373 research outputs found

    The independent contribution of neighborhood disadvantage and individual-level socioeconomic position to self-reported oral health: a multilevel analysis

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    © Blackwell Munksgaard 2007ObjectivesTo examine the association between neighborhood disadvantage and individual-level socioeconomic position (SEP) and self-reported oral health.MethodsA population-based cross-sectional study conducted in 2003 among males and females aged 43-57 years. The sample comprised 2915 individuals and 60 neighborhoods and was selected using a stratified two-stage cluster design. Data were collected using a mail survey (69.4% response rate). Neighborhood disadvantage was measured using a census-based composite index, and individual-level SEP was measured using education and household income. Oral health was indicated by self-reports of the impact of oral conditions on quality of life (0 = none or minor, 1 = severe), self-rated oral health (0 = excellent-good, 1 = fair/poor) and missing teeth (measured as a quantitative outcome). Data were analyzed using multilevel modeling.ResultsAfter adjusting for age, sex, education, and household income, residents of socioeconomically disadvantaged neighborhoods were significantly more likely than those in more advantaged neighborhoods to indicate negative impacts of oral conditions on quality of life, to assess their oral health as fair or poor, and to report greater tooth loss. In addition, respondents with low levels of education and those from a low income household reported poorer oral health for each outcome independent of neighborhood disadvantage.ConclusionsThe socioeconomic characteristics of neighborhoods are important for oral health over and above the socioeconomic characteristics of the people living in those neighborhoods. Policies and interventions to improve population oral health should be directed at the social, physical and infrastructural characteristics of places as well as individuals (i.e. the traditional target of intervention efforts).Gavin Turrell, Anne E. Sanders, Gary D. Slade, A. John Spencer, Wagner Marcene

    Socioeconomic disadvantage and the purchase of takeaway food : a multilevel analysis

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    This study examined relationships between individual-level socioeconomic position, area-level disadvantage, characteristics of the takeaway food environment, and the purchase of takeaway food. ‘Takeaway’ is conceptualised as foods or meals that are prepared and purchased outside of the home, and ready for immediate consumption either at the place of purchase or elsewhere. The analytic sample comprised 1001 households and 50 small areas in Brisbane, Australia. Takeaway food was purchased more regularly by high-income householders and those with higher levels of education. Residents of advantaged areas purchased takeaway food more regularly, although area differences attenuated to the null after adjustment for individual-level compositional factors. Number of takeaway shops in the local food environment, and road distance to the closest takeaway shop, were largely unrelated to the purchase of takeaway food. We conclude that there is little evidence that takeaway food purchasing in Brisbane is influenced by area-level socioeconomic disadvantage or features of the takeaway food environment. Rather, it seems that what matters most in terms of influencing the decision or capacity of Brisbane residents to purchase takeaway food are the socioeconomic characteristics of individuals and their households. The findings of this and previous analyses of the Brisbane Food Study data suggest that policy and health promotion aimed at improving the diets of residents and reducing dietary inequalities between socioeconomic groups should focus on people more so than places.\ud \u

    Short-term functional health and well-being after marital separation: Does initiator status make a difference?

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    The authors investigated the health consequences of marital separation and whether the partners who initiated the separation had better health than those who did not. The data came from the Households, Income and Labour Dynamics in Australia (HILDA) panel study (2001-2007), comprising an analytic sample of 1,786 men and 2,068 women who were in their first marriages in 2001. For participants who separated, the authors distinguished between self-initiated, partner-initiated, and jointly initiated separations. Using linear random-intercept models, they examined scores on the 8 physical and mental health dimensions of Short Form 36, with scale scores ranging from 0 to 100. The results indicated that in general, men who separated had a decline in health, although this was more pronounced for mental dimensions than for physical dimensions. Among separated men, those whose partner initiated the separation had poorer mental health than those for whom the separation was self-initiated or jointly initiated (-4.61). Women's physical health improved with separation, but their mental health declined. For separated women, those whose partner initiated the separation had lower scores on the general health (-5.39), role-emotional (-11.08), and mental health (-7.18) scales than women who self-initiated separation. The health consequences of separation were less severe for self- or jointly initiated separations, suggesting that not all marital dissolutions are equally bad for health

