135 results on '"Marmot, Michael"'
Search Results
2. Health in Sri Lanka: building on a success story.
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Marmot M
- Subjects
- Humans, Sri Lanka epidemiology, Public Health
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- 2023
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3. Public health and health inequalities: a half century of personal involvement.
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Marmot M
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- Humans, Public Health, Health Status Disparities
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- 2022
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4. Public mental health: required actions to address implementation failure in the context of COVID-19.
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Campion J, Javed A, Lund C, Sartorius N, Saxena S, Marmot M, Allan J, and Udomratn P
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- Humans, COVID-19, Health Policy, Mental Disorders therapy, Mental Health standards, Mental Health Services organization & administration, Mental Health Services standards, Public Health standards
- Abstract
Mental disorders account for at least 18% of global disease burden, and the associated annual global costs are projected to be US$6 trillion by 2030. Evidence-based, cost-effective public mental health (PMH) interventions exist to prevent mental disorders from arising, prevent associated impacts of mental disorders (including through treatment), and promote mental wellbeing and resilience. However, only a small proportion of people with mental disorders receive minimally adequate treatment. Compared with treatment, there is even less coverage of interventions to prevent the associated impacts of mental disorders, prevent mental disorders from arising, or promote mental wellbeing and resilience. This implementation failure breaches the right to health, has increased during the COVID-19 pandemic, and results in preventable suffering, broad impacts, and associated economic costs. In this Health Policy paper, we outline specific actions to improve the coverage of PMH interventions, including PMH needs assessments, collaborative advocacy and leadership, PMH practice to inform policy and implementation, training and improvement of population literacy, settings-based and integrated approaches, use of digital technology, maximising existing resources, focus on high-return interventions, human rights approaches, legislation, and implementation research. Increased interest in PMH in populations and governments since the onset of the COVID-19 pandemic supports these actions. Improved implementation of PMH interventions can result in broad health, social, and economic impacts, even in the short-term, which support the achievement of a range of policy objectives, sustainable economic development, and recovery., Competing Interests: Declaration of interests AJ, MM, PU, CL, SS, JC, and JA are members of the Public Mental Health Working Group for the World Psychiatric Association's 2020–2023 Action Plan. JC has contributed to national policy in England, has done mental health needs assessments for local authorities in England (for which his employer received payment); is strategic and clinical director of the Royal College of Psychiatrist's Public Mental Health Implementation Centre; and is a public mental health advisor to WHO Europe. CL has received research funding from the UK Department for International Development, UK National Institute for Health Research, US National Institute of Mental Health, UK Economic and Social Research Council, European Commission, the Wellcome Trust, and Prudential Africa. NS has received honoraria for lectures from the Lundbeck company and from several universities. JA has contributed to national and state policy and service development in his role as a senior public servant., (Copyright © 2022 Elsevier Ltd. All rights reserved.)
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- 2022
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5. Addressing the public mental health challenge of COVID-19.
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Campion J, Javed A, Sartorius N, and Marmot M
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- COVID-19, Humans, Coronavirus Infections prevention & control, Health Promotion, Mental Disorders prevention & control, Mental Health, Mental Health Services, Pandemics prevention & control, Pneumonia, Viral prevention & control, Preventive Health Services, Public Health
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- 2020
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6. Mobilising society to implement solutions for non-communicable diseases.
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Akselrod S, Bloomfield A, Marmot M, Moran AE, Nishtar S, and Placella E
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- Global Health, Humans, Public Health methods, Resource Allocation, Risk Factors, Socioeconomic Factors, Communication Barriers, Cost of Illness, Noncommunicable Diseases economics, Noncommunicable Diseases epidemiology, Noncommunicable Diseases prevention & control, Noncommunicable Diseases psychology, Public Health standards
- Abstract
Competing Interests: Competing interests: We have read and understood BMJ policy on declaration of interests and have no interests to declare.
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- 2019
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7. An inverse care law for our time.
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Marmot M
- Subjects
- Health Services Accessibility history, Health Services Needs and Demand, History, 20th Century, Humans, Public Health history, State Medicine history, Health Services Accessibility legislation & jurisprudence, Public Health legislation & jurisprudence, State Medicine legislation & jurisprudence
- Abstract
Competing Interests: Competing interests: I have read and understood BMJ policy on declaration of interests and have no interests to declare.
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- 2018
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8. Importance of monitoring health inequalities.
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Marmot M and Goldblatt P
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- Humans, Socioeconomic Factors, United Kingdom, Epidemiological Monitoring, Health Status Disparities, Public Health economics
- Published
- 2013
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- View/download PDF
9. Europe: good, bad, and beautiful.
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Marmot M
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- Economic Recession, Europe, Forecasting, Health Services Needs and Demand trends, Humans, Life Expectancy trends, Medicine in the Arts, Paintings, Capitalism, Communism, European Union, Public Health trends, Social Welfare trends, Socioeconomic Factors
- Published
- 2013
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10. Closing the health gap in a generation: the work of the Commission on Social Determinants of Health and its recommendations.
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Marmot M
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- Humans, United Kingdom, World Health Organization, Health Status Disparities, Politics, Prejudice, Public Health, Public Health Practice, Social Justice
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- 2009
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11. Calling all Don Quixotes and Sancho Panzas: achieving the dream of global health equity through practical action on the social determinants of health.
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Friel S, Bell R, Houweling T, and Marmot M
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- Health Status Disparities, Humans, Leadership, Global Health, Health Promotion, Public Health, Social Justice
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- 2009
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12. Closing the gap in a generation: health equity through action on the social determinants of health.
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Marmot M, Friel S, Bell R, Houweling TA, and Taylor S
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- Delivery of Health Care trends, Female, Humans, Male, Maternal Welfare, Mental Health, Public Health methods, Public Policy, Delivery of Health Care organization & administration, Health Promotion methods, Health Status Disparities, Intergenerational Relations, Public Health trends, Social Class
- Abstract
The Commission on Social Determinants of Health, created to marshal the evidence on what can be done to promote health equity and to foster a global movement to achieve it, is a global collaboration of policy makers, researchers, and civil society, led by commissioners with a unique blend of political, academic, and advocacy experience. The focus of attention is on countries at all levels of income and development. The commission launched its final report on August 28, 2008. This paper summarises the key findings and recommendations; the full list is in the final report.
