High Socioeconomic Neighborhoods Research Articles

Parental socioeconomic status and preschool children’s school accompaniment patterns: Exploring the role of parents in commuting behavior

ObjectiveThe purposes of this study were: 1) to describe the preschool children's accompaniment patterns to school and 2) to analyze the association of the accompaniment person with the parental socioeconomic status. MethodsA total of 2356 parents and their preschool children (4.56 ± 0.87 years old, 46.9% girls) from Spain participated in this study. Parents self-reported their marital status, educational and professional level, and their children’s mode of commuting to school behavior. Binary logistic regressions models were fitted to analyze the associations between the accompaniment with the parental educational and professional level. ResultsThe preschool children were mainly accompanied by the mother (68%) and the father’s accompaniment rate was higher when the parents reported higher educational and professional levels (p < 0.05). When the parental educational and professional levels were lower (OR = 1.59 and OR = 1.85, respectively, p < 0.05) or the father’s educational and professional levels were higher (OR = 1.81 and OR = 1.61, respectively, p < 0.05) preschool children were more likely to be actively accompanied by the mother. ConclusionsThus, the preschool children were escorted by the mother and actively by the parents when the educational and professional levels were lower. These results highlight the importance of intervening through the father's involvement in high socioeconomic neighborhoods to increase active commuting to school.

Are All Apartments Equal? An Investigation of Contemporary Apartment Design Quality by Neighbourhood-Level Socioeconomic Disadvantage

ABSTRACT Rapid increases in apartment construction have ignited concerns about design quality. Lower income populations could be disproportionately impacted by poor design as they are more likely to live in apartments and have fewer resources to mitigate design problems. We examined whether there was a socioeconomic gradient in contemporary apartment design by measuring the implementation of quantifiable policy-specific requirements in buildings (n = 172) sampled from relatively low, mid, and high socioeconomic neighbourhoods within Sydney, Melbourne, and Perth. Findings suggest the presence (or absence) of detailed policy instruments interacts with local market conditions to impact apartment design quality.

Neighborhood-level Socioeconomic Position During Early Pregnancy and Risk of Gastroschisis.

Neighborhood-level socioeconomic position has been shown to influence birth outcomes, including selected birth defects. This study examines the un derstudied association between neighborhood-level socioeconomic position during early pregnancy and the risk of gastroschisis, an abdominal birth defect of increasing prevalence. We conducted a case-control study of 1,269 gastroschisis cases and 10,217 controls using data from the National Birth Defects Prevention Study (1997-2011). To characterize neighborhood-level socioeconomic position, we conducted a principal component analysis to construct two indices-Neighborhood Deprivation Index (NDI) and Neighborhood Socioeconomic Position Index (nSEPI). We created neighborhood-level indices using census socioeconomic indicators corresponding to census tracts associated with addresses where mothers lived the longest during the periconceptional period. We used generalized estimating equations to estimate odds ratios (ORs) and 95% confidence intervals (CIs), with multiple imputations for missing data and adjustment for maternal race-ethnicity, household income, education, birth year, and duration of residence. Mothers residing in moderate (NDI Tertile 2 aOR = 1.23; 95% CI = 1.03, 1.48 and nSEPI Tertile 2 aOR = 1.24; 95% CI = 1.04, 1.49) or low socioeconomic neighborhoods (NDI Tertile 3 aOR = 1.28; 95% CI = 1.05, 1.55 and nSEPI Tertile 3 aOR = 1.32, 95% CI = 1.09, 1.61) were more likely to deliver an infant with gastroschisis compared with mothers residing in high socioeconomic neighborhoods. Our findings suggest that lower neighborhood-level socioeconomic position during early pregnancy is associated with elevated odds of gastroschisis. Additional epidemiologic studies may aid in confirming this finding and evaluating potential mechanisms linking neighborhood-level socioeconomic factors and gastroschisis.

Employment Precarity and Increased Risk of Hazardous Occupational Exposures Among Residents of High Socioeconomic Hardship Neighborhoods.