    Confidence to cook vegetables and the buying habits of Australian households

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    Cooking skills are emphasized in nutrition promotion but their distribution among population subgroups and relationship to dietary behavior is researched by few population-based studies. This study examined the relationships between confidence to cook, sociodemographic characteristics, and household vegetable purchasing. This cross-sectional study of 426 randomly selected households in Brisbane, Australia, used a validated questionnaire to assess household vegetable purchasing habits and the confidence to cook of the person who most often prepares food for these households. The mutually adjusted odds ratios (ORs) of lacking confidence to cook were assessed across a range of demographic subgroups using multiple logistic regression models. Similarly, mutually adjusted mean vegetable purchasing scores were calculated using multiple linear regression for different population groups and for respondents with varying confidence levels. Lacking confidence to cook using a variety of techniques was more common among respondents with less education (OR 3.30; 95% confidence interval [CI] 1.01 to 10.75) and was less common among respondents who lived with minors (OR 0.22; 95% CI 0.09 to 0.53) and other adults (OR 0.43; 95% CI 0.24 to 0.78). Lack of confidence to prepare vegetables was associated with being male (OR 2.25; 95% CI 1.24 to 4.08), low education (OR 6.60; 95% CI 2.08 to 20.91), lower household income (OR 2.98; 95% CI 1.02 to 8.72) and living with other adults (OR 0.53; 95% CI 0.29 to 0.98). Households bought a greater variety of vegetables on a regular basis when the main chef was confident to prepare them (difference: 18.60; 95% CI 14.66 to 22.54), older (difference: 8.69; 95% CI 4.92 to 12.47), lived with at least one other adult (difference: 5.47; 95% CI 2.82 to 8.12) or at least one minor (difference: 2.86; 95% CI 0.17 to 5.55). Cooking skills may contribute to socioeconomic dietary differences, and may be a useful strategy for promoting fruit and vegetable consumption, particularly among socioeconomically disadvantaged groups.\ud \u

    Socioeconomic Inequalities in All-cause and Specific-cause Mortality in Australia: 1985-87 and 1995-97

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    Background. Socioeconomic inequalities in mortality have been repeatedly observed in Britain, the United States, and Europe, and in some countries, there is evidence that the differentials are widening. This study describes trends in socioeconomic mortality inequality in Australia for males and females aged 0-14, 15-24 and 25-64 years over the period 1985-87 to 1995-97.\ud Methods. SES was operationalised using the Index of Relative Socioeconomic Disadvantage, an area based measure developed by the Australian Bureau of Statistics. Mortality differentials were examined using age-standardised rates, and mortality inequality was assessed using rate ratios, gini coefficients, and a measure of excess mortality.\ud Results. For both periods, and for each sex/age sub-group, mortality rates were highest in the most disadvantaged areas. The extent and nature of socioeconomic mortality inequality differed for males and females and for each age group: both increases and decreases in mortality inequality were observed, and for some causes, the degree of inequality remained unchanged. If it were possible to reduce death rates among the SES areas to a level equivalent to that of the least disadvantaged area, premature all–cause mortality for males in the three age groups would be lower by 22%, 28% and 26% respectively, and for females, 35%, 70% and 56%.\ud Conclusions. The mortality burden in the Australian population attributable to socioeconomic inequality is large, and has profound and far-reaching implications in terms of the unnecessary loss of life, the loss of potentially economically productive members of society, and increased costs for the health care system.\ud Keywords: Socioeconomic status, mortality inequality, Australia, area-based measures

    Key influences on cycling for transport

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    Over recent years, the health, transport and environment\ud sectors have been increasingly focused on the promotion of transport cycling. From a health perspective, transport\ud cycling is recognised as a beneficial form of physical\ud activity as it can be easily integrated into daily living, is done at an intensity that confers health benefits, and is\ud associated with reductions in mortality and morbidity [1].\ud From a safety perspective, the risk of a serious cycling\ud injury decreases as cycling increases [2] as having more\ud cyclists on roads increases motor vehicle drivers’ awareness\ud of cyclists and in turn makes cycling safer.\ud \ud Whereas cycling for recreation is the fourth most commonly reported physical activity among Australian adults [3], transport cycling is an underutilised travel mode. Approximately 1.3% of journeys to work in Australia are made by bicycle [4]. This low prevalence is mirrored in the\ud UK and the US, but not in some European countries like the Netherlands and Denmark, where over 18% and 26%, respectively, of all journeys are made by bicycle [5].\ud \ud In the past decade, concerted efforts have been made by Australian state and local governments to increase cycling rates [6]. Notably, Melbourne, Sydney and Brisbane have implemented policies, increased bicycle commuting infrastructure, and offered information and promotion programs to encourage commuter cycling [6,7]. Governments have also developed comprehensive longterm plans for guiding future cycling strategies, using lessons learned from around the world in developing successful cycling policy and promotion [6,7]. Changes in transport cycling rates in inner cities since these efforts have been implemented are encouraging. In Sydney, census data indicate an 83% increase in the number of people using a bicycle for commuting between 2001 and 2011 [8]. Counts of bicycles being ridden along major cycling commuter routes indicate increases in weekday morning cycling trips in Brisbane (63% increase from 2004 to 2010) [7] and in Melbourne (a 43% increase from 2006 to 2008) [9]. However, bicycle mode share to work has changed little: for example, between 2001 and 2011, it decreased slightly from 1.6% to 1.3% in Brisbane [10,11].\ud \ud Researchers have been investigating factors that may be\ud contributing to low rates of cycling for transport, to inform future policy and programming to encourage transport\ud cycling. The aim of this paper is to overview our work to\ud date in this area of research in Queensland
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