Insights into social disparities in smoking prevalence using Mosaic, a novel measure of socioeconomic status: an analysis using a large primary care dataset

<p>Abstract</p> <p>Background</p> <p>There are well-established socio-economic differences in the prevalence of smoking in the UK, but conventional socio-economic measures may not capture the range and degree of these associations. We have used a commercial geodemographic profiling system, Mosaic, to explore associations with smoking prevalence in a large primary care dataset and to establish whether this tool provides new insights into socio-economic determinants of smoking.</p> <p>Methods</p> <p>We analysed anonymised data on over 2 million patients from The Health Improvement Network (THIN) database, linked via patients' postcodes to Mosaic classifications (11 groups and 61 types) and quintiles of Townsend Index of Multiple Deprivation. Patients' current smoking status was identified using Read Codes, and logistic regression was used to explore the associations between the available measures of socioeconomic status and smoking prevalence.</p> <p>Results</p> <p>As anticipated, smoking prevalence increased with increasing deprivation according to the Townsend Index (age and sex adjusted OR for highest vs lowest quintile 2.96, 95% CI 2.92-2.99). There were more marked differences in prevalence across Mosaic groups (OR for group G vs group A 4.41, 95% CI 4.33-4.49). Across the 61 Mosaic types, smoking prevalence varied from 8.6% to 42.7%. Mosaic types with high smoking prevalence were characterised by relative deprivation, but also more specifically by single-parent households living in public rented accommodation in areas with little community support, having no access to a car, few qualifications and high TV viewing behaviour.</p> <p>Conclusion</p> <p>Conventional socio-economic measures may underplay social disparities in smoking prevalence. Newer classification systems, such as Mosaic, encompass a wider range of demographic, lifestyle and behaviour data, and are valuable in identifying characteristics of groups of heavy smokers which might be used to tailor cessation interventions.</p

The role of corporates in creating sustainable Olympic legacies

The Olympic Games is a major stimulus for increased tourism. In recent years there have been greater calls for this and other mega events to leave sustainable positive legacies for the host city, partly to offset the massive cost of hosting. To date, little consideration has been afforded to the role of corporates might play in contributing to event legacies. This gap is compounded by the lack of research examining stakeholder engagement in legacy planning more generally. This paper adopts Holmes, Hughes, Mair and Carlsen’s (2015) sustainable event legacy timeline to conceptualise how corporates through the Corporate Social Responsibility (CSR) initiatives of sponsorship and employee volunteering can engage across the Olympic event planning cycle to generate volunteering legacies. Drawing upon a comparative study of the Sydney 2000 and London 2012 Olympic Games, tentative evidence of corporate engagement was noted but for the most part it was fragmented and CSR initiatives primarily focused on the immediate planning and delivery stages of the event cycle. The paper advances new knowledge of how volunteering legacies can be generated through the best practice engagement of corporates as key stakeholders involved in legacy planning and governance across the Olympic planning cycle

Socioeconomic variations in access to smoking cessation interventions in UK primary care: insights using the Mosaic classification in a large dataset of primary care records

Background Smoking prevalence is particularly high amongst more deprived social groups. This cross-sectional study uses the Mosaic classification to explore socioeconomic variations in the delivery and/or uptake of cessation interventions in UK primary care. Methods Data from 460,938 smokers registered in The Health Improvement Network between 2008 and 2010 were analysed. Logistic regression was used to calculate odds ratios for smokers having a record of receiving cessation advice or a prescription for a cessation medication during the study period by Townsend quintile and for each of the 11 Mosaic groups and 61 Mosaic types. Both of these measures are area-level indicators of deprivation. Profiles of Mosaic categories were used to suggest ways to target specific groups to increase the provision of cessation support. Results Odds ratios for smokers having a record of advice or a prescription increased with increasing Townsend deprivation quintile. Similarly, smokers in more deprived Mosaic groups and types were more likely to have a documented cessation intervention. The odds of smokers receiving cessation advice if they have uncertain employment and live in social housing in deprived areas were 35% higher than the odds for successful professionals living in desirable areas (odds ratio (OR) 1.35, 95% confidence interval (CI) 1.20-1.52; absolute risks 57.2% and 50.1% respectively), and those in low-income families living in estate-based social housing were 50% more likely to receive a prescription than these successful professionals (OR 1.50, 95% CI 1.31-1.73; absolute risks 19.5% and 13% respectively). Smokers who did not receive interventions were generally well educated, financially successful, married with no children, read broadsheet newspapers and had broadband internet access. Conclusions Wide socioeconomic variations exist in the delivery and/or uptake of smoking cessation interventions in UK primary care, though encouragingly the direction of this variation may help to reduce smoking prevalence-related socioeconomic inequalities in health. Groups with particularly low intervention rates may be best targeted through broadsheet media, the internet and perhaps workplace-based interventions in order to increase the delivery and uptake of effective quit support