived measure of greenness. Results Reduced psychological distress was associated with residing in a terraced dwelling (OR = 0.48, p = 0.03), higher degrees of land-use mix (OR = 0.42, p = 0.03 for the high tertile) and having higher local-level street-network accessibility (‘movement potential’) (OR = 0.54, p = 0.03). Hillier topography with higher slope variability was associated with increased risks of psychological distress (OR = 1.38, p = 0.05). Conclusions The findings support our hypothesis that built environment configuration is independently associated with psychological distress. The study underscores the need for effective intervention in the planning and design of residential built environment to achieve the goal of health-sustaining communities.
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Affiliation(s)
- Chinmoy Sarkar
- School of Planning and Geography, Glamorgan Building, Cardiff University, Cardiff CF10 3WA, UK
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20
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Ernst KC, Phillips BS, Duncan BD. Slums are not places for children to live: vulnerabilities, health outcomes, and possible interventions. Adv Pediatr 2013; 60:53-87. [PMID: 24007840 PMCID: PMC7112084 DOI: 10.1016/j.yapd.2013.04.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Kacey C Ernst
- Epidemiology, College of Public Health, University of Arizona, Tucson, AZ 85724, USA.
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21
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Abstract
We employ longitudinal survey data from the Welfare, Children, and Families project (1999, 2001) to examine the effects of household disrepair (e.g., living with leaky structures, busted plumbing, broken windows, and pests) on psychological distress among low-income urban women with children. Building on previous research, we adjust for related housing concepts, neighborhood disorder, financial hardship, and a host of relevant background factors. We also formally test the mediating influences of social support and self-esteem. Our cross-sectional analysis indicated that household disrepair is positively associated with recent symptoms of psychological distress. Our longitudinal change score analysis demonstrates two important patterns. First, women living with household disrepair at baseline are not necessarily vulnerable to increases in symptoms of psychological distress over the 2-year study period. Second, women who report an increase in disrepair over the study period are also likely to report a concurrent increase in symptoms of distress. Although social support and self-esteem favor mental health in our cross-sectional and longitudinal analyses, these psychosocial resources fail to mediate or explain the association between disrepair and distress.
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22
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Wells NM, Evans GW, Beavis A, Ong AD. Early childhood poverty, cumulative risk exposure, and body mass index trajectories through young adulthood. Am J Public Health 2010; 100:2507-12. [PMID: 20966374 DOI: 10.2105/ajph.2009.184291] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We assessed whether cumulative risk exposure underlies the relation between early childhood poverty and body mass index (BMI) trajectories. METHODS We interviewed youths and their mothers in rural upstate New York (168 boys and 158 girls) from 1995 to 2006 when the youths were aged 9, 13, and 17 years. At each interview, we calculated their BMI-for-age percentile. RESULTS Early childhood poverty predicted BMI growth trajectories from ages 9 to 17 years (b = 3.64; SE = 1.39; P < .01). Early childhood poverty also predicted changes in cumulative risk (b = 0.31; SE = 0.08; P < .001). Cumulative risk, in turn, predicted BMI trajectories (b = 2.41; SE = 0.75; P < .01). Finally, after we controlled for cumulative risk, the effect of early childhood poverty on BMI trajectories was no longer significant, indicating that cumulative risk exposure mediated the relation between early childhood poverty and BMI trajectories (b = 2.01; SE = 0.94). CONCLUSIONS We show for the first time that early childhood poverty leads to accelerated weight gain over the course of childhood into early adulthood. Cumulative risk exposure during childhood accounts for much of this accelerated weight gain.
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Affiliation(s)
- Nancy M Wells
- Department of Design and Environmental Analysis, College of Human Ecology, Cornell University, Ithaca, NY 14853, USA.