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- 2008
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13. Achieving health equity: from root causes to fair outcomes.
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Marmot M
- Subjects
- Adult, Child Mortality, Child, Preschool, Female, Humans, Male, Poverty, Developing Countries, Global Health, Life Expectancy trends, Mortality, Occupations classification, Public Health, Social Class
- Abstract
Health is a universal human aspiration and a basic human need. The development of society, rich or poor, can be judged by the quality of its population's health, how fairly health is distributed across the social spectrum, and the degree of protection provided from disadvantage due to ill-health. Health equity is central to this premise and to the work of the Commission on Social Determinants of Health. Strengthening health equity--globally and within countries--means going beyond contemporary concentration on the immediate causes of disease. More than any other global health endeavour, the Commission focuses on the "causes of the causes"--the fundamental structures of social hierarchy and the socially determined conditions these create in which people grow, live, work, and age. The time for action is now, not just because better health makes economic sense, but because it is right and just. The outcry against inequity has been intensifying for many years from country to country around the world. These cries are forming a global movement. The Commission on Social Determinants of Health places action to ensure fair health at the head and the heart of that movement.
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- 2007
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14. Status syndrome: a challenge to medicine.
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Marmot MG
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- Humans, United States, Health Services Accessibility, Health Status, Public Health, Socioeconomic Factors
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- 2006
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15. Social determinants of health inequalities.
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Marmot M
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- Adult, Aged, Aged, 80 and over, Child, Female, Health Status, Health Status Indicators, Humans, Male, Middle Aged, Poverty, Social Justice, Developing Countries, Public Health, Socioeconomic Factors
- Abstract
The gross inequalities in health that we see within and between countries present a challenge to the world. That there should be a spread of life expectancy of 48 years among countries and 20 years or more within countries is not inevitable. A burgeoning volume of research identifies social factors at the root of much of these inequalities in health. Social determinants are relevant to communicable and non-communicable disease alike. Health status, therefore, should be of concern to policy makers in every sector, not solely those involved in health policy. As a response to this global challenge, WHO is launching a Commission on Social Determinants of Health, which will review the evidence, raise societal debate, and recommend policies with the goal of improving health of the world's most vulnerable people. A major thrust of the Commission is turning public-health knowledge into political action.
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- 2005
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16. Ganges, Cambridge, Chicago, Edinburgh, Cambridge... Values and public health.
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Marmot M
- Subjects
- Humans, Philosophy, Medical, Human Rights, Public Health, Social Values
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- 2005
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17. Socioeconomic position in childhood and cancer in adulthood: a rapid-review
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Vohra, Jyotsna, Marmot, Michael G, Bauld, Linda, and Hiatt, Robert A
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Epidemiology ,Public Health ,Health Sciences ,Cancer ,Prevention ,Digestive Diseases ,2.3 Psychological ,social and economic factors ,Aetiology ,Adolescent ,Adult ,Aged ,Child ,Europe ,Female ,Health Behavior ,Humans ,Life Style ,Male ,Neoplasms ,Social Class ,Socioeconomic Factors ,Stomach Neoplasms ,United Kingdom ,CANCER ,Health inequalities ,POLICY ,POVERTY ,SOCIAL INEQUALITIES - Abstract
BackgroundThe relationship of childhood socioeconomic position (SEP) to adult cancer has been inconsistent in the literature and there has been no review summarising the current evidence focused solely on cancer outcomes.Methods and resultsWe performed a rapid review of the literature, which identified 22 publications from 13 studies, primarily in the UK and northern European countries that specifically analysed individual measures of SEP in childhood and cancer outcomes in adulthood. Most of these studies adjusted for adult SEP as a critical mediator of the relationship of interest.ConclusionsResults confirm that childhood socioeconomic circumstances have a strong influence on stomach cancer and are likely to contribute, along with adult circumstances, to lung cancer through cumulative exposure to smoking. There was also some evidence of increased risk of colorectal, liver, cervical and pancreatic cancers with lower childhood SEP in large studies, but small numbers of cancer deaths made these estimates imprecise. Gaps in knowledge and potential policy implications are presented.
- Published
- 2016
18. Association between alcohol and cardiovascular disease: Mendelian randomisation analysis based on individual participant data