While there is evidence that workers in nonstandard employment arrangements are disproportionately exposed to recognized occupational hazards, existing studies have not comprehensively examined associations between employment precarity and exposure to occupational hazards for these workers in the USA. The aim of this study was to examine relationships between employment precarity and occupational hazards in two contiguous high socio-economic hardship neighborhoods in Chicago. Using a community-based participatory research approach, community researchers administered a community-developed survey to 489 residents of Greater Lawndale who reported current or recent employment in a job that met at least one characteristic of precarious employment (e.g. unpredictable schedule, insecure work, no living wage/benefits). Employment precarity was calculated using a modified version of the Employment Precarity Index (EPI) developed by the Poverty and Employment Precarity in Southern Ontario group. We modeled the association between employment precarity and occupational exposures using logistic regression models. We identified a high prevalence of precarious employment in this sample, as well as a high prevalence of self-reported exposure to recognized occupational hazards. Increases in relative employment precarity were significantly associated with self-reported exposure to chemical and biological hazards, physical hazards, and slip, trip, strike, fall, trap or crush hazards at work. Results highlight the importance of using community research approaches and robust measures of employment characteristics, such as the EPI, to evaluate associations between employment precarity and hazardous exposures. These results suggest that variability in employment situations and resultant relative employment precarity are important predictors of exposure to recognized occupational hazards. Findings also suggest that health inequities observed among precariously employed workers may be partly explained by increased risk for exposure to occupational hazards, which has implications for community health and should be investigated in future longitudinal research.

Emotional perceptions and barriers to Children's active school travel in low and high socio-economic neighbourhoods in Iran

IntroductionWalking to schools has declined with the rise of automobility, particularly in developing countries, due to fast urbanization. Conversely, Active School Travel (AST) benefits children’s physical health and contributes to their emotional health. PurposeThis cross-sectional study has developed a new model for analyzing children's AST behavior with environmental, household, and child factors, as well as exploring the relationships between children's AST and emotional perception among children residing in low and high socio-economic neighbourhoods in Bandar Abbas, Iran. MethodsOut of 1421 questionnaires distributed among school students (grades 1 to 6) and their parents, 1001 questionnaires qualified to be used for further analysis. Smart-PLS and SPSS were used to analyse the data. ResultsTraveling by private car (34.5%) and carpool (26.2%) respectively were the most common mode of commuting to school. Safety problems, traffic issues, and distance, respectively, were the most common barriers reported by parents for AST. Higher perceived crime and traffic safety by parents was associated with a higher level of AST. Meanwhile, parent’s perceived barriers to active commuting to schools decreased the chance of AST for children. Parents who reported having higher collective efficacy in their neighbourhoods positively affected the level of their child’s AST. Model results suggest that using AST modes positively correlates with children's positive emotional perceptions. ConclusionAST should be incorporated into school plans as a viable health promotion strategy. In addition, attempts to increase AST among children should emphasize improving safety and distance perceptions to adjust children's habits and tendency towards being driven to school every day.

Associations between the built environment and emotional, social and physical indicators of early child development across high and low socioeconomic neighbourhoods

