Urban Setting Study Research Articles

Consistent metropolitan boundaries for the remote sensing of urban land

This paper introduces an internationally consistent definition of metropolitan areas to the literature regarding the remote sensing of urban land use or land cover. In the cross-comparison of land use or land cover for explicitly bounded urban areas, the observed ‘economic’ definition is argued to hold distinct potential merits over administrative or agglomeration-based boundaries, which typically underpin other studies. To illustrate the proposed merits as well as their implications for the remote sensing literature, the empirical analysis considers the case of 687 European metropolitan areas. Across these metropolitan areas, whose boundaries are defined jointly by the OECD and the European Commission, land cover and land use are segmented in a fusion of imagery from radar and optical sensors in Sentinel satellites. Segmentation is achieved using deep learning in a well-established model architecture. The analytical focus is on built-up areas that are in a residential use or in a commercial or industrial use. Map classifications and accuracy measures are obtained for cities as well as their respective commuting zones as these together embody metropolitan areas. The results underline that not only land use area estimates but also map classification accuracy vary widely across individual metropolitan areas. Whereas classification accuracy to some degree varies for metropolitan areas within as well as between countries, classification accuracy is positively associated with population size and built-up area density as regression analysis confirms. Additionally, the extent of built-up areas in distinct uses is shown to vary across different types of metropolitan (sub-)areas. This study's findings highlight the typically unobserved role that study area definition and selection may play in affecting outcomes in remote sensing studies in urban settings, as relevant to both studies of single as well as multiple urban areas. The consistent comparison of remote sensing outcomes across metropolitan areas may further promote generalization in a growing and global field and potentially supports better-informed policy making processes.

REFLECTION MAGNITUDE AND ITS ASSOCIATION WITH INCIDENT HYPERTENSION AND BLOOD PRESSURE CHANGES IN A MULTI-ETHNIC COHORT: THE HELIUS STUDY

Objective: A higher reflection magnitude (RM), defined as the ratio of the backward and forward moving pressure wave, is associated with hypertension and incident heart failure. Whether RM is predictive of future hypertension and blood pressure (BP) increase is unknown. We assessed the association between RM, incident hypertension and BP increase over time. Design and method: Data of the Healthy Life in an Urban Setting study was analysed focusing on the six major ethnic groups living in Amsterdam, The Netherlands, aged between 18 and 70 years. Central arterial blood pressure was reconstructed from non-invasive continuous finger BP measurements. RM was calculated through wave separation analysis. Logistic regression models were created to investigate the association between RM and incident hypertension in the normotensive individuals. Linear regression was used to investigate the association between RM and changes in BP, which was corrected for the use of antihypertensive medication. All models were corrected for age, sex, ethnicity and baseline BP. The association between RM and delta SBP was additionally corrected for BMI. Results: A total of 5,779 participants were included for analysis, median age was 48 years (IQR 37-55), 54.6% were female and 67% were normotensive at baseline. In normotensive participants aged < 50 years at baseline, a 10% increase in RM resulted in an increased odds ratio (OR) of 1.37 (95% CI 1.09 – 1.72 for developing incident hypertension, which attenuated to 1.12 (95% CI 0.88 – 1.42) following adjustment for baseline SBP. Additionally, in individuals below 50 years an increase in RM of 10% was associated with a 1.77 mmHg (95% CI 1.00 – 2.53) increase in SBP (figure 1). No significant association between delta SBP and RM was found in the participants aged 50 or older. Conclusions: In a multi-ethnic cohort, RM is positively associated with the development of hypertension in individuals aged < 50 years. However, additional correction for baseline SBP attenuated this association. In addition, RM is predictive of SBP increase, with significant interaction for ethnicity.

Ethnic differences in urinary monocyte chemoattractant protein-1 and heparanase-1 levels in individuals with type 2 diabetes: the HELIUS study

IntroductionWe aimed to investigate ethnic differences in two urinary inflammatory markers in participants with type 2 diabetes mellitus (T2DM).Research design and methodsWe included 55 Dutch, 127 South-Asian Surinamese, 92 African...

