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We evaluated the available literature on the association between characteristics of the food environment and household food insecurity. Systematic review. Studies published until January 9th, 2023, were searched in the PubMed, Web of Science, Science Direct, EMBASE and LILACS databases. The included studies were summarized with a narrative synthesis with information on the study location, population studied, prevalence and type of measure/instrument used to assess food (in)security, method of evaluating the food environment and measure between food insecurity and food environment. Twenty-two articles were included. Different methods were used to measure food security and the food environment. Most food insecurity assessment tools assessed the dimension of access to food, more precisely economic access. The dimensions of the food environment most evaluated were food availability and affordability. An association between characteristics of the food environment and food insecurity was found in 18 of these studies. Homes with food insecurity have a greater availability of unhealthy foods, more frequent purchasing of foods in convenience stores and small markets as well as a lower availability of healthy foods, such as fruits and vegetables. This review revealed that household food insecurity was associated with the food environment, highlighting the importance of policies to promote healthy diets, especially in vulnerable communities. Few studies were found in the Global South, demonstrating the gap in this knowledge in these locations. [ABSTRACT FROM AUTHOR]

Women referred to social work services during pregnancy are more likely to experience social disadvantage than those who are not, resulting in reduced antenatal care attendance. Lack of antenatal care engagement leads to poor identification and management of concerns that can have immediate and long-term health consequences for women and their babies. Identifying the barriers and enablers to antenatal care attendance for women referred to social work services is important for designing models of care that promote effective engagement. This study aimed to explore the barriers and enablers to antenatal care attendance by women referred to social work services from the perspectives of women, and clinicians who provide antenatal healthcare. A qualitative descriptive study using constructivist grounded theory methods was undertaken. Ten women referred to social work services and 11 antenatal healthcare providers were purposively recruited for interviews from a regional maternity service in Victoria, Australia. Continuity of care and healthcare providers partnering with women were central to effective engagement with antenatal care services. Three interrelated concepts were identified: 1) experiences of the hospital environment and access to care; 2) perceptions of care influence engagement, and 3) motivations for regularly attending services. Continuity of care is essential for supporting women referred to social work services to attend antenatal appointments. Women are better equipped to overcome other barriers to antenatal service attendance when they have a strong partnership with clinicians involved in their care. [ABSTRACT FROM AUTHOR]

Background: Food environments can contribute to excess weight gain among adults, but the evidence is mixed.Objectives: This longitudinal study investigates the association between changes in the food environment and changes in body mass index (BMI) in adults and whether changes in the food environment differentially impact various subgroups.Methods: At two time points, BMI was calculated using self-reported height and weight data from 517 adults (mean age, 41 years) living in four New Jersey cities. The count of different types of food outlets within 0.4, 0.8, and 1.6 km of respondents' residences was collected at baseline and tracked until follow-up. A binary measure of social standing (social advantage, n = 219 vs social disadvantage, n = 298) was created through latent class analysis using social, economic, and demographic variables. Multivariable linear regression modelled the association between changes in BMI with measures of the food environment; additionally, interaction terms between the measures of social standing and the food environment were examined.Results: Overall, over 18 months, an increase in the number of small grocery stores within 0.4 km of a respondent's residence was associated with a decrease in BMI (β = -1.0, 95% CI: -1.9, -0.1, P = 0.024), while an increase in the number of fast-food restaurants within 1.6 km was associated with an increase in BMI (β = 0.1, 95% CI: 0.01, 0.2, P = 0.027). These overall findings, however, masked some group-specific associations. Interaction analyses suggested that associations between the food environment and change in BMI vary by social standing. For instance, the positive association between changes in fast-food restaurants and changes in BMI was only observed in the social disadvantage group (β = 0.1, 95% CI: 0.02, 0.2, P = 0.021).Conclusions: In a sample of adults living in New Jersey, changes in food environment had differential effect on individuals' BMI based on their social standing. [ABSTRACT FROM AUTHOR]

Background: The relationship between social disadvantage and alcohol use disorder (AUD) among Asian American and Pacific Islander (AAPI) people is poorly understood. The study explores the patterns of social disadvantage and their associations with the AUD criteria in this population.Methods: This study used data from the National Epidemiologic Survey of Alcohol and Related Conditions-III on AAPI people's (N = 1801) social disadvantage, adverse childhood experiences (ACEs), racial discrimination, and AUD. A three-step latent class analysis (LCA) using the Bolck, Croon, and Hagenaars (BCH) method was conducted to examine the heterogeneity within response patterns to items that describe social disadvantage among AAPI people. In addition, the relationship between classes and the AUD criteria was examined.Results: Three classes were identified: Class 1, labeled "High Adversity" (8.2%); Class 2, labeled "High Discrimination" (9.7%); and Class 3, labeled "Low Disadvantage" (82.2%). Results from the analyses of a multiple regression model suggest that Class 1 (High Adversity; B = 1.049, SE = 0.27, p < 0.001) is more susceptible to AUD compared to Class 3 (Low Disadvantage).Conclusions: The average number of AUD criteria among AAPI people who had experienced high levels of adversity was 2.2. Latent class models demonstrate how social disadvantage is distributed across classes and illustrate its associations with the AUD criteria. Tailored interventions for AAPI people are required. Further studies are also necessary to more effectively understand social disadvantage in AAPI populations. [ABSTRACT FROM AUTHOR]

• Busy schedules of parents are major barriers to timely childhood immunizations. • Long distances, transportation issues, and clinic hours exacerbate access issues. • Concerns about vaccines also play a major role in parents' decision making. • Parents want better access to vaccinations and reliable information about vaccines. Under-immunization increases the risk of acquiring vaccine-preventable diseases in children and the community. The targeted coverage rate for routine childhood immunization in Alberta, especially in disadvantaged communities in rural and remote geographic areas, has not been achieved for many years. This study was conducted to identify reasons for under-immunization in children in low socioeconomic status (SES) communities and propose suggestions to address issues/concerns identified by low SES parents for improving immunization coverage in their communities. Fourteen semi-structured phone interviews of low SES parents with under-immunized children living in rural and remote geographic areas in Northern Alberta were conducted. Transcripts were analyzed to identify relevant themes. Busy lifestyles of many parents prevented them from taking their children to clinics for immunization, which were exacerbated by long distances to clinics, transportation issues, operating hours of clinics, and lack of reminders. Many disadvantaged parents also exhibited varying levels of vaccine hesitancy due to safety concerns, especially about newer vaccines, thereby causing some parents to delay immunizing their child intentionally. Implementing procedures to alleviate access issues, such as offering extended operating hours, opening drop-in clinics/satellite clinics in distant areas, nurse visits to their homes, updating contact information of parents, frequent reminder options and addressing safety and effectiveness concerns about vaccines in plain language using evidence-based communication strategies can promote timely immunization among children of low SES parents. [ABSTRACT FROM AUTHOR]

