Explaining Socioeconomic Inequalities in Health Behaviours: the role of environmental factors

In general, those who are worse off in terms of power, knowledge and wealth are also worse off in terms of health. This inverse relation between socioeconomic status (ses ) and health has been observed for centuries . With few exceptions, the association exists regardless of the measure of ses that is employed (education, income, or occupation) or the health outcome studied. Still today, in a developed country like the Netherlands, considerable socioeconomic differences in health exist. Those with a lower socioeconomic position live three to five years shorter than their higher status counterparts (on average), and also spend ten to fifteen more years in poorer health. Lower socioeconomic groups have higher rates of morbidity and mortality from cardiovascular diseases, obesity, type 2 diabetes and cancers [, report more health problems and complaints, and have poorer self-perceived health. Despite all advances during the last century that have resulted in today’s modern society, health inequalities have not reduced over time, in fact, they have even widened over the recent decades. However, the common convention in nowadays’ Western societies is that socioeconomic health inequalities should be reduced, for several reasons. First, health inequalities are considered unjust, as the poorer health of lower socioeconomic groups is at least partly due to societal and environmental processes which are beyond their individual control. Secondly, good health and freedom of choice are valued high within our society, and good health is an important predisposition for every individual’s opportunities in life. Thirdly, if the average health status of lower ses groups could be upgraded to the level of their more advantaged counterparts, this would have large

The effects of small-scale physical and social environmental interventions on walking behaviour among Dutch older adults living in deprived neighbourhoods: Results from the quasi-experimental NEW.ROADS study

Purpose: Improving the physical and social conditions of residential neighbourhoods may increase walking, especially among older people. Evidence on the effects of physical and social environmental interventions, and particularly the combination of both, on walking behaviour is scarce. We evaluated the effects of a small-scale physical environmental intervention (designated walking route), a social environmental intervention (neighbourhood walking group) and the combination of both on walking behaviour of older adults living in deprived neighbourhoods. Methods: Survey data of 644 older adults residing in four deprived neighbourhoods of Rotterdam, the Netherlands, were used to compare changes in walking behaviour over time (weekly minutes spent recreational walking, utilitarian walking and total walking) of those exposed to 1) a designated walking route (physical condition), 2) walking groups (social condition), 3) walking routes and walking groups (combined condition), and 4) no intervention (control condition). Measurements took place at baseline (T0), and 3 months (T1) and 9 months (T2) after the intervention. Data were analysed on a multiple imputed dataset, using multi-level negative binomial regression models, adjusting for clustering of observations within individuals. All models were adjusted for demographic covariates. Results: Total time spent walking per week increased between T0 and T1 for all conditions. The Incidence Rate Ratio (IRR) for the physical condition was 1.46 (95% CI:1.06;2.05) and for the social intervention 1.52 (95%CI:1.07;2.16). At T2, these differences remained significant for the physical condition, but not for the social condition and the combined condition. These findings were mirrored for utilitarian walking. No evidence was found for an effect on recreational walking. Conclusion: Implementing small scale, feasible, interventions in a residential neighbourhood may increase total and utilitarian walking behaviour among older adults

Development of a framework to guide research into policies promoting physical activity and healthy diets in the European context: the system-based Policy Evaluation Network (PEN) framework

Background The Policy Evaluation Network (PEN) is a multidisciplinary Pan-European research consortium focussing on policies affecting dietary intake, physical activity and sedentary behaviour. At the start, the PEN consortium expressed the need for an overarching, system-based framework covering the complexities between the different domains of the policy process (design, implementation and outcomes) in order to execute all research activities in a coherent way. This article describes the PEN framework itself and its development process. Methods A staged approach to the development of a system-based framework was executed between February 2019 and February 2022. We started with a point-of-departure framework, made use of existing models, collected PEN outputs at different project stages (through online meetings, e-mail exchanges and workshops with PEN researchers) and drew updated versions of the framework, which resulted in the system-based PEN framework. Results The system-based PEN framework depicts the policy process as a complex system, visualizing the dynamic interrelations between and within policy domains (i.e. policy design, policy implementation and policy outcomes), the ways they interact with the context, and how to assure a focus on equity in each domain. Conclusions The system-based PEN framework may guide researchers and professionals involved in the evaluation of health- or sustainability-related policies to consider their evaluation in a comprehensive picture, including domain interactions, contextual influences and equity considerations, as these can have important implications for the scope of their research. The stage-based process as applied for the development of the PEN framework can serve as a template for other research projects wishing to develop their own framework