Association between the reflection magnitude and blood pressure in a multiethnic cohort: the Healthy Life in an Urban Setting study.

Aims:Reflection magnitude (RM), the ratio of the amplitudes of the backward and forward central arterial pressure waves, has been shown to predict cardiovascular events. However, the association with blood pressure (BP) and hypertension is unclear.Methods:We assessed RM in 10 195 individuals of Dutch, South-Asian Surinamese, African Surinamese, Ghanaian, Turkish and Moroccan origin aged between 18 and 70 years (54.2% female) participating in the Healthy Life in an Urban Setting study. To determine RM, central arterial pressure and flow were reconstructed from finger BP. Hypertension was defined based on office-BP and medication. Associations with BP, hypertension, and hypertensive organ damage were assessed using linear regression models with correction for relevant covariates.Results:Mean RM was 62.5% (standard deviation [SD] 8.0) in men and 63.8% (SD 8.1) in women. RM was lowest in Dutch and highest in South-Asian and African participants. RM increased linearly with 1.35 (95% confidence interval [CI] 1.23–1.46) for every 10 mmHg increase in systolic BP from 120 mmHg onwards, while the relation with diastolic BP was nonlinear. RM was 2.40 (95% CI 2.04–2.76) higher in hypertensive men and 3.82 (95% CI 3.46–4.19) higher in hypertensive women compared to normotensive men and women. In hypertensive men and women with ECG-based left ventricular hypertrophy or albuminuria RM was 1.64 (95% CI 1.09–2.20) and 0.94 (95% CI 0.37–1.52) higher compared to hypertensive participants without hypertensive organ damage.Conclusion:RM is associated with BP, hypertension and hypertensive organ damage, and may in part explain disparities in hypertension associated cardiovascular risk.

Ethnic disparities in the association between low-grade inflammation biomarkers and chronic kidney disease: The HELIUS Cohort Study

AimsEthnic differences exist in the prevalence and progression of chronic kidney disease (CKD). However, underlying mechanisms remain unclear. It has been proposed that chronic low-grade inflammation plays an important role in CKD pathogenesis. In the current analysis, we study the association between systemic inflammatory biomarkers and CKD prevalence in different ethnic groups. MethodsWe examined cross-sectional associations between biomarkers of low-grade inflammation, including serum high-sensitive (hs)-CRP, fibrinogen, and D-dimer, and CKD prevalence in different ethnic groups residing in Amsterdam, the Netherlands. We included 5740 participants (similar-sized Dutch, African Surinamese, South-Asian Surinamese, Ghanaian, Turkish and Moroccan populations) aged 18 to 70 years of the Healthy Life in an Urban Setting study (HELIUS) cohort. ResultsIn the fully adjusted models, adjusted for ethnicity-specific cut-off values, elevated fibrinogen [odds ratio 2.50 (95 % confidence interval 1.10–5.78)] and D-dimer [2.99 (1.28–7.00)] were significantly associated with CKD in Dutch. In South-Asian Surinamese, a significant association with elevated D-dimer [2.66 (1.32–5.37)] was found. ConclusionsOur study shows that there are both differences in biomarker levels and the association with CKD across ethnic groups. Future research to identify potential drivers of the differential associations and susceptibility of CKD among ethnic groups to reduce the CKD burden is necessary.

Prospective analysis of gender-related characteristics in relation to cardiovascular disease

ObjectiveDifferences in cardiovascular disease (CVD) incidence between men and women have been widely reported. Next to sex-related (biological) characteristics, gender-related (sociocultural) characteristics may partly explain how these differences arise. In...

The association between socioeconomic status and prevalence, awareness, treatment and control of hypertension in different ethnic groups: the Healthy Life in an Urban Setting study.

