544 research outputs found

    Testing conditionality with Bourdieu's capital theory: How economic, social, and embodied cultural capital are associated with diet and physical activity in the Netherlands

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    Although Bourdieu's capital theory emphasized that economic, social, and embodied cultural capital interact to shape health behavior, existing empirical research mainly considered separate associations of the three forms of capital. Our aim was to investigate if and how economic, social, and embodied cultural capital are conditional on each other in their associations with adults' diet and physical activity.Cross-sectional, self-reported data from the 2014 GLOBE survey of 2812 adults aged between 25 and 75 years residing in Eindhoven, the Netherlands were used. Step-wise multiple logistic regression models included economic, social, and embodied cultural capital and adjustment for potential confounders. The models estimated odds ratios of main effects and two-way interactions of the forms of capital with fruit consumption, vegetable consumption, sports participation, and leisure time walking or cycling.In the main effects models, embodied cultural capital was consistently positively associated with all outcomes. Social capital was positively associated with sports participation, fruit consumption, and vegetable consumption, and economic capital was positively associated with sports participation and vegetable consumption. In the two-way interaction models, having specific higher levels of both economic and social capital strengthened their positive association with sports participation. No other combinations of capital were conditional on each other.Economic and social capital were conditional on each other in their association with sports participation, so interventions that provide both economic and social support may be especially effective for increasing this type of physical activity. As its association was strong with all outcomes but not conditional on other forms of capital, embodied cultural capital may operate distinctly from economic and social resources. Policy that takes differences in embodied cultural capital into account or changes to the environment that dampen the importance of embodied cultural resources for health behavior may help improve both diet and physical activity

    Association of Neighborhood Deprivation and Depressive Symptoms With Epigenetic Age Acceleration:Evidence From the Canadian Longitudinal Study on Aging

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    BACKGROUND: Neighborhood deprivation and depression have been linked to epigenetic age acceleration. The next-generation epigenetic clocks including the DNA methylation (DNAm) GrimAge, and PhenoAge have incorporated clinical biomarkers of physiological dysregulation by selecting cytosine-phosphate-guanine sites that are associated with risk factors for disease, and have shown improved accuracy in predicting morbidity and time-to-mortality compared to the first-generation clocks. The aim of this study is to examine the association between neighborhood deprivation and DNAm GrimAge and PhenoAge acceleration in adults, and assess interaction with depressive symptoms.METHODS: The Canadian Longitudinal Study on Aging recruited 51‚ÄÖ338 participants aged 45-85 years across provinces in Canada. This cross-sectional analysis is based on a subsample of 1 445 participants at baseline (2011-2015) for whom epigenetic data were available. Epigenetic age acceleration (years) was assessed using the DNAm GrimAge and PhenoAge, and measured as residuals from regression of the biological age on chronological age.RESULTS: A greater neighborhood material and/or social deprivation compared to lower deprivation (b‚ÄÖ=‚ÄÖ0.66; 95% confidence interval [CI]‚ÄÖ=‚ÄÖ0.21, 1.12) and depressive symptoms scores (b‚ÄÖ=‚ÄÖ0.07; 95% CI‚ÄÖ=‚ÄÖ0.01, 0.13) were associated with higher DNAm GrimAge acceleration. The regression estimates for these associations were higher but not statistically significant when epigenetic age acceleration was estimated using DNAm PhenoAge. There was no evidence of a statistical interaction between neighborhood deprivation and depressive symptoms.CONCLUSIONS: Depressive symptoms and neighborhood deprivation are independently associated with premature biological aging. Policies that improve neighborhood environments and address depression in older age may contribute to healthy aging among older adults living in predominantly urban areas.</p

    Climate distress, climate-sensitive risk factors, and mental health among Tanzanian youth:a cross-sectional study