Екслібриси Станіслава Шодуара на книжках родового бібліотечного зібрання Шодуарів у фондах НБУВ

Проаналізовано екслібриси з рукописно-книжкового зібрання найвідомішого представника роду баронів Шодуарів – Станіслава Шодуара, зокрема, здійснений їх книгознавчий та мистецтвознавчий аналіз, визначено кількість та різновиди екслібрисів Станіслава Шодуара у різні періоди, атрибутовано авторство, встановлено роль екслібрисів у контексті формування та розвитку зібрання першої половини ХІХ ст.The author performs the analysis of the bookplates from the manuscript and book collection of the most famous member of the Chaudoir family – Stanislav Chaudoir. In particular, their bibliological and art analysis is carried out, the number and kinds of Chaudoir’s bookplates are defined, the authorship is attributed, the role of bookplates in the context of formation and growth of the collection if the 1st half of the 19th century is ascertained

How to Study and Understand Socioeconomic Inequalities in Health

Socioeconomic position (SEP) is a major fault line in contemporary societies that plays an important role in many aspects of people’s life chances, including their health. In this chapter, approaches and challenges to studying and understanding SEP and the impact of socioeconomic inequalities on health and society are discussed. Various explanations for socioeconomic inequalities are presented with an emphasis on the importance of considering factors at multiple levels, including cultural, psychosocial, material, behavioural, and environmental factors. Special attention is given to the influence of SEP-related stereotypes on solidarity and policymakers’ willingness to implement certain policies. This chapter discusses the complexity involved in measuring and explaining socioeconomic inequalities in health and how individual and structural approaches to address these inequalities can impact social justice

Urban population density and mortality in a compact Dutch city

We investigated the association and underlying pathways between urban population density and mortality in a compact mid-sized university city in the Netherlands. Baseline data from the GLOBE cohort study (N = 10,120 residents of Eindhoven) were linked to mortality after 23 years of follow up and analyzed in multilevel models. Higher population density was modestly related to increased mortality, independently of baseline socioeconomic position and health. Higher population density was related to more active transport, more perceived urban stress and smoking. Increased active transport suppressed the mortality-increasing impact of higher population density. Overall, in dense cities with good infrastructure for walking and cycling, high population density may negatively impact mortality

Residential area characteristics and disabilities among Dutch community-dwelling older adults

Background: Living longer independently may be facilitated by an attractive and safe residential area, which stimulates physical activity. We studied the association between area characteristics and disabilities and whether this association is mediated by transport-related physical activity (TPA). Methods: Longitudinal data of 271 Dutch community-dwelling adults aged 65years and older participating in the Elderly And their Neighbourhood (ELANE) study in 2011-2013 were used. Associations between objectively measured aesthetics (range 0-22), functional features (range 0-14), safety (range 0-16), and destinations (range 0-15) within road network buffers surrounding participants' residences, and self-reported disabilities in instrumental activities of daily living (range 0-8; measured twice over a 9months period) were investigated by using longitudinal tobit regression analyses. Furthermore, it was investigated whether self-reported TPA mediated associations between area characteristics and disabilities. Results: A one unit increase in aesthetics within the 400m buffer was associated with 0.86 less disabilities (95% CI -1.47 to -0.25; p<0.05), but other area characteristics were not related to disabilities. An increase in area aesthetics was associated with more TPA, and more minutes of TPA were associated with less disabilities. TPA however, only partly mediated the associated between area aesthetics and disabilities. Conclusions: Improving aesthetic features in the close by area around older persons' residences may help to prevent disability. © 2016 The Author(s)

Relaties van de fysieke omgeving met leefstijl, redzaamheid en sociale verbindingen

Onderzoeknaar de rol van de leefomgeving voor gezondheid en leefstijl is een relatief jong onderzoeksterrein. Ondanks een exponentiele toename in het aantal studies op dit terrein in de laatste twee decennia bestaat er

Sports participation, perceived neighborhood safety, and individual cognitions: how do they interact?

After publication of this work [Beenackers et al: Int J Behav Nutr Phys Act 2011, 8:76] it was realized that formula 3 and formula 4 in the Statistical Analysis section of the Methods were incorrectly listed. Since the formulas were correctly used in the analysis, this correction does not affect the results or conclusions of the paper