16 results
Search Results
2. A labour of Sisyphus? Public policy and health inequalities research from the Black and Acheson Reports to the Marmot Review.
- Author
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Bambra, C., Smith, K. E., Garthwaite, K., Joyce, K. E., and Hunter, D. J.
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PREVENTION of obesity ,EDUCATION ,EMPLOYMENT ,EXERCISE ,FOOD ,GREENHOUSE effect ,HEALTH behavior ,HEALTH services accessibility ,HOUSING ,MATHEMATICAL models ,HEALTH policy ,MEDICAL research ,NATIONAL health services ,PRACTICAL politics ,TRANSPORTATION ,WORK environment ,THEORY ,GOVERNMENT policy ,LIFESTYLES - Abstract
Objectives To explore similarities and differences in policy content and the political context of the three main English government reports on health inequalities: the Black Report (1980), the Acheson Enquiry (1998), and the Marmot Review (2010). Methods Thematic policy and context analysis of the Black Report (1980), the Acheson Enquiry (1998), and the Marmot Review (2010) in terms of: (i) underpinningtheoretical principles; (ii) policy recommendations; (iii) the political contexts in which each was released; and (iv) their actual or potential influence on research and policy. Results There were great similarities and very few differences in terms of both the theoretical principles guiding the recommendations of these reports and the focus of the recommendations themselves. However, there were clear differences in terms of the political contexts of each report, as well as their subsequent impacts on research and policy. Conclusion The paper calls into question the progress of health inequalities research, the use of evidence and of the links between research, politics and policy. [ABSTRACT FROM AUTHOR]
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- 2011
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3. Well London Phase-1: results among adults of a cluster-randomised trial of a community engagement approach to improving health behaviours and mental well-being in deprived inner-city neighbourhoods.
- Author
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Phillips, Gemma, Bottomley, Christian, Schmidt, Elena, Tobi, Patrick, Lais, Shahana, Ge Yu, Lynch, Rebecca, Lock, Karen, Draper, Alizon, Moore, Derek, Clow, Angela, Petticrew, Mark, Hayes, Richard, and Renton, Adrian
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BEHAVIOR modification ,COMMUNITIES ,CONFIDENCE intervals ,HEALTH behavior ,HEALTH promotion ,QUESTIONNAIRES ,RESEARCH funding ,STATISTICAL sampling ,CITY dwellers ,WELL-being ,RANDOMIZED controlled trials ,RELATIVE medical risk ,PHYSICAL activity ,DESCRIPTIVE statistics - Abstract
Background We report the main results, among adults, of a cluster-randomised-trial of Well London, a community-engagement programme promoting healthy eating, physical activity and mental well-being in deprived neighbourhoods. The hypothesis was that benefits would be neighbourhood-wide, and not restricted to intervention participants. The trial was part of a multicomponent process/outcome evaluation which included nonexperimental components (self-reported behaviour change amongst participants, case studies and evaluations of individual projects) which suggested health, well-being and social benefits to participants. Methods Twenty matched pairs of neighbourhoods in London were randomised to intervention/control condition. Primary outcomes (five portions fruit/vegetables/day; 5×30 m of moderate intensity physical activity/week, abnormal General Health Questionnaire (GHQ)-12 score and Warwick–Edinburgh Mental Well-being Scale (WEMWBS) score) were measured by postintervention questionnaire survey, among 3986 adults in a random sample of households across neighbourhoods. Results There was no evidence of impact on primary outcomes: healthy eating (relative risk [RR] 1.04, 95% CI 0.93 to 1.17); physical activity (RR:1.01, 95% CI 0.88 to 1.16); abnormal GHQ12 (RR:1.15, 95% CI 0.84 to 1.61); WEMWBS (mean difference [MD]: −1.52, 95% CI −3.93 to 0.88). There was evidence of impact on some secondary outcomes: reducing unhealthy eating-score (MD: −0.14, 95% CI −0.02 to 0.27) and increased perception that people in the neighbourhood pulled together (RR: 1.92, 95% CI 1.12 to 3.29). Conclusions The trial findings do not provide evidence supporting the conclusion of non-experimental components of the evaluation that intervention improved health behaviours, well-being and social outcomes. Low participation rates and population churn likely compromised any impact of the intervention. Imprecise estimation of outcomes and sampling bias may also have influenced findings. There is a need for greater investment in refining such programmes before implementation; new methods to understand, longitudinally different pathways residents take through such interventions and their outcomes, and new theories of change that apply to each pathway. [ABSTRACT FROM AUTHOR]
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- 2014
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4. Evaluating social and behavioural impacts of English smoke-free legislation in different ethnic and age groups: implications for reducing smoking-related health inequalities.