Emerging evidence indicates that the built environment influences early child development. Access to, and the quality of, built environment features vary with the socioeconomic status (SES) of neighbourhoods. It has not yet been established whether the association between built environment features and early child development varies by neighbourhood SES. We sought to identify built environment features associated with neighbourhood-level variations in the early child development domains of physical health and wellbeing, social competence, and emotional maturity, and how these associations differ among high and low SES neighbourhoods where child development patterns follow expected outcomes ("on-diagonal" neighbourhoods) and where child development patterns differ from expected outcomes ("off-diagonal" neighbourhoods). This cross-sectional study analysed data from the Australian Early Development Census (AEDC) for children residing in 3839 neighbourhoods in the Perth and Peel metropolitan areas of Western Australia. Children's AEDC scores were aggregated at the area-level and merged with Geographic Information Systems derived measures of neighbourhood residential density, parks, walkability, community facilities and public transport. Multivariate logistic regressions modelled the odds of low and high SES neighbourhoods having a higher proportion of children developmentally "on-track" (scores in the 26th to 100th percentile of the AEDC) or "not on-track" (scores in the bottom 25th percentile of the AEDC) for each built environment feature. In high SES neighbourhoods, better development across all three domains was associated with greater residential density and improved access to parks, public transport, learning, childcare and health services. Conversely, in low SES neighbourhoods, greater residential density was associated with better physical, but poorer social and emotional development; increased traffic and street connectivity were associated with poorer physical and emotional development; shorter distances to parks, learning, childcare and health services were associated with poorer physical and emotional development; and more services and public transport stops were associated with poorer emotional development. The mixed findings in low SES neighbourhoods suggest that positive associations with built environment features seen in one domain of early child development may be negative in other domains. The reasons for the mixed findings in low SES neighbourhoods are likely multifactorial and may include parental neighbourhood perceptions, as well as quality and usage of built environment features. These findings can be used to inform state and local governments to establish child-friendly town planning and urban design features. Further research is needed to confirm the interplay between SES, early child development, the built environment and other unmeasured factors to better inform public health policy.

Does the socioeconomic positioned neighbourhood matter? Norwegian adolescents' perceptions of barriers and facilitators for physical activity.

A higher proportion of adolescents from lower socioeconomic position families tend to be less physically active than their counterparts from higher socioeconomic position families. More research is needed to understand the causes of these differences, particularly the influence of the neighbourhood environment. This qualitative study aims to explore how adolescents and their parents from higher and lower socioeconomic neighbourhoods perceive the social, organisational and physical environment influencing adolescents' physical activity behaviours. We conducted six semi-structured focus groups with 35 13-14-year-olds and eight interviews with some of their parents. The interviewees were recruited from one higher and two lower socioeconomic neighbourhoods in Oslo, Norway. Theme-based coding was used for analysis, and the results discussed in light of an ecological framework. The results indicate that factors like social norms in a neighbourhood could shape adolescents' physical activity behaviour, and a social norm of an active lifestyle seemed to be an essential facilitator in the higher socioeconomic neighbourhood. Higher availability of physical activity and high parental engagement seemed to facilitate higher physical activity in this neighbourhood. In the lower socioeconomic neighbourhoods, the availability of local organised physical activity and volunteer engagement from parents varied. Programmes from the municipality and volunteer organisations seemed to influence and be essential for adolescents' physical activity behaviour in these neighbourhoods. The results illustrate the complexity of behaviour and environment interaction, and a limitation in explaining the phenomenon by focusing primarily on the individual level rather than an ecological perspective.

Systemic diseases and their association with open-angle glaucoma in the population of Stockholm

ObjectiveWe aimed to study open-angle glaucoma in association with somatic comorbidities in the total population of adults in Region Stockholm.MethodsThe study population included all living persons aged 19 years and above who resided in Stockholm County, Sweden, on 1 January 2017 (N = 1 703 675). Subjects with specified diseases were identified with data from all registered consultations and hospital stays during 2008–2019. As outcome, the risk of being associated with a diagnosis of open-angle glaucoma was identified during 2012–2018. Analyses were performed by gender, controlling for age and socio-economic status. Age-adjusted odds ratios (ORs) with 95% confidence intervals (95% CI) for women and men with open-angle glaucoma, using individuals without this as referents, were calculated. Socio-economic status was assessed based on the neighbourhood the subjects lived in.ResultsIn total, 16,299 cases of open-angle glaucoma were identified during 2012–2018, 9204 women and 7095 men. Higher fully adjusted OR (95% CI) for risk of being associated with open-angle glaucoma was for women and men with diabetes 1.138 (1.074–1.207) and 1.216 (1.148–1.289), cancer 1.175 (1.120–1.233) and 1.106 (1.048–1.166), hypertension 1.372 (1.306–1.440) and 1.243 (1.179–1.311); and for women with thyroid diseases 1.086 (1.030–1.146), chronic lung diseases 1.153 (1.093–1.216), and inflammatory arthropathies 1.132 (1.006–1.275). Higher glaucoma incidence was observed in individuals residing in high socio-economic status neighbourhoods.ConclusionThe risk of glaucoma is increased in some somatic diseases, especially in individuals with diabetes, hypertension and cancer; and in higher socio-economic neighbourhoods as compared to lower socio-economic neighbourhoods.