Background: Many environmental factors are known to hinder breastfeeding, yet the role of the family living environment in this regard is still poorly understood.Objectives: We used data from a large cohort to identify associations between neighborhood characteristics and breastfeeding behavior.Methods: Our observational study included 11,038 children (0-2 years) from the Southwest Finland Birth Cohort. Participant information was obtained from the Medical Birth Register and municipal follow-up clinics. Neighborhood socioeconomic disadvantage, greenness, and population density were measured for a period of 5 years prior to childbirth within the residential neighborhood on a 250 × 250-m grid. Any breastfeeding and breastfeeding at 6 months were the primary outcomes. Binary logistic regression models were adjusted for maternal health and socioeconomic factors.Results: Adjusted analyses suggest that mothers living in less populated areas were less likely to display any breastfeeding (OR: 0.46; 95% CI: 0.36, 0.59) and breastfeeding at 6 months (OR: 0.37; 95% CI: 0.34, 0.40). Mothers living in highly disadvantaged neighborhoods were less likely to display any breastfeeding if the neighborhood was less populated (OR: 0.54; 95% CI: 0.30, 0.95) but more likely to breastfeed at 6 months if the neighborhood was highly populated (OR: 3.74; 95% CI: 1.92, 7.29). Low greenness was associated with higher likelihood of any breastfeeding (OR: 3.82; 95% CI: 1.53, 9.55) and breastfeeding at 6 months (OR: 4.41; 95% CI: 3.44, 5).Conclusions: Our results suggest that neighborhood characteristics are associated with breastfeeding behavior in Finland. Unravelling breastfeeding decisions linked to the living environment could help identify interventions that will allow the appropriate support for all mothers and infants across different environmental challenges. [ABSTRACT FROM AUTHOR]

One of the main challenges for policymakers aiming to promote cycling in car-oriented transport systems is how to increase social diversity among its users. The under-representation of certain groups makes it difficult to normalise cycling and distribute its benefits throughout society. Many studies have explored cycling levels in relation to age and gender, and to a lesser extent disability and ethnicity. Less attention has been paid to bicycle use related to income and other socioeconomic factors associated with disadvantage. This study aims to better understand the relationship between income and other factors of socioeconomic disadvantage and cycling behaviour. We analysed data from the English National Travel Survey to estimate the likelihood of cycling participation (if individuals cycle at all), cycling frequency ('how often' they cycle), and cycling distance ('how far' they cycle) using regression models. We found that people in lower-income households cycle less for transport, particularly for commuting, than people in higher-income households. However, no income inequalities were found for leisure cycling. In addition, low-income leisure cyclists were found to cycle more often, but higher-income leisure cyclists further. Our findings may have important policy implications. Favouring a broader focus on non-commuting cycling and subsidising cycle access and maintenance could help to diversify cycling. [ABSTRACT FROM AUTHOR]

There is increasing emphasis in research and at the level of international human rights bodies such as the United Nations on the gendered contours of age-based disadvantage and discrimination, and the cumulative effects of gender inequalities over the life-course on outcomes in later life. However, to date, the role of mental health in shaping the age/gender nexus in the realization of human rights has received little attention. In response, this paper aims to 1) elucidate the economic, social and cultural disadvantages and discrimination faced by older women living with mental health conditions; and 2) identify opportunities to protect their human rights. It concludes that older women face inequalities and disadvantages at the intersections of age, gender, and mental health and wellbeing that compromise their capacity to age well, illuminating the urgent need for a UN Convention on the Human Rights of Older Persons that considers the role of mental health in shaping the realization of human rights among older people. [ABSTRACT FROM AUTHOR]

In many ways modern child protection systems begin with the 1962 seminal article 'The battered-child syndrome' by Kempe and colleagues. The article focused on injuries to a child presented at a hospital that were at variance with the explanation given by a parent regarding the occurrence of the trauma. What followed somewhat later from this seminal article was the introduction in 1974 in the US of mandatory reporting of child abuse and prevention legislation that defined what must be reported. This legislation was influenced by the equally seminal 'In the best interest of the child' construct as developed by Goldstein and colleagues that was published in book form in 1973. The purpose of this commentary is to call attention to limitations to how the "best interests of the child" has been implemented. This article provides an overview of criticisms of the best interests construct and suggestions that the construct is a dated view about what is in a child's best interests. There is a need for a new balance between explanations about child abuse and neglect (CAN) that takes account of poverty, social disadvantage, and the interests of children and their families. [ABSTRACT FROM AUTHOR]

Persisting disparities in maternal and child health outcomes in high income countries require new insights for health service response. Significant social hardship, including factors related to migration, are associated with perinatal morbidity and mortality. The universality of maternity and child health care offers opportunities to reduce health disparities. Process evaluation of health service initiatives to address refugee health inequalities in Melbourne, Australia, is the setting for the study. To explore the views of health service leaders about health system and service capacity to tailor care to address social adversity and reduce disparities in maternal and child health outcomes. In-depth interviews with leaders of maternity and maternal and child health services with questions guided by a diagram to promote discussion. Thematic analysis of transcribed interviews. Health care leaders recognised the level of social complexity and diversity of their clientele. The analysis revealed three key themes: grappling with the complexity of social disadvantage; 'clinical risk' versus 'social risk'; and taking steps for system change. Priority given to clinical requirements and routine practices together with the rising demand for services is limiting service response to families experiencing social hardship and hampering individualised care. System change was considered possible only if health service decision makers engaged with consumer and community perspectives and that of front-line staff. Achieving equity in maternal and child health outcomes requires engagement of all key stakeholders (communities, clinicians, managers) to facilitate effective system re-design. [ABSTRACT FROM AUTHOR]

• Interrelationships between ICT, social disadvantage, and activity participation. • Evidence of positive relationship between 'access to ICT' and 'social advantage'. • Marginal effects of 'access to ICT' were most prominent on leisure activities. Studies on the social role of transport disadvantage have influenced the policy discourse, especially in the developed world. However, the potential of information and communication technologies (ICT) to improve access to opportunities has been rarely explored. In a scenario where disparities exist in both physical proximity and access to ICT, this study aims to analyse the interrelationships between three key areas viz. ICT, social disadvantage, and activity participation behaviour. A time use survey representative of Mumbai's housing disparity was conducted for 1205 individuals. The data showcased the differences in household socio-economic characteristics, individual personal characteristics, ICT use patterns, activity participation, and time allocation patterns. Structural equation modelling was used to evaluate exclusionary factors and their interconnectedness. It was found out that 'social advantage' had a significant positive relationship with 'access to ICT' and 'farness to services'. The effects of exclusionary factors, along with activity and individual specific variables were tested on activity participation and time allocation behaviour using type II Tobit models. Finally, marginal effects of 'access to ICT' and 'farness to services' on activity participation and time allocation behaviour were estimated. The findings suggested that an increase in access to ICT increased in-home leisure participation and travel time allocation. However, no significant positive relationship was established between access to ICT and in-home mandatory activities. Policy implications of the findings were discussed highlighting the importance of an integrated framework to improve both physical access and the access to ICT to tackle the issue of social exclusion. [ABSTRACT FROM AUTHOR]

Abstract The study presented here focuses on northeastern Brazil and aims to analyse the relationship among children's situation of social disadvantage -as reported by children-, subjective well-being and coping. The sample analysed comprises 864 pre-adolescents in the final year of primary and first year of secondary education (age range 10–15) attending 27 randomly-selected state-run and private schools in the province of Ceará. The administered questionnaire contains: (a) items related to situations of multidimensional social disadvantage combined within an index, (b) three psychometric scales of subjective well-being, and (c) a measure of coping strategies and styles (cognitive-behavioural distraction, acting out and active strategies). Results indicate that the social disadvantage index predicts subjective well-being as measured by any of the three indicators used here; however, the perception of social disadvantage reported by children using different indicators seems to increase with age. Children reporting situations of greater social disadvantage according to this index exhibit significantly lower subjective well-being scores; children using the distraction coping strategy tend to display higher scores and children using the acting out coping strategy tend to display lower scores on the subjective well-being indicators. Surprisingly, girls in this sample report using acting out coping estrategies more frequently than boys. [ABSTRACT FROM AUTHOR]