Socioeconomic status (SES) and ethnicity are both important determinants of hypertension prevalence and control rates but their separate contribution is unknown. We assessed the association of SES with hypertension prevalence, awareness, treatment and control, and whether this differs between ethnic groups. We used baseline data from the Healthy Life in an Urban Setting (HELIUS) study, a multiethnic population-based cohort study, including 18 106 participants (84% of the total cohort) of Dutch (n = 4262), African Surinamese (n = 3732), Moroccan (n = 2902), Turkish (n = 2694), South-Asian Surinamese (n = 2664) and Ghanaian (n = 1947) descent with data on SES and hypertension status. Regardless of ethnicity, lower SES was associated with higher hypertension prevalence, especially in participants with no education compared with those with higher levels of education [OR 2.29 (2.05-2.56)]. There was an inverse association between SES and hypertension treatment with the strongest association for lower compared with higher educated participants [OR 1.63 (1.39-1.90)]. In addition, lower SES was associated with lower hypertension control with the strongest association for participants with the lowest compared with the highest occupational level [OR 0.76 (0.60-0.95)]. The association between educational level and treatment but not the other SES- or hypertension-indicators, was influenced by ethnicity, with lower educated Dutch and African Surinamese having higher ORs for hypertensive treatment [Dutch OR 1.98 (1.43-2.76); African Surinamese OR 1.44 (1.10-1.89)]. SES, in particular education, impacts hypertension treatment in the Netherlands, whereas the association of specific SES parameters with hypertension indicators differ across ethnic groups. Further exploration is needed on how sociocultural beliefs and behaviours may differentially affect blood pressure control across ethnic minority populations.

Health Effects from Urban Stress in Women in Mexico City

BACKGROUND AND AIM: Individuals in urban neighborhoods often face disproportionately higher levels of environmental and social stressors; however, the health effects from urban stressors remains poorly understood. We studied the association between urban stress and symptoms of depression, fatigue, and sleep disruption in a cohort of women in Mexico City. METHODS: Participants included 343 women from the Programming Research in Obesity, Growth, Environment and Social Stressors (PROGRESS) birth cohort in Mexico City. Women were administered the urban stress scale, where they were asked to rate their annoyance on select urban situations that city-dwellers face, such as unhealthy air, traffic, noise, lack of green space, and aggression. Six different constructs were summarized to create an overall continuous index and this was dichotomized at the median. Symptoms of depression were assessed at the same study visit using the Edinburgh Depression Scale; the NIH toolbox was used to assess fatigue and sleep disruption. Linear regression models were used to estimate the association with continuous symptoms comparing women with high urban stress to those with lower levels. Models were adjusted for socioeconomic status, education, age, body mass index, and social support. RESULTS:High urban stress was associated with higher depressive symptoms (β: 1.50; 95% CI: 0.34, 2.65), fatigue (β: 2.18; 95% CI: 0.65, 3.71), and sleep disruption (β: 2.01; 95% CI: 0.45, 3.58). Associations were strongest among women who were highly annoyed by environmental concerns, including unhealthy air and lack of green space. CONCLUSIONS:Urban stress plays an important role in women’s psychological and physical health, highlighting the importance of including these measures in environmental health studies in urban settings. KEYWORDS: built environment, environmental justice, female, mental health outcomes, socio-economic factors, non-chemical stressors

The distribution of selected woody invasive alien species in small towns in the Eastern Cape, South Africa