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Holmes, Michael V, Dale, Caroline E, Zuccolo, Luisa, Silverwood, Richard J, Guo, Yiran, Ye, Zheng, Prieto-Merino, David, Dehghan, Abbas, Trompet, Stella, Wong, Andrew, Cavadino, Alana, Drogan, Dagmar, Padmanabhan, Sandosh, Li, Shanshan, Yesupriya, Ajay, Leusink, Maarten, Sundstrom, Johan, Hubacek, Jaroslav A, Pikhart, Hynek, Swerdlow, Daniel I, Panayiotou, Andrie G, Borinskaya, Svetlana A, Finan, Chris, Shah, Sonia, Kuchenbaecker, Karoline B, Shah, Tina, Engmann, Jorgen, Folkersen, Lasse, Eriksson, Per, Ricceri, Fulvio, Melander, Olle, Sacerdote, Carlotta, Gamble, Dale M, Rayaprolu, Sruti, Ross, Owen A, McLachlan, Stela, Vikhireva, Olga, Sluijs, Ivonne, Scott, Robert A, Adamkova, Vera, Flicker, Leon, Bockxmeer, Frank M van, Power, Christine, Marques-Vidal, Pedro, Meade, Tom, Marmot, Michael G, Ferro, Jose M, Paulos-Pinheiro, Sofia, Humphries, Steve E, Talmud, Philippa J, Mateo Leach, Irene, Verweij, Niek, Linneberg, Allan, Skaaby, Tea, Doevendans, Pieter A, Cramer, Maarten J, van der Harst, Pim, Klungel, Olaf H, Dowling, Nicole F, Dominiczak, Anna F, Kumari, Meena, Nicolaides, Andrew N, Weikert, Cornelia, Boeing, Heiner, Ebrahim, Shah, Gaunt, Tom R, Price, Jackie F, Lannfelt, Lars, Peasey, Anne, Kubinova, Ruzena, Pajak, Andrzej, Malyutina, Sofia, Voevoda, Mikhail I, Tamosiunas, Abdonas, Maitland-van der Zee, Anke H, Norman, Paul E, Hankey, Graeme J, Bergmann, Manuela M, Hofman, Albert, Franco, Oscar H, Cooper, Jackie, Palmen, Jutta, Spiering, Wilko, de Jong, Pim A, Kuh, Diana, Hardy, Rebecca, Uitterlinden, Andre G, Ikram, M Arfan, Ford, Ian, Hyppönen, Elina, Almeida, Osvaldo P, Wareham, Nicholas J, Khaw, Kay-Tee, Hamsten, Anders, Husemoen, Lise Lotte N, Tjønneland, Anne, Tolstrup, Janne S, Rimm, Eric, Beulens, Joline WJ, and Verschuren, WM Monique
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Epidemiology ,Public Health ,Health Sciences ,Substance Misuse ,Genetics ,Brain Disorders ,Cardiovascular ,Alcoholism ,Alcohol Use and Health ,Heart Disease ,Clinical Research ,Aetiology ,2.1 Biological and endogenous factors ,Oral and gastrointestinal ,Stroke ,Good Health and Well Being ,Adult ,Aged ,Alcohol Dehydrogenase ,Alcohol Drinking ,Biomarkers ,Coronary Disease ,Female ,Genetic Markers ,Genotype ,Humans ,Male ,Mendelian Randomization Analysis ,Middle Aged ,Models ,Statistical ,Polymorphism ,Single Nucleotide ,InterAct Consortium ,Clinical Sciences ,Public Health and Health Services ,General & Internal Medicine ,Biomedical and clinical sciences ,Health sciences ,Psychology - Abstract
ObjectiveTo use the rs1229984 variant in the alcohol dehydrogenase 1B gene (ADH1B) as an instrument to investigate the causal role of alcohol in cardiovascular disease.DesignMendelian randomisation meta-analysis of 56 epidemiological studies.Participants261 991 individuals of European descent, including 20 259 coronary heart disease cases and 10 164 stroke events. Data were available on ADH1B rs1229984 variant, alcohol phenotypes, and cardiovascular biomarkers.Main outcome measuresOdds ratio for coronary heart disease and stroke associated with the ADH1B variant in all individuals and by categories of alcohol consumption.ResultsCarriers of the A-allele of ADH1B rs1229984 consumed 17.2% fewer units of alcohol per week (95% confidence interval 15.6% to 18.9%), had a lower prevalence of binge drinking (odds ratio 0.78 (95% CI 0.73 to 0.84)), and had higher abstention (odds ratio 1.27 (1.21 to 1.34)) than non-carriers. Rs1229984 A-allele carriers had lower systolic blood pressure (-0.88 (-1.19 to -0.56) mm Hg), interleukin-6 levels (-5.2% (-7.8 to -2.4%)), waist circumference (-0.3 (-0.6 to -0.1) cm), and body mass index (-0.17 (-0.24 to -0.10) kg/m(2)). Rs1229984 A-allele carriers had lower odds of coronary heart disease (odds ratio 0.90 (0.84 to 0.96)). The protective association of the ADH1B rs1229984 A-allele variant remained the same across all categories of alcohol consumption (P=0.83 for heterogeneity). Although no association of rs1229984 was identified with the combined subtypes of stroke, carriers of the A-allele had lower odds of ischaemic stroke (odds ratio 0.83 (0.72 to 0.95)).ConclusionsIndividuals with a genetic variant associated with non-drinking and lower alcohol consumption had a more favourable cardiovascular profile and a reduced risk of coronary heart disease than those without the genetic variant. This suggests that reduction of alcohol consumption, even for light to moderate drinkers, is beneficial for cardiovascular health.
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- 2014
19. Income Inequality, Social Environment, and Inequalities in Health
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Marmot, Michael
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- 2001
20. Diet and Disease, and Durkheim and Dasgupta, and Deuteronomy
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Marmot, Michael G.
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- 1998
21. Association between Psychosocial Factors at Work and Nonfatal Myocardial Infarction in a Population-Based Case-Control Study in Czech Men
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Bobák, Martin, Hertzman, Clyde, Škodová, Zdenka, and Marmot, Michael
- Published
- 1998
22. From health inequalities to health justice in 50 years.
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Venkatapuram, Sridhar and Marmot, Michael
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HEALTH policy , *HEALTH services accessibility , *DENTAL care , *PUBLIC health , *HEALTH equity , *COVID-19 pandemic - Abstract
In the following discussion, we present a quick conceptual history of healthy equity and health justice, some plausible outcomes from the Covid‐19 pandemic for the public's understanding of these concepts, and some recent and relevant learnings for realizing equity and justice that could be useful for dental public health and beyond. [ABSTRACT FROM AUTHOR]
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- 2023
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23. Socioeconomic inequalities in all-cause mortality in the Czech Republic, Russia, Poland and Lithuania in the 2000s: findings from the HAPIEE Study
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Vandenheede, Hadewijch, Vikhireva, Olga, Pikhart, Hynek, Kubinova, Ruzena, Malyutina, Sofia, Pajak, Andrzej, Tamosiunas, Abdonas, Peasey, Anne, Simonova, Galina, Topor-Madry, Roman, Marmot, Michael, and Bobak, Martin