• Comparison of intake data from 3089 participants by IRSD tertiles, allowing for a unique analysis of demographic factors, and clinical and functional status, in relation to socio-economic status. • Relative underrepresentation of those from more socially disadvantaged areas across Australia when comparing those accessing services with the catchment area populations. • Similar clinical functioning across all tertiles in both ultra high risk and first episode psychosis cohorts. • Those experiencing more social disadvantage received fewer direct services in both cohorts, and remained in the program for fewer days within the UHR cohort, when compared with individuals from middle and high socio-economic status. Incidence of psychosis varies geographically due to factors such as social disadvantage. Whether this influences the clinical presentation and/or engagement of those experiencing psychosis remains relatively understudied. This study analysed data from young people across Australia accessing ultra-high risk (UHR) or first episode psychosis (FEP) services delivered through the headspace Early Psychosis (hEP) program between June 2017 and March 2021. The cohort was categorised into low, middle, and high tertiles of social disadvantage using the Index of Relative Socioeconomic Disadvantage (IRSD). Data from 3089 participants aged 15–25 were included (1515 UHR, 1574 FEP). The low and middle tertiles for both cohorts had greater percentages of those not in education or employment (NEET), with First Nations or culturally and linguistically diverse backgrounds. Clinical presentations to services were similar across all tertiles in both cohorts, however, functioning at presentation varied significantly within the FEP cohort. Significantly lower numbers of direct services were provided in the low tertile of both cohorts, with significantly poorer engagement in the initial three-months also occurring for these young people. This variation in early psychosis service patterns associated with geographical variation in social deprivation demonstrates the need for further research and fine tuning of national early psychosis services. [ABSTRACT FROM AUTHOR]

In 2014 the Australian immunisation target was raised from 90% to 95% of children to be fully immunised. A national priority is to identify geographic areas of low coverage and implement strategies to improve immunisation rates. Using The World Health Organization’s Tailoring Immunization Programmes (TIP) Guidelines, the aim of this study was to identify areas of low immunisation coverage for children in the Hunter New England Local Health District, New South Wales, and to gain a deeper understanding of the factors influencing immunisation in those areas in order to develop tailored strategies for increasing immunisation coverage. Data from the Australian Immunisation Register was used to identify geographic areas of low coverage. Data from interviews and focus groups with parents and service providers were used to gain a deeper understanding of the factors influencing immunisation in those areas. The regional city of Maitland in New South Wales was identified as having a persistently high number and relatively high proportion of children not fully immunised (n = 427, 15.4% in 2016). Themes from 59 stakeholder interviews and focus groups included; (i) limited engagement with health services unless the need is urgent, (ii) multi-dimensional access barriers to immunisation services in Maitland, (iii) a flexible, supportive family centred, primary health care approach, utilising strong partnerships, is most likely to be effective in increasing childhood immunisation rates in Maitland, (iv) data can be used more effectively to inform service providers about trends and individual children not fully immunised. TIP guidelines proved useful for identifying areas of low coverage and providing an understanding of determining factors and the strategies most likely to be effective. Understanding the complex problems many parents face and the access barriers that contribute to low immunisation coverage is essential in developing appropriate solutions. Finding ways to support parents and remove those barriers can contribute to higher coverage. In Maitland, targeted outreach and home visiting has been implemented in consultation with community and health service representatives to ensure that the children from socially disadvantaged populations identified do not miss out on vaccination. [ABSTRACT FROM AUTHOR]

Green infrastructure has recently risen to international prominence for its purported capacity to enhance urban sustainability, and particularly to modulate ambient temperatures in the context of climate change. We assess whether residents in a sub-tropical Australian city perceive green infrastructure as an effective climate adaptation response for reducing vulnerability to heat stress. Gold Coast City has pursued urban densification policies, such as reducing block sizes and increasing building heights, to accommodate rapid population growth. Little attention has been given to the combined impact of local heat island effects and global climate change upon lower-income residents in the city's suburban fringe, including rising energy costs associated with cooling homes. The study has three aims: to assess whether social disadvantage is associated with (1) concern about climate change impacts; (2) perceptions about the potential of green infrastructure to offer potential climate-adaptive benefits; and (3) the desire for more urban greening in a working class suburb. We used a mail-back survey to elicit information related to cooling dwellings, awareness of, and concern about, climate change impacts, perceptions of the benefits of green infrastructure, and desire for more urban greening. Results indicate that despite their vulnerability to heat stress, comparatively disadvantaged residents are no more concerned about climate change; nor are they any more inclined to encourage local government to enhance neighbourhood greenery. These residents are, if anything, less likely to perceive benefits of urban greening. Our findings indicate that cultivating support for green infrastructure in disadvantaged neighbourhoods will require parallel efforts to redress inequality. [ABSTRACT FROM AUTHOR]

Social disadvantages persist over generations, while the mechanisms behind the intergenerational transmission are not well understood. To fill this gap, first, we examine to what degree being diagnosed with a mental health disorder in adolescence mediate the transmission of social disadvantage. Second, we investigate whether the role of mental health varies for different outcomes. Third, we examine differences between disorder groups and gender. We exploited register data on the full Finnish population including information on mental health diagnoses (MHD) based on ICD-10 classification recorded in public specialized health care. As socioeconomic outcomes, we used offspring's (N = 511,835) records for low educational attainment, unemployment, and social assistance dependency in early adulthood. In addition to linear probability models, the g-computation method was used to simulate the degree to which reducing mental health inequalities in adolescence could narrow the differences between children of different family backgrounds. Our results show that adolescents with MHD had a higher likelihood of experiencing social disadvantage as young adults even after accounting for parental socioeconomic status and alternative health pathways. The counterfactual analysis indicated that the proportion mediated by unevenly distributed MHD was with 7.5% highest for social assistance followed by 4.2% for education and 3.2% for unemployment. The effect of mental health was modified by gender yet direction and strength varied across methods and externalizing behaviors mattered more for the intergenerational persistence than internalizing behaviors. Hypothetically reducing MHD to the level of families with high socioeconomic status might indeed lower part of the intergenerational transmission of social assistance dependency but to lesser degree of unemployment and low educational attainment. We demonstrate the need of support and services for those with MHD, especially among socially disadvantaged groups. However, social disadvantage should not be overly medicalized as family background has an important independent effect on offspring's socioeconimic outcomes. • Mental health mediated the intergenerational persistence of social disadvantage. • Proportion mediated was higher for social assistance than education or unemployment. • Gender modified the effect of mental health. • Externalizing behaviors mattered more than internalizing. • We used diagnoses from register data with policy-relevant G-computation method. [ABSTRACT FROM AUTHOR]

Having been used extensively since the 1980s, the concept of social exclusion has given a new impetus to the discussions of poverty and disadvantageousness. Widely known as being quite difficult, complex, and controversial to define in essence, the concept of social exclusion can be defined as the condition in which certain individuals or social groups cannot integrate into the society either socially or economically or politically. The inability of the individuals to build meaningful social relationships in the community or lack of access to social activities in the city lead to social cohesion problems. This triggers segregation of the society, particularly in large cities, in both social and spatial terms. In the context of accessibility, “urban transport” appears as one of the most important factors determining level of social inclusion/exclusion of the individuals or groups. In this study relations between social exclusion and transport has been evaluated as an attempt to identify socio-spatial segregation pattern of Ankara. By doing so, it has been intended to illustrate the spatial segregation of the city formed by the social exclusion due to the transportation constraints. [ABSTRACT FROM AUTHOR]

Objective: in 1997, The Albany Midwifery Practice was established within King's College Hospital NHS Trust in a South East London area of high social disadvantage. The Albany midwives provided continuity of care to around 216 women per year, including those with obstetric, medical or social risk factors. In 2009, the Albany Midwifery Practice was closed in response to concerns about safety, amidst much publicity and controversy. The aim of this evaluation was to examine trends and outcomes for all mothers and babies who received care from the practice from 1997-2009. Design: a retrospective, descriptive analysis of data routinely collected over the 12.5 year period was undertaken including changes over time and outcomes by demographic features. Setting and participants: all women booked with the Albany Midwifery Practice were included. Findings: of the 2568 women included over the 12.5 year period, more than half (57%) were from Black, Asian and Minority Ethnic (BAME) communities; one third were single and 11.4% reported being single and unsupported. Almost all women (95.5%) were cared for in labour by either their primary or secondary midwife. There were high rates of spontaneous onset of labour (80.5%), spontaneous vaginal birth (79.8%), homebirth (43.5%), initiation of breastfeeding (91.5%) and breastfeeding at 28 days (74.3% exclusively and 14.8% mixed feeding). Of the 79% of women who had a physiological third stage, 5.9% had a postpartum haemorrhage. The overall rate of caesarean section was 16%. The preterm birth rate was low (5%). Ninety-five per cent of babies had an Apgar score of 8 or greater at 5 minutes and 6% were admitted to a neonatal unit for more than two days. There were 15 perinatal deaths (perinatal mortality rate of 5.78 per 1000 births); two were associated with significant congenital abnormalities. There were no intrapartum intrauterine deaths. Key conclusions: this analysis has shown that the Albany Midwifery Practice demonstrated positive outcomes for women and babies in socially disadvantaged and BAME groups, including those with complex pregnancies and perceived risk factors. Implications for practice: consideration should be given to making similar models of care available to all women. [ABSTRACT FROM AUTHOR]

Traumatic childhood experiences predict many adverse outcomes in adulthood including Complex-PTSD. Understanding complex trauma within socially disadvantaged populations has important implications for policy development and intervention implementation. This paper examined the nature of complex trauma experienced by disadvantaged individuals using a latent class analysis (LCA) approach. Data were collected through the large-scale Journeys Home Study ( N = 1682), utilising a representative sample of individuals experiencing low housing stability. Data on adverse childhood experiences, adulthood interpersonal trauma and relevant covariates were collected through interviews at baseline (Wave 1). Latent class analysis (LCA) was conducted to identify distinct classes of childhood trauma history, which included physical assault, neglect, and sexual abuse. Multinomial logistic regression investigated childhood relevant factors associated with class membership such as biological relationship of primary carer at age 14 years and number of times in foster care. Of the total sample ( N = 1682), 99% reported traumatic adverse childhood experiences. The most common included witnessing of violence, threat/experience of physical abuse, and sexual assault. LCA identified six distinct childhood trauma history classes including high violence and multiple traumas. Significant covariate differences between classes included: gender, biological relationship of primary carer at age 14 years, and time in foster care. Identification of six distinct childhood trauma history profiles suggests there might be unique treatment implications for individuals living in extreme social disadvantage. Further research is required to examine the relationship between these classes of experience, consequent impact on adulthood engagement, and future transitions though homelessness. [ABSTRACT FROM AUTHOR]

There is consistent evidence that inflammation is involved in mental disorders pathogenesis. Herein, using data from the High Risk Cohort Study for Psychiatric Disorders, we investigated the relationship between parental mood disorders (PMD), environmental factors, serum interleukin-6 (IL6) and mental health problems in children aged 6–12. We measured the serum levels of IL6 in 567 children. Information related to socio-demographic characteristics, mental health problems and multiple risk factors, as well as parent’s psychiatric diagnosis, was captured. We evaluated two groups of environmental risk factors (i.e. perinatal complications and social disadvantage) using a cumulative risk model. Results showed that higher serum levels of IL6 were associated with PMD (RR = 1.072, p = 0.001), perinatal complications (RR = 1.022, p = 0.013) and social disadvantage (RR = 1.024, p = 0.021). There was an interaction between PMD and social disadvantage (RR = 1.141, p = 0.021), as the effect of PMD on IL6 was significantly higher in children exposed to higher levels of social disadvantage. Moreover, there was a positive correlation between IL6 and mental health problems (RR = 1.099, p = 0.026), which was moderated by exposure to perinatal complications or social disadvantage (RR = 1.273, p = 0.015 and RR = 1.179, p = 0.048, respectively). In conclusions, there is evidence of a differential inflammatory activation in children with PMD and exposure to environmental risk factors, when compared to matched peers. Systemic inflammation may be involved in the pathway linking familial risk and mental health problems. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to model the travel behaviour of socially disadvantaged population segments in the United Kingdom (UK) using the data from the UK National Travel Survey 2002–2010. This was achieved by introducing additional socioeconomic variables into a standard national-level trip end model (TEM) and using purpose-based analysis of the travel behaviours of certain key socially disadvantaged groups. Specifically the paper aims to explore how far the economic and social disadvantages of these individuals can be used to explain the inequalities in their travel behaviours. The models demonstrated important differences in travel behaviours according to household income, presence of children in the household, possession of a driver’s licence and belonging to a vulnerable population group, such as being disabled, non-white or having single parent household status. In the case of household income, there was a non-linear relationship with trip frequency and a linear one with distance travelled. The recent economic austerity measures that have been introduced in the UK and many other European countries have led to major cutbacks in public subsidies for socially necessary transport services, making results such as these increasingly important for transport policy decision-making. The results indicate that the inclusion of additional socioeconomic variables is useful for identifying significant differences in the trip patterns and distances travelled by low-income. [ABSTRACT FROM AUTHOR]

Citizen engagement in water-related issues is vital for securing future water supplies and protecting waterways. In this paper we explore elements of engagement in water related issues -- what people know, what they value and their actions, and describe how these cohere in ways that can inform planning and interventions. Drawing on a nationally representative survey (N = 5194) and an interdisciplinary conceptual framework, this paper outlines how groups within the population differ on engagement in water-related issues. We identify five key groups: (i) the Disengaged, (ii) Aware but inactive, (iii) Active but not engaged, (iv) Engaged but cautious, and (v) Highly engaged. Homeownership, having a garden, being older, and life experiences such as experience of water restrictions had a significant impact on each of the engagement profiles. The utility of this analysis is demonstrated through finding that the groups have distinct views on two key policy examples, support for raingardens and willingness to pay for waterway protection. We suggest ways of targeting individual and community interventions to reach the identified groups. [ABSTRACT FROM AUTHOR]

Despite over 20 years of uninterrupted economic growth and population expansion, distinct concentrations of poverty and disadvantage remain extant in all Australia’s major conurbations. This paper systematically identifies, classifies and maps disadvantaged places in the nation’s largest cities – Sydney, Melbourne and Brisbane. Our exploratory analysis indicates the presence of four distinct disadvantaged area types across the three cities. For each city we measure the ongoing intensification of spatially concentrated disadvantage and the pace at which ‘disadvantage epicentres’ have continued to shift outwards in the direction of the metropolitan periphery. Contributing to this process, the small fraction of disadvantaged suburbs exiting the ‘disadvantaged’ cohort 2006–2011 were predominantly those located closer to CBDs. 2006–2011 change over time analysis also validates the typology in highlighting that particular types of low-income suburbs have had a disproportionate propensity to acquire ‘disadvantaged’ status over this period. [ABSTRACT FROM AUTHOR]