The potential and real negative and positive effects of invasive alien species (IAS) are increasingly recognised by researchers, land managers and decision-makers. However, most of the research and knowledge stems from understandings developed from rural and natural landscapes, with relatively little derived from studies in urban settings. Small towns in particular pose a novel suite of conditions that make the study and mangment of IAS particularly pressing. Here we examined the distribution of seven woody IAS (Acacia mearnsii, Cestrum laevigatum, Eucalyptus spp., Lantana camara, Melia azedarach, Senna didymobotrya and Solanaum mauritianum) within and between five small towns in the Eastern Cape via means of drive-by road surveys of every street in each town. Across the five towns and seven IAS 4,307 individuals were recorded, with the highest densities found in the two more coastal towns. Almost two-thirds (63%) of the IAS were located in residential properties, 24 % in public spaces and 13 % on road verges, closely mirroring the proportional area of these landuses. Within the residential landuse zone specifically, the townships had between 41 % and 61 % of all the recorded IAS plants per town, followed by the affluent neighbourhoods (22 – 41 %) and lastly, the RDP neighbourhoods (6 – 32 %). Cestrum laevigatum was the most abundant woody IAS across the five towns as a whole (1,783 inviduals). The second-most abundant species was M. azedarach (914 stems) and the least recorded was S. mauritianum (44). Additionally, there were differences in the general distribution of the seven species across residential neighbourhoods, with C. laevigatum (71.2 %), M. azedarach (49.3 %) and S. mauritianum (60.0 %) concentrated in township neighbourhoods, whilst A. mearnsii (66.4 %), L. camara (64.1 %) and Eucalyptus spp. (48.6 %) were most common in the affluent neighbourhoods. This study confirms that woody IAS are widespread in small towns of the region, but that they are unevenly distributed between towns and landuses within towns, indicating the need for local-scale inventories and management.

Socioeconomic Differences in Sympathovagal Balance: The Healthy Life in an Urban Setting Study.

Alterations in sympathovagal balance are associated with cardiovascular disease. If sympathovagal balance differs across socioeconomic groups, it may reflect a mechanism through which disparities in cardiovascular disease occur. We therefore assessed the association between education and occupation with measures of sympathovagal balance in a large multiethnic sample. We included cross-sectional data of 10,202 South Asian Surinamese, African Surinamese, Ghanaian, Turkish, Moroccan, and Dutch-origin participants from the Healthy Life in an Urban Setting study. Sympathovagal balance was measured by baroreflex sensitivity (BRS) and the standard deviation of the interbeat interval, calculated from changes in blood pressure and interbeat intervals, from 5-minute recordings. We calculated geometric means and estimated the relative index of inequality, using age- and ethnicity-adjusted linear regression, to quantify the association between education and occupation and sympathovagal balance. In addition, we assessed whether the association was consistent across ethnic groups. The geometric means of BRS ranged from 8.16 ms/mm Hg (confidence interval [CI] = 7.91-8.43 ms/mm Hg) in low-educated to 14.00 ms/mm Hg (CI = 13.53-14.48 ms/mm Hg) in highly educated women, and from 8.32 ms/mm Hg (CI, 7.97-8.69 ms/mm Hg) in low-educated to 12.25 ms/mm Hg (CI = 11.86-12.66 ms/mm Hg) in highly educated men. High education and occupation were statistically significantly associated with higher BRS and standard deviation of the interbeat interval. Compared with the participants of Dutch origin, a pattern of weaker associations was found in the Surinamese and Ghanaian ethnic groups, but not the Turkish and Moroccan groups. There is a clear socioeconomic gradient in measures of sympathovagal balance, indicating that sympathovagal balance may play a role in socioeconomic disparities in cardiovascular morbidity and mortality.

From cellular positioning data to trajectories: Steps towards a more accurate mobility exploration

The recent years have witnessed a greater demand for understanding how people move in urban environments. Due to the widespread usage of mobile phones, there have been several trajectory-based studies focusing on extracting the characteristics of human mobility from georeferenced mobile phone data. Mobile positioning data is generally generated as scattered points in CDRs (Call Detail Records). Even though CDR data can be regarded as an inexpensive scalable source of information on human mobility, mobility studies in urban settings based on such data sources still prove to be a research challenge due to the coarseness of CDR spatial granularity. Motivated by the need for transforming large-scale CDRs to movement trajectories, the present study offers a new solution which is made of two principal building blocks: (1) Developing a Bayesian-based induction method through adopting a GIS-based wave propagation model to solve the GSM-based localization problem when methods such as triangulation are not applicable due to the lack of measurements from more than one base station; (2) Reconstruction of movement trajectories from cellular location information using overlapping relations existing between observed cells as well as detection of ping-pong phenomena as auxiliary information. A case study employing CDR and GPS records obtained from an experimental survey on one of the central urban zones of Tehran was conducted, which showed the effectiveness of the proposed methodology in comparison to current approaches with respect to three perspectives, including movement path exploration, individual-oriented movement features extraction, and crowd-movement modelling.