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    Background:¬†Climate change threatens youth mental health through multiple mechanisms, yet empirical studies typically focus on single pathways. We explored feelings of distress over climate change among Tanzanian youth, considering associations with climate change awareness and climate-sensitive risk factors, and assessed how these factors relate to mental health.¬†Methods:¬†Tanzanian youth (aged 18‚Äď23 years) from a cluster randomised controlled trial in Mbeya and Iringa regions of Tanzania were interviewed between Jan 25, and March 3, 2021, and included in this cross-sectional study. A threshold of at least 10 on the ten-item Centre for Epidemiological Studies Depression Scale was used to classify symptom severity indicative of depression. Regardless of climate change awareness, respondents were asked about their feelings of distress on climate change using inclusive language (changing weather patterns or changing seasons). We estimated rate differences in climate change distress (slight or moderate or extreme vs none) by youth characteristics, extent of climate awareness, and climate-sensitive livelihoods (eg, agriculture, tending livestock) and climate-sensitive living conditions (eg, food or water insecurity), using generalised linear models. We compared depression prevalence by extent of climate change distress and climate-sensitive living conditions.Findings:¬†Among 2053 youth (1123 [55%] were male and 930 [45%] were female) included in this analysis, 946 (46%) had reported any distress about climate change. Distress was higher among female, more educated, more religious, older youth, and those working in extreme temperatures. Adjusting for climate awareness‚ÄĒa factor strongly associated with climate distress‚ÄĒhelped to explain some of these associations. Depression was 23 percentage points (95% CI 17‚Äď28) higher among youth who had severe water insecurity than those who did not. Similarly, youth who had severe food insecurity had 23 percentage points higher depression (95% CI 17‚Äď28) compared with those who did not. Those reporting climate change distress also had worse mental health‚ÄĒextremely distressed youth had 18 percentage points (95% CI 6‚Äď30) higher depression than those reporting none.¬†Interpretation:¬†Living in conditions worsened by climate change and feeling distressed over climate change have mental health implications among young people from low-resource settings, indicating that climate change can impact youth mental health through multiple pathways.¬†</p

    Socio-economic inequalities in smoking and drinking in adolescence:Assessment of social network dynamics

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    AIMS: We investigated whether (1) adolescents selected friends with a similar socio-economic status (SES), (2) smoking and alcohol consumption spread in networks and (3) the exclusion of non-smokers or non-drinkers differed between SES groups.DESIGN: This was a longitudinal study using stochastic actor-oriented models to analyze complete social network data over three waves.SETTING: Eight Hungarian secondary schools with socio-economically diverse classes took part.PARTICIPANTS: This study comprised 232 adolescents aged between 14 and 15‚ÄČyears in the first wave.MEASUREMENTS: Self-reported smoking behavior, alcohol consumption behavior and friendship ties were measured. SES was measured based upon entitlement to an income-tested regular child protection benefit.FINDINGS: Non-low-SES adolescents were most likely to form friendships with peers from their own SES group [odds ratio (OR)‚ÄČ=‚ÄČ1.07, 95% confidence interval (CI)‚ÄČ=‚ÄČ1.02-1.11]. Adolescents adjusted their smoking behavior (OR‚ÄČ=‚ÄČ24.05, 95% CI‚ÄČ=‚ÄČ1.27-454.86) but not their alcohol consumption (OR‚ÄČ=‚ÄČ1.65, 95% CI‚ÄČ=‚ÄČ0.62-4.39) to follow the behavior of their friends. Smokers did not differ from non-smokers in the likelihood of receiving a friendship nomination (OR‚ÄČ=‚ÄČ0.98, 95% CI‚ÄČ=‚ÄČ0.87-1.10), regardless of their SES. Alcohol consumers received significantly more friendship nominations than non-consumers (OR‚ÄČ=‚ÄČ1.16, 95% CI‚ÄČ=‚ÄČ1.01-1.33), but this association was not significantly different according to SES.CONCLUSIONS: Hungarian adolescents appear to prefer friendships within their own socio-economic status group, and smoking and alcohol consumption spread within those friendship networks. Socio-economic groups do not differ in the extent to which they encourage smoking or alcohol consumption.</p

    Micro urban spaces and mental well-being: Measuring the exposure to urban landscapes along daily mobility paths and their effects on momentary depressive symptomatology among older population