Sleep in New Zealand children aged 7-9: associations with ethnicity, socioeconomic status, and achievement in reading and mathematics.

The aims were (1) to investigate differences by ethnicity and socioeconomic status (SES) in objective measures of sleep in children aged 7-9 years and (2) determine whether measures of sleep predict child achievement in reading or mathematics after controlling for ethnicity and SES. Four groups of parent-child dyads were recruited: Māori, low-SES schools (n = 18); Māori, high-SES schools (n = 17); New Zealand European, low-SES schools (n = 18); New Zealand European, high-SES schools (n = 17). Child sleep was measured by actigraphy. Parents and teachers reported child daytime sleepiness and behavior, and children completed a self-report of anxiety symptoms. Teachers also reported on child achievement in reading and mathematics. Children from low-SES schools went to bed later on school nights (F[1,68] = 12.150, P = .001) and woke later (F[1,68] = 15.978, P < .001) than children from high-SES schools but had similar sleep duration. There were no differences related to ethnicity. Children from low-SES schools were almost 3 times more likely to be below national standards for mathematics. Children not meeting academic standards in mathematics had a later sleep start time, lower sleep period efficiency, and a decreased total sleep time. However, when SES and sleep period efficiency were modeled together neither were found to significantly influence achievement in mathematics. In this study, SES influenced sleep timing but not the quality and quantity of sleep in 7- to 9-year-old children, and a significant independent effect of sleep efficiency on learning could not be demonstrated.

Living in High-SES Neighborhoods Is Protective against Obesity among Higher-Income Children but Not Low-Income Children: Results from the Healthy Communities Study.

Numerous studies have focused on the role of neighborhood socioeconomic status in childhood obesity and physical activity, but few studies have examined the effect of neighborhood socioeconomic changes over time and the interaction between family and neighborhood SES on childhood obesity and physical activity. This study measured neighborhood socioeconomic histories between 2000 and 2010 and examined the associations between neighborhood socioeconomic histories and childhood obesity, as well as physical activity. The moderating role of family poverty status was also examined. Using the Healthy Communities Study (2013-2015), we measured obesity indicators (objectively measured body mass index z-score and waist circumference) and a physical activity indicator (self-reported moderate-to-vigorous physical activity) for a cohort of 4114 children. Multilevel linear regression models were used to examine the associations between neighborhood socioeconomic histories between 2000 and 2009-2013 and body-mass index z-score, waist circumference, and moderate-to-vigorous physical activity. Results showed that higher-income children in consistently high socioeconomic neighborhoods had lower measured BMIz and WC and engaged in more moderate-to-vigorous physical activity than higher-income children in consistently low socioeconomic neighborhoods. Additionally, low-income children in consistently moderate socioeconomic neighborhoods reported a lower level of moderate-to-vigorous physical activity than low-income children in consistently low socioeconomic neighborhoods. The findings indicate that considering both family and neighborhood socioeconomic status may help elucidate the underlying differences in childhood obesity and physical activity levels by socioeconomic status.

Food Purchasing Characteristics and Perceptions of Neighborhood Food Environment of South Africans Living in Low-, Middle- and High-Socioeconomic Neighborhoods