To what extent do socioeconomic inequalities in SRH reflect inequalities in burden of disease? The HELIUS study.

ABSTRACTBackgroundSelf-rated health (SRH), an attractive measure for health monitoring, shows persistent inequalities with regard to socioeconomic status (SES). However, knowledge on the extent to which inequalities in SRH reflect inequalities in disease burden is lacking.MethodsData come from the multi-ethnic HEalthy LIfe in an Urban Setting study (Dutch, South-Asian Surinamese, African Surinamese, Ghanaian, Turkish or Moroccan origin, N = 19 379, aged 18–70). SES was defined by educational and occupational level. Disease burden was operationalized as chronic diseases, physical and mental functioning (measured with SF-12) and depressive symptoms (measured with PHQ-9). We applied logistic regression analyses and reported average marginal effects (AME).ResultsDutch origin participants with low educational or low occupational level had higher probabilities of reporting fair/poor SRH, compared to the highest levels (AME = 0.20 95% CI: 0.13;0.27; and 0.12 (0.09;0.15), respectively). Associations were attenuated after adjusting for all disease burden indicators, to AME = 0.03 (0.01;0.04) and AME = 0.02 (−0.00;0.04). In all the non-Dutch origin groups, a larger part of the inequalities remained after adjustment.ConclusionSocioeconomic inequalities in SRH are for a large part explained by higher disease burden in lower socioeconomic groups, but less so in those with non-Dutch origin. Future research should examine if our conclusions also hold for trend data on inequalities in SRH.

A Comparison of Excessive Drinking, Binge Drinking and Alcohol Dependence in Ethnic Minority Groups in the Netherlands: The HELIUS Study

Background: The Dutch multi-ethnic Healthy Life in an Urban Setting study recently showed that alcohol consumption was lower in ethnic minority groups than those of Dutch origin, but that binge drinking in drinkers of Turkish and Moroccan origin was relatively high. The aim of the current study is to examine factors that may contribute to the differences in drinking patterns and how they relate to the relationship between drinking patterns and alcohol dependence (AD) across ethnic groups. Methods: The rate of last year alcohol use, alcohol use patterns and AD was assessed in 4,635 Dutch, 4,317 Moroccan, 4,036 Turkish, 2,459 Ghanaian, 4,426 African Surinamese and 3,357 South-Asian Surinamese participants (both men and women) born in Amsterdam, the Netherlands. Results: Compared to the Dutch, the prevalence of (regular) drinking is substantially lower in all ethnic minority groups and regular drinkers among most ethnic minority groups have a lower adjusted risk to develop binge drinking and AD than the Dutch. For the prevalence of regular drinking, the ethnic differences are bigger than for the prevalence of current drinking. However, regular drinkers of Moroccan origin have a risk similar to the Dutch to develop binge drinking and AD; a finding that could not be explained by group differences in age, sex, religiosity, perceived discrimination, depression or guilt feelings about drinking. Discussion: The prevalence data show that current drinking is lower and that regular drinking is much lower in ethnic minorities and – with the exception of those of Moroccan origin – ethnic minority regular drinkers also have a significant lower risk to develop binge drinking or AD than regular drinkers of Dutch origin. This implies that the magnitude of problematic alcohol use is substantially smaller in ethnic minorities than in the ethnic Dutch population of Amsterdam. Unfortunately, no explanation was found for the special risk situation of regular drinkers of Moroccan origin.