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Lock, K., Adams, E., Pilkington, P., Duckett, K., Gilmore, A., and Marston, C.
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SMOKING laws ,SMOKING prevention ,SMOKING & psychology ,AGE distribution ,HEALTH promotion ,HEALTH behavior ,INTERVIEWING ,LONGITUDINAL method ,RESEARCH methodology ,RACE ,RESEARCH funding ,SMOKING ,SMOKING cessation ,SOCIAL isolation ,SOUND recordings ,QUALITATIVE research ,JUDGMENT sampling ,SOCIAL context ,THEMATIC analysis ,LAW - Abstract
Objective To explore social and behavioural impacts of English smoke-free legislation (SFL) in different ethnic groups. Design A longitudinal, qualitative panel study of smokers using in-depth interviews conducted before and after introduction of SFL. Participants A purposive sample of 32 smokers selected from three ethnic groups in deprived London neighbourhoods with approximately equal numbers of younger and older, male and female respondents. Results SFL has had positive impacts with half smoking less and three quitting. Although there were no apparent differences in smoking and quitting behaviours between groups, there were notable differences in the social impacts of SFL. The greatest negative impacts were in smokers over 60 years, potentially increasing their social isolation, and on young Somali women whose smoking was driven more underground. In contrast, most other young adult smokers felt relatively unaffected by SFL, describing unexpected social benefits. Although there was high compliance, reports of illegal smoking were more frequent among young, ethnic minority smokers, with descriptions of venues involved suggesting they are ethnically distinct and well hidden. Half of respondents reported stopping smoking in their own homes after SFL, but almost all were Somali or Turkish. White respondents tended to report increases in home smoking. Discussion Although our study suggests that SFL can lead to reductions in tobacco consumption, it also shows that impacts vary by ethnicity, age and sex. This study highlights the importance of understanding the meaning of smoking in different social contexts so future tobacco control interventions can be developed to reduce health and social inequalities. [ABSTRACT FROM AUTHOR]
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- 2010
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5. Dental attendance and behavioural pathways to adult oral health inequalities.
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Guarnizo Herreño, Carol C., Scholes, Shaun, Heilmann, Anja, O'Connor, Rhiannon, Fuller, Elizabeth, Jing Shen, Watt, Richard G., Morris, Steve, Wildman, John, and Tsakos, Georgios
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STRUCTURAL equation modeling ,ORAL health ,ECONOMIC status ,TOOTH care & hygiene ,SOCIOECONOMIC factors ,HEALTH behavior ,SOCIAL classes ,HEALTH equity ,SMOKING ,EDUCATIONAL attainment - Published
- 2021
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6. Changing behaviour: an essential component of tackling health inequalities.
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Marteau, Theresa M., Rutter, Harry, and Marmot, Michael
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HEALTH policy ,LIFE expectancy ,SOCIOECONOMIC factors ,HEALTH behavior ,HEALTH & social status ,HEALTH equity ,POLICY sciences ,BEHAVIOR modification ,COVID-19 pandemic - Published
- 2021
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7. Did Henry make Leeds's child obesity fall?