Abstract: In Germany, academic achievement at school depends primarily on students' socioeconomic status (SES). This contribution tries to find an explanation for this fact and adopts a sociolinguistic point of view: the language used at school contains specific speech variants that differ from the language experiences of low SES children. It is language skills – predominantly learned within families, their social strata and cultural rearing – that influence to some extent the chances of successful participation in school. By using differential-item functioning, this article focuses on German items within the domain of mathematics (TIMSS 2007) to analyze challenge-determining characteristics in those items that are more difficult to handle for low than for high SES students. [Copyright &y& Elsevier]

Abstract: Background: The association between DUI (driving under the influence) and disadvantaged social background has been shown in cross-sectional studies, but less is known about the processes behind this phenomenon. We aimed to examine the effect of DUI arrest on subsequent social disadvantage in Finland during 1993–2006 to provide more understanding about the dynamics of DUI and marginalization and to study DUI arrest as a potential point of intervention. Methods: In this longitudinal, register-based study the Register of DUI suspects (n =68894) was linked with the Employment Register. An age- and gender-matched reference population (n =67740) was drawn from the general Finnish population. A multi-state model was used to estimate the transition intensities between three different states (advantaged social status/disadvantaged social status/death) among three different DUI groups (alcohol only, prescription drugs, illicit drugs). Results: Compared to references, the movement of DUI suspects between different social states was more dynamic in that they were more likely to either move to a disadvantaged social state or to an improved status (except DUI suspects using prescription drugs). A DUI's relative risk of death compared to references was high, especially if currently in advantaged social status. The effect of DUI did not diminish over time. Conclusions: Driving under the influence is associated with an increased long-term risk for social disadvantage. DUI arrest could serve as an opportunity for intervention in the marginalization process. [Copyright &y& Elsevier]

Abstract: The role of marital breakdown in women's mental health is of key concern in Malaysia and internationally. A cross-sectional questionnaire study of married and separated/divorced and widowed women examined insecure attachment style as an associated risk factor for depression among 1002 mothers in an urban community in Malaysia. A previous report replicated a UK-based vulnerability-provoking agent model of depression involving negative evaluation of self (NES) and negative elements in close relationships (NECRs) interacting with severe life events to model depression. This article reports on the additional contribution of insecure attachment style to the model using the Vulnerable Attachment Style Questionnaire (VASQ). The results showed that VASQ scores were highly correlated with NES, NECR and depression. A multiple regression analysis of depression with backward elimination found that VASQ scores had a significant additional effect. Group comparisons showed different risk patterns for single and married mothers. NES was the strongest risk factor for both groups, with the ‘anxious style′ subset of the VASQ being the best additional predictor for married mothers and the total VASQ score (general attachment insecurity) for single mothers. The findings indicate that attachment insecurity adds to a psychosocial vulnerability model of depression among mothers cross-culturally and is important in understanding and identifying risk. [Copyright &y& Elsevier]

This article explores the spatial mobility of disadvantaged populations in order to enhance our understanding of transport poverty. It is based on participatory GPS tracking data collected in peripheral rural regions in Czechia and Germany. The data provide information on the two-week mobility of 61 socially disadvantaged study participants belonging to the following groups: (a) the lone elderly, (b) the labor market disadvantaged, and (c) single parents. The quantitative analysis utilizes group comparisons of activity space metrics. The results show that the mobility of disadvantaged people varied little between countries and regions, which indicates that individual social disadvantage mattered more than regional spatial disadvantage. Daily mobility depended on individual mobility strategies, and on people's embeddedness in social networks. The mobility patterns of socially disadvantaged groups differed, and showed considerable within-group variability. Our analysis finds that the effects of car access depended on the respondents' levels of social disadvantage; and that a car was not a merely a transport variable, but a socially conditioned variable. Understanding how automobility in rural peripheries is mediated by social ties, and how it can both enable and constrain chances for social participation, is essential for developing measures aimed at reducing transport poverty. • The mobility of disadvantaged people varies little between countries and regions. • Patterns of mobility differ between and within socially disadvantaged groups. • Car access is a key factor enabling extensive mobility with group-specific effects. • Social networks are crucial for mobility potentials and obligations in rural areas. • GPS tracking is valuable for measuring the mobility of the socially disadvantaged. [ABSTRACT FROM AUTHOR]

Communities where polluting human activities are sited often show disadvantage in terms of social and economic variables. Environmental distributive justice studies seek to identify common characteristics in exposed populations and highlight the presence of environmental inequalities. We have conducted a review of the existing literature about justice in the distribution of health hazards from industrial pollution. We included papers investigating associations between social disadvantage and contamination through assessments at national or macro-area level. From each study we extracted: indicators for the social determinants of exposed communities (classified according to PROGRESS-plus categories); definition and measurement of environmental hazard (as either proximity to contamination sources, exposure to emissions or health impacts from pollutants); study design and methods; significant results. We retrieved 45 eligible articles. Most publications were from USA and had a nationwide scope with data at municipal/sub-municipal scale. Socioeconomic position and race/ethnicity were the social determinants most often explored, followed by occupation and education; air pollution was the commonest sort of contamination, while proximity prevailed as measurement of hazard. All papers found significant associations between social dimensions and health hazard from industrial contamination: the majority of associations supported an increased burden on vulnerable categories, especially ethnic minorities and unemployed – however, several relationships were found in the opposite direction or in both ways, particularly with wealth and education, reflecting a mixed reality where potential discrimination in siting decisions coexists with socioeconomic benefits for nearby communities due to industrial development. Assessments of environmental distributive justice are lacking in most countries and those that are conducted show vast methodological heterogeneity. We recommend consistency in models and indicators, the inclusion of female-led households among indicators of social disadvantage, and the adoption of a small scale to elicit significant findings and provide meaningful policy action. • Pollution may be disproportionally directed to socially deprived communities. • National/subnational assessments can detect local and systemic inequalities. • Studies are few (except in USA). Methods and results are heterogenous. • Most evidence supports disparity, with many differences among countries. • We give recommendations for effective assessments to improve knowledge and policy. [ABSTRACT FROM AUTHOR]

Abstract: Background: Depression is more common amongst those who are economically disadvantaged. However there is inconsistent evidence concerning the relationship between socioeconomic position and antidepressant use. Moreover, evidence of greater antidepressant use amongst those of lower socioeconomic position may reflect their greater psychiatric morbidity, a prescribing bias towards pharmacological treatments, or provide evidence of an effective social safety net. This study investigates these issues whilst addressing methodological limitations of earlier studies. Method: Data were from a large, random community survey of Australian adults (N=4493) with linked administrative data for primary-care service use. Depression was measured using the Patient Health Questionnaire, with other measures of current mental health and history of depression included in analysis. Multiple personal indicators and a combined measure of social disadvantage were considered. A series of analyses systematically examined competing explanations for socioeconomic differences in depression and antidepressant treatment. Results: Markers of socioeconomic disadvantage were associated with a greater likelihood of antidepressant use. This finding was not attributable to the higher rates of depression amongst the disadvantaged. A similar pattern of results was evident for non-pharmaceutical treatments (primary care consultations). Socioeconomic position was not associated with use of complementary medications for depression, not covered by Australia's social safety net. Limitations: Analysis did not consider specialist mental health services. Conclusions: Socially disadvantaged respondents reported greater antidepressant use and service use after controlling for current depression symptoms. This pattern of findings suggests Australia's universal health-care system and social safety net may help address potential inequalities in health care. [Copyright &y& Elsevier]