- Published
- 2014
24. Experience of South and Southeast Asian minority women in Hong Kong during COVID-19 pandemic: a qualitative study.
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Chung, Roger Yat-Nork, Lee, Tobey Tsz-Yan, Chan, Siu-Ming, Chung, Gary Ka-Ki, Chan, Yat-Hang, Wong, Samuel Yeung-Shan, Lai, Eric, Wong, Hung, Yeoh, Eng Kiong, Marmot, Michael, and Woo, Jean
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MINORITIES ,INTERVIEWING ,ACTIVITIES of daily living ,CULTURAL pluralism ,PUBLIC health ,SOCIOECONOMIC factors ,SEX distribution ,PSYCHOLOGY of women ,RESEARCH funding ,SOCIAL attitudes ,SOCIAL distancing ,HEALTH equity ,COVID-19 pandemic - Abstract
Background: Hong Kong has a relatively low incidence rate of COVID-19 across the globe. Nevertheless, ethnic minorities in Hong Kong, especially South Asians (SAs) and Southeast Asians (SEAs), face numerous physical, mental, social, economic, cultural and religious challenges during the pandemic. This study explores the experiences of SA and SEA women in a predominantly Chinese metropolitan city. Methods: Ten SA and SEA women were recruited and face-to-face interviews were conducted. Questions about participants' daily life experience, physical and mental health conditions, economic situation and social interaction amid COVID-19 pandemic were asked to assess the impact of COVID-19. Results: SAs and SEAs have a distinctive family culture, and women experienced significant physical and mental impact of COVID-19 due to their unique gender role in the family. In addition to taking care of their family in Hong Kong, SA and SEA women also had to mentally and financially support family members residing in their home countries. Access to COVID-related information was restricted due to language barrier. Public health measures including social distancing imposed extra burden on ethnic minorities with limited social and religious support. Conclusions: Even when COVID-19 incidence rate is relatively low in Hong Kong, the pandemic made life even more challenging for SAs and SEAs, which is a community already struggling with language barriers, financial woes, and discrimination. This in turn could have led to greater health inequalities. Government and civil organizations should take the social determinants of health inequalities into account when implementing COVID-19-related public health policies and strategies. [ABSTRACT FROM AUTHOR]
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- 2023
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25. Change in economic difficulties and physical and mental functioning: Evidence from British and Finnish employee cohorts
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Lallukka, Tea, Ferrie, Jane E, Rahkonen, Ossi, Shipley, Martin J, Pietiläinen, Olli, Kivimäki, Mika, Marmot, Michael G, and Lahelma, Eero
- Published
- 2013
26. Strong evidence that the economic crisis caused a rise in suicides in Europe: the need for social protection
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De Vogli, Roberto, Marmot, Michael, and Stuckler, David
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- 2013
27. Excess suicides and attempted suicides in Italy attributable to the great recession
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De Vogli, Roberto, Marmot, Michael, and Stuckler, David
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- 2013
28. Reducing the health inequalities associated with employment conditions
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Benach, Joan, Muntaner, Carles, Chung, Haejoo, Solar, Orielle, Santana, Vilma, Friel, Sharon, Houweling, Tanja AJ, and Marmot, Michael
- Published
- 2010
29. Do pre-employment influences explain the association between psychosocial factors at work and coronary heart disease? The Whitehall II study
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Hintsa, Taina, Shipley, Martin J, Gimeno, David, Elovainio, Marko, Chandola, Tarani, Jokela, Markus, Keltikangas-Järvinen, Liisa, Vahtera, Jussi, Marmot, Michael G, and Kivimäki, Mika
- Published
- 2010
30. Injustice at Work and Health: Causation, Correlation or Cause for Action?
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Ferrie, Jane E., Head, Jenny A., Shipley, Martin J., Vahtera, Jussi, Marmot, Michael G., and Kivimäki, Mika
- Published
- 2007
31. Neighbourhood Environment and Its Association with Self Rated Health: Evidence from Scotland and England
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Cummins, Steven, Stafford, Mai, Macintyre, Sally, Marmot, Michael, and Ellaway, Anne
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- 2005
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32. Dreaming a Different Epidemiological Future
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Marmot, Michael
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- 2005
33. Evidence based policy or policy based evidence?: Willingness to take action influences the view of the evidence—look at alcohol
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Marmot, Michael G
- Published
- 2004
34. Smoke intake among smokers is higher in lower socioeconomic groups
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Bobak, Martin, Jarvis, Martin J, Skodova, Zdenka, and Marmot, Michael
- Published
- 2000
35. Britain's First Minister of Public Health
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Powles, John, Day, Nick, McPherson, Klim, McKee, Martin, McMichael, Tony, Chalmers, Iain, Smith, George Davey, Gabbay, John, Marks, David, Sharp, Imogen, Wilkinson, Richard, Marmot, Michael, Crown, June, Clarke, Michael, and Griffiths, Sian
- Published
- 1997
36. Ecological Analysis of Collectivity of Alcohol Consumption in England: Importance of Average Drinker
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Colhoun, Helen, Ben-Shlomo, Yoav, Dong, Wei, Bost, Lulu, and Marmot, Michael
- Published
- 1997
37. Restructuring OHID is another step away from tackling health inequalities.
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Bambra, Clare and Marmot, Michael
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HEALTH services accessibility ,SOCIAL support ,LIFE expectancy ,MEDICAL care ,PUBLIC health ,MEDICAL care costs ,NATIONAL health services ,PUBLIC sector ,HEALTH equity ,BUDGET ,SOCIAL case work - Published
- 2024
38. Liberalism and public health.
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Marmot, Michael
- Subjects
- *
LIBERALISM , *PUBLIC health - Published
- 2024
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39. The Transformative Potential of Strategic Partnerships to Form a Health Equity Network of the Americas
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Castro, Arachu, Rodríguez, Michael A., Marmot, Michael G., Salgado de Snyder, V. Nelly, Galvão, Luiz A.C., Avellaneda, Ximena, Saenz, Maria del Rocio, Dubois, Anne M., Tarzibachi, Eugenia, Ritterbusch, Amy Elizabeth, Plough, Alonzo, and Heymann, Jody
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Economic growth ,Latin Americans ,Epidemiology ,Social Determinants of Health ,SOCIAL POLICY ,LATIN AMERICA ,International Perspectives ,QUALITY OF LIFE ,Strategic partnership ,Political science ,CALIDAD DE VIDA ,Humans ,Social determinants of health ,Policy Making ,Intersectoral Collaboration ,International network ,geography ,Summit ,geography.geographical_feature_category ,Health Equity ,General Medicine ,Health Status Disparities ,Quality Improvement ,Health equity ,Transformative learning ,Latin America ,HEALTH ,SALUD ,PUBLIC HEALTH ,POLÍTICA SOCIAL ,SALUD PÚBLICA - Abstract