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Thornton, Jacqui
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PREVENTION of childhood obesity ,BEHAVIOR modification ,HEALTH behavior ,CHILDHOOD obesity ,SOCIAL media ,HUMAN services programs ,PARENTING education - Published
- 2019
8. Socioeconomic inequality in recovery from poor physical and mental health in mid-life and early old age: prospective Whitehall II cohort study.
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Tanaka, Akihiro, Shipley, Martin J., Welch, Catherine A., Groce, Nora E., Marmot, Michael G., Kivimaki, Mika, Singh-Manoux, Archana, and Brunner, Eric J.
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ADIPOSE tissues ,AGE distribution ,BLOOD pressure ,BLUE collar workers ,HUMAN body composition ,CHOLESTEROL ,CHRONIC diseases ,CONFIDENCE intervals ,CONVALESCENCE ,EMPLOYMENT ,ETHNIC groups ,HEALTH behavior ,LONGITUDINAL method ,MENTAL health ,PHYSICAL fitness ,QUESTIONNAIRES ,RETIREMENT ,SEX distribution ,SOCIOECONOMIC factors ,BODY mass index ,DISEASE prevalence ,ODDS ratio - Published
- 2018
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9. Role of psychosocial work factors in the relation between becoming a caregiver and changes in health behaviour: results from the Whitehall II cohort study.
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Dich, Nadya, Head, Jenny, and Rod, Naja Hulvej
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CAREGIVERS ,CONFIDENCE intervals ,STATISTICAL correlation ,HEALTH behavior ,LONGITUDINAL method ,QUESTIONNAIRES ,RESEARCH funding ,REPEATED measures design ,WORK-life balance ,DATA analysis software ,DESCRIPTIVE statistics ,ODDS ratio - Published
- 2016
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10. Explanatory factors for health inequalities across different ethnic and gender groups: data from a national survey in England.
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Mindell, J. S., Knott, C. S., Ng Fat, L. S., Roth, M. A., Manor, O., Soskolne, V., and Daoud, N.
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HEALTH equity ,CONFIDENCE intervals ,ETHNOPSYCHOLOGY ,HEALTH behavior ,RACE ,RESEARCH funding ,SELF-evaluation ,LOGISTIC regression analysis ,SOCIOECONOMIC factors ,DATA analysis software ,HEALTH & social status ,DESCRIPTIVE statistics ,ODDS ratio ,PSYCHOLOGY - Abstract
Background: The objective of this study was to examine the relative contribution of factors explaining ethnic health inequalities (EHI) in poor self-reported health (pSRH) and limiting long-standing illness (LLI) between Health Survey for England (HSE) participants. Method: Using HSE 2003–2006 data, the odds of reporting pSRH or of LLI in 8573 Bangladeshi, Black African, Black Caribbean, Chinese, Indian, Irish and Pakistani participants was compared with 28 470 White British participants. The effects of demographics, socioeconomic position (SEP), psychosocial variables, community characteristics and health behaviours were assessed using separate regression models. Results: Compared with White British men, age-adjusted odds (OR, 95% CI) of pSRH were higher among Bangladeshi (2.05, 1.34 to 3.14), Pakistani (1.77, 1.34 to 2.33) and Black Caribbean (1.60, 1.18 to 2.18) men, but these became non-significant following adjustment for SEP and health behaviours. Unlike Black Caribbean men, Black African men exhibited a lower risk of age-adjusted pSRH (0.66, 0.43 to 1.00 (p=0.048)) and LLI (0.45, 0.28 to 0.72), which were significant in every model. Likewise, Chinese men had a lower risk of age-adjusted pSRH (0.51, 0.26 to 1.00 (p=0.048)) and LLI (0.22, 0.10 to 0.48). Except in Black Caribbean women, adjustment for SEP rendered raised age-adjusted associations for pSRH among Pakistani (2.51, 1.99 to 3.17), Bangladeshi (1.85, 1.08 to 3.16), Black Caribbean (1.78, 1.44 to 2.21) and Indian women (1.37, 1.13 to 1.66) insignificant. Adjustment for health behaviours had the largest effect for South Asian women. By contrast, Irish women reported better age-adjusted SRH (0.70, 1.51 to 0.96). Conclusions: SEP and health behaviours were major contributors explaining EHI. Policies to improve health equity need to monitor these pathways and be informed by them. [ABSTRACT FROM AUTHOR]
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- 2014
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11. Income-related inequality in health and health-related behaviour: exploring the equalisation hypothesis.