The Indigenous Birthing in an Urban Setting study: the IBUS study

BackgroundWith persisting maternal and infant health disparities, new models of maternity care are needed to meet the needs of Aboriginal and Torres Strait Islander people in Australia. To date, there is limited evidence of successful and sustainable programs. Birthing on Country is a term used to describe an emerging evidence-based and community-led model of maternity care for Indigenous families; its impact requires evaluation.MethodsMixed-methods prospective birth cohort study comparing different models of care for women having Aboriginal and Torres Strait Islander babies at two major maternity hospitals in urban South East Queensland (2015–2019). Includes women’s surveys (approximately 20 weeks gestation, 36 weeks gestation, two and six months postnatal) and infant assessments (six months postnatal), clinical outcomes and cost comparison, and qualitative interviews with women and staff.DiscussionThis study aims to evaluate the feasibility, acceptability, sustainability, clinical and cost-effectiveness of a Birthing on Country model of care for Aboriginal and Torres Strait Islander families in an urban setting. If successful, findings will inform implementation of the model with similar communities.Trial registrationAustralian New Zealand Clinical Trial Registry #ACTRN12618001365257. Registered 14 August 2018 (retrospectively registered).

The Association of Acylcarnitines and Amino Acids With Age in Dutch and South-Asian Surinamese Living in Amsterdam.

Type 2 diabetes and cardiovascular disease occur more frequently and at a younger age in South-Asians than Europeans. This may be related to differences in regulation of the fatty acid metabolism during aging. We compared age-related acylcarnitine and amino acid concentrations in Dutch and South-Asian Surinamese study participants. We measured types of acylcarnitine and amino acid concentrations in plasma (by tandem mass spectrometry) in a random subsample of 350 Dutch and 350 South-Asian Surinamese origin participants of the Healthy Life in an Urban Setting study (Amsterdam, Netherlands). We derived principal components (PCs) from the metabolites. Linear regression was used to assess differences in PCs and individual metabolite concentrations, and their age trends between the groups by sex. We adjusted for body mass index and intake of fat and total energy. Mean age was 44.8 (SD, 13.3) years. Amino acid concentrations were higher among South-Asian Surinamese women compared with Dutch women; acylcarnitine and amino acid levels were higher among South-Asian Surinamese men than Dutch men. Metabolite levels increased similarly with age in both ethnic groups. Results remained similar after adjustment. Ethnic differences in metabolite concentrations suggest that fatty acid and amino acid metabolism are more dysregulated among South-Asian Surinamese compared with Dutch from a young age. During adulthood, metabolites increase similarly in both ethnic groups.

Increased cardiovascular disease risk in international migrants is independent of residence duration or cultural orientation: the HELIUS study

BackgroundInternational migrants differ from host populations in cardiovascular disease (CVD) risk. It has been postulated that these disparities narrow with longer residence duration. Our aim was to determine whether CVD...

Ethnic disparities in educational and occupational gradients of estimated cardiovascular disease risk: The Healthy Life in an Urban Setting study.

Background: European societies are becoming increasingly ethnically diverse. This may have important implications for socio-economic inequalities in health due to the often disadvantaged position of ethnic minority groups in both socio-economic status (SES) and disease, especially cardiovascular disease (CVD). Objective: The aim of this study was to determine whether the socio-economic gradient of estimated CVD risk differs between ethnic groups. Methods: Using the Healthy Life in an Urban Setting study, we obtained data on SES and CVD risk factors among participants from six ethnic backgrounds residing in Amsterdam. SES was measured using educational level and occupational level. CVD risk was estimated based on the occurrence of CVD risk factors using the Dutch version of the systematic coronary risk evaluation algorithm. Ethnic disparities in socio-economic gradients for estimated CVD risk were determined using the relative index of inequality (RII). Results: Among Dutch-origin men, the RII for estimated CVD risk according to educational level was 6.15% (95% confidence interval [CI] 4.35–7.96%), indicating that those at the bottom of the educational hierarchy had a 6.15% higher estimated CVD risk relative than those at the top. Among Dutch-origin women, the RII was 4.49% (CI 2.45–6.52%). The RII was lower among ethnic minority groups, ranging from 0.83% to 3.13% among men and −0.29% to 5.12% among women, indicating weaker associations among these groups. Results were similar based on occupational level. Conclusions: Ethnic background needs to be considered in associations between SES and disease. The predictive value of SES varies between ethnic groups and may be quite poor for some groups.