Health inequities across the Americas are avoidable and unjust yet continue to persist. Systemic social determinants of health, which could be addressed at the policy level, are root causes of many inequities and prevent marginalized individuals and at-risk populations from reaching optimal health and well-being. In this article, we describe our approach to promote health equity through the intersectoral partnerships that were forged, and strategies that were shared, during the convening entitled “Summit 2017: Health Equity in the Americas” and the resulting emergence of the Health Equity Network of the Americas (HENA). We illustrate how this international network will raise awareness of policies and programs to inform decision makers about actions they can take to put an end to the unjust, persistent and mostly avoidable health inequities facing the Americas today Las inequidades en salud en las Américas son evitables e injustas, pero continúan persistiendo. Los determinantes sociales sistémicos de la salud, que podrían abordarse a nivel de políticas, son las causas fundamentales de muchas inequidades e impiden que las personas marginadas y las poblaciones en riesgo alcancen una salud y un bienestar óptimos. En este artículo, describimos nuestro enfoque para promover la equidad en salud a través de las alianzas intersectoriales que se forjaron y las estrategias que se compartieron durante la convocatoria titulada “Cumbre 2017: Equidad en Salud en las Américas” y el surgimiento resultante de la Red de Equidad en Salud de las Américas (HENA). Ilustramos cómo esta red internacional creará conciencia sobre políticas y programas para informar a los tomadores de decisiones sobre las acciones que pueden tomar para poner fin a las desigualdades en salud injustas, persistentes y en su mayoría evitables que enfrentan las Américas hoy. David Geffen School of Medicine at UCLA, Estados Unidos Institute for Health Equity, Reino Unido Instituto Nacional de Salud Publica de México, México Center for Global Health - Centro de Relações Internacionais em Saúde, Brasil Grupo de estudios sobre la Mujer Rosario Castellanos, México Universidad Nacional, Costa Rica Dubois, Betourné & Associates, Estados Unidos University of San Martín and University of Buenos Aires, Argentina UCLA Luskin School of Public Affairs, Estados Unidos Tulane University School of Public Health and Tropical Medicine, Estados Unidos Robert Wood Johnson Foundation, Estados Unidos UCLA Fielding School of Public Health, Estados Unidos Escuela de Planificación y Promoción Social
- Published
- 2019
40. The biology of inequalities in health: the LIFEPATH project
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Vineis, Paolo, Avendano-Pabon, Mauricio, Barros, Henrique, Chadeau-Hyam, Marc, Costa, Giuseppe, Dijmarescu, Michaela, Delpierre, Cyrille, D’Errico, Angelo, Fraga, Silvia, Giles, Graham, Goldberg, Marcel, Zins, Marie, Kelly-Irving, Michelle, Kivimaki, Mika, Lang, Thierry, Layte, Richard, Mackenbach, Johan P., Marmot, Michael, McCrory, Cathal, Carmeli, Cristian, Milne, Roger L., Muennig, Peter, Nusselder, Wilma, Polidoro, Silvia, Ricceri, Fulvio, Robinson, Oliver, Stringhini, Silvia, Alenius, Harri, Avendano, Mauricio, Bochud, Murielle, Carra, Luca, Castagne, Raphaele, Chadeau, Marc Hyam, Clavel, Francoise Chapelon, Courtin, Emilie, Dugue, Pierre Antoine, Elliott, Paul, Gares, Valerie, Greco, Dario, Hodge, Allison, Kelly, Michelle Irving, Karisola, Piia, Krogh, Vittorio, Lepage, Benoit, Panico, Salvatore, Petrovic, Dusan, Preisig, Martin, Raitakari, Olli, Ribeiro, Ana Isabel, Valverde, Jose Rubio, Sacerdote, Carlotta, Satolli, Roberto, Severi, Gianluca, Simmons, Terrence, Tumino, Rosario, Vergnaud, Anne Clare, Vollenweider, Petter, Medical Research Council (MRC), Commission of the European Communities, Public Health, and Epidemiology
- Subjects
0301 basic medicine ,Gerontology ,Psychological intervention ,Social Sciences ,0302 clinical medicine ,SOCIOECONOMIC INEQUALITIES ,Social Sciences - Other Topics ,030212 general & internal medicine ,DNA METHYLATION ,Public, Environmental & Occupational Health ,education.field_of_study ,biology ,1. No poverty ,Social Sciences, Interdisciplinary ,3. Good health ,omics ,Socioeconomic status ,Life course approach ,Psychology ,healthy ageing ,Life Sciences & Biomedicine ,medicine.medical_specialty ,life-course ,Population ,Omics ,1603 Demography ,socioeconomic status ,03 medical and health sciences ,Life-course ,PSYCHOSOCIAL ENVIRONMENT ,Healthy ageing ,medicine ,Social inequality ,CORONARY-HEART-DISEASE ,Social determinants of health ,SOCIAL INEQUALITIES ,MIDLIFE FINDINGS ,ALLOSTATIC LOAD ,Life-span and Life-course Studies ,education ,1608 Sociology ,Biology ,Science & Technology ,Public health ,Conditional cash transfer ,030104 developmental biology ,RISK-FACTORS ,BRITISH BIRTH COHORT ,EUROPEAN COUNTRIES ,Social inequalities - Abstract
Socioeconomic differences in health have been consistently observed worldwide. Physical health deteriorates more rapidly with age among men and women with lower socioeconomic status (SES) than among those with higher SES. The biological processes underlying these differences are best understood by adopting a life course approach. In this paper we introduce the pan- European LIFEPATH project which uses multiple cohorts - including biomarker data - to investigate ageing as a phenomenon with two broad stages across life: build-up and decline. The ‘build-up’ stage, from conception and early intra-uterine life to late adolescence or early twenties, is characterised by rapid successions of developmentally and socially sensitive periods. The second stage, starting in early adulthood, is a period of ‘decline’ from maximum attained health to loss of function, overt disease and death. LIFEPATH adopts a study design that integrates social science and public health approaches with biology (including molecular epidemiology), using well-characterised population cohorts and omics measurements (particularly epigenomics). LIFEPATH includes information and biological samples from 17 cohorts, including several with extensive phenotyping and repeat biological samples, and a very large cohort (1 million individuals) without biological samples (WHIP, from Italy). The countries that are covered by the cohorts are France, Italy, Portugal, Ireland, UK, Finland, Switzerland and Australia. These cohorts are only a small proportion of all cohorts available in Europe, but we have chosen them for the combination of good measures of socioeconomic status, risk factors for non-communicable diseases (NCDs) and biomarkers already measured (or availability of blood samples for further testing). The majority of cohorts include ‘hard’ outcomes (diabetes, cancer, Cardiovascular Disease (CVD), total mortality), and the extensively phenotyped cohorts also include several measurements of the functional components of healthy ageing, including frailty, impaired vision, cognitive function, renal and brain function, osteoporosis, sleep disturbances and mental health. All age groups are represented with two birth cohorts, one cohort of adolescents and several cohorts encompassing young adults (age 18 and above). Furthermore, there is a strong representation of elderly subjects in seven cohorts. The specific objectives of the project are: (a) to show that healthy ageing is an achievable goal for society; (b) to improve the understanding of the mechanisms through which healthy ageing pathways diverge by SES, by investigating life course biological pathways using omic technologies; (c) to examine the consequences of the current economic recession on health and the biology of ageing (and the consequent increase in social inequalities); (d) to provide updated, relevant and innovative evidence for healthy ageing policies (particularly ‘health in all policies’) using both observational studies and an experimental approach based on a reanalysis of data from a ‘conditional cash transfer’ randomised experiment in New York and new data collected as part of an earned income tax credit randomised experiment in Atlanta and New York. To achieve these objectives, data are used from three categories of studies: 1. national census-based followup data to obtain mortality by socioeconomic status; 2. cohorts with intense phenotyping and repeat biological samples; 3. large cohorts with biological samples. With these objectives and methodologies, LIFEPATH seeks to provide updated, relevant and innovative evidence to underpin future policies and strategies for the promotion of healthy ageing, targeted disease prevention and clinical interventions that address the issue of social disparities in ageing and the social determinants of health. The present paper describes the design and some initial results of LIFEPATH as an example of the integration of social and biological sciences to provide evidence for public health policies.