Abstract: Objective: Determine whether a history of family social disadvantage and/or child abuse and neglect explain the overrepresentation of Indigenous Australian young people in youth detention. Methods: Maternal survey data from the Mater University Study of Pregnancy was linked with child abuse and neglect and youth justice data from the Queensland Department of Families, Youth and Community Care. Results: Indigenous Australian children were 1.81 times more likely to be notified to child protection authorities for maltreatment and 1.77 times more likely to have that maltreatment substantiated. Indigenous Australian young people were 3.07 times more likely to have a youth justice history. When adjusted for social disadvantage, the odds of the Indigenous Australian youth having had involvement with the youth justice authorities remained 2.51 times that of their non-Indigenous peers. When adjusted for substantiated maltreatment, the odds of the Indigenous Australian youth having had involvement with the youth justice authorities remained 2.83 times that of their non-Indigenous peers. When adjusted for both social disadvantage and substantiated maltreatment, the odds of the Indigenous Australian youth having had involvement with the youth justice authorities remained 2.48 times that of their non-Indigenous peers. Conclusions: The overrepresentation of Australian Aboriginal and Torres Strait Islander young people in the youth justice system, including Youth Detention, is only partly explained by their greater social disadvantage and by their greater experience of substantiated maltreatment, either separately or combined. [Copyright &y& Elsevier]

Abstract: In this paper, we examine whether county-level measures of poverty and social disadvantage are correlated with county-level variation in the black/white foster care placement gap. The black/white placement gap refers to the fact that when the rate of placement into foster care for black children is compared to the rate for white children living in the same area, the black placement rate is almost always higher than the rate for whites. Although differential exposure to poverty is often used to explain why the placement gap is so large, the problem has rarely been studied. Using Poisson event count models, we find that poverty, measured at the county ecological level, is associated with a narrower gap rather than a wider gap. The counterintuitive finding is due to the fact that the relationship between poverty and placement rates depends on race. [Copyright &y& Elsevier]

Abstract: Increase in the consumption of food and drinks outside the home by adolescents and young people and associations with rising levels of obesity is a significant concern worldwide and it has been suggested that the food environment around schools may be a contributory factor. As few studies have explored this issue in a UK setting, we examined whether different types of food outlets are clustered around public secondary schools in Glasgow, and whether this pattern differed by social disadvantage. We found evidence of clustering of food outlets around schools but a more complex picture in relation to deprivation was observed. Across all schools there were numerous opportunities for pupils to purchase energy dense foods locally and the implications for policy are discussed. [Copyright &y& Elsevier]

Abstract: Irish Travellers are an indigenous nomadic minority group with poor life expectancy. As part of a census survey of Travellers (80% participation rate), a health status interview was conducted (n=2065, 43.5% male). In the final regression model, positive predictors of self-rated health (SRH) were having a flush toilet (OR 2.2, p=0.021), considering where one lives to be healthy (OR 1.9, p=0.017), travelling twice yearly (OR 2.3 p=0.026), taking a brisk walk weekly (OR 2.4, p=0.000) and non-smoking (OR 1.7, p=0.03). Conversely, SRH was negatively associated with age (p=0.000), activity-limiting ill health (OR 0.4, p=0.001), or chronic health condition (OR 0.4, p=0.002). [Copyright &y& Elsevier]

Abstract: Inequalities in child health are of major concern to policymakers, public health specialists and clinicians. This review of studies within the context of the Generation R study illustrates that inequalities in population health, at least partly, originate in pregnancy and early childhood. The review shows inequalities with regard to the health of the pregnant mother, with regard to the growth of the fetus, with regard to birth outcomes, and with regard to health indicators in early childhood. These results are shown with regard to both biological/somatic outcomes, as well as with regard to psychosocial outcomes and healthy lifestyles. Both socioeconomic inequalities and ethnic inequalities in health are present. Although some inequalities can be explained by known determinants, research needs to be done to reach a full understanding of the pathways between social disadvantage and ill health in early childhood. [Copyright &y& Elsevier]

Abstract: Objective: Data suggest there are established socio-economic disparities associated with mental health although most research has focused on individual-level indicators of socio-economic position. The aim of this study was to investigate the association between mood disorders and area-based socio-economic status (SES), and whether both ends of the SES continuum experienced increased odds for a mood disorder. Methods: Using a clinical interview (SCID-I/NP), psychiatric history was ascertained in a population-based sample of 1095 women (20–93 years) from the Barwon Statistical Division, south-eastern Australia. SES was determined by cross-referencing residential addresses with Australian Bureau of Statistics 2006 census data for the region and categorised into three groupings of low, mid, and upper SES. The Index of Economic Resources (IER), Index of Education and Occupation (IEO), and Index of Relative Socioeconomic Advantage/Disadvantage (IRSAD) were utilised. Lifestyle factors were self-reported. Results: For IER, the low SES group had a 2.0-fold increased odds of a current mood disorder compared to the mid group, after adjustment for physical activity and current anxiety (OR=2.0, 95% CI 1.0–4.1, p =0.05). This pattern was similarly observed for IEO (OR=1.8, 95% CI 0.9–3.7, p =0.1) and IRSAD (OR=1.6 95% CI 0.8–3.4, p =0.2). Those within the upper SES group showed a non-significant increase in the odds of a current mood disorder compared to the mid-group; IER (OR=1.4, 95% CI 0.8–2.5, p =0.3), IEO (OR=1.2, 95% CI 0.07–2.3, p =0.5) and IRSAD (OR=1.2, 95% CI 0.7–2.1, p =0.6). Conclusions: Women in the low SES category were most likely to have a mood disorder. Furthermore, being in an upper SES group may not be protective against mood disorders. [Copyright &y& Elsevier]

Abstract: Aims: There is an inverse association between socioeconomic status (SES) and most causes of morbidity. Hip fractures pose a significant public health burden on society. However, the association between quintiles of area-based SES and incident hip fractures has not been examined in Australia. Using a comprehensive register of hip fractures for the entire Barwon Statistical Division (BSD), we assessed the association between area-based SES and incident hip fractures over a two-year period in residents aged ≥50years. Methods: Incident hip fractures were identified using a computerized keyword search of all radiological reports from all the radiological centers serving the BSD. Pathological fractures were excluded. SES was determined by cross-referencing residential addresses with Australian Bureau of Statistics census data and categorized in quintiles based upon the BSD reference range. Homogeneity of population at risk in each SES quintile was tested using chi square comparison. Hip fractures in each quintile and within each age strata for the entire BSD region were defined as rates per 1000 person-years. Results: During 2006–2007, there were 495 hip fractures (336 female). An inverse pattern of association was observed between SES and hip fracture incidence, with a peak in fracture numbers observed in the second quintile of SES, with differences between SES quintiles observed for both females (p =0.005) and males (p =0.007). Conclusion: The association between incident hip fractures and quintiles of area-based SES provides evidence that those of greater social disadvantage should be a specific target population for intervention to reduce the burden of hip fracture within Australia. [Copyright &y& Elsevier]