Using intercept surveys, we explored demographic and socioeconomic factors associated with food purchasing characteristics of supermarket shoppers and the perceptions of their neighborhood food environment in urban Cape Town. Shoppers (N = 422) aged ≥18 years, categorized by their residential socioeconomic areas (SEAs), participated in a survey after shopping in supermarkets located in different SEAs. A subpopulation, out-shoppers (persons shopping outside their residential SEA), and in-shoppers (persons residing and shopping in the same residential area) were also explored. Fruits and vegetables (F&amp;V) were more likely to be perceived to be of poor quality and healthy food not too expensive by shoppers from low- (OR = 6.36, 95% CI = 2.69, 15.03, p &lt; 0.0001), middle-SEAs (OR = 3.42, 95% CI = 1.45, 8.04, p &lt; 0.001) compared to the high-SEA shoppers. Low SEA shoppers bought F&amp;V less frequently than high- and middle-SEA shoppers. Purchase of sugar-sweetened beverages (SSBs) and snacks were frequent and similar across SEAs. Food quality was important to out-shoppers who were less likely to walk to shop, more likely to be employed and perceived the quality of F&amp;V in their neighborhood to be poor. Food purchasing characteristics are influenced by SEAs, with lack of mobility and food choice key issues for low-SEA shoppers.

Geographical and social inequalities in survival after incident acute myocardial infarction in Denmark: A spatial epidemiological cohort study based on nationwide register data

Introduction Survival after acute myocardial infarction (AMI) is associated with receiving adequate and often time-dependent treatment as well as sociodemographic characteristics of the patient. Access to adequate AMI treatment might depend on where you live as distance to the nearest hospital differs substantially across the country. Moreover, where you live is to some degree influenced by your socioeconomic position and economical resources. The interplay between the geographical and social inequalities in survival after an AMI is not clearly understood and it remains unclear whether geographical patterns in survival can be explained by sociodemographic factors. This study aimed to examine whether the geographical patterns in survival after incident AMI can be explained by individual- and neighborhood-level sociodemographic characteristics. Methods The study population consisted of patients (≥ 30 years) with an incident AMI between 1 January 2005 and 31 December 2014 registered in the National Patient Register or the Danish Register of Causes of Death. The population was followed for a maximum of 365 days or until emigration, study end or death, whichever came first. The year 2005 was used as run-in period to ensure adequate results estimates across calendar years. Hence, the study period was 1 January 2006 to 31 December 2014. Poisson regression of incidence rates of all-cause mortality with a geographical component as a random effect was performed in R by use of the Bayesian Integrated Nested Laplace Approximations (INLA) method. The analysis included the individual-level variables age, sex, ethnicity, calendar year, cohabitation status, disposable household income, and educational level and the neighborhood-level variables population density, socioeconomic position, and ethnical composition of the neighborhood. Results The study population consisted of 95,274 patients with incident AMI contributing with 62,8210 person-years at-risk between 2006 and 2014. During the study period 28,194 deaths occurred within 365 days. Crude mortality rates varied substantially across the country as well as across neighborhood and individual-level characteristics, e.g., 53.2/100 person-years died within 365 days after an AMI in neighborhoods with low socioeconomic position, whereas this number was 36.7/100 person-years in high socioeconomic position neighborhoods. Results from the model only including calendar year and the geographically structured random effect component showed clear geographical patterns in survival after an AMI with especially the northern part of Jutland being a high-risk area. After additionally including sociodemographic characteristics of the population and neighborhood in the model the variation in survival after an AMI decreased across the country, but high-risk areas were still observed. Results on fixed effects from the adjusted model showed that persons with low educational level, low-income level and persons living in neighborhoods with low socioeconomic position had an increased incidence rate ratio (IRR) of dying within 365 days after AMI compared to the most educated and affluent population groups [IRRs (95% confidence intervals) of 1.29 (1.23–1.36), 1.26 (1.20–1.32) and 1.11 (1.05–1.17), respectively]. Furthermore, risk of dying within 365 days after an AMI decreased throughout the study period. Results from sensitivity analyses showed that the geographical patterns were more pronounced in out-of-hospital than in-hospital deaths. Conclusions Evident geographical and social inequalities in survival after an incident AMI exist in Denmark. Sociodemographic characteristics at the individual- and neighborhood-level explained part of the geographical variation in survival after an AMI; however, marked geographical patterns in survival after AMI persisted. Further studies are needed to explain the remaining geographical inequalities in survival after an AMI, especially with focus on out-of-hospital deaths.

