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1.
Int J Health Geogr ; 20(1): 16, 2021 04 06.
Artigo em Inglês | MEDLINE | ID: mdl-33823853

RESUMO

BACKGROUND: Accounting for the co-occurrence of multiple environmental influences is a more accurate reflection of population exposure than considering isolated influences, aiding in understanding the complex interactions between environments, behaviour and health. This study examines how environmental 'goods' such as green spaces and environmental 'bads' such as alcohol outlets co-occur to develop a nationwide area-level healthy location index (HLI) for New Zealand. METHODS: Nationwide data were collected, processed, and geocoded on a comprehensive range of environmental exposures. Health-constraining 'bads' were represented by: (i) fast-food outlets, (ii) takeaway outlets, (iii) dairy outlets and convenience stores, (iv) alcohol outlets, (v) and gaming venues. Health-promoting 'goods' were represented by: (i) green spaces, (ii) blue spaces, (iii) physical activity facilities, (iv) fruit and vegetable outlets, and (v) supermarkets. The HLI was developed based on ranked access to environmental domains. The HLI was then used to investigate socio-spatial patterning by area-level deprivation and rural/urban classification. RESULTS: Results showed environmental 'goods' and 'bads' co-occurred together and were patterned by area-level deprivation. The novel HLI shows that the most deprived areas of New Zealand often have the most environmental 'bads' and less access to environmental 'goods'. CONCLUSIONS: The index, that is now publicly available, is able to capture both inter-regional and local variations in accessibility to health-promoting and health-constraining environments and their combination. Results in this study further reinforce the need to embrace the multidimensional nature of neighbourhood and place not only when designing health-promoting places, but also when studying the effect of existing built environments on population health.


Assuntos
Fast Foods , Características de Residência , Ambiente Construído , Planejamento Ambiental , Abastecimento de Alimentos , Humanos , Nova Zelândia/epidemiologia
2.
Eur J Public Health ; 31(3): 561-566, 2021 07 13.
Artigo em Inglês | MEDLINE | ID: mdl-33624065

RESUMO

BACKGROUND: Declining childhood immunization represents a serious public health problem globally and in New Zealand. To guide efforts to increase immunization coverage, this study monitors nationwide change in immunization coverage since the introduction of the National Immunisation Register (NIR) in 2005 and spatiotemporal patterns of immunization coverage from 2006 to 2017. METHODS: The study population consisted of 4 482 499 individual immunization records that were obtained from the NIR (2005-2017). Data on yearly and average immunization coverage in census area units (CAUs) in New Zealand were calculated by milestone age (6/8/12/18/24/60/144 months). Data for 2005 were excluded due to missing records in the introductory period of the NIR. We analyzed spatial and spatiotemporal patterns using Gi* and SaTScan methods. RESULTS: Immunization coverage improved since the introduction of the NIR in 2005, reaching a peak in 2014 and 2015 with a slight decrease in 2016 and 2017. Well and insufficiently immunized areas were identified with spatial autocorrelation analyses highlighting several hot- and cold-spots. Comparison of CAUs with neighbouring CAUs allowed for the identification of places where immunization coverage was significantly higher or lower than expected, over both time and space. CONCLUSION: We provide the first spatiotemporal analysis of childhood immunization in New Zealand that utilizes a large sample of over 4.4 million individual immunization records. Our spatial analyses enable policymakers to understand the development of childhood immunization coverage and make more effective prevention strategies in New Zealand.


Assuntos
Imunização , Vacinação , Humanos , Programas de Imunização , Lactente , Nova Zelândia , Cobertura Vacinal
3.
N Z Geog ; 77(3): 185-190, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35440831

RESUMO

Changes in people's movement and travel behaviour have been apparent in many places during the COVID-19 pandemic, with differences seen at a range of spatial scales. These changes, occurring as a result of the COVID-19 'natural experiment', have afforded us an opportunity to reimagine how we might move in our day-to-day travels, offering a hopeful glimpse of possibilities for future policy and planning around transport. The nature and scale of changes in movement and transport resulting from the pandemic have shown we can shift travel behaviour with strong policy responses, which is especially important in the concurrent climate change crisis.