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Vallejo-Torres, Laura, Hale, Daniel, Morris, Stephen, and Viner, Russell M.
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AGE distribution ,HEALTH behavior ,INCOME ,QUESTIONNAIRES ,RESEARCH funding ,SOCIOECONOMIC factors ,WELL-being ,BODY mass index ,HEALTH equity ,DATA analysis software ,HEALTH & social status - Abstract
Background Previous studies have found the socioeconomic gradient in health among adolescents to be lower than that observed during childhood and adulthood. The aim of this study was to examine income-related inequalities in health and health-related behaviour across the lifespan in England to explore ‘equalisation’ in adolescence. Methods We used five years of data (2006–2010) from the Health Survey for England to explore inequalities in six indicators: self-assessed general health, longstanding illness, limiting longstanding illness, psychosocial wellbeing, obesity and smoking status. We ran separate analyses by age/gender groups. Inequality was measured using concentration indices. Results Our findings for longstanding illnesses, psychosocial wellbeing and obesity were consistent with the equalisation hypothesis. For these indicators, the extent of income-related inequality was lower among late adolescents (16–19 years) and young adults (20–24 years) compared to children and young adolescents (under 15 years), mid- and late-adults (25–44 and 45–64 years) and the elderly (65+ years). The remaining indicators showed lower inequality among adolescents compared to adults, but higher inequality when compared with children. Conclusions Our work shows that inequalities occur across the life-course but that for some health issues there may be a period of equalisation in late adolescence and early adulthood. [ABSTRACT FROM AUTHOR]
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- 2014
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12. Measures of exposure to the Well London Phase-1 intervention and their association with health well-being and social outcomes.
- Author
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Phillips, Gemma, Bottomley, Christian, Schmidt, Elena, Tobi, Patrick, Lais, Shahana, Ge Yu, Lynch, Rebecca, Lock, Karen, Draper, Alizon, Moore, Derek, Clow, Angela, Petticrew, Mark, Hayes, Richard, and Renton, Adrian
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PUBLIC health ,COMMUNITIES ,HEALTH behavior ,HEALTH promotion ,RESEARCH methodology ,SURVEYS ,CITY dwellers ,WELL-being ,RANDOMIZED controlled trials ,PHYSICAL activity - Abstract
The article discusses the trial of "Well London" programme which focuses on increasing physical activity, healthy eating and mental health in 20 most deprived neighborhoods in London, England. It mentions that the London Health Commission helped in delivering the14 interlinked projects of the programme which focused not only on the health issues of people but also in improving the local environment, providing cultural activities and employment and training opportunities to the residents.
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- 2014
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13. Estimating EQ-5D utility values for major health behavioural risk factors in England.
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Maheswaran, Hendramoorthy, Petrou, Stavros, Rees, Karen, and Stranges, Saverio
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QUALITY of life ,CONFIDENCE intervals ,STATISTICAL correlation ,DIET ,ALCOHOL drinking ,EPIDEMIOLOGY ,HEALTH behavior ,OBESITY ,RISK-taking behavior ,SMOKING ,STATISTICS ,LOGISTIC regression analysis ,DATA analysis ,PHYSICAL activity ,DATA analysis software ,DESCRIPTIVE statistics - Abstract
Background: Major behavioural risk factors, namely obesity, alcohol consumption, smoking, lack of fruit and vegetable intake and physical inactivity negatively impact on self-reported quality of life. However, little is known about their impact on preference-based measures of health-related quality of life commonly used to inform economic evaluations. Methods: Preference-based health-related quality of life outcomes associated with major behavioural risk factors were estimated using the EuroQol EQ-5D responses of 14 117 participants, aged ≥16 years, in the 2008 Health Survey for England. Multivariable linear regression was used to model the relationship between the five risk factors and EQ-5D utility scores. In addition, logistic regression was used to model their relationship to dichotomous reports of problems for each of the five EQ-5D dimensions. Results: Only one-third of participants had a body mass index within normal range, never drank alcohol, consumed at least five portions of fruit or vegetable/day or exercised regularly, while nearly half of participants were smokers or ex-smokers. In the fully adjusted multivariable analyses, reductions in EQ-5D utility scores (95% CI) of 0.105 (0.072 to 0.137), 0.062 (0.042 to 0.082) and 0.142 (0.129 to 0.155) were estimated for a body mass index ≥40 kg/m2, heavy smoking (≥20 cigarettes/day) and physical inactivity, respectively. Hazardous alcohol consumption (men >4 and ≤8 units/ day; women >3 and ≤6 units/day) and daily fruit and vegetable intake between three and less than five portions were associated with small positive effects on EQ-5D utility scores (p<0.05). Conclusions: The high prevalence and substantial utility loss associated with obesity, smoking and physical inactivity highlight the potential impact that interventions aimed at their prevention or alleviation may have on population health. [ABSTRACT FROM AUTHOR]
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- 2013
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14. Trends and inequalities in late-life health and functioning in England.
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Martin, Linda G., Schoeni, Robert F., Andreski, Patricia M., and Jagger, Carol
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OLDER people with disabilities ,C-reactive protein ,CONCEPTUAL structures ,HEALTH behavior ,HEARING disorders ,HEALTH self-care ,ACTIVITIES of daily living ,SOCIOECONOMIC factors ,BODY movement ,HEALTH equity ,CROSS-sectional method ,DESCRIPTIVE statistics - Abstract
Background Recently, late-life disability rates have declined in several countries of the Organisation for Economic Co-operation, but no national-level trend analysis for England has been available. The authors provide such analysis, including measures both early and late in the disablement process, and the authors investigate the extent to which temporal trends are associated with population changes in socioeconomic position (SEP). Methods The authors fit logistic models of trends in self-reports and nurse measures of 16 health indicators, based on cross-sectional data from those aged 65 years and older from the 1992 to 2007 Health Survey for England. Results Overall, prevalence rates of limitations in seeing, hearing and usual activities declined (p<0.05); ever smoking, measured high blood pressure, high cholesterol, and high C reactive protein decreased (p<0.05); and the proportion with limitations in self-care activities remained stable. But obesity and limitations in walking 200 yards and climbing stairs increased (p<0.05). Increases over time in education and non-manual social class membership were associated with declines in smoking, C reactive protein and problems with usual activities. Had the changes in SEP not occurred, the increases in problems walking and climbing would have been greater. People with less education or of manual social classes experienced relatively worse trends for hearing, mobility functions and usual activities. The opposite was true for seeing. Conclusions Recent trends in late-life health and functioning in England have been mixed. A better understanding of which specific activities pose challenges, how the environment in which activities are conducted influences functioning and the causes of relatively worse trends for some SEP groups is needed. [ABSTRACT FROM AUTHOR]
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- 2012
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15. Population Based Studies: Mid Life and Older Age.
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BEREAVEMENT ,CONFERENCES & conventions ,CORONARY disease ,EPIDEMIOLOGY ,HEALTH behavior ,SMOKING - Abstract
The article presents abstracts on medical topics which include the protection of older people from mortality after bereavement through good health, the rapid decrease of coronary heart disease (CHD) incidence among Scottish towns, and the healthy behaviours in middle age.
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- 2012
16. Public Health Interventions: Area and Weight Management.
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REGULATION of body weight ,CONFERENCES & conventions ,HEALTH behavior ,PUBLIC health ,WELL-being - Abstract
The article presents abstracts on public health interventions which include topics on the effect of weight management intervention on body mass index, the use of community development cluster-randomised trial for health behavior improvement, and community-based intervention.
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- 2012
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