Ethnic differences in current smoking and former smoking in the Netherlands and the contribution of socioeconomic factors: a cross-sectional analysis of the HELIUS study

ObjectivesData exploring how much of the ethnic differences in smoking prevalence and former smoking are explained by socioeconomic status (SES) are lacking. We therefore assessed ethnic differences in smoking prevalence...

Parental Smoking and Adult Offspring's Smoking Behaviors in Ethnic Minority Groups: An Intergenerational Analysis in the HELIUS Study.

To understand smoking behaviors among ethnic minority groups, studies have largely focused on societal factors, with little attention to family influences. Yet studies among majority groups have identified parental smoking as an important risk factor. It is unknown whether this applies to ethnic minority groups. We investigated the association between parental smoking and adult offspring's smoking behaviors among ethnic minority groups with an immigrant background. We used data from the Healthy Life in an Urban Setting study from Amsterdam (the Netherlands) from January 2011 to December 2015. The sample consisted of 2184 parent-offspring pairs from South-Asian Surinamese, African Surinamese, Turkish, Moroccan, and Ghanaian origin. We collected self-reported smoking data: current status, duration of exposure to parental smoking, number of daily cigarettes, heavy smoking ( > 10 cigarettes/day), and nicotine dependency (using the Fagerström Test). Analyses were stratified by offspring's age, cohabitation with parent, education (parent/offspring), offspring's cultural orientation, and gender concordance within pairs. Logistic regression was used. Overall, parental smoking was associated with offspring's smoking behaviors (eg, current smoking: odds ratio 2.33; 95% confidence interval 1.79-3.03), with little ethnic variation. We found dose-response associations between exposure to parental smoking and offspring's smoking. The associations were similar across different strata but stronger in gender-concordant pairs (3.16; 2.12-4.51 vs. 1.73; 1.15-2.59 in gender-discordant pairs; p-value for interaction .017). Parental smoking is associated with offspring's smoking behaviors in ethnic minority groups across different strata but particularly in gender-concordant pairs. Similar to majority groups, family influences matter to smoking behaviors in ethnic minority groups. Our findings have deepened our understanding of smoking behaviors among ethnic minority groups. Future studies should simultaneously consider societal factors and parental influences, to comprehensively understand their impact on smoking among ethnic minority groups. Also, smoking patterns among family members should be addressed in individual counselling, irrespective of ethnicity.

Perceived Ethnic Discrimination and the Metabolic Syndrome in Ethnic Minority Groups: The Healthy Life in an Urban Setting Study.

Ethnic differences in the metabolic syndrome could be explained by perceived ethnic discrimination (PED). It is unclear whether PED is associated with the metabolic syndrome. We assessed this association and quantified the contribution of PED to the metabolic syndrome. Baseline data were used from the Healthy Life in an Urban Setting study collected in the Netherlands from 2011 to 2014. The population-based sample included South-Asian Surinamese, African Surinamese, Ghanaian, Turkish, and Moroccan participants (aged 18 to 70 years). PED was measured using the Everyday Discrimination Scale. The metabolic syndrome was determined according to the harmonized definition of the International Diabetes Federation, American Heart Association, and others. Logistic regression was used for analysis. population-attributable fraction was used to calculate the contribution of PED. PED was positively associated with the metabolic syndrome in South-Asian Surinamese, African Surinamese, and Moroccan participants (odds ratio [95% confidence interval] = 1.13 [0.99-1.30], 1.15 [1.00-1.32], and 1.19 [1.03-1.38], respectively) after adjusting for potential confounders and mediators. No significant association was observed among Ghanaian and Turkish participants. For the individual components, the associations were statistically significant for blood pressure, fasting glucose, and waist circumference among Surinamese participants. PED was associated with dyslipidemia in Moroccan participants. The population-attributable fractions were 5% for South-Asian Surinamese and Moroccan participants, and 7% for African Surinamese participants. We found a positive association of PED with the metabolic syndrome in some ethnic groups, with PED contributing around 5% to 7% to the metabolic syndrome among Surinamese and Moroccans. This suggests that PED might contribute to ethnic differences in the metabolic syndrome.