4.
Int J Health Geogr ; 16(1): 32, 2017 08 23.
Artigo em Inglês | MEDLINE | ID: mdl-28830461

RESUMO

BACKGROUND: The potential spatial access to urban health services is an important issue in health geography, spatial epidemiology and public health. Computing geographical accessibility measures for residential areas (e.g. census tracts) depends on a type of distance, a method of aggregation, and a measure of accessibility. The aim of this paper is to compare discrepancies in results for the geographical accessibility of health services computed using six distance types (Euclidean and Manhattan distances; shortest network time on foot, by bicycle, by public transit, and by car), four aggregation methods, and fourteen accessibility measures. METHODS: To explore variations in results according to the six types of distance and the aggregation methods, correlation analyses are performed. To measure how the assessment of potential spatial access varies according to three parameters (type of distance, aggregation method, and accessibility measure), sensitivity analysis (SA) and uncertainty analysis (UA) are conducted. RESULTS: First, independently of the type of distance used except for shortest network time by public transit, the results are globally similar (correlation >0.90). However, important local variations in correlation between Cartesian and the four shortest network time distances are observed, notably in suburban areas where Cartesian distances are less precise. Second, the choice of the aggregation method is also important: compared with the most accurate aggregation method, accessibility measures computed from census tract centroids, though not inaccurate, yield important measurement errors for 10% of census tracts. Third, the SA results show that the evaluation of potential geographic access may vary a great deal depending on the accessibility measure and, to a lesser degree, the type of distance and aggregation method. Fourth, the UA results clearly indicate areas of strong uncertainty in suburban areas, whereas central neighbourhoods show lower levels of uncertainty. CONCLUSION: In order to accurately assess potential geographic access to health services in urban areas, it is particularly important to choose a precise type of distance and aggregation method. Then, depending on the research objectives, the choices of the type of network distance (according to the mode of transportation) and of a number of accessibility measures should be carefully considered and adequately justified.


Assuntos
Sistemas de Informação Geográfica , Mapeamento Geográfico , Acessibilidade aos Serviços de Saúde , Viagem , Serviços Urbanos de Saúde , Viés , Sistemas de Informação Geográfica/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Humanos , Quebeque , Viagem/estatística & dados numéricos , Serviços Urbanos de Saúde/estatística & dados numéricos
5.
Environ Health ; 15 Suppl 1: 25, 2016 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-26960925

RESUMO

BACKGROUND: Climate change is a global threat to health and wellbeing. Here we provide findings of an international research project investigating the health and wellbeing impacts of policies to reduce greenhouse gas emissions in urban environments. METHODS: Five European and two Chinese city authorities and partner academic organisations formed the project consortium. The methodology involved modelling the impact of adopted urban climate-change mitigation transport, buildings and energy policy scenarios, usually for the year 2020 and comparing them with business as usual (BAU) scenarios (where policies had not been adopted). Carbon dioxide emissions, health impacting exposures (air pollution, noise and physical activity), health (cardiovascular, respiratory, cancer and leukaemia) and wellbeing (including noise related wellbeing, overall wellbeing, economic wellbeing and inequalities) were modelled. The scenarios were developed from corresponding known levels in 2010 and pre-existing exposure response functions. Additionally there were literature reviews, three longitudinal observational studies and two cross sectional surveys. RESULTS: There are four key findings. Firstly introduction of electric cars may confer some small health benefits but it would be unwise for a city to invest in electric vehicles unless their power generation fuel mix generates fewer emissions than petrol and diesel. Second, adopting policies to reduce private car use may have benefits for carbon dioxide reduction and positive health impacts through reduced noise and increased physical activity. Third, the benefits of carbon dioxide reduction from increasing housing efficiency are likely to be minor and co-benefits for health and wellbeing are dependent on good air exchange. Fourthly, although heating dwellings by in-home biomass burning may reduce carbon dioxide emissions, consequences for health and wellbeing were negative with the technology in use in the cities studied. CONCLUSIONS: The climate-change reduction policies reduced CO2 emissions (the most common greenhouse gas) from cities but impact on global emissions of CO2 would be more limited due to some displacement of emissions. The health and wellbeing impacts varied and were often limited reflecting existing relatively high quality of life and environmental standards in most of the participating cities; the greatest potential for future health benefit occurs in less developed or developing countries.


