HISTORICAL POPULATION HEALTH: SPATIOTEMPORAL MORTALITY PATTERNS OF HAMILTON, ONTARIO 1880–1882 AND 1910–1912

This dissertation empirically investigates multifaceted causes of health inequity by exploring historical connections between shifting economic activity, urban development, population change, and mortality. The purpose is to reveal the impact of changing socioeconomics on population structure and urban development, and the association of this impact on spatiotemporal mortality patterns. This research advances knowledge on the complex ecological interplay of population, behaviour, habitat, and subsequent health inequities, revealing a link between health disparities and economic transitions. Examining Hamilton, Ontario, at two cross-sections (1880–1882 and 1910–1912), using purposive working-age and infant samples provides a snapshot of life and death before and during heavy industrial activity. Mixed-methods use data from census and death records, health reports, photographs, and maps to construct a profile of demography, epidemiology, and the urban environment (physical, built, and social). Two major findings are identified: 1) industrialization played a major role in emerging human health ecology risks correlating to the mortality patterns; and 2) industrialization tended to increase health inequities amongst the population and across the city. The onset of predominately industrial economic activity caused further class divide, uneven urban development, and inequitable health outcomes. Statistical inquiry (multiple logistic regression) of the working-age mortality sample revealed an increased association between age at death and dying of tuberculosis, and an increased association between accidental death with biological sex, age at death, and birthplace. The infant mortality sample revealed a temporal shift with an increased association between diarrhoeal mortality and infant age, and between infectious respiratory mortality and infant age. Results from Historical GIS inquiry indicate residential working-class sections were more unhealthy environments than other areas of the city. Historical documentation and photographs supported these results, presenting the likelihood of a social disparity to health outcomes. The interplay between population, environment, and behaviour manifests into a spatiotemporal pattern of stressors related to socioeconomic status, urban development, and health disparity. Industrialization brought new stressors to Hamilton creating unequal opportunities for the rapidly growing working classes. Thus, without careful planning in urban development, concentrations of health risks lead to inequitable population health outcomes, especially those undergoing an economic transition, such as industrialization

Internal sensations as a source of fear: exploring a link between hypoxia and flight phobia

Although flight phobia is very common in the general population, knowledge of the underlying mechanisms is limited. The aim of the current study is to determine whether hypoxia is selectively associated with flight anxiety. We wanted to explore levels of oxygen saturation (SpO2) and the associated subjective somatic sensations in flight phobics and controls. The data collected in this study were obtained from 103 participants: 54 had flight phobia, 49 were controls. SpO2 as well as a subjective report of somatic sensations and anxiety were measured during short haul flights, both at ground level and at cruising altitude. Results indicated that both flight phobics and controls showed a comparable clinical significant decrease in SpO2 from sea level to cruising altitude. Next, at ground level the flight phobic group reported more somatic sensations, most likely due to the elevated levels of anxiety at that point. However, at cruising altitude the flight phobic group still reported more somatic sensations while the level of anxiety was no longer significantly different from controls. This finding points to altered symptom perception in flight phobia and stresses the importance of somatic sensations in this particular phobia

A prospective study exploring the construct and predictive validity of the COM-B model for physical activity

The final, definitive version of this paper has been published in Journal of Health Psychology, November 2017, doi: https://doi.org/10.1177/1359105317739098, published by SAGE Publishing, All rights reserved.This study examined the constructs of Capability, Opportunity, and Motivation from the COM-B model and their influence on moderate-to-vigorous physical activity (MVPA). Using a prospective survey design, 186 healthy adults completed measures representing the Theoretical Domains Framework mapped to the COM-B, and MVPA one week later. The main indicators for the COM constructs were ‘habits’ (Capability), ‘subjective norms’ (Opportunity), and ‘exercise self-identity’ (Motivation). Motivation (77%) and MVPA (50%) were strongly predicted, with Capability and Motivation as key drivers of behaviour. Motivation was a strong mediator for Capability on behaviour. Future research should consider this approach for other populations and behaviours.Peer reviewe

The association between parenting behavior and somatization in adolescents explained by physiological responses in adolescents

Introduction: This study adds to the knowledge on somatization in adolescents by exploring its relation with parenting behavior and the mediating/moderating role of physiological responses in adolescents to parenting behavior. Method: Eighteen adolescents with high and 18 adolescents with low somatization scores and their mothers completed a discussion task, from which observed parenting behavior scores were derived. Skin conductance in adolescents was measured before and during the discussion. Results: For adolescents with high levels of physiological responses, unadaptive parenting was related to a higher chance of high somatization scores. For low physiologically responsive adolescents, the relation between parenting behavior and somatization was not significant. Conclusion: Parenting behavior is not univocally related to somatization in adolescents, but the association depends on physiological responses in adolescents. (C) 2014 Elsevier B.V. All rights reserved

Attachment relationships and internalization and externalization problems in a group of adolescents with pathological gambling disorder

Objective: The evidence accumulated in the relevant literature suggests that the presence and evolution of gambling could be correlated with the internalizing and externalizing problems and with the attachment style. This paper aims at exploring this perspective further. In particular, it analyses how such risk factors interact within the specific context of adolescent gambling disorder. Method: The sample comprises 91 adolescents, 61 male and 30 female, in the 17-22 age range (M = 17.77; SD = 0.98). A structural equation model was used to examine the relationship between the Youth Self-Report latent factors and pathological gambling, and the mode of attachment was assumed to act as a moderator. Results: Our results suggest that in the group characterized by a fearful attachment style there was a positive relationship between somatization and propensity to risk (p = 0.008), whereas in the dismissing attachment group there was a positive relationship between a greater tendency to delinquent behaviour and gambling risk (p = 0.042). Conclusions: The various insecure attachment stylespatterns may contribute in different ways to the development of oppositional-provocative behaviour and problems of conduct in adolescents