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- 2017
41. Public mental health and associated opportunities.
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Campion, Jonathan, Javed, Afzal, Vaishnav, Mrugesh, and Marmot, Michael
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HEALTH planning ,MEDICAL care ,MEDICAL needs assessment ,MENTAL health ,PUBLIC health - Abstract
The article presents Public mental health (PMH) takes a whole population approach to sustainably reduce mental disorder and improve mental well‑being through the provision of PMH interventions to treat mental disorder, prevent associated impacts, prevent mental disorder from arising, and promote mental well‑being.
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- 2020
- Full Text
- View/download PDF
42. Cardiovascular Disease
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Marmot, Michael
- Published
- 1993
43. Chapter 2. Social inequalities, global public health, and cancer.
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Marmot, Michael
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CANCER & society ,EQUALITY ,PUBLIC health ,NON-communicable diseases ,HEALTH equity ,CANCER prevention - Abstract
The article discusses the global public health issues associated with social inequalities in cancer. Topics explored include highlights of the October 2017 Global Conference on Noncommunicable Diseases (NCD) held by the World Health Organization (WHO) and the Uruguay Government, the observed health inequalities between high-income and middle-income countries, and the lifestyle changes deemed necessary for cancer prevention according to Cancer Research UK.
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- 2019
44. Just societies, health equity, and dignified lives: the PAHO Equity Commission.
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Marmot, Michael
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- *
HEALTH services accessibility , *MEDICAL care , *PUBLIC health , *HEALTH policy , *COMMUNITY health services , *HEALTH programs - Abstract
The article focuses on public health and medical care services in the Americas. It highlghts the creation of the Commission of the Pan American Health Organization on Equity and Health Inequalities in the Americas by the director of the Pan American Health Organization Carissa Etienne in an aim to address health inequalities.
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- 2018
- Full Text
- View/download PDF
45. Education modifies the association of wealth with obesity in women in middle-income but not low-income countries: an interaction study using seven national datasets, 2005-2010
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Aitsi-Selmi, Amina, Bell, Ruth, Shipley, Martin J., and Marmot, Michael G.
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Adult ,Non-Clinical Medicine ,Adolescent ,Epidemiology ,lcsh:Medicine ,Colombia ,Social and Behavioral Sciences ,Young Adult ,Sociology ,Peru ,Psychology ,Humans ,Obesity ,lcsh:Science ,Poverty ,Nutrition ,Health Care Policy ,Jordan ,lcsh:R ,Middle Aged ,Socioeconomic Aspects of Health ,Social Epidemiology ,Survey Methods ,Health Education and Awareness ,Socioeconomic Factors ,Income ,Medicine ,Egypt ,Female ,lcsh:Q ,Public Health ,Economic Epidemiology ,Research Article - Abstract
BACKGROUND:Education and wealth may have different associations with female obesity but this has not been investigated in detail outside high-income countries. This study examines the separate and inter-related associations of education and household wealth in relation to obesity in women in a representative sample of low- and middle-income countries (LMICs). METHODS:The seven largest national surveys were selected from a list of Demographic and Health Surveys (DHS) ordered by decreasing sample size and resulted in a range of country income levels. These were nationally representative data of women aged 15-49 years collected in the period 2005-2010. The separate and joint effects, unadjusted and adjusted for age group, parity, and urban/rural residence using a multivariate logistic regression model are presented. RESULTS:In the four middle-income countries (Colombia, Peru, Jordan, and Egypt), an interaction was found between education and wealth on obesity (P-value for interaction
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- 2014
46. A return to austerity will further damage the public's health.
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Marmot, Michael
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HEALTH policy ,WELL-being ,LIFE expectancy ,PUBLIC health ,SOCIOECONOMIC factors ,HEALTH equity ,PUBLIC spending - Published