Abstract: Overall, socioeconomic status (SES) is inversely associated with poorer health outcomes. However, current literature provides conflicting data of the relationship between SES and bone mineral density (BMD) in men. In an age-stratified population-based randomly selected cross-sectional study of men (n =1467) we assessed the association between SES and lifestyle exposures in relation to BMD. SES was determined by matching the residential address for each subject with Australian Bureau of Statistics 2006 census data for the study region. BMD was measured at the spine and femoral neck by dual energy X-ray absorptiometry. Lifestyle variables were collected by self-report. Regression models were age-stratified into younger and older groups and adjusted for age, weight, dietary calcium, physical activity, and medications known to affect bone. Subjects with spinal abnormalities were excluded from analyses of BMD at the spine. In younger men, BMD was highest at the spine in the mid quintiles of SES, where differences were observed compared to quintile 1 (1–7%, p <0.05). In older men, the pattern of BMD across SES quintiles was reversed, and subjects from mid quintiles had the lowest BMD, with differences observed compared to quintile 5 (1–7%, p <0.05). Differences in BMD at the spine across SES quintiles represent a potential 1.5-fold increase in fracture risk for those with the lowest BMD. There were no differences in BMD at the femoral neck. Further research is warranted which examines the mechanisms that may underpin differences in BMD across SES quintiles and to address the current paucity of data in this field of enquiry. [Copyright &y& Elsevier]

Abstract: The purpose of this study was to examine bingo halls as a frequent site for exposure to secondhand cigarette smoke for First Nations women in rural communities. Thematic analysis of interviews with key informants, group discussions with young women, and observations in the study communities revealed that smoky bingo halls provided an important refuge from everyday experiences of stress and trauma, as well as increased women''s risk for addiction, marginalization, and criticism. The findings illustrate how the bingo economy in isolated, rural First Nation communities influences tobacco use and second-hand smoke exposure, and how efforts to establish smoke-free bingos can be supported. [Copyright &y& Elsevier]

The neighborhood environment plays an essential role in shaping the geography of property crime. However, criminologists and planners hold different views on the role of built environmental characteristics such as neighborhood permeability. Meanwhile, the consequence of social disadvantage has not been adequately considered along with built environmental measurements. We revisit the debate using the 2017 data from Dallas and Fort Worth, TX. Following a context-based theoretical framework, we use enhanced measurements of neighborhood characteristics to examine the relationship between neighborhood characteristics and property crime. The results of the geographically weighted negative binomial regression show that commercial and mixed land-use development, number of transit facilities, and alcohol-related establishments are positively associated with property crime rate, all else being equal. Neighborhoods with a higher per capita income exhibit a higher property crime rate. Neighborhoods with a higher percentage of Blacks/African Americans and a lower level of educational attainment tend to register a higher property crime rate. This research points to several areas for future studies. • Mixed land use is positively related to property crime. • There is a significant positive relationship between population density and property crime. • Convenient access to liquor stores and transit is associated with high property crime. • Both built- and socio-environmental effects need to be adequately considered in crime research. [ABSTRACT FROM AUTHOR]

• Healthcare utilisation is affected by user- and provider-side characteristics. • These characteristics can act as barriers or facilitators. • Barriers and facilitators can be linked to specific stages in accessing healthcare. • User characteristics may be especially influential prior to healthcare utilisation. • Provider characteristics may be especially influential upon healthcare utilisation. Women with social disadvantage have poorer perinatal outcomes compared to women in advantaged social positions, which may be linked to poorer healthcare utilisation. Disadvantaged groups may experience a greater diversity of barriers (e.g., feeling embarrassed about pregnancy, lack of transportation) or barriers judged to be particularly difficult (e.g., embarrassment about pregnancy). They may also experience barriers more frequently (e.g., depression). Using Levesque et al.'s (2013) framework of healthcare access, our review identifies the barriers and facilitators that affect maternal healthcare utilisation in the perinatal period among women with social disadvantage in high-income nations. Our review searches for the barriers and facilitators affecting maternal healthcare utilisation in the perinatal period, from pregnancy to the first year postpartum, among women with social disadvantage (Prospero registration CRD42020151506). We conducted a theory-guided systematic review. PubMed, Embase, MEDLINE, PsycINFO, and Social Science Citation Index databases were searched for publications between 1999 and 2018. 37 articles out of 12′972 were included in the qualitative synthesis. 19 domains of barriers and facilitators were extracted. Domains on the provider side includes 'information regarding available treatments' and 'trustful relationships.' On the user-side, domains include 'awareness of pregnancy' and 'unplanned/unwanted pregnancy' Provider- and user-side characteristics interact to affect access. User-side characteristics that pose a barrier can be offset by provider-side characteristics that lower barriers to access. User-side characteristics (e.g., lack of awareness of pregnancy) play an important role in the initial steps toward access. Among women with social disadvantage, reducing barriers may require active outreach on the part of providers. [ABSTRACT FROM AUTHOR]

Abstract: This study examined the relations between neighbourhood socio-economic status and features of public open spaces (POS) hypothesised to influence children''s physical activity. Data were from the first follow-up of the Children Living in Active Neighbourhoods (CLAN) Study, which involved 540 families of 5–6 and 10–12-year-old children in Melbourne, Australia. The Socio-Economic Index for Areas Index (SEIFA) of Relative Socio-economic Advantage/Disadvantage was used to assign a socioeconomic index score to each child''s neighbourhood, based on postcode. Participant addresses were geocoded using a Geographic Information System. The Open Space 2002 spatial data set was used to identify all POS within an 800m radius of each participant''s home. The features of each of these POS (1497) were audited. Variability of POS features was examined across quintiles of neighbourhood SEIFA. Compared with POS in lower socioeconomic neighbourhoods, POS in the highest socioeconomic neighbourhoods had more amenities (e.g. picnic tables and drink fountains) and were more likely to have trees that provided shade, a water feature (e.g. pond, creek), walking and cycling paths, lighting, signage regarding dog access and signage restricting other activities. There were no differences across neighbourhoods in the number of playgrounds or the number of recreation facilities (e.g. number of sports catered for on courts and ovals, the presence of other facilities such as athletics tracks, skateboarding facility and swimming pool). This study suggests that POS in high socioeconomic neighbourhoods possess more features that are likely to promote physical activity amongst children. [Copyright &y& Elsevier]

Summary: Objective: To compare self-reported perception of weight with biomedically measured body mass index in different socioeconomic and cultural groups. Method: Of the original North West Adelaide Health (Cohort) Study (n =4060) 68.5% (n =2780) underwent a computer assisted telephone interview (CATI) answering additional questions related to their social and health status. The participants were asked “In terms of your weight, do you consider yourself to be… too thin, a little thin, normal weight, a little overweight or very overweight”. The self-perception of weight was compared to biomedically measured BMI (body mass index). Binary logistic regression was used to compare those participants who were obese (BMI≥30) with the self-perceived weight status of ‘a little overweight’. The outcome measures included the Socioeconomic Indexes for Areas Index of Relative Socioeconomic Disadvantage (SEIFA IRSD), country of birth and household income. Results: Of those that were underestimating their obese weight status, 41.5% were male and 32.2% female. The highest misclassification was for those who considered their weight to be ‘a little overweight’, with 59.6% biomedically measured with a BMI of over 30. The odds of being biomedically measured obese (BMI≥30) were compared to those who considered themselves to be ‘a little overweight’. Those that misreported their weight status and were biomedically obese, were more likely to be living in the lowest quintile of disadvantage, have a household income of less then $20,000 or be born in Eastern or Western Europe. Conclusion: There are psychosocial, sociocultural and social environmental influences related to the perception of weight status. Future research will need to understand the processes whereby people are not aware they have a weight problem. [Copyright &y& Elsevier]

