Are neighbourhood social capital and availability of sports facilities related to sports participation among Dutch adolescents?

<p>Abstract</p> <p>Background</p> <p>The aim of this study is to explore whether availability of sports facilities, parks, and neighbourhood social capital (NSC) and their interaction are associated with leisure time sports participation among Dutch adolescents.</p> <p>Methods</p> <p>Cross-sectional analyses were conducted on complete data from the last wave of the YouRAction evaluation trial. Adolescents (n = 852) completed a questionnaire asking for sports participation, perceived NSC and demographics. Ecometric methods were used to aggregate perceived NSC to zip code level. Availability of sports facilities and parks was assessed by means of geographic information systems within the zip-code area and within a 1600 meter buffer. Multilevel logistic regression analyses, with neighborhood and individual as levels, were conducted to examine associations between physical and social environmental factors and leisure time sports participation. Simple slopes analysis was conducted to decompose interaction effects.</p> <p>Results</p> <p>NSC was significantly associated with sports participation (OR: 3.51 (95%CI: 1.18;10.41)) after adjustment for potential confounders. Availability of sports facilities and availability of parks were not associated with sports participation. A significant interaction between NSC and density of parks within the neighbourhood area (OR: 1.22 (90%CI: 1.01;1.34)) was found. Decomposition of the interaction term showed that adolescents were most likely to engage in leisure time sports when both availability of parks and NSC were highest.</p> <p>Conclusions</p> <p>The results of this study indicate that leisure time sports participation is associated with levels of NSC, but not with availability of parks or sports facilities. In addition, NSC and availability of parks in the zip code area interacted in such a way that leisure time sports participation is most likely among adolescents living in zip code areas with higher levels of NSC, and higher availability of parks. Hence, availability of parks appears only to be important for leisure time sports participation when NSC is high.</p

Age-related difference in health care use and costs of patients with chronic kidney disease and matched controls

_Background_ The financial burden of chronic kidney disease (CKD) is increasing due to the ageing population and increased prevalence of comorbid diseases. Our aim was to evaluate age-related differences in health care use and costs in Stage G4/G5 CKD without renal replacement therapy (RRT), dialysis and kidney transplant patients and compare them to the general population. _Methods_ Using Dutch health care claims, we identified CKD patients and divided them into three groups: CKD Stage G4/G5 without RRT, dialysis and kidney transplantation. We matched them with two controls per patient. Total health care costs and hospital costs unrelated to CKD treatment are presented in four age categories (19–44, 45–64, 65–74 and ≥75 years). _Results_ Overall, health care costs of CKD patients ≥75 years of age were lower than costs of patients 65–74 years of age. In dialysis patients, costs were highest in patients 45–64 years of age. Since costs of controls increased gradually with age, the cost ratio of patients versus controls was highest in young patients (19–44 years). CKD patients were in greater need of additional specialist care than the general population, which was already evident in young patients. _Conclusion_ Already at a young age and in the earlier stages of CKD, patients are in need of additional care with corresponding health care costs far exceeding those of the general population. In contrast to the general population, the oldest patients (≥75 years) of all CKD patient groups have lower costs than patients 65–74 years of age, which is largely explained by lower hospital and medication costs

Healthcare costs of patients on different renal replacement modalities – Analysis of Dutch health insurance claims data