Descriptive epidemiology of changes in weight and weight-related behaviours of Australian children aged 5 years: two population-based cross-sectional studies in 2010 and 2015

ObjectiveOver the past 10–15 years there has been substantial investment in New South Wales (NSW), Australia, to reduce child obesity through interventions in children aged 0–5 years. We report changes...

Anaemia Frequency and its Socioeconomic and Dietary Determinants among Teenage School Girls of Karachi

Objective: To assess the frequency of anaemia and to determine its socioeconomic and dietary de- terminants among teenage school girls of Karachi.&#x0D; Methods: A cross-sectional study was carried out from January to July, 2015. The study subjects were chosen from four schools, two each from high socioeconomic and poor neighbourhoods of Karachi. Our study was conducted on 497 school girls aged 13 to 18 years, who were enrolled by employing convenient sampling, after informed consent of parents and principal of the school. All study subjects were interviewed using a questionnaire, clinically examined for signs of anaemia and measurements taken for anthropometric and haemoglobin estimation.&#x0D; Results: The primary study outcome was the anaemia status of the study participants as determined by their haemoglobin level using a cut off of 11 gm/dl. The study results showed that only 167 (36.5%) of the participants were anaemic and majority of them was negative for signs of skin pallor (66.6%), conjunctival pallor (79.8%), koilonychia (95.8%) or brittle hair (86.4%). The factors found to be significantly associated with anaemia included lower socioeconomic status (p&lt;0.0001), paternal illiteracy (p=0.022) and paternal unemployment (p&lt;0.0001). Furthermore, the study findings also re- vealed infrequent consumption of eggs (p=0.015), milk (p=0.019), spinach/green leafy vegetables (p=0.004) and chocolates/candies/biscuits/cakes (p=0.039) to be significantly associated with anaemia.&#x0D; Conclusion: The study suggest that frequency of anaemia in teenage school girls was significantly associated with lower socioeconomic status, paternal illiteracy, unemployment, infrequent consump- tion of eggs, milk, spinach/green leafy vegetables and chocolates/candies/biscuits/cakes. Hence, urgent needs of improving paternal illiteracy, decreasing unemployment and increasing educational awareness in teenage girls regarding the consumption of iron rich foods.

Behavior Problems and Post-traumatic Stress Symptoms in Children Beginning School: A Comparison of Pre- and Post-Earthquake Groups.

Introduction:Literature reviews caution that estimating the effects of disasters on the behavior of children following a disaster is difficult without baseline information and few studies report the effects of earthquakes on young children. In addition the relationship between age at the time of disaster and consequential behavior problems have not been reported for young children who experience disaster-related stress during a developmentally sensitive period.Methods:Behavior problems and symptoms of post-traumatic stress (PTS) were reported for two groups of children from nearby neighborhoods during their first term at school, using the Behavior Problem Index by teacher report, following approved informed consent procedures. Data on one group, “Pre-EQ” (N=297), was collected four years before the beginning of the earthquakes on children born 2001-2002. Data on the second group, “Post-EQ” (N=212), was collected approximately three to four years after the beginning of the earthquakes on children born 2007-2009 and living in heavily damaged neighborhoods. The Post-EQ group had significantly more children from high socioeconomic neighborhoods but no other significant differences on main demographic characteristics.Results:The mean behavior problem score was significantly higher in the Post-EQ group (Mean =6.11) as compared to the Pre-EQ group (Mean = 3.78). PTS symptoms were also significantly higher in the Post-EQ group (Mean =2.91) as compared to the Pre-EQ group (Mean=1.98) and more children had high PTS scores (20.9% v. 8.8%, OR= 2.73, 95%CI =1.57, 4.76). Model testing identified that a younger age at the time of exposure was the only significant predictor of high numbers of PTS symptoms in the Post-EQ group.Discussion: Rates of teacher-reported behavior problems in young children more than doubled following the Christchurch earthquakes. Younger children may be more vulnerable to the effects of earthquakes that occur during a developmentally sensitive period. Additional research is needed to consider the effects of age and duration of disaster effects to better understand the effects of disasters on children, their families and communities.