Assuntos
Poluição do Ar/prevenção & controle , Efeito Estufa/prevenção & controle , Política de Saúde/legislação & jurisprudência , Saúde Pública/legislação & jurisprudência , Poluentes Atmosféricos/análise , China , Cidades , Mudança Climática , Estudos Transversais , Europa (Continente) , União Europeia , Gases/análise , Regulamentação Governamental , Humanos , Estudos Longitudinais
7.
BMC Public Health ; 14: 553, 2014 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-24894572

RESUMO

BACKGROUND: The prevalence of adult obesity is escalating in most wealthy and middle income countries. Due to the magnitude of this issue, research and interventions at the individual-level abound. However, the limited success and high costs of such interventions has led to a growing recognition of the potential role of environmental factors in reducing obesity and promoting physical activity and healthy diets. METHODS: This study utilised individual-level data from the 2006/7 New Zealand Health Survey on obesity, physical activity, diet and socio-economic variables linked to geographic information from other sources on potentially aetiologically-relevant environmental factors, based on the respondent's residential address. We fitted logistic regression models for eight binary measures of weight or weight-related behaviours: 1) overweight; 2) obesity; 3) overweight + obesity; 4) active at least 30 minutes a day for 5+ days per week; 5) active <30 minutes per week; 6) walk 150 minutes + per week; 7) walk <30 minutes per week; and 8) consumption of 5+ fruits and vegetables per day. We included a range of independent environmental characteristics of interest in separate models. RESULTS: We found that increased neighbourhood deprivation and decreased access to neighbourhood greenspace were both significantly associated with increased odds of overweight and/or obesity. The results for weight-related behaviours indicate that meeting the recommended level of physical activity per week was associated with urban/rural status, with higher activity in the more rural areas and a surprising tendency for less activity among those living in areas with higher levels of active travel to work. Increased access to greenspace was associated with high levels of walking, while decreased access to greenspace was associated with low levels of walking. There was also a significant trend for low levels of walking to be positively associated with neighbourhood deprivation. Results for adequate fruit and vegetable consumption show a significant urban/rural gradient, with more people meeting recommended levels in the more rural compared to more urban areas. CONCLUSION: Similar to findings from other international studies, these results highlight greenspace as an amenable environmental factor associated with obesity/overweight and also indicate the potential benefit of targeted health promotion in both urban and deprived areas in New Zealand.


Assuntos
Comportamentos Relacionados com a Saúde , Atividade Motora , Obesidade/epidemiologia , Características de Residência/estatística & dados numéricos , Adolescente , Adulto , Idoso , Demografia , Meio Ambiente , Feminino , Promoção da Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Nova Zelândia/epidemiologia , Obesidade/etiologia , Obesidade/prevenção & controle , Prevalência , Fatores Socioeconômicos
8.
Soc Sci Med ; 288: 113231, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-32741687