Background The aim of this study is to present average annual healthcare costs for Dutch renal replacement therapy (RRT) patients for 7 treatment modalities. Methods Health insurance claims data from 2012–2014 were used. All patients with a 2014 claim for dialysis or kidney transplantation were selected. The RRT related and RRT unrelated average annual healthcare costs were analysed for 5 dialysis modalities (in-centre haemodialysis (CHD), home haemodialysis (HHD), continuous ambulatory peritoneal dialysis (CAPD), automated peritoneal dialysis (APD) and multiple dialysis modalities in a year (Mix group)) and 2 transplant modalities (kidney from living and deceased donor, respectively). Results The total average annual healthcare costs in 2014 ranged from €77,566 (SD = €27,237) for CAPD patients to €105,833 (SD = €30,239) for patients in the Mix group. For all dialysis modalities, the vast majority (72–84%) of costs was RRT related. Patients on haemodialysis 4x/week had significantly higher average annual costs compared to those dialyzing 3x/ week (Δ€19,122). Costs for kidney transplant recipients were €85,127 (SD = €39,679) in the year of transplantation and rapidly declined in the first and second year after successful transplantation (resp. €29,612 (SD = €34,099) and €15,018 (SD = €16,186)). Transplantation with a deceased donor kidney resulted in higher costs (€99,450, SD = €36,036)) in the year of transplantation compared to a living donor kidney transplantation (€73,376, SD = €38,666). Conclusions CAPD patients have the lowest costs compared to other dialysis modalities. Costs in the year of transplantation are 25% lower for patients with kidneys from living vs. deceased donor. After successful transplantation, annual costs decline substantially to a level that is approximately 14–19% of annual dialysis costs

Neighborhood context and health: How neighborhood social capital affects individual health

Does it matter for my health in which neighborhood I live? The fact is, health is determined not only by individual characteristics but also by the neighborhood in which someone lives. This thesis shows that health clusters in Dutch neighborhoods and that this is not only a composition effect (that people with healthy characteristics cluster into one neighborhood and unhealthy people cluster in another neighborhood) but also a context effect. In addition to traditional explanations for this cluster, this thesis studies mainly the effects and conditions of neighborhood social capital on individual health. Neighborhood social capital can be defined as the access to resources which are generated by relationships between people in a friendly, well-connected and tightly knit community. Is the health of an individual actually affected by neighborhood social capital? If so, under which conditions is health affected most? And how can this association be explained? This dissertation is the first work that tests the effect of neighborhood social capital on individual health in a multilevel design while using data representative for a whole country (The Netherlands) and a number of control variables for both levels. The results of this dissertation showed a stable association between neighborhood social capital and health. The more neighborhood social capital, the better individual health was, independent of control variables for both individual and neighborhood levels of social capital as well as independent of individual-level social capital. Interestingly, people in urban areas report on average worse health and less social capital than people in rural areas; however, the neighborhood social capital does relate to their health, while it is not associated with the health of ‘rural’ people. A main finding of this dissertation is that individual health can be enhanced through neighborhood social capital without contacts with specific others. Furthermore, the results show that neighborhood social capital is especially valuable for people with low non-local individual-level social capital. Next, the results of this dissertation indicated that longer exposure to social capital is not necessarily better – the association is curvilinear. Finally, this dissertation presents one out of five possible health-related behaviors as a significant mediating factor for the association between neighborhood social capital and individual health. Several behaviors were tested: non-smoking, moderate alcohol intake, nutrition habits, sleep habits, and physical activity. Only physical activity significantly attenuated the association between neighborhood social capital and self-rated health. This dissertation aimed to clarify conditions and mechanisms of a health improving factor, with the goal that its results could be used by policymakers and neighborhood workers. These people often have to argue that neighborhood work matters. The difficult part is not only arguing that the context neighborhood matters but also that the people living in the neighborhoods and their interrelation matter

Neighborhood social capital and individual health.

Neighborhood social capital is increasingly considered to be an important determinant of an individual's health. Using data from the Netherlands we investigate the influence of neighborhood social capital on an individual's self-reported health, while accounting for other conditions of health on both the level of the neighborhood and the individual. We use national representative data ('The Housing and Living Survey', 2006) on the Netherlands with 61,235 respondents in 3273 neighborhoods. The cross-sectional data were combined with information provided by Statistics Netherlands on neighborhoods, i.e., the percentage of residents in the highest income quintile per neighborhood and the municipality's degree of urbanity. The association of neighborhood social capital with individual health was assessed by multilevel logistic regression analysis. Our results show that neighborhood social capital is positively associated with health. Interestingly, residents in urban neighborhoods benefit particularly from their neighborhood social capital. (aut. ref.