Consuming calories and creating cavities: beverages NZ children associate with sport

Sugar-sweetened beverages (SSBs) are widely available, discounted and promoted, and despite recommendations to the contrary, frequently consumed by children. They provide few nutritional benefits, and their consumption is implicated in a number of poor health outcomes. This study examined the nature of the beverages that sport-playing New Zealand (NZ) children associate with sport. It assessed how well the beverages aligned with nutrition guidelines and relevant regulations, and their likely impacts on health. Eighty-two children (38 girls and 44 boys) aged 10–12 years were purposively selected from netball, rugby and football clubs in low and high socioeconomic neighbourhoods, in Wellington, New Zealand (NZ). Children photographed beverages they associated with sport. The beverages were then purchased and analysed in accordance with NZ nutrition guidelines, and relevant content and labelling regulations, by: package and serving size; energy, sugar, sodium and caffeine content; pH; and advisory statements. The beverages the children associated with sport overwhelmingly had characteristics which do not support children in adhering to NZ nutrition guidelines. Implementing public health mechanisms, such as healthy food and beverage policies, widely promoting water as the beverage of choice in sport, and implementing healthy eating and drinking campaigns in sports clubs, would assist children who play organised sport to select beverages that are in keeping with children's nutrition guidelines. As part of a comprehensive public health approach they would also reduce the substantial, unnecessary and potentially harmful contribution sugar-sweetened beverages make to their diet.

Suboptimal Omega-3 Levels in Australian Adolescents

Objective: To quantitate the omega-3 status in a cohort of Australian adolescents. Design, Setting and Participants: A cross-sectional descriptive study of 251 apparently healthy adolescents (192 female, 59 male) aged 15-17 years, in year 11, from 10 schools within the Northern Sydney and Central Coast areas of New South Wales. Participants provided a morning non-fasting blood sample via finger-prick and written answers to specific demographic and lifestyle questions. Omega-3 index was calculated by adding %EPA and %DHA values in the whole blood. Equivalent erythrocyte omega-3 index values were obtained by using conversion factors (1.33 for EPA and 2.22 for DHA) from published erythrocyte/whole blood values. Main Outcome Measures: Quantitation of the individual, and estimation of the group average, blood omega-3 Index. Results: The blood omega-3 Index for this adolescent cohort ranged from 2.1-22.3 with a mean of 8.3±3.2, and median of 7.8. On average males had a higher omega-3 Index compared to females (10.5±3.7 vs 7.7±2.6, p&lt;0.001). Fifty three percent of adolescents tested had an omega-3 Index below the optimum of &gt;8. Three percent had an Index of &lt;4, placing them in the high risk category for disease. On average, adolescents from low or medium socioeconomic communities had a significantly lower omega-3 Index compared to those from higher socioeconomic neighbourhoods (mean difference=1.4, p=0.018). Overall 20% of boys and 17% of girls reported regularly taking omega-3 supplements. Regular use of omega-3 supplements was associated with a higher average omega-3 Index (9.8±3.7, n=44 compared to 8.0±3.0, n=203, p=0.001 in those not taking supplements). Conclusion: This study indicates that Australian adolescents, even when from advantaged homes, have a high probability of below optimum omega-3 levels. As reduced omega-3 levels are linked to conditions of public health concern such as diabetes, asthma and depression, targeted strategies to improve the omega-3 status in the childhood population may be warranted.

Tax Increment Financing in Chicago, IL, Building Neoliberal Exclusion One School at a Time

The article examines how the entrepreneurial municipal government in Chicago, IL has deployed tax increment financing revenues to realize so-called urban education reform through the construction of exclusive neoliberal schools. At the same time traditional open enrollment schools are relatively deprived of tax increment financing revenues for school construction projects. In effect, Chicago’s municipal government is allotted the financial flexibility by the tax increment financing program to construct a variegated, unequal and polarized school system consisting of well funded, high quality exclusive public schools and underfunded, lower quality open enrollment public schools. Further, the placement of exclusive schools is also polarized as prestigious selective enrollment public schools are located in high socio-economic neighborhoods and partially privatized charter and contract schools, outside of local democratic control, are located in predominantly African-American low socio-economic neighborhoods, thus disempowering these residents.