- 2022
- Full Text
- View/download PDF
47. THE LOST DECADE: How austerity put back England's health gains.
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Marmot, Michael
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PUBLIC spending ,HEALTH services accessibility ,HEALTH status indicators ,LIFE expectancy ,PUBLIC health ,PUBLIC housing ,GOVERNMENT policy ,HEALTH equity ,HEALTH & social status - Published
- 2020
48. Job Strain and Tobacco Smoking: An Individual-Participant Data Meta-Analysis of 166 130 Adults in 15 European Studies
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Heikkilä, Katriina, Nyberg, Solja T., Fransson, Eleonor I., Alfredsson, Lars, de Bacquer, Dirk, Bjorner, Jakob B., Bonenfant, Sébastien, Borritz, Marianne, Burr, Hermann, Clays, Els, Casini, Annalisa, Dragano, Nico, Erbel, Raimund, Geuskens, Goedele A., Goldberg, Marcel, Hooftman, Wendela E., Houtman, Irene L., Joensuu, Matti, Jöckel, Karl-Heinz, Kittel, France, Knutsson, Anders, Koskenvuo, Markku, Koskinen, Aki, Kouvonen, Anne, Leineweber, Constanze, Lunau, Thorsten, Madsen, Ida E. H., Hanson, Linda L. Magnusson, Marmot, Michael G., Nielsen, Martin L., Nordin, Maria, Pentti, Jaana, Salo, Paula, Rugulies, Reiner, Steptoe, Andrew, Siegrist, Johannes, Suominen, Sakari, Vahtera, Jussi, Virtanen, Marianna, Väänänen, Ari, Westerholm, Peter, Westerlund, Hugo, Zins, Marie, Theorell, Töres, Hamer, Mark, Ferrie, Jane E., Singh-Manoux, Archana, David Batty, G., Kivimäki, Mika, IPD-Work Consortium, UCL - SSH/IPSY - Psychological Sciences Research Institute, ULB - School of public health, Finnish Institute of Occupational Health, Stress Research Institute, Stockholm University, School of Health Science, Jönköping University [Sweden], Institute of Environmental Medicine, Karolinska Institutet [Stockholm], Centre for Occupational and Environmental Medicine, Stockholm County Council, Department of Public Health, Universiteit Gent = Ghent University [Belgium] (UGENT), National Research Centre for the Working Environment, National Research Centre for the Working Environment (NRCWE), Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Federal Institute for Occupational Safety and Health (BAuA), State University of Ghent, School of Public Health, Université libre de Bruxelles (ULB), Institute for Medical Sociology, Medical Faculty, Heinrich Heine Universität Düsseldorf = Heinrich Heine University [Düsseldorf], Department of cardiology, Universität Duisburg-Essen [Essen], The Netherlands Organisation for Applied Scientific Research (TNO), Institute for Medical Informatics, Biometry, and Epidemiology, Department of Health Sciences, Mid Sweden University, School of Sociology, Social Policy, & Social Work, Queen's University [Belfast] (QUB), Department of Epidemiology and Public Health, University College of London [London] (UCL), Department of Psychology, Umeå University, Department of Public Health [Copenhagen], Faculty of Health and Medical Sciences, University of Copenhagen = Københavns Universitet (KU)-University of Copenhagen = Københavns Universitet (KU), Department of Medical Sociology, Medical Faculty, Nordic School of Public Health, University of Turku, Folkhälsan Research Center, The IPD work consortium is supported by the EU New OSH ERA research programme (funded by the Finnish Work Environment Fund, Finland, the SwedishResearch Council for Working Life and Social Research, Sweden, the German Social Accident Insurance, Germany, the Danish Work Environment ResearchFund,Denmark), the Academy of Finland (grant#132944), and the BUPA Foundation (grant 22094477). The HNR was funded by the Heinz Nixdorf Foundation, Germany,German Ministry of Education and Science (BMBF) and the German Research Foundation (DFG). The German Social Accident Insurance (DGUV) supports analyses inthe frame of the OSH ERA project. POLS was funded by the Ministry of Social Affairs and Employment, The Netherlands. The funders had no role in the study design,data collection and analysis, decision to publish, or preparation of the manuscript, SZTAJNBOK, Pascale, Universiteit Gent = Ghent University (UGENT), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), University of Copenhagen = Københavns Universitet (UCPH)-University of Copenhagen = Københavns Universitet (UCPH), Hjelt Institute (-2014), Department of Social Research (2010-2017), Sociology, and Center for Population, Health and Society
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Male ,Longitudinal study ,Pulmonology ,Cross-sectional study ,Epidemiology ,OVERTIME ,medicine.medical_treatment ,Logistic regression ,Social and Behavioral Sciences ,0302 clinical medicine ,Surveys and Questionnaires ,Odds Ratio ,Medicine ,Psychology ,Longitudinal Studies ,lcsh:Science ,ASSOCIATIONS ,Tobacco harm reduction ,MESH: Middle Aged ,ta3142 ,MESH: European Continental Ancestry Group ,Sciences bio-médicales et agricoles ,030210 environmental & occupational health ,MESH: Smoking Cessation ,3. Good health ,MESH: Young Adult ,Public Health ,Behavioral and Social Aspects of Health ,education ,Psychological Stress ,White People ,03 medical and health sciences ,MESH: Cross-Sectional Studies ,Sciences sociales ,WORK STRESS ,Humans ,PATIENT DATA ,Aged ,MESH: Adolescent ,MESH: Humans ,Job strain ,MESH: Questionnaires ,lcsh:R ,MESH: Adult ,Odds ratio ,FINNISH PUBLIC-SECTOR ,BSS - Behavioural and Societal Sciences ,Sciences humaines ,Cross-Sectional Studies ,Organisation ,Smoking cessation ,lcsh:Q ,ADVERSE HEALTH BEHAVIORS ,MESH: Female ,Medicin och hälsovetenskap ,Medizin ,lcsh:Medicine ,Medical and Health Sciences ,Medicine and Health Sciences ,030212 general & internal medicine ,Workplace ,MESH: Workplace ,RISK ,MESH: Aged ,Multidisciplinary ,Smoking ,Public Health, Global Health, Social Medicine and Epidemiology ,MESH: Stress, Psychological ,Middle Aged ,3142 Public health care science, environmental and occupational health ,Europe ,TRIALS ,Mental Health ,Female ,Healthy Living ,Research Article ,Adult ,MESH: Smoking ,MESH: Socioeconomic Factors ,Tobacco Control ,Adolescent ,WH - Work & Health ,Clinical Research Design ,WHITEHALL-II ,Young Adult ,Environmental health ,Primary Care ,business.industry ,Smoking Related Disorders ,Confidence interval ,MESH: Male ,MESH: Odds Ratio ,Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ,Socioeconomic Factors ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Smoking Cessation ,MESH: Europe ,Healthy for Life ,business ,Stress, Psychological - Abstract
Tobacco smoking is a major contributor to the public health burden and healthcare costs worldwide, but the determinants of smoking behaviours are poorly understood. We conducted a large individual-participant meta-analysis to examine the extent to which work-related stress, operationalised as job strain, is associated with tobacco smoking in working adults., Journal Article, Research Support, Non-U.S. Gov't, SCOPUS: ar.j, info:eu-repo/semantics/published
- Published
- 2012
49. Using additional information on working hours to predict coronary heart disease: a cohort study
- Author
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Kivimäki, Mika, Batty, G David, Hamer, Mark, Ferrie, Jane, Vahtera, Jussi, Virtanen, Marianna, Marmot, Michael, Singh-Manoux, Archana, Shipley, Martin, Department of Epidemiology and Public Health, University College of London [London] (UCL), Department of Public Health, University of Turku-Turku University Hospital (TYKS), Finnish Institute of Occupational Health, Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Sources of Funding: Medical Research Council, British Heart Foundation, Wellcome Trust, Health and Safety Executive, Department of Health, Agency for Health Care Policy Research, UK, John D and Catherine T MacArthur Foundation Research Networks on Successful Midlife Development and Socio-economic Status and Health, National Heart, Lung and Blood Institute and National Institute on Aging, NIH, US, Academy of Finland, Finland, EU New OSH ERA Research Programme and European Science Foundation. MK and JV are supported by the Academy of Finland. GDB is a Wellcome Trust Fellow. GDB is a Wellcome Trust Fellow. MM is a MRC professor. MJS is supported by the British Heart Foundation, AS-M is supported by a 'European Young Investigator Award' from the European Science Foundation, and JEF is supported by the Medical Research Council, UK., and Turku University Hospital (TYKS)-University of Turku
- Subjects
MESH: Humans ,MESH: Middle Aged ,primary prevention ,public health ,risk assessment ,MESH: Adult ,MESH: Male ,Coronary heart disease ,prevention ,MESH: Risk Factors ,risk factors ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,cardiovascular diseases ,MESH: Coronary Disease ,MESH: Incidence ,MESH: Female ,MESH: Work Schedule Tolerance - Abstract
International audience; BACKGROUND: Long working hours are associated with increased risk for coronary heart disease (CHD). Adding information on long hours to traditional risk factors for CHD may help to improve risk prediction for this condition. OBJECTIVE: To examine whether information on long working hours improves the ability of the Framingham risk model to predict CHD in a low-risk, employed population. DESIGN: Cohort study with baseline medical examination performed between 1991 and 1993 and prospective follow-up for incident CHD performed until 2004. SETTING: Civil service departments in London (the Whitehall II study). PARTICIPANTS: 7095 adults (2109 women and 4986 men) aged 39 to 62 years working full-time without CHD at baseline. MEASUREMENTS: Working hours and the Framingham risk score were measured at baseline. Coronary death and nonfatal myocardial infarction were ascertained from medical screenings every 5 years, hospital data, and registry linkage. RESULTS: 192 participants had incident CHD during a median 12.3-year follow-up. After adjustment for their Framingham risk score, participants working 11 hours or more per day had a 1.67-fold (95% CI, 1.10- to 2.55-fold) increased risk for CHD compared with participants working 7 to 8 hours per day. Adding working hours to the Framingham risk score led to a net reclassification improvement of 4.7% (P = 0.034) due to better identification of persons who later developed CHD (sensitivity gain). LIMITATION: The findings may not be generalizable to populations with a larger proportion of high-risk persons and were not validated in an independent cohort. CONCLUSION: Information on working hours may improve risk prediction of CHD on the basis of the Framingham risk score in low-risk, working populations. PRIMARY FUNDING SOURCE: Medical Research Council; British Heart Foundation; Bupa Foundation; and the National Heart, Lung, and Blood Institute and National Institute on Aging of the National Institutes of Health.
- Published
- 2011
50. Validating the Framingham Hypertension Risk Score: results from the Whitehall II study
- Author
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Kivimäki, Mika, Batty, G David, Singh-Manoux, Archana, Ferrie, Jane, Tabak, Adam, Jokela, Markus, Marmot, Michael, Smith, George Davey, Shipley, Martin, Department of Epidemiology and Public Health, University College of London [London] (UCL), MRC Social & Public Health Sciences Unit, University of Glasgow, Santé publique et épidémiologie des déterminants professionnels et sociaux de la santé, Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), 1st Department of Medicine, Semmelweis University of Medicine [Budapest], Finnish Institute of Occupational Health, Department of Psychology, Medical Research Council Centre for Causal Analyses in Translational Epidemiology, University of Bristol [Bristol], Medical Research Council, British Heart Foundation, Wellcome Trust, Health and Safety Executive, Department of Health, Agency for Health Care Policy Research, UK, John D and Catherine T MacArthur Foundation Research Networks on Successful Midlife Development and Socio-economic Status and Health, National Institute on Aging, NIH, US, Academy of Finland, Finland, and and European Science Foundation. David Batty is a Wellcome Trust Fellow
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MESH: Smoking ,primary prevention ,MESH: Risk Assessment ,MESH: Hypertension ,prevention ,MESH: Risk Factors ,MESH: Body Height ,MESH: Government Agencies ,risk factors ,MESH: Prevalence ,MESH: Aged ,MESH: Humans ,MESH: Middle Aged ,MESH: Employment ,public health ,risk assessment ,MESH: Adult ,MESH: Blood Pressure ,MESH: Follow-Up Studies ,MESH: London ,MESH: Male ,MESH: Body Weight ,MESH: Reproducibility of Results ,Hypertension ,MESH: Family Health ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,MESH: Female - Abstract
International audience; A promising hypertension risk prediction score using data from the US Framingham Offspring Study has been developed, but this score has not been tested in other cohorts. We examined the predictive performance of the Framingham hypertension risk score in a European population, the Whitehall II Study. Participants were 6704 London-based civil servants aged 35 to 68 years, 31% women, free from prevalent hypertension, diabetes mellitus, and coronary heart disease. Standard clinical examinations of blood pressure, weight and height, current cigarette smoking, and parental history of hypertension were undertaken every 5 years for a total of 4 times. We recorded a total of 2043 incident (new-onset) cases of hypertension in three 5-year baseline follow-up data cycles. Both discrimination (C statistic: 0.80) and calibration (Hosmer-Lemeshow chi(2): 11.5) of the Framingham hypertension risk score were good. Agreement between the predicted and observed hypertension incidences was excellent across the risk score distribution. The overall predicted:observed ratio was 1.08, slightly better among individuals >50 years of age (0.99 in men and 1.02 in women) than in younger participants (1.16 in men and 1.18 in women). Reclassification with a modified score on the basis of our study population did not improve the prediction (net reclassification improvement: -0.5%; 95% CI: -2.5% to 1.5%). These data suggest that the Framingham hypertension risk score provides a valid tool with which to estimate near-term risk of developing hypertension.
- Published
- 2009
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