Health Equity in Cancer Screening in Calgary – A Geographic Approach to Account for Population Socioeconomic Status

Introduction There is substantial evidence that cancer screening rates are lower among Canadians with low socioeconomic status (SES) than they are among those with higher SES. In order to optimize cancer screening, there is a need to reduce inequities in cancer screening. Objectives and Approach The purpose of this study is to understand how breast, colorectal and cervical cancer screening participation varies by socioeconomic status within local geographic areas (LGAs) in the city of Calgary. A Bayesian multilevel regression method with a spatial component was used to estimate Standardized Incidence Rates (SIR) at the LGA level. Bivariate spatial clustering analyses between screening rates at the Dissemination Area (DA) level and Pampalon material and social deprivation index was performed to better understand spatial structures of low and high screening rates compared to high and low material and social deprivation scores within LGAs. Results The effect of material (income, education and employment) and social (living alone, separated, and divorced or windowed) deprivation on lower screening rates was stronger for breast cancer screening, compared to cervical and colorectal screening. Estimated likelihood of screening significantly decreased from the least deprived to the most deprived (9% for the material component and 18% for the social component for Breast cancer; 8% for the material component and 10% for the social component for cervical cancer screening). Clusters of lower screening rates and higher social and material deprivation were identified in the northeastern and central areas of the city. Conclusion/Implications The study allowed identifying LGAs and neighborhoods within those LGAs that have lower screening rates likely to be explained by the material and social deprivation of the population. The approach provides additional evidence for planning targeted interventions and reducing inequities for screening

Intergenerational teen pregnancy: a population based cohort study

Introduction Mothers can influence on a teen’s knowledge and attitude about sexual and reproductive health practices. Prior studies on intergenerational teen pregnancy between mother and daughter were largely limited to livebirths. Objectives and Approach To estimate the odds of intergenerational teenage pregnancy, and whether there is a coupling tendency between mother and daughter in how their teen pregnancies end, such as induced abortion (IA) vs. livebirth. A cohort study was conducted in Ontario, Canada among 15,097 mothers and their 16,177 daughters. The mother and her daughter were each assessed, between ages 15-19 years, for the number and nature of teenage pregnancy. The nature of teen pregnancy was categorized as i) no teen pregnancy, ii) ≥1 teen pregnancy, all exclusively ending with livebirth, and iii) ≥1 teen pregnancy, with at least one ending with IA. Results 13,036 daughters’ mothers had a teen pregnancy and 3,141 daughters’ mothers did not. Teen pregnancy occurred among 3,777(29.0%) and 513(16.2%) daughters, respectively. The adjusted odds ratio (aOR) of a daughter having a teen pregnancy was 1.42 (95% CI 1.25-1.61) if her mother had 1, 1.97 (95% CI 1.71-2.26) if her mother had 2, and 2.17 (95% CI 1.84-2.56) if her mother had ≥3 teen pregnancies, relative to none. If a mother had ≥1 teen pregnancy ending with IA, then her daughter had an aOR of 2.12 (95% CI 1.76-2.56) for having a teen pregnancy also ending with IA; whereas, if a mother had ≥1 teen pregnancy, all ending with livebirth, then her daughter had an aOR of 1.73 (95% CI 1.46-2.05) for that same outcome. Conclusion/Implications There is a strong intergenerational occurrence of teenage pregnancy between a mother and daughter, including a coupling tendency in how the pregnancy ends. Such evidence supports the use of family-centered interventions that engage parents to reduce unprotected sex and unintended pregnancies among teenagers

Le bonheur au xviiie siècle

Le bonheur a-t-il été une idée neuve du xviiie siècle ? Prolongeant les travaux antérieurs, en particulier de Robert Mauzi dans L’idée du bonheur dans la littérature et la pensée françaises au xviiiesiècle, le présent recueil se propose une exploration de cette « idée-force » qui « éclaire l’unité du siècle » et qui « recouvre toutes les contradictions du temps ». Plusieurs domaines sont minutieusement explorés : littéraire, social, politique, philosophique, esthétique et éthique. Cette notion complexe et polysémique est approchée chez des auteurs tels que Rousseau, Diderot, Casanova ou Rétif de La Bretonne. Les divers axes et perspectives de recherche suggèrent l’expansion de cette idée-slogan : théories de la fiction, histoire des idées, poétique des genres et regards croisés. En soulignant la solidarité entre le mouvement des idées et l’analyse de la société et des arts, les contributions réunies ici font émerger la sensibilité d’une époque, les représentations et les expériences collectives et individuelles