11 FACTORS ASSOCIATED WITH MISPERCEPTION OF ABDOMINAL OBESITY AT PRIMARY CARE CLINICS IN KARACHI, PAKISTAN

Objectives: To assess weight perceptions of individuals with abdominal obesity, identify misperceptions and factors associated with these misperceptions to provide appropriate counseling to such individuals. Methods: This was a cross sectional study conducted at primary care clinics from low, middle, and high socioeconomic neighbourhoods. A trained interviewer collected information on a structured questionnaire, after obtaining verbal informed consent, from 493 individuals. Proportion of individuals with misperceived waist circumference was calculated and used as the outcome variable. Univariate and multivariate logistic regression was used to identify factors associated with misperception. SPSS 16 was used for data analysis. Results: Half (n = 251) of the individuals had increased waist circumference. Out of which 77% were obese, 13% were overweight, and 11% were of normal weight. 15% of individuals with normal BMI had increased waist circumference, equally divided between males and females. One third of the individuals with increased waist circumference perceived their weight circumference to be normal. Individuals with increased waist circumference were more likely to misperceive if they were satisfied with their weight (AOR 10.8, 95% CI 6.4-18.2), had a co-morbid (AOR 2.95, 95% CI 1.7-5.0), had not been given weight advice by health professionals (AOR 1.8, 95% CI 1.1-3.0) and were unaware of their weight (AOR 1.9, 95%, CI 1.05-3.3). Conclusions: We found a high proportion of individuals with misperception of their waist circumference. Effective strategies are needed to increase awareness regarding abdominal obesity in this population especially focusing on the identified groups.

Environmental factors associated with overweight among adults in Nigeria.

BackgroundUnderstanding environmental factors related to obesity can inform interventions for the world wide obesity epidemic, yet no study has been conducted in this context in Africa. This study examined associations between neighbourhood environment variables and overweight in Nigerian adults.MethodsA total of 1818 randomly selected residents (age: 20-65 years, 40% female, 31% overweight and 61.2% response) living in high and low socioeconomic (SES) neighbourhoods in Metropolitan Maiduguri, Nigeria, participated in a cross-sectional study. Anthropometric measurements of height and weight and an interview-assisted self-reported measure of 16 items of perceived neighborhood environments were conducted. The primary outcome was overweight (body mass index [BMI] > or = 25 kg/m2) vs. normal weight (BMI = 18.5-24.9 kg/m2).ResultsAfter adjustment for sociodemographic variables, overweight was associated with distant access to commercial facilities (odds ratio [OR], 1.49; 95% confidence interval [CI], 1.02- 2.18), poor neighbourhood aesthetics (OR, 1.58; 95% CI, 1.16-2.09), perceiving garbage and offensive odours in the neighbourhood (OR, 1.41; 95% CI, 1.05-1.89) and feeling unsafe from crime at night (OR, 1.47; 95% CI, 1.13- 1.91) and unsafe from traffic (OR, 1.56; 95% CI, 1.17-2.07) in the total sample. Significant interactions regarding overweight were found between gender and four environmental variables, with low residential density (OR, 1.39; 95% CI, 1.02-1.93) and poorly maintained pedestrian pathways (OR, 1.89; 95% CI, 1.13-3.17) associated with overweight in men only, and absence of beautiful things (OR, 2.23; 95% CI, 1.42-3.50) and high traffic making it unsafe to walk (OR, 2.39; 95% CI, 1.49-3.83) associated with overweight in women only. There were few significant interactions between environmental factors and neighborhood SES regarding overweight.ConclusionNeighbourhood environment factors were associated with being overweight among Nigerian adults. These findings support previous reports in international literature, but should be replicated in other African studies before any firm conclusions can be drawn.