Hybrid journal (It can contain Open Access articles) ISSN (Print) 0143-005X - ISSN (Online) 1470-2738 This journal is no longer being updated because: the publisher no longer provides RSS feeds
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Ghassabian, A; Titus, A. R, Conderino, S, Azan, A, Weinberger, R, Thorpe, L. E. Pages: 273 - 276 Abstract: New York City (NYC) is slated to be the first jurisdiction in the USA to implement a cordon-based congestion tax, which will be levied on vehicles entering its Central Business District. Several cities around the world, for example, London and Stockholm, have had similar cordon-based pricing programmes, defined as road pricing that charges drivers a fee for entering a specified area (typically a congested urban centre). In addition to reducing congestion and creating revenue, projections suggest the NYC congestion pricing plan may yield meaningful traffic-related air quality improvements that could result in health benefits. NYC is a large city with high air pollution and substantial racial/ethnic and socioeconomic health inequities. The distinct geography and meteorological conditions of the city also suggest that the policy’s impact on air quality may extend beyond the NYC metropolitan area. As such, the potential breadth, directionality and magnitude of health impacts on communities who might be heavily affected by the nation’s first congestion pricing plan should be empirically investigated. We briefly review evaluation studies of other cordon-based congestion pricing policies and argue that implementation of this policy provides an excellent opportunity to employ a quasi-experimental study design to evaluate the policy’s impacts on air quality and health outcomes across population subgroups using a health equity lens. We discuss why real-time evaluations of the NYC congestion pricing plan can potentially help optimise benefits for communities historically negatively affected by traffic-related air pollution. Assessing intended and unintended impacts on health equity is key to achieving these goals. PubDate: 2024-04-10T00:45:29-07:00 DOI: 10.1136/jech-2023-221639 Issue No:Vol. 78, No. 5 (2024)
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Hu, Y; Metsä-Simola, N, Malmberg, S, Martikainen, P. Pages: 277 - 283 Abstract: BackgroundGrey divorce and later remarriage have become increasingly common in high-income countries, but previous evidence on their impacts on mental health is scarce. Even less is known about the effects of non-marital separation and re-partnering in later life.MethodsUsing Finnish registry data from 1996 to 2018 on 228 644 individuals aged 50–70 in 2000–2014, trajectories of antidepressant (AD) use 4 years before and 4 years after divorce, non-marital separation, bereavement and subsequent re-partnering were examined using individual fixed-effects (FE) linear probability models.ResultsIn adjusted FE models, for both genders AD use increased during the 4 years before divorce (men: 5.00 percentage points (95% CI 4.50 to 5.50); women: 6.96 (95% CI 6.34 to 7.59)), non-marital separation (men: 3.20 (95% CI 2.72 to 3.69); women: 5.98 (95% CI 5.30 to 6.66)) and bereavement (men: 4.53 (95% CI 3.97 to 5.09); women: 5.64 (95% CI 5.25 to 6.04)), with the increase accelerating immediately before the event. AD use gradually declined after union dissolution, after which it stabilised on a persistently higher level compared with pre-dissolution. Re-partnering was only associated with a small and transitory reduction in AD use (0.1–1.5 percentage points). The increases in AD use associated with union dissolution were larger in women than in men, whereas the small reductions in AD use associated with re-partnering were particularly short-lived among women.ConclusionsOur results suggest that union dissolution in later life is associated with large and persistent increases in AD use, whereas the reductions associated with re-partnering are limited both in magnitude and duration. Keywords:
Press releases
PubDate: 2024-04-10T00:45:29-07:00 DOI: 10.1136/jech-2023-221529 Issue No:Vol. 78, No. 5 (2024)
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Artazcoz, L; Cortes-Franch, I, Arcas, M. M, Olle-Espluga, L, Perez, K. Pages: 284 - 289 Abstract: BackgroundDespite its growing interest, time poverty is a neglected issue in public health analysis and policies. The objectives of this study were: (1) to analyse gender differences in paid, unpaid and total working time; (2) to identify gender differences in the factors related to time poverty; and (3) to examine gender differences in the relationship between time poverty, health and health-related behaviours in the city of Barcelona (Spain).MethodsCross-sectional study based on salaried workers aged 16–64 years interviewed in the 2021 Barcelona Health Survey (695 men and 713 women). Time poverty was defined as the top tercile of the total paid and unpaid work. Dependent variables were self-perceived health status, mental health, sleep time, sleep quality and leisure time physical activity.ResultsWomen were more likely to be time poor. In both sexes, time poverty was related to the number of children. Whereas among men time poverty was not associated with any health indicators, among women it was related to poor mental health status (aOR=2.11, 95% CI 1.39 to 3.20), short sleep (aOR=1.54, 95% CI 1.05 to 2.25), poor sleep quality (aOR=1.83, 95% CI 1.25 to 2.68) and low leisure time physical activity (aOR=1.50, 95% CI 1.00 to 2.26).ConclusionsThis study suggests that time use can be an important social determinant of health and of gender inequalities in health. At the local level, in many European cities, time poverty could be reduced, among other interventions, by increasing affordable and good quality public services for the care of dependent persons. PubDate: 2024-04-10T00:45:29-07:00 DOI: 10.1136/jech-2023-220750 Issue No:Vol. 78, No. 5 (2024)
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San Sebastian, M; Gustafsson, P. E, Stoor, J. P. A. Pages: 290 - 295 Abstract: BackgroundEthnic discrimination is acknowledged as a social determinant of health for Indigenous populations worldwide. This study aimed to investigate embodiment of perceived ethnic discrimination among the Sámi population in Sweden.MethodsA population-based health study was conducted among the Sámi population aged 18–84 years in 2021. Perceived discrimination was assessed by three variables: exposure to threat, humiliation treatment and ethnic discrimination. To capture current physical health, complaints of headache, back pain, stomach pain, sleeping problems, dizziness and tiredness were used. An overall somatic complaints score was created by summing up the six individual symptoms. The magnitude of the association between the independent variables and the outcomes was summarised with the β coefficients and prevalence ratios using 95% credible intervals (95% CrI) for inferential purposes.ResultsOverall, 4.3% reported to have been exposed to threat, 26.1% to humiliation and 11.2% and 32.3% to ethnic discrimination in the last 12 months and beyond 12 months, respectively. After mutual adjustment, threat (β=1.25; 95% CrI=0.88 to 1.60), humiliation (β=1.29; 95% CrI: 1.14 to 1.44) and the two categories of discrimination (β=0.92; 95% CI: 0.64 to 1.21 in the last 12 months and β=0.68; 95% CI: 0.54 to 0.83 beyond) remained significantly associated to the overall somatic complaints score. Similar results were found for individual complaints.ConclusionsThis study has shown a strong relationship between different expressions of perceived ethnic discrimination and a series of somatic complaints among the Sámi in Sweden. Efforts to alleviate interpersonal and institutional discrimination against the Sámi would contribute to improve their health. Keywords:
Open access
PubDate: 2024-04-10T00:45:29-07:00 DOI: 10.1136/jech-2023-221365 Issue No:Vol. 78, No. 5 (2024)
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McCann, Z. H; Chang, H. H, D'Souza, R, Scovronick, N, Ebelt, S. Pages: 296 - 302 Abstract: IntroductionAmbient particulate matter ≤ 2.5 µm in aerodynamic diameter (PM2.5) exposure elevates the risk for cardiovascular disease morbidity (CVDM). The aim of this study is to characterise which area-level measures of socioeconomic position (SEP) modify the relationship between PM2.5 exposure and CVDM in Missouri at the census-tract (CT) level.MethodsWe use individual level Missouri emergency department (ED) admissions data (n=3 284 956), modelled PM2.5 data, and yearly CT data from 2012 to 2016 to conduct a two-stage analysis. Stage one uses a case-crossover approach with conditional logistic regression to establish the baseline risk of ED visits associated with IQR changes in PM2.5. In the second stage, we use multivariate metaregression to examine how CT-level SEP modifies the relationship between ambient PM2.5 exposure and CVDM.ResultsWe find that overall, ambient PM2.5 exposure is associated with increased risk for CVDM. We test effect modification in statewide and urban CTs, and in the warm season only. Effect modification results suggest that among SEP measures, poverty is most consistently associated with increased risk for CVDM. For example, across Missouri, the highest poverty CTs are at an elevated risk for CVDM (OR=1.010 (95% CI 1.007 to 1.014)) compared with the lowest poverty CTs (OR=1.004 (95% CI 1.000 to 1.008)). Other SEP modifiers generally display an inconsistent or null effect.ConclusionOverall, we find some evidence that area-level SEP modifies the relationship between ambient PM2.5 exposure and CVDM, and suggest that the relationship between air-pollution, area-level SEP and CVDM may be sensitive to spatial scale. PubDate: 2024-04-10T00:45:29-07:00 DOI: 10.1136/jech-2023-221438 Issue No:Vol. 78, No. 5 (2024)