Abstract: In a voluntary tutor-based training program, socially disadvantaged adolescents acquired basic computer skills. Two training groups were compared: one group was instructed by adolescents, the other by adults. Both groups achieved comparable results in a final test. The tutees'' learning results did not differ with respect to their initial knowledge, gender, school type, or socio-economic status, nor did these factors interact with the training group. We identified a significant interaction between the tutees'' immigration status and training group. These results are interpreted on the basis of (1) the tutees'' attitudes towards adolescent and adult teachers, and (2) the instructional styles of adolescent and adult tutors. Finally, the adolescents'' self-esteem increased throughout the program. [Copyright &y& Elsevier]

Abstract: Purpose: Low socioeconomic status (SES) and minority race/ethnicity are both associated with chronic stress and co-vary in American society. As such, these factors are often used synonymously, without clear theoretical conceptualization of their roles in the development of stress-related health disparities. This study theorized that race/ethnicity and SES reflect social disadvantage, which is the underlying factor in the development of stress-related illness, and examined how social disadvantage, defined in terms of both race/ethnicity and SES, influences adolescents’ stress. Methods: This is a cross-sectional school-based study of 1209 non-Hispanic black and white 7th–12th graders from a single Midwestern metropolitan public school district. Each student completed a questionnaire and a parent provided SES information. Race/ethnicity was obtained from school records. Linear regression analyses determined the influence of race/ethnicity and SES to stress. Race/ethnicity and presence or absence of at least one parent who graduated from college were used to define four subgroups for within-group analyses. Results: Stress was higher among black students, those from lower SES families, and those with lower perceived SES. In subgroup analyses, neither race nor SES maintained their independent associations with stress among socially disadvantaged groups. Black race was not associated with stress among those without a college-educated parent, and parent education did not influence stress among black students. In contrast, among more socially advantaged groups, both SES and race explained variation in adolescents’ stress. Conclusions: Social disadvantage is associated with increased stress, regardless of whether disadvantage is defined in terms of race or SES. This suggests that race and SES measure adversity in the social environment, and therefore, serve as risk markers, rather than risk factors. Future research should focus on the experience of adversity, which is reflected by these social characteristics, and the processes by which it operates. [Copyright &y& Elsevier]

• Nature contact supports young people's health and wellbeing. • Children from socially disadvantaged areas have limited access to nature. • A community intervention connected socially disadvantaged children to urban nature. • The importance of a youth led approach based on hands on activities is discussed. • Good practice is highlighted and recommendations for practitioners. This paper uses ethnography to explore young people's engagement with a UK based intervention designed to promote a meaningful connection to locally accessible urban nature. During the intervention seven young people (aged between 11 and 12 years old) from a socially disadvantaged area, took part in three two-hour sessions held in a patch of urban nature close to their school. During the sessions, facilitators and teachers worked collaboratively with the young people as they explored the space and took part in den building activities. All sessions were recorded using audio and video equipment and a case study approach was utilised to explore the experiences of two young people involved in the project as they worked with practitioners and each other to develop a meaningful connection to the space. Analysis highlights the importance of youth centred interventions which use practical activities to develop a sense of belonging and wellbeing. These issues are discussed in relation to traditional nature engagement interventions and recommendations for practitioners are put forward. [ABSTRACT FROM AUTHOR]

There is consistent evidence that members of the black Caribbean population in the UK are more likely to have coercive relationships with mental health services, typified by high levels of police involvement and compulsory treatment. This research has relied upon a medical epidemiological framework that has enumerated differences in service use but failed to unravel the complex interplay of individual, social, and cultural factors that inform the pathway to care. The purpose of this study was to explore the journey through mental health services from the perspective of individuals from the black Caribbean and majority white British population to help understand variation in the use of mental health services. Individual interviews were conducted with 17 black Caribbean, 15 white British, and 3 non-British white people with psychosis as part of AESOP-10, a 10 year follow up of an ethnically diverse cohort of individuals with first episode psychosis in the UK. Thematic narrative analysis identified three overarching narrative categories: 'losing self within the system' narratives gave primacy to individuals' identity as a chronic psychiatric patient with participants unable to break the cycle of service use; 'steadying self through the system' narratives combined recognition of the value of psychiatry and its limitations with the ability to access psychological therapy and protect valued social roles; 'finding strength beyond the system' narratives challenged negative dominant discourses and emphasised social, interpersonal and intrapersonal factors in recovery. We found variation in narratives across ethnic groups with 'losing self within the system' and 'finding strength beyond the system' narratives most common, though not exclusive to, black Caribbean participants. Distress appeared rooted in social structures that disadvantage black people, and psychiatry appeared to be experienced as a further form of oppression, that initially provoked resistance and fear, and over time, resignation to the identity of psychiatric patient. • Novel study of the journey through mental health services across ethnic groups. • The psychiatric meta-narrative threatened to engulf participants' voices. • Distress appeared rooted in social structures that disadvantage black people. • Social and cultural factors help to resist/cast off the role of 'chronic patient'. • Social interventions are required across multiple domains. [ABSTRACT FROM AUTHOR]

This study analyzes the pathways leading to violent offending. We examine whether the lethality of a violent crime could be predicted based on individuals' prior history of violent crime and income, and whether the trajectories of lethal offenders are distinguishable from the pathways of non-lethal offenders. We use a sample of police-reported violent crimes committed in Finland in 2010–2011 (N = 26,303) and contrast the pathways to homicide with the trajectories leading to petty assault, assault, aggravated assault, and attempted homicide. Group-based trajectory modeling is applied for identifying individuals with similar trajectories, and multilevel modeling is used for estimating the mean trajectories for offenders of differing severity. Results indicate that homicide offenders display a clear escalation in the frequency of violent offending and a slight decrease in income prior to the offense, but the pathways to homicide largely resemble the pathways to aggravated assault and attempted homicide. The lethality of violent offending cannot be predicted from the offender's crime and income. The greatest divide in the violence severity continuum is between offenders of assaults and offenders of aggravated assaults, with the latter group largely resembling offenders of completed and attempted homicides. • We examine crime and income trajectories of violent offenders committing offenses of different severity. • Longitudinal police data are analyzed by group-based trajectory modeling and multilevel modeling. • Lethal offenders appear more criminally active and disadvantaged population than assault offenders. • Pathways to homicide largely resemble the pathways to other severe violent offenses. • The lethality of violent offending cannot be predicted from the offender's prior crime and income. [ABSTRACT FROM AUTHOR]

Aims: To explore the information-seeking experiences of patients with Type 2 diabetes and how these influenced self-management behaviours.Methods: We interviewed 18 patients with Type 2 Diabetes attending outpatient diabetes centers in South Western Sydney. Data were analyzed thematically.Results: Patients described a number of challenges they faced when seeking information about diabetes self-management. One major challenge was receiving inconsistent and insufficient information from healthcare professionals, which consequently undermined patients' ability to self-manage diabetes. This became a disincentive in carrying out self-management tasks, and led to confusion and mistrust regarding the veracity of information received. Participants also described finding reliable information, and difficulty understanding and accessing relevant information as challenges. Medical jargon and lack of comprehensive explanations exacerbated knowledge deficits compounded by the complex maze of internet resources that some patients accessed. In response to what they perceived as confusing or inconsistent information, some patients followed "their own way" of managing their diabetes.Conclusions: Inconsistent information not tailored to the needs of patients adversely affects self-management. Taking time to provide simple explanations and assisting patients in navigating reliable web resources is becoming a vital role of healthcare professionals to reduce knowledge gaps in patients with low health literacy. [ABSTRACT FROM AUTHOR]