Nosocomial and ventilator-associated pneumonias: developing country perspective

Nosocomial pneumonias are recognized as an important cause of morbidity and mortality in industrialized nations. Emerging data show that they play a similar role in the developing world. A host of extrinsic and intrinsic factors predispose individuals to the development of pneumonias, and a modification of some of these factors provides a low cost solution to prevention of pneumonias. The ideal modality for microbiologic diagnosis of pneumonia remains to be determined. Recent data suggest that there is no difference in outcome when noninvasive techniques are compared with invasive techniques. Antimicrobial resistance is a rapidly increasing problem globally, and combating this with appropriate antibiotic policies, close surveillance, and physician education is essential

Social capital impact on individual health due to neighbours or the neighbourhood?

Background: We test two different perspectives on social capital and its association with health; a macro perspective focusing on resources on the neighbourhood level, and a micro perspective focusing on the individual level personal network. So far, most researchers inquired into these perspectives separately, and studies combining and testing both views are scarce. More specifically, we examine whether both macro and micro social capital are associated with individual’s health, whether a shortage of one type of social capital can be compensated by the other, and whether both types of social capital accumulate (that people who are rich in both types of social capital are better off). Methods: The ‘Dutch Housing Demand Survey’ is used and combined with relevant macro information (Statistics Netherlands). Results: In a logistic multilevel analysis we found that both forms of social capital were positively associated with self-perceived health. Having only few contacts to friends or family members is compensated by a high level of neighbourhood social capital. Micro and macro social capital also accumulate. We provide two possible explanations: micro-social capital might be an access to macro social capital, or a high social capital neighbourhood increases the likelihood of frequent contact to friends (e.g. the neighbourhood has a good image and friends like to come by). Conclusions: Macro social capital is associated with self-perceived health and it matters even while controlling for micro social capital. We propose that future research should take the interrelatedness of the two types of social capital into account

You have to be there to enjoy it? Neighbourhood social capital and health

Several studies have shown the positive effect of neighbourhood social capital on health. Existing research, however, has hitherto not studied whether the duration and intensity of exposure to neighbourhood social capital conditions and its effect on health. The aim of this study was to examine whether neighbourhood social capital affects individual’s health immediately and equally. Methods: We used two waves of the Dutch cross-sectional ‘Housing and Living Survey’. One (from 2009) as individual data (n = 65 990), and the other (from 2006) to estimate with ecometric measurements a social capital measure for 3001 Dutch neighbourhoods. We assessed by means of multilevel regression models the combined effect of exposure and amount of neighbourhood social capital on self-rated health. Results: Duration of exposure, measured by the length of stay in the same neighbourhood is not linearly associated with individual health. Health of people who live up to 6 years or >22 years in the same neighbourhood is not affected by neighbourhood social capital. People with young children in the household or elderly were assumed to be more intensively exposed. However, exposure intensity was only found to have an effect for households with young children. Conclusions: Duration and intensity of exposure to neighbourhood social capital, a social aspect of the environment, matters for people’s health. Interventions focusing on the health of people with young children may want to stimulate the creation of neighbourhood social capital

You have to be there to enjoy it? Neighbourhood social capital and health.

Background: Several studies have shown the positive effect of neighbourhood social capital on health. Existing research, however, has hitherto not studied whether the duration and intensity of exposure to neighbourhood social capital conditions and its effect on health. The aim of this study was to examine whether neighbourhood social capital affects individual’s health immediately and equally. Methods: We used two waves of the Dutch cross-sectional ‘Housing and Living Survey’. One (from 2009) as individual data (n = 65 990), and the other (from 2006) to estimate with ecometric measurements a social capital measure for 3001 Dutch neighbourhoods. We assessed by means of multilevel regression models the combined effect of exposure and amount of neighbourhood social capital on self-rated health. Results: Duration of exposure, measured by the length of stay in the same neighbourhood is not linearly associated with individual health. Health of people who live up to 6 years or >22 years in the same neighbourhood is not affected by neighbourhood social capital. People with young children in the household or elderly were assumed to be more intensively exposed. However, exposure intensity was only found to have an effect for households with young children. Conclusions: Duration and intensity of exposure to neighbourhood social capital, a social aspect of the environment, matters for people’s health. Interventions focusing on the health of people with young children may want to stimulate the creation of neighbourhood social capital. (aut. ref.