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    The urban environment plays an important role for the mental health of residents. Researchers mainly focus on residential neighbourhoods as exposure context, leaving aside the effects of non-residential environments. In order to consider the daily experience of urban spaces, a people-based approach focused on mobility paths is needed. Applying this approach, (1) this study investigated whether individuals’ momentary mental well-being is related to the exposure to micro-urban spaces along the daily mobility paths within the two previous hours; (2) it explored whether these associations differ when environmental exposures are defined considering all location points or only outdoor location points; and (3) it examined the associations between the types of activity and mobility and momentary depressive symptomatology. Using a geographically-explicit ecological momentary assessment approach (GEMA), momentary depressive symptomatology of 216 older adults living in the Ile-de-France region was assessed using smartphone surveys, while participants were tracked with a GPS receiver and an accelerometer for seven days. Exposure to multiple elements of the streetscape was computed within a street network buffer of 25 m of each GPS point over the two hours prior to the questionnaire. Mobility and activity type were documented from a GPS-based mobility survey. We estimated Bayesian generalized mixed effect models with random effects at the individual and day levels and took into account time autocorrelation. We also estimated fixed effects. A better momentary mental wellbeing was observed when residents performed leisure activities or were involved in active mobility and when they were exposed to walkable areas (pedestrian dedicated paths, open spaces, parks and green areas), water elements, and commerce, leisure and cultural attractors over the previous two hours. These relationships were stronger when exposures were defined based only on outdoor location points rather than all location points, and when we considered within-individual differences compared to between-individual differences

    The role of labor market inequalities in explaining the gender gap in depression risk among older US adults

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    We aim to investigate to what extent gender inequality at the labor market explains higher depression risk for older US women compared to men. We analyze data from 35,699 US adults aged 50‚Äď80 years that participated in the Health and Retirement Study. The gender gap is calculated as the difference in prevalence in elevated depressive symptoms (score ‚Č• 3 on the 8-item Center for Epidemiological Studies Depression Scale) between women and men. We employ a dynamic causal decomposition and simulate the life course of a synthetic cohort from ages 50‚Äď80 with the longitudinal g-formula and introduce four nested interventions by assigning women the same probabilities of A) being in an employment category, B) occupation class, C) current income and D) prior income group as men, conditional on women's health and family status until age 70. The gender gap in depression risk is 2.9%-points at ages 50‚Äď51 which increases to 7.6%-points at ages 70‚Äď71. Intervention A decreases the gender gap over ages 50‚Äď71 by 1.2%-points (95%CI for change: 2.81 to 0.4), intervention D by 1.64%-points (95%CI for change: 3.28 to ‚ąí0.15) or 32% (95%CI: 1.39 to 62.83), and the effects of interventions B and C are in between those of A and D. The impact is particularly large for Hispanics and low educated groups. Gender inequalities at the labor market substantially explain the gender gap in depression risk in older US adults. Reducing these inequalities has the potential to narrow the gender gap in depression.</p

    Public support for smoke-free policies in outdoor areas and (semi-)private places: a systematic review and meta-analysis

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    Background: Smoke-free policies are essential to protect people against tobacco smoke exposure. To successfully implement smoke-free policies that go beyond enclosed public places and workplaces, public support is important. We undertook a comprehensive systematic review of levels and determinants of public support for indoor (semi-)private and outdoor smoke-free policies. Methods: In this systematic review and meta-analysis, six electronic databases were searched for studies (published between 1 January 2004 and 19 January 2022) reporting support for (semi-)private and outdoor smoke-free policies in representative samples of at least 400 respondents aged 16 years and above. Two reviewers independently extracted data and assessed risk of bias of individual reports using the Mixed Methods Appraisal Tool. The primary outcome was proportion support for smoke-free policies, grouped according to location covered. Three-level meta-analyses, subgroup analyses and meta-regression were performed. Findings: 14,749 records were screened, of which 107 were included; 42 had low risk of bias and 65 were at moderate risk. 99 studies were included in the meta-analyses, reporting 326 measures of support from 896,016 individuals across 33 different countries. Support was pooled for indoor private areas (e.g., private cars, homes: 73%, 95% confidence interval (CI): 66‚Äď79), indoor semi-private areas (e.g., multi-unit housing: 70%, 95% CI: 48‚Äď86), outdoor hospitality areas (e.g., caf√© and restaurant terraces: 50%, 95% CI: 43‚Äď56), outdoor non-hospitality areas (e.g., school grounds, playgrounds, parks, beaches: 69%, 95% CI: 64‚Äď73), outdoor semi-private areas (e.g., shared gardens: 67%, 95% CI: 53‚Äď79) and outdoor private areas (e.g., private balconies: 41%, 95% CI: 18‚Äď69). Subcategories showed highest support for smoke-free cars with children (86%, 95% CI: 81‚Äď89), playgrounds (80%, 95% CI: 74‚Äď86) and school grounds (76%, 95% CI: 69‚Äď83). Non-smokers and ex-smokers were more in favour of smoke-free policies compared to smokers. Support generally increased over time, and following implementation of each smoke-free policy. Interpretation: Our findings suggested that public support for novel smoke-free policies is high, especially in places frequented by children. Governments should be reassured about public support for implementation of novel smoke-free policies. Funding: Dutch Heart Foundation, Lung Foundation Netherlands, Dutch Cancer Society, Dutch Diabetes Research Foundation and Netherlands Thrombosis Foundation

