Preventive medicine
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Preventive medicine · Apr 2021
Exploring neighborhood socioeconomic disparity in self-rated health: a multiple mediation analysis.
There is still a need for more empirical investigations to better understand the causal pathways by which neighborhood socioeconomic contexts translate into states of health. This study explored the relationship between neighborhood socioeconomic position and health, as well as the role of social cohesion, violence, places to buy healthy food, and sports and leisure spaces in mediating this relationship in a diverse set of neighborhoods in Brazil. We applied a general multiple mediation approach to analyze a cross-sectional survey of 4.046 adults living in 149 neighborhoods in 2008 and 2009. ⋯ We did not ascertain as mediators social cohesion, places to buy healthy food, and sports and leisure spaces. Violence perception mediates the relationship between neighborhood socioeconomic position and self-rated health. Targeted interventions designed to improve the health status of the population could usefully focus on reducing the level of violence in which people live.
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Preventive medicine · Apr 2021
The multivariate physical activity signature associated with body mass index in young children.
The evidence regarding associations between intensity-specific physical activity and adiposity in young children is conflicting. Moreover, the evidence is limited by analytical approaches that cannot handle the multicollinearity among multiple variables across the entire intensity spectrum. We aimed to determine the multivariate physical activity intensity signature associated with body mass index in a large sample of preschool children aged 3-6 years. 1182 Norwegian preschool children (mean age 4.7 years, 51% boys) provided data on physical activity (ActiGraph GT3X+) and body mass index during 2015-2016. ⋯ Association patterns were comparable for boys and girls. In conclusion, we found clear associations with body mass index across the physical activity intensity spectrum in preschool children. However, the age-specific association patterns suggest negative (unfavorable) associations with vigorous physical activity intensities develop around 5-6 years of age.
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Preventive medicine · Apr 2021
Device-measured physical activity and sedentary behaviour in relation to mental wellbeing: An analysis of the 1970 British cohort study.
Although physical activity and sedentary behaviour have established associations with mental illness, the extent to which they impact on mental wellbeing is not well understood. We examined associations between moderate to vigorous physical activity (MVPA), sitting time (ST) and mental wellbeing in 4526 participants from the 1970 British Cohort Study (UK) in the age 46 survey (2016-18). MVPA and ST were measured using a thigh mounted accelerometer device (activPAL 3 micro) worn continuously for 7 days and participants completed the 14-item Warwick-Edinburg Mental Wellbeing Scale (WEMWBS) to assess mental wellbeing. ⋯ Our main limitation was the cross-sectional design which precludes any inference of direction of association or causality. Nevertheless, interventions to promote MVPA may be an effective public health policy to promote mental wellbeing. Further investigation of the effect different sitting behaviours has on mental wellbeing is warranted.
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Preventive medicine · Apr 2021
Alcohol policy effects on 100% chronic alcohol-attributable mortality across racial/ethnic subgroups.
In the United States, some racial/ethnic minorities suffer from higher rates of chronic alcohol problems, and alcohol-related morbidity and mortality than Whites. Furthermore, state-level alcohol policies may affect racial/ethnic subgroups differentially. We investigate effects of beverage-specific taxes and government control of spirits retail on alcohol-related mortality among non-Hispanic Whites, non-Hispanic Blacks, non-Hispanic American Indians/Alaska Natives (AI/AN) and Hispanics using death certificate and state-level alcohol policy data for 1999-2016. ⋯ Tax associations were not robust. Results support that government control of spirits retail is associated with significantly lower 100% AAD from chronic causes Overall and among non-Hispanic Whites and Hispanics. Government control of spirits retail may reduce both population-level 100% chronic AAD as well as racial/ethnic disparities in 100% chronic AAD.
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Preventive medicine · Apr 2021
Removing conscientious objection: The impact of 'No Jab No Pay' and 'No Jab No Play' vaccine policies in Australia.
Vaccine refusal and hesitancy pose a significant public health threat to communities. Public health authorities have been developing a range of strategies to improve childhood vaccination coverage. This study examines the effect of removing conscientious objection on immunisation coverage for one, two and five year olds in Australia. ⋯ The improvement in coverage was largest in areas with greater socioeconomic disadvantage, lower median income, more benefit dependency, and higher pre-policy baseline coverage. Overall, while immunisation coverage has increased post removal of conscientious objection, the policies have disproportionally affected lower income families whereas socioeconomically advantaged areas with lower baseline coverage were less responsive. More effective strategies require investigation of differential policy effects on vaccine hesitancy, refusal and access barriers, and diagnosis of causes for unresponsiveness and under-vaccination in areas with persistently low coverage, to better address areas with persistent non-compliance with accordant interventions.