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Bailie R, Stevens M, McDonald E, Brewster D, Guthridge S. Exploring cross-sectional associations between common childhood illness, housing and social conditions in remote Australian Aboriginal communities. BMC Public Health 2010; 10:147. [PMID: 20302661 PMCID: PMC2848201 DOI: 10.1186/1471-2458-10-147] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2009] [Accepted: 03/20/2010] [Indexed: 11/30/2022] Open
Abstract
Background There is limited epidemiological research that provides insight into the complex web of causative and moderating factors that links housing conditions to a variety of poor health outcomes. This study explores the relationship between housing conditions (with a primary focus on the functional state of infrastructure) and common childhood illness in remote Australian Aboriginal communities for the purpose of informing development of housing interventions to improve child health. Methods Hierarchical multi-level analysis of association between carer report of common childhood illnesses and functional and hygienic state of housing infrastructure, socio-economic, psychosocial and health related behaviours using baseline survey data from a housing intervention study. Results Multivariate analysis showed a strong independent association between report of respiratory infection and overall functional condition of the house (Odds Ratio (OR) 3.00; 95%CI 1.36-6.63), but no significant association between report of other illnesses and the overall functional condition or the functional condition of infrastructure required for specific healthy living practices. Associations between report of child illness and secondary explanatory variables which showed an OR of 2 or more included: for skin infection - evidence of poor temperature control in the house (OR 3.25; 95%CI 1.06-9.94), evidence of pests and vermin in the house (OR 2.88; 95%CI 1.25-6.60); for respiratory infection - breastfeeding in infancy (OR 0.27; 95%CI 0.14-0.49); for diarrhoea/vomiting - hygienic state of food preparation and storage areas (OR 2.10; 95%CI 1.10-4.00); for ear infection - child care attendance (OR 2.25; 95%CI 1.26-3.99). Conclusion These findings add to other evidence that building programs need to be supported by a range of other social and behavioural interventions for potential health gains to be more fully realised.
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Affiliation(s)
- Ross Bailie
- Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, Northern Territory, Australia.
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Evans GW, Marcynyszyn LA. Environmental justice, cumulative environmental risk, and health among low- and middle-income children in upstate New York. Am J Public Health 2004; 94:1942-4. [PMID: 15514234 PMCID: PMC1448566 DOI: 10.2105/ajph.94.11.1942] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We documented inequitable, cumulative environmental risk exposure and health between predominantly White low-income and middle-income children residing in rural areas in upstate New York. METHODS Cross-sectional data for 216 third- through fifth-grade children included overnight urinary neuroendocrine levels, noise levels, residential crowding (people/room), and housing quality. RESULTS After control for income, maternal education, family structure, age, and gender, cumulative environmental risk exposure (0-3) (risk >1 SD above the mean for each singular risk factor [0, 1]) was substantially greater for low-income children. Cumulative environmental risk was positively correlated with elevated overnight epinephrine, norepinephrine, and cortisol in the low-income sample but not in the middle-income sample. CONCLUSIONS Cumulative environmental risk exposure among low-income families may contribute to bad health, beginning in early childhood.
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Affiliation(s)
- Gary W Evans
- Department of Design and Environmental Analysis, Cornell University, Ithaca, NY 14853-4401, USA.
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Shenassa ED, Stubbendick A, Brown MJ. Social disparities in housing and related pediatric injury: a multilevel study. Am J Public Health 2004; 94:633-9. [PMID: 15054017 PMCID: PMC1448310 DOI: 10.2105/ajph.94.4.633] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We conducted an ecologic analysis to determine whether housing characteristics mediate the associations between concentration of poverty and pediatric injury and between concentration of racial minorities and pediatric injury and whether the association between housing conditions and pediatric injury is independent of other risks. METHODS We created a hierarchical data set by linking individual-level data for pediatric injury with census data. Effect sizes were estimated with a Poisson model. RESULTS After adjustment for owner occupancy and the percentage of housing built before 1950, the association between concentration of poverty and pediatric injury was attenuated. For concentration of racial minorities, only percentage of owner occupancy had some mediating effect. In hierarchical models, housing characteristics remained independent and significant predictors of pediatric injury. CONCLUSIONS The association between community characteristics and pediatric injury is partially mediated by housing conditions. Risk of pediatric injury associated with housing conditions is independent of other risks.
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Affiliation(s)
- Edmond D Shenassa
- Department of Community Health and the Centers for Behavioral and Preventive Medicine, Brown Medical School/Miriam Hospital, Providence, RI 02903, USA.
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