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To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1745-7939.2009.01164.x Byline: Anna Stevenson (1), Jamie Pearce (2), Tony Blakely (3), Vivienne Ivory (3), Karen Witten (4) Keywords: health; health inequality; neighbourhood; New Zealand Abstract: Abstract Over the past two decades, there has been a resurgence of interest into place-based influences on health. Researchers have identified that various characteristics of neighbourhoods exert an influence on the health outcomes and behaviours of local residents. Understanding the processes linking places to health provides considerable potential for a range of policy interventions. We review the New Zealand-based neighbourhoods and health research. Consideration is given to the types of neighbourhood characteristics, as well the range of health outcomes that have been studied. Finally, we suggest some priorities for further research into the mechanisms underpinning neighbourhood influences on health in New Zealand. Author Affiliation: (1)Community and Public Health, Canterbury District Health Board, Christchurch, New Zealand; (2)Institute of Geography, School of GeoSciences, University of Edinburgh, Edinburgh, UK; (3)Health Inequalities Research Programme, University of Otago, Wellington, New Zealand; (4)Centre for Social and Health Outcomes Research and Evaluation, Massey University, Auckland, New Zealand Article note: Anna Stevenson is a public health physician who works with Christchurch City Council and the Canterbury District Health Board on urban design issues; Jamie Pearce is a reader in Human Geography at the University of Edinburgh, UK, and co-director of the GeoHealth Laboratory, Department of Geography, University of Canterbury; Tony Blakely is research professor of Public Health at the Wellington School of Medicine and Health Sciences, University of Otago and the director of the Health Inequalities Research Programme (HIRP); Vivienne Ivory is a research fellow on the HIRP, Wellington School of Medicine and Health Sciences, University of Otago; Karen Witten is associate professor at the Centre for Social and Health Outcomes Research and Evaluation (SHORE), Massey University, Auckland., E-mail: jamie.pearce@ed.ac.uk; jamie.pearce@canterbury.ac.nz

Abstract Background Adult socioeconomic position (SEP) is one of the most frequently hypothesised indirect pathways between childhood SEP and adult health. However, few studies that explore the indirect associations between childhood SEP and adult health systematically investigate the mediating role of multiple individual measures of adult SEP for different health outcomes. We examine the potential mediating role of individual measures of adult SEP in the associations of childhood SEP with self-rated health, self-reported mental health, current smoking status and binge drinking in adulthood. Methods Data came from 10,010 adults aged 25-64 years at Wave 3 of the Survey of Family, Income and Employment in New Zealand. The associations between childhood SEP (assessed using retrospective information on parental occupation) and self-rated health, self-reported psychological distress, current smoking status and binge drinking were determined using logistic regression. Models were adjusted individually for the mediating effects of education, household income, labour market activity and area deprivation. Results Respondents from a lower childhood SEP had a greater odds of being a current smoker (OR 1.70 95% CI 1.42-2.03), reporting poorer health (OR 1.82 95% CI 1.39-2.38) or higher psychological distress (OR 1.60 95% CI 1.20-2.14) compared to those from a higher childhood SEP. Two-thirds to three quarters of the association of childhood SEP with current smoking (78%), and psychological distress (66%) and over half the association with poor self-rated health (55%) was explained by educational attainment. Other adult socioeconomic measures had much smaller mediating effects. Conclusions This study suggests that the association between childhood SEP and self-rated health, psychological distress and current smoking in adulthood is largely explained through an indirect socioeconomic pathway involving education. However, household income, area deprivation and labour market activity are still likely to be important as they are intermediaries in turn, in the socioeconomic pathway between education and health.