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Collonnaz, M; Minary, L, Riglea, T, Kalubi, J, O'Loughlin, J, Kestens, Y, Agrinier, N. Pages: 303 - 310 Abstract: BackgroundSocial network analysis (SNA) is often used to examine how social relationships influence adolescent health behaviours, but no study has documented the range of network measures used to do so. We aimed to identify network measures used in studies on adolescent health behaviours.MethodsWe conducted a systematic review to identify network measures in studies investigating adolescent health behaviours with SNA. Measures were grouped into eight categories based on network concepts commonly described in the literature: popularity, position within the network, network density, similarity, nature of relationships, peer behaviours, social norms, and selection and influence mechanisms. Different subcategories were further identified. We detailed all distinct measures and the labels used to name them in included articles.ResultsOut of 6686 articles screened, 201 were included. The categories most frequently investigated were peer behaviours (n=201, 100%), position within the network (n=144, 71.6%) and popularity (n=110, 54.7%). The number of measurement methods varied from 1 for ‘similarity on popularity’ (within the ‘similarity’ category) to 28 for the ‘characterisation of the relationship between the respondent and nominated peers’ (within the ‘nature of the relationships’ category). Using the examples of ‘social isolation’, ‘group membership’, ‘individuals in a central position’ (within the ‘position within the network’ category) and ‘nominations of influential peers’ (sub within the ‘popularity’ category), we illustrated the inconsistent reporting and heterogeneity in measurement methods and semantics.ConclusionRobust methodological recommendations are needed to harmonise network measures in order to facilitate comparison across studies and optimise public health intervention based on SNA. PubDate: 2024-04-10T00:45:29-07:00 DOI: 10.1136/jech-2023-220980 Issue No:Vol. 78, No. 5 (2024)
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Hahm, S; Altweck, L, Schmidt, S, Fleischer, T, Helmert, C, Ulke, C, Speerforck, S, Schomerus, G, Klinger-König, J, Grabe, H. J, Schmidt, C. O, Beutel, M. E, Brähler, E, Muehlan, H. Pages: 311 - 318 Abstract: BackgroundSocio-political change often leads to disruptions in employment and social networks, which can exacerbate health issues and increase mortality rates. These consequences are likely observed as an increase in negative life events (NLEs), serving as indicators of the broader social and health impacts. Using the German reunification in 1989/1990 as an example, this study investigates changes in reported numbers of NLEs and differences regarding sociodemographic characteristics.MethodsWe used data from the population-based Study of Health in Pomerania (SHIP-START-0, SHIP-Life-Events and Gene-Environment Interaction in Depression; N=1932). Numbers of NLEs in different categories (work/financial, social/interpersonal, illness (own) and illness/death (others)) were measured retrospectively in 5-year intervals (1980–2004) using a semistructured interview. Pre-reunification and post-reunification changes were modelled using piecewise mixed-effects Poisson regressions with the 1990–1994 interval (reunification) as change point. Interactions with age, sex and education were examined.ResultsThe number of most NLE categories, except social/interpersonal NLEs, increased at reunification. Whereas work/financial NLEs slightly decreased post-reunification, illness-related NLEs continued to increase. Higher numbers of social/interpersonal NLEs were found with younger age. More illness-related NLEs were reported with older age, lower education (illness (own)) and by women (illness/death (others)). However, the majority reported no NLEs at reunification (68.2%–80.7%, varying by category).ConclusionOur findings suggest that although some individuals experience a marked increase in NLEs due to socio-political changes, many remain unaffected, emphasising the need for a differentiated understanding of these effects. This increase in NLEs may partly account for ongoing health and well-being disparities among countries with differing transformation histories. Keywords:
Open access
PubDate: 2024-04-10T00:45:30-07:00 DOI: 10.1136/jech-2023-221549 Issue No:Vol. 78, No. 5 (2024)
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Lopez-Doriga Ruiz, P; Tapia, G, Bakken, I. J, Haberg, S. E, Gulseth, H. L, Skrivarhaug, T, Joner, G, Stene, L. C. Pages: 319 - 325 Abstract: BackgroundSocioeconomic status in the risk of developing type 1 diabetes seems inconsistent. We investigated whether risk of childhood-onset type 1 diabetes differed by parental education or occupation in a nationwide cohort.MethodsThis cohort study included all children born in Norway from 1974 to 2013. In individually linked data from nationwide population registries following children born in Norway up to 15 years of age, we identified 4647 with newly diagnosed type 1 diabetes during 15 381 923 person-years of follow-up.ResultsChildren of mothers with a master’s degree had lower risk of type 1 diabetes than children of mothers with completed upper secondary education only (adjusted incidence rate ratio, aIRR=0.82 95% CI: 0.70 to 0.95). There was no difference between upper secondary and lower secondary maternal education (aIRR=0.98, 95% CI: 0.89 to 1.08). Paternal education was not significantly associated with type 1 diabetes, lower secondary compared with upper secondary aIRR 0.96 (0.88–1.05) and master compared with upper secondary aIRR 0.93 (0.83–1.05). While maternal elementary occupation was associated with a lower risk of type 1 diabetes, specific maternal or paternal occupations were not.ConclusionsOur results suggested inverse U-shaped associations between maternal socioeconomic status and risk of type 1 diabetes. Non-linear associations may be part of the reason why previous literature has been inconsistent. PubDate: 2024-04-10T00:45:30-07:00 DOI: 10.1136/jech-2023-220693 Issue No:Vol. 78, No. 5 (2024)
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Metsä-Simola, N; Heggebo, K, Kjaer Urhoj, S, Martikainen, P, Einiö, E, Östergren, O. Pages: 326 - 333 Abstract: BackgroundPrior studies suggest that poor physical health, accompanied by functional disability, is associated with increased divorce risk. However, this association may depend on gender, the socioeconomic resources of the couple, as well as the social policy and social (in)equality context in which the illness is experienced. This study focuses on neurological conditions, which often have substantial functional consequences.MethodsWe used longitudinal population-wide register data from the years 2007–2016 (Denmark, Sweden) or 2008–2017 (Finland, Norway) to follow 2 809 209 married couples aged 30–64 for neurological conditions, identified using information on specialised healthcare for diseases of the nervous system and subsequent divorce. Cox regression models were estimated in each country, and meta-analysis used to calculate across-country estimates.ResultsDuring the 10-year follow-up period, 22.2% of couples experienced neurological conditions and 12.0% of marriages ended in divorce. In all countries, divorce risk was elevated among couples where at least one spouse had a neurological condition, and especially so if both spouses were ill. The divorce risk was either larger or similar for husband’s illness, compared with wife’s illness, in all educational categories. For the countries pooled, the weighted average HR was 1.21 (95% CI 1.20 to 1.23) for wives’ illness, 1.27 (95% CI 1.25 to 1.29) for husbands’ illness and 1.38 (95% CI 1.34 to 1.42) for couples where both spouses were ill.ConclusionsDespite some variation by educational resources and country context, the results suggest that the social consequences of illness are noticeable even in Nordic welfare states, with the husband’s illness being at least as important as the wife’s. Keywords:
Editor's choice
PubDate: 2024-04-10T00:45:30-07:00 DOI: 10.1136/jech-2023-221328 Issue No:Vol. 78, No. 5 (2024)
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Chen, K; Kornas, K, Rosella, L. C. Pages: 335 - 340 Abstract: BackgroundPredicting chronic disease incidence at a population level can help inform overall future chronic disease burden and opportunities for prevention. This study aimed to estimate the future burden of chronic disease in Ontario, Canada, using a population-level risk prediction algorithm and model interventions for equity-deserving groups who experience barriers to services and resources due to disadvantages and discrimination.MethodsThe validated Chronic Disease Population Risk Tool (CDPoRT) estimates the 10-year risk and incidence of major chronic diseases. CDPoRT was applied to data from the 2017/2018 Canadian Community Health Survey to predict baseline 10-year chronic disease estimates to 2027/2028 in the adult population of Ontario, Canada, and among equity-deserving groups. CDPoRT was used to model prevention scenarios of 2% and 5% risk reductions over 10 years targeting high-risk equity-deserving groups.ResultsBaseline chronic disease risk was highest among those with less than secondary school education (37.5%), severe food insecurity (19.5%), low income (21.2%) and extreme workplace stress (15.0%). CDPoRT predicted 1.42 million new chronic disease cases in Ontario from 2017/2018 to 2027/2028. Reducing chronic disease risk by 5% prevented 1500 cases among those with less than secondary school education, prevented 14 900 cases among those with low household income and prevented 2800 cases among food-insecure populations. Large reductions of 57 100 cases were found by applying a 5% risk reduction in individuals with quite a bit workplace stress.ConclusionConsiderable reduction in chronic disease cases was predicted across equity-defined scenarios, suggesting the need for prevention strategies that consider upstream determinants affecting chronic disease risk. Keywords:
Open access
PubDate: 2024-04-10T00:45:30-07:00 DOI: 10.1136/jech-2023-221080 Issue No:Vol. 78, No. 5 (2024)
Hybrid journal (It can contain Open Access articles)