    Healthy immigrants, unhealthy ageing?:Analysis of health decline among older migrants and natives across European countries

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    The probability of having multiple chronic conditions simultaneously, or multimorbidity, tends to increase with age. Immigrants face a particularly high risk of unhealthy ageing. This study investigates the immigrant-native disparities in the speed of age-related chronic disease accumulation, focusing on the number of chronic health conditions; and considers the heterogeneity of this trajectory within immigrant populations by origin and receiving country. We use data from the Survey of Health, Ageing and Retirement in Europe from 2004 to 2020 on adults aged 50 to 79 from 28 European countries and employ both cross-sectional and longitudinal analyses. For longitudinal panel analyses, we use fixed-effects regression models to account for the unobserved heterogeneity related to individual characteristics including migration background. Our results indicate that immigrants report a higher number of chronic conditions at all ages relative to their native-born peers, but also that the immigrant-native differential in the number of chronic conditions decreases from age 65 onwards. When considering differences by origin country, we find that the speed of chronic disease accumulation is slower among immigrants from the Americas and the Asia and Oceania country groups than it is among natives. When looking at differences by receiving country group, we observe that the speed of accumulating chronic diseases is slower among immigrants in Eastern Europe than among natives, particularly at older ages. Our findings suggest that age-related trajectories of health vary substantially among immigrant populations by origin and destination country, which underscore that individual migration histories play a persistent role in shaping the health of ageing immigrant populations throughout the life course.</p

    Evaluation proposal of a national community-based obesity prevention programme: a novel approach considering the complexity perspective

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    Community-based obesity prevention programmes are considered an important strategy to curb the obesity epidemic. The JOGG (Youth At a Healthy Weight) approach is a large-scale community-based programme for childhood obesity prevention in the Netherlands that has been implemented over the past ten years. Practice-based development of the programme, both at the national and local level, increasingly poses challenges for its evaluation. One considerable challenge is the increasing acknowledgement of the complexity in the JOGG-approach, characterized by (a) objectives that vary locally, (b) adaptions to the programme over time in response to a community’s shifting needs, challenges and opportunities, and (c) emergent outcomes and non-linear causality. We propose an evaluation framework that highlights elements of the complex local practice, including the local programme theory, implementation, adaption, the influence of context and feedback loops and intended as well as emergent and unintended outcomes. By studying each of these elements in practice, we hope to learn about principles that guide effective obesity prevention across contexts. The results of the proposed evaluation will inform both practice and research. Considering complexity in evaluation is a relatively new challenge in public health and therefore an emergent research area. The proposed framework for complex evaluations allows to retrospectively evaluate a programme that was implemented and developed in practice, and enables us to learn from practice-based experiences. Following the ISBNPA Dare2Share initiative, we kindly invite other researchers in the field to share their ideas and experiences regarding integration of complexity in evaluation

    A wake-up call for social epidemiologists studying health inequalities: Response to Dijkstra & Horstman

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    In their paper, published in this journal, Dijkstra & Horstman critically reflect on a selection of social epidemiological articles and examine how low socioeconomic status populations are constructed in these articles. They identify four components which they argue represent the ‚Äúdominant thought style‚ÄĚ of this literature: 1) proliferation, 2) generalization, 3) problematization and 4) individualization. We largely agree with their first two points, but strongly disagree with the other two, and explain why in our reply. All in all, we believe that their analysis is a wake-up call for social epidemiologists, rightly pointing to the risk that the relevance and moral origins of the use and study of categories, like ‚Äėlow socioeconomic status‚Äô, can easily become less visible, and therefore should be articulated and explained every time
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