RESUMO

The aim of this research is to analyse the spatial epidemiology of Type 2 Diabetes Mellitus (T2DM) and investigate associations with the built environment in urban New Zealand. Data on T2DM was sourced from the New Zealand Virtual Diabetes Register (2016), and data on environmental variables sourced from the Ministry for Primary Industries and Territorial Authorities (2013-2016). Novel measures of the built environment using an enhanced two-step floating catchment area model were established using data on fast food outlets, takeaways, dairy/convenience stores, supermarkets and fruit/vegetable stores. Rates of T2DM per 1000 population and standardised morbidity ratios were computed and visualised for all urban areas. Getis Ord was used to assess spatial clustering, and Bayesian modelling was used to understand associations between T2DM and environmental variables. Results indicate that T2DM is influenced by demographic factors, spatially clustered and associated with accessibility to environmental exposures. Health-promoting resources, such as fruit/vegetable stores, were shown to have a consistently protective effect on T2DM while those considered detrimental to health showed varying, and largely insignificant, associations. This is the first study in New Zealand to spatially quantify the effects of multiple environmental exposures on population level T2DM for all urban areas using a geospatial approach. It has implications for both policy and future research efforts as a deeper knowledge of local environments forms a basis on which to better understand spatial associations between the built environment and health, as well as formulate policy directed toward environmental influences on chronic health conditions.


Assuntos
Diabetes Mellitus Tipo 2 , Teorema de Bayes , Ambiente Construído , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/etiologia , Abastecimento de Alimentos , Humanos , Nova Zelândia/epidemiologia , Características de Residência
9.
J Epidemiol Community Health ; 75(9): 903-905, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33727245

RESUMO

BACKGROUND: The COVID-19 pandemic has asked unprecedented questions of governments around the world. Policy responses have disrupted usual patterns of movement in society, locally and globally, with resultant impacts on national economies and human well-being. These interventions have primarily centred on enforcing lockdowns and introducing social distancing recommendations, leading to questions of trust and competency around the role of institutions and the administrative apparatus of state. This study demonstrates the unequal societal impacts in population movement during a national 'lockdown'. METHODS: We use nationwide mobile phone movement data to quantify the effect of an enforced lockdown on population mobility by neighbourhood deprivation using an ecological study design. We then derive a mobility index using anonymised aggregated population counts for each neighbourhood (2253 Census Statistical Areas; mean population n=2086) of national hourly mobile phone location data (7.45 million records, 1 March 2020-20 July 2020) for New Zealand (NZ). RESULTS: Curtailing movement has highlighted and exacerbated underlying social and spatial inequalities. Our analysis reveals the unequal movements during 'lockdown' by neighbourhood socioeconomic status in NZ. CONCLUSION: In understanding inequalities in neighbourhood movements, we are contributing critical new evidence to the policy debate about the impact(s) and efficacy of national, regional or local lockdowns which have sparked such controversy.


Assuntos
COVID-19 , Pandemias , Controle de Doenças Transmissíveis , Humanos , Nova Zelândia/epidemiologia , SARS-CoV-2
10.
Health Soc Care Community ; 29(6): 1971-1979, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34089274

RESUMO

Volunteering is a way for people to develop meaningful relationships within a social group and can lead to the building of social capital, from which both individuals and the wider group can benefit in the form of enhanced well-being. This study aimed to explore and describe the impact of volunteering on the volunteer coordinators and volunteers themselves in the eastern suburbs of Christchurch, New Zealand, an area particularly impacted by the devastating earthquakes in the period 2010/2011. Data were collected via semi-structured interviews with volunteer coordinators and volunteers (n = 35; 16 men, 19 women) from November 2018 to mid-January 2019. Thematic analysis of data highlighted a key theme of Creating and strengthening valued community connections, with subthemes of Personal growth, Community connections and Role of coordination. The key theme illustrated how formal volunteering created effort and opportunities towards the strengthening of personal and community connectedness. Our study demonstrates the importance of social connection for both individual and community well-being, emphasises the important role of "champions" in facilitating the building of bridging and bonding relationships between individuals and communities, and suggests a role for healthcare professionals to prescribe volunteering as a way to improve individual health and well-being outcomes.


