Public Health - Articles in Press

Lifestyle, weight perception and change in body mass index of Japanese workers: MY Health Up Study - Corrected Proof

2010-08-23

Summary: Objectives: To investigate the effect of weight perception and lifestyle on body mass index (BMI) over a 2-year period.Study design: Longitudinal study to compare the change in BMI (kg/m2) according to weight perception and lifestyle at baseline.Methods: Study subjects were 6029 men and 18,567 women aged 20–69 years who worked at a large financial firm in Japan. Subjects’ weight and height were measured in 2004 and 2006. The data in 2004 were used as baseline data. Weight perception and lifestyle factors, including eating, physical exercise, hours of sleep, smoking and alcohol consumption, were determined by a self-administered questionnaire in 2004.Results: The age-adjusted mean change in BMI over the 2-year period was –0.0593 among men and 0.0890 among women. In men, subjects who perceived themselves to be overweight had a reduced BMI 2 years later compared with subjects who perceived themselves to be ‘just right’ or underweight. Multiple regression analysis of lifestyle factors, adjusted for age and BMI at baseline, indicated that less time spent commuting, not having a hobby, not having a fixed lunch time, consumption of sweets, smoking and colleagues’ smoking were associated with increased BMI among men. Fewer hours of sleep, no fixed lunch time and frequent soft drink consumption were associated with increased BMI among women.Conclusions: A perception of being overweight was associated with a decrease in BMI for Japanese male workers. Positive lifestyle factors associated with a decrease in BMI in both men and women include having a fixed lunch time and being older. These factors should therefore be highlighted in future health promotion activities in workplaces.

It’s not just deprivation – or is it? - Corrected Proof

S. George — 2010-08-23

In this month’s issue of Public Health David Walsh and colleagues present us with that oldest of epidemiological puzzles: the unexplained difference. They explore what was first known as the “Scotland effect” but has now become the “Glasgow effect”.

Explaining the Glasgow effect: could adverse childhood experiences play a role? - Corrected Proof

P.D. Donnelly — 2010-08-23

The authors of “Its not just deprivation” make a convincing case for the existence of the so called Glasgow effect. They go on to raise a number of possible explanations which suggest the need for further research. One area not explicitly explored is that of adverse childhood experiences and their effect on later adult ill health.

Association of availability of tobacco products with socio-economic and racial/ethnic characteristics of neighbourhoods - Corrected Proof

M. Siahpush, P.R. Jones, G.K. Singh, L.R. Timsina, J. Martin — 2010-08-19

Summary: Objective: To examine the association of neighbourhood median income and racial/ethnic composition with the availability of tobacco products in Omaha Metropolitan Area, Nebraska, USA.Methods: A total of 94 census tracts were selected at random. The outcome measures were the percentage of stores that sold tobacco and the number of stores that sold tobacco per square mile in each census tract.Results: Median household income was negatively associated (P<0.001), and percentage African American population (P<0.001) and percentage Hispanic population (P=0.049) were positively associated with the percentage of stores that sold tobacco. Median household income was negatively associated (P<0.001) and percentage Hispanic population (P=0.012) was positively associated with the number of stores that sold tobacco per square mile.Conclusion: Policies that reduce the number of tobacco outlets might reduce social disparities in tobacco use.

Gender differences in adolescent health-related behaviour diminished between 1998 and 2006 - Corrected Proof

L. Pitel, A. Madarasova Geckova, J.P. van Dijk, S.A. Reijneveld — 2010-08-19

Summary: Objectives: Male teenagers used to smoke more than females, but this male:female ratio has reversed in several European countries over recent decades. The aim of this study was to assess whether a similar shift in gender differences in smoking and other health-related behaviours has occurred in Slovak adolescents over the last decade.Study design: Cross-sectional study.Methods: Data were collected in 1998 (n=2616, 52.4% male, mean age 14.9±0.6 years, response rate 96.3%) and 2006 (n=1081, 47.0% male, mean age 14.3±0.6 years, response rate 93.0%). Changes in gender-specific prevalence rates for smoking, alcohol consumption and lack of physical activity were assessed for both cohorts overall and by socio-economic group using the highest educational level of the parents.Results: Statistically significant changes occurred in the male:female ratios for smoking and lack of physical activity but not for alcohol consumption. The prevalence of smoking in males dropped below that in females, and the physical activity of females increased substantially. However, changes in gender ratios varied strongly by socio-economic group. The greatest shift in the gender ratio for smoking occurred in the middle socio-economic group, showing an increase in the entire sample. Changes in gender ratios over time among adolescents from the highest socio-economic group were much smaller.Conclusions: The behaviour of Slovak female adolescents has become similar to that of their male peers in terms of smoking and physical activity. This shift in the gender ratio in Slovakia over the last decade mimics the shift in Western Europe from approximately two decades ago.

Comparison of the perforation rate for acute appendicitis between nationals and migrants in Taiwan, 1996–2001 - Corrected Proof

T-L. Liu, J-H. Tsay, Y-J. Chou, N. Huang — 2010-08-18

Summary: Objective: Immigrant populations have grown rapidly in recent years in many countries. Immigrant-related healthcare issues have thus become more and more important. The aim of this study was to assess any possible disparity in access to care between migrants and nationals under the national health insurance (NHI) system in Taiwan.Study design: Retrospective population-based observational study.Methods: National population-based data on patients aged ≥20 years in Taiwan under the NHI programme were studied. The frequency of use and expenditure on ambulatory care, inpatient care and emergency care were analysed separately. Ruptured appendicitis was also analysed as an outcome indicator for access to care. Logistic regression and two-part models were applied.Results: Overall, migrants had a lower rate of healthcare utilization than nationals, and this gap remained consistent from 1996 to 2001. However, using ruptured appendicitis as the outcome indicator, no significant overall difference in access to care was found between nationals and migrants under the NHI programme in Taiwan (odds ratio 1.01, 95% confidence interval 0.93∼1.11).Conclusion: This study found that although migrants had a lower rate of healthcare utilization than nationals, their rate of adverse outcome was similar to nationals when they faced an acute, non-selective emergency condition such as appendicitis. The findings suggest that the use of more dimensional indicators may help to avoid possible misleading inferences on the variation in access to health care in Taiwan.

Does attendance at preschool affect adult health? A systematic review - Corrected Proof

K. D'Onise, R.A. McDermott, J.W. Lynch — 2010-08-17

Summary: Background: Early child development interventions can set children on positive social and educational trajectories. The aim of this review was to examine the evidence for the adult health impacts of centre-based preschool interventions for preschoolers.Methods: Medline, Embase, ERIC, Psych Info, Sociological Abstracts, the Cochrane Library, C2-SPECTR and the Head Start database were searched (1980–2008), and reference lists were searched for articles missed by the electronic search.Results: The 12 eligible articles reviewed reported multi-faceted interventions and involved disadvantaged populations in all but one study. Limitations included a restricted range of health outcomes, reliance on self-report measures (11 studies), small sample sizes (nine studies with <100 in each arm) and a relatively young adult age at follow-up. There were positive intervention effects across the majority of behavioural outcomes, and a suggestion of a reduction in symptoms of depression. Non-communicable disease outcomes (e.g. diabetes mellitus) tended to have adverse or near-zero effect estimates.Conclusions: The reviewed articles provide some support for the role of early childhood interventions to improve health behaviours but not chronic disease outcomes. Population health researchers should become more involved in the evaluation of preschool interventions as there is great potential for broad population health benefit.

Effectiveness of a puppet show on iodine knowledge, attitudes and behaviour of elementary students and the indirect effects on their parents and households in Ho Chi Minh City: a pilot study - Corrected Proof

Q.G. To, H.K. Le, T.T.Y. Dao, C.G. Magnussen, Q.T.K. Le — 2010-08-17

Deficiencies in iodine levels have been shown to seriously affect a child’s intellectual development and learning capacity. In South-East Asia, iodine deficiency remains a major public health concern. Approximately 30% of the region’s population of 503.6 million have insufficient iodine intake, and only 61% of households have access to iodized salt. For this reason, it is necessary to initiate effective, community-based health promotion activities that are targeted toward populations of various ages. A puppet show is one imaginative and entertaining method of health education that has been advocated for use in communicating positive health behaviours to children. The authors undertook a literature review and found no studies assessing the effectiveness of a puppet show to teach an iodine education programme.

Cuban healthcare providers in Venezuela: A case study - Corrected Proof

W.W. Westhoff, R. Rodriguez, C. Cousins, R.J. McDermott — 2010-08-16

Summary: Approximately 31,000 Cuban healthcare providers reside in Venezuela as part of an initiative to increase Venezuelans’ access to health care. The concept began in 1999 as part of the new constitution, and has grown steadily to include 6000 clinics, health promotion and prevention programmes, an integrated healthcare system, and a vision to train and deploy community public health physicians selected from and trained within the neighbourhood. In the case study described herein, physician–patient consultations increased from 3.5 million to 17 million, and the numbers of primary care physicians, nurses and dentists increased dramatically. Furthermore, in Caracas, there has been a 30% reduction in the use of emergency rooms at public hospitals. Estimates are provided for preventive services and potential lives saved. As health care is a politically-laden issue in many countries, all approaches to reducing healthcare disparities are worth analysing for their potential contributions to population health improvement.

Corrigendum to “Climate change and rising energy costs will change everything: a new mindset and action plan for 21st Century public health” [Public Health 122(2008) 658–663] - Corrected Proof

G. McCartney, F. Romanes — 2010-08-16

The authors regret that in the above paper, reference 18 should have been: Global Commons Institute 2000, ‘GCI Briefing: Contraction and Convergence’, Available at: http://www.gci.org.uk/Briefings/ICE.pdf [accessed 17.05.10] originally published as Meyer, A. 2000, Engineering Sustainability 157(4): 189–92.

It's not ‘just deprivation’: Why do equally deprived UK cities experience different health outcomes? - Corrected Proof

D. Walsh, N. Bendel, R. Jones, P. Hanlon — 2010-03-12

Summary: Background: The link between deprivation and health is well established. However, recent research has highlighted the existence of a ‘Scottish effect’, a term used to describe the higher levels of poor health experienced in Scotland over and above that explained by socio-economic circumstances. Evidence of this ‘excess’ being concentrated in West Central Scotland has led to discussion of a more specific ‘Glasgow effect’. However, within the UK, Glasgow is not alone in experiencing relatively high levels of poor health and deprivation; Liverpool and Manchester are two other cities which also stand out in this regard. Previous analyses of this ‘effect’ were also constrained by limitations of data and geography.Objectives: To establish whether there is evidence of a so-called ‘Glasgow effect’: (1) even when compared with its two most similar and comparable UK cities; and (2) when based on a more robust and spatially sensitive measure of deprivation than was previously available to researchers.Study design and methods: Rates of ‘income deprivation’ (a measure very highly correlated with the main UK indices of multiple deprivation) were calculated for small areas (average population size: 1600) in Glasgow, Liverpool and Manchester. All-cause and cause-specific standardized mortality ratios were calculated for Glasgow relative to Liverpool and Manchester, standardizing for age, gender and income deprivation decile. In addition, a range of historical census and mortality data were analysed.Results: The deprivation profiles of Glasgow, Liverpool and Manchester are almost identical. Despite this, premature deaths in Glasgow are more than 30% higher, with all deaths approximately 15% higher. This ‘excess’ mortality is seen across virtually the entire population: all ages (except the very young), both males and females, in deprived and non-deprived neighbourhoods. For premature mortality, standardized mortality ratios tended to be higher for the more deprived areas (particularly among males), and approximately half of ‘excess’ deaths under 65 years of age were directly related to alcohol and drugs. Analyses of historical data suggest that it is unlikely that the deprivation profile of Glasgow has changed significantly relative to Liverpool and Manchester in recent decades; however, the mortality gap appears to have widened since the early 1970s, indicating that the ‘effect’ may be a relatively recent phenomenon.Conclusion: While deprivation is a fundamental determinant of health and, therefore, an important driver of mortality, it is only one part of a complex picture. As currently measured, deprivation does not explain the higher levels of mortality experienced by Glasgow in relation to two very similar UK cities. Thus, additional explanations are required.