Assuntos
Capital Social , Voluntários , Feminino , Pessoal de Saúde , Humanos , Masculino , Nova Zelândia , Satisfação Pessoal
11.
J Phys Act Health ; 18(5): 524-532, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33811187

RESUMO

BACKGROUND: This study investigates the association between television (TV) viewing and child adiposity and if parental education and child ethnicity moderate this association. METHOD: Cross-sectional, pooled (2013/2014-2016/2017) adult and child New Zealand Health Survey were matched resulting in 13,039 children (2-14 y) and parent dyads. Child TV viewing was estimated using self-reported time for each weekday and weekend. The height (in centimeters), weight (in kilograms), and waist circumference of parents and children were measured. Childhood body mass index and obesity were defined using the International Obesity Task Force cutoff values. Effect modification was assessed by interaction and then by stratifying regression analyses by parent education (low, moderate, and high) and child ethnicity (Asian, European/other, Maori, and Pacific). RESULTS: Overall, watching ≥2 hours TV on average per day in the past week, relative to <2 hours TV viewing, was associated with a higher odds of obesity (adjusted odds ratio = 1.291 [1.108-1.538]), higher body mass index z score (b = 0.123 [0.061-0.187]), and higher waist circumference (b = 0.546 [0.001-1.092]). Interactions considering this association by child ethnicity and parent education revealed little evidence of effect modification. CONCLUSION: While TV viewing was associated with child adiposity, the authors found little support for a moderating role of parental education and child ethnicity.


Assuntos
Adiposidade , Televisão , Adulto , Índice de Massa Corporal , Criança , Estudos Transversais , Humanos , Obesidade/epidemiologia , Fatores de Tempo
12.
BMC Public Health ; 10: 240, 2010 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-20459768

RESUMO

BACKGROUND: There is mounting international evidence that exposure to green environments is associated with health benefits, including lower mortality rates. Consequently, it has been suggested that the uneven distribution of such environments may contribute to health inequalities. Possible causative mechanisms behind the green space and health relationship include the provision of physical activity opportunities, facilitation of social contact and the restorative effects of nature. In the New Zealand context we investigated whether there was a socioeconomic gradient in green space exposure and whether green space exposure was associated with cause-specific mortality (cardiovascular disease and lung cancer). We subsequently asked what is the mechanism(s) by which green space availability may influence mortality outcomes, by contrasting health associations for different types of green space. METHODS: This was an observational study on a population of 1,546,405 living in 1009 small urban areas in New Zealand. A neighbourhood-level classification was developed to distinguish between usable (i.e., visitable) and non-usable green space (i.e., visible but not visitable) in the urban areas. Negative binomial regression models were fitted to examine the association between quartiles of area-level green space availability and risk of mortality from cardiovascular disease (n = 9,484; 1996 - 2005) and from lung cancer (n = 2,603; 1996 - 2005), after control for age, sex, socio-economic deprivation, smoking, air pollution and population density. RESULTS: Deprived neighbourhoods were relatively disadvantaged in total green space availability (11% less total green space for a one standard deviation increase in NZDep2001 deprivation score, p < 0.001), but had marginally more usable green space (2% more for a one standard deviation increase in deprivation score, p = 0.002). No significant associations between usable or total green space and mortality were observed after adjustment for confounders. CONCLUSION: Contrary to expectations we found no evidence that green space influenced cardiovascular disease mortality in New Zealand, suggesting that green space and health relationships may vary according to national, societal or environmental context. Hence we were unable to infer the mechanism in the relationship. Our inability to adjust for individual-level factors with a significant influence on cardiovascular disease and lung cancer mortality risk (e.g., diet and alcohol consumption) will have limited the ability of the analyses to detect green space effects, if present. Additionally, green space variation may have lesser relevance for health in New Zealand because green space is generally more abundant and there is less social and spatial variation in its availability than found in other contexts.


Assuntos
Doenças Cardiovasculares/mortalidade , Ecossistema , Planejamento Ambiental , Neoplasias Pulmonares/mortalidade , Características de Residência , Saúde da População Urbana , Causas de Morte/tendências , Feminino , Humanos , Masculino , Nova Zelândia , Características de Residência/classificação , Fatores de Risco , Fatores Socioeconômicos
13.
Geospat Health ; 15(1)2020 06 19.
Artigo em Inglês | MEDLINE | ID: mdl-32575971

RESUMO

Social and natural capital are fundamental to people's wellbeing, often within the context of local community. Developing communities and linking people together provide benefits in terms of mental well-being, physical activity and other associated health outcomes. The research presented here was carried out in Christchurch - Otautahi, New Zealand, a city currently re-building, after a series of devastating earthquakes in 2010 and 2011. Poor mental health has been shown to be a significant post-earthquake problem, and social connection has been postulated as part of a solution. By curating a disparate set of community services, activities and facilities, organised into a Geographic Information Systems (GIS) database, we created i) an accessibility analysis of 11 health and well-being services, ii) a mobility scenario analysis focusing on 4 general well-being services and iii) a location-allocation model focusing on 3 primary health care and welfare location optimisation. Our results demonstrate that overall, the majority of neighbourhoods in Christchurch benefit from a high level of accessibility to almost all the services; but with an urban-rural gradient (the further away from the centre, the less services are available, as is expected). The noticeable exception to this trend, is that the more deprived eastern suburbs have poorer accessibility, suggesting social inequity in accessibility. The findings presented here show the potential of optimisation modelling and database curation for urban and community facility planning purposes.


Assuntos
Acessibilidade aos Serviços de Saúde , Atenção Primária à Saúde , Saúde da População Urbana , Sistemas de Informação Geográfica , Humanos , Nova Zelândia , Seguridade Social
14.
J Safety Res ; 72: 67-74, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32199579

RESUMO

INTRODUCTION: Recent increases in road crashes have reversed New Zealand's formerly declining crash rates to produce annual fatal and serious injury counts that are 49% higher than the lowest rates achieved in 2013. METHOD: We model twenty-one factors in fatal and serious injury crashes, four years before and after 2013 using logistic regression. Three major factors are significantly different in the period after 2013, when crash rates increased: (1) alcohol as a cause, (2) learner licence holders, and (3) a regional effect for Auckland. Newly defined speed zones are a more common setting for crashes in the period of upturn but there is no coinciding elevated likelihood of 'speed as a causal factor'. Three factors related to road safety were less common: aged under 25-years old, fatigue, and not wearing a seatbelt. RESULTS: Results are compared to rates of prosecutions for alcohol-related driving offences over this period. It is possible that New Zealand's successful road safety initiatives of the past have been undermined by reduced levels of enforcement and an unexpected outcome from the graduated driving licence system.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Condução de Veículo/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nova Zelândia , Adulto Jovem
15.
Soc Sci Med ; 264: 113292, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32829214

RESUMO

BACKGROUND: Immunisation is a safe and effective way of protecting children and adults against harmful diseases. However, immunisation coverage of children is declining in some parts of New Zealand. AIM: Use a nationwide sample to first, examine the socioeconomic and demographic determinants of immunisation coverage and spatial variation in these determinants. Second, it investigates change in immunisation coverage in New Zealand over time. METHODS: Individual immunisation records were obtained from the National Immunisation Register (NIR) (2005-2017; 4,482,499 events). We calculated the average immunisation coverage by year and milestone age for census area units (CAU) and then examined the immunisation coverage by selected socioeconomic and demographic determinants. Finally, local variations in the association between immunisation coverage and selected determinants were investigated using geographically weighted regression. RESULTS: Findings showed a decrease of immunisation rates in recent years in CAUs with high immunisation coverage in the least deprived areas and increasing immunisation rates in more deprived areas. Nearly all explanatory variables exhibited a spatial variation in their association with immunisation coverage. For instance, the strongest negative effect of area-level deprivation is observed in the northern part of the South Island, the central-southern part of the North Island, around Auckland, and in Northland. CONCLUSION: Our findings show that childhood immunisation coverage varies by socioeconomic and demographic factors across CAUs. We also identify important spatial variation and changes over time in recent years. This evidence can be used to improve immunisation related policy in New Zealand.


Assuntos
Programas de Imunização , Cobertura Vacinal , Adulto , Criança , Humanos , Imunização , Lactente , Nova Zelândia , Vacinação
16.
Int J Epidemiol ; 49(3): 908-916, 2020 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-32347945

RESUMO

BACKGROUND: We examined the association between area-level deprivation and dental ambulatory sensitive hospitalizations (ASH) and considered the moderating effect of community water fluoridation (CWF). The hypothesis was that higher levels of deprivation are associated with higher dental ASH rates and that CWF will moderate this association such that children living in the most deprived areas have greater health gain from CWF. METHODS: Dental ASH conditions (dental caries and diseases of pulp/periapical tissues), age, gender and home address identifier (meshblock) were extracted from pooled cross-sectional data (Q3, 2011 to Q2, 2017) on children aged 0-4 and 5-12 years from the National Minimum Dataset, New Zealand (NZ) Ministry of Health. CWF was obtained for 2011 and 2016 from the NZ Institute of Environmental Science and Research. Dental ASH rates for children aged 0-4 and 5-12 years (/1000) were calculated for census area units (CAUs). Multilevel negative binomial models investigated associations between area-level deprivation, dental ASH rate and moderation by CWF status. RESULTS: Relative to CWF (2011 and 2016), no CWF (2011 and 2016) was associated with increased dental ASH rates in children aged 0-4 [incidence rate ratio (IRR) = 1.171 (95% confidence interval 1.064, 1.288)] and aged 5-12 years [IRR = 1.181 (1.084, 1.286)]. An interaction between area-level deprivation and CWF showed that the association between CWF and dental ASH rates was greatest within the most deprived quintile of children aged 0-4 years [IRR = 1.316 (1.052, 1.645)]. CONCLUSIONS: CWF was associated with a reduced dental ASH rate for children aged 0-4 and 5-12 years. Children living in the most deprived areas showed the greatest effect of CWF on dental ASH rates, indicating that the greater health gain from CWF occurred for those with the highest socio-economic disadvantage. Variation in CWF contributes to structural inequities in oral-health outcomes for children.


Assuntos
Cárie Dentária , Fluoretação , Hospitalização , Áreas de Pobreza , Criança , Pré-Escolar , Estudos Transversais , Cárie Dentária/epidemiologia , Fluoretação/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Nova Zelândia/epidemiologia
17.
Br Dent J ; 228(4): 269-276, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32112020

RESUMO

Introduction Despite improvements in oral health outcomes in New Zealand over the last number of decades, there are still high levels of preventable tooth decay in adults and children. We investigate the prevalence and spatial variation of non-fluoride toothpaste use in a nationally representative sample of adults and children in New Zealand.Method Individual-level self-reported data were sourced from the New Zealand Health Survey (2017/18). Both child (n = 4,723) and adult (n = 13,869) data were used. Data included sociodemographic (for example, age), socioeconomic (for example, area-level deprivation) and dental-related (for example, type of toothpaste used) variables.Results Overall, 6.8% of adults and 6.4% of children use non-fluoride toothpaste. When split by deprivation, the highest prevalence of non-fluoride toothpaste use for children and adults was in the moderate to least deprived areas, while the lowest prevalence was in the most deprived areas. When disaggregated by ethnicity, the Asian population had the highest prevalence of non-fluoride toothpaste use for both adults and children compared to Maori, Pacific and European/Other. There was little difference in prevalence by rural/urban classification; however, prevalence varied geographically across the study area.Conclusion This is the first study that uses a nationally representative sample of adults and children to show variation in the use of non-fluoride toothpaste in New Zealand.


Assuntos
Cariostáticos , Cremes Dentais , Adulto , Criança , Estudos Transversais , Fluoretos , Humanos , Nova Zelândia , Prevalência
18.
Health Place ; 61: 102243, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-32329723

RESUMO

Spatial lifecourse epidemiology is an interdisciplinary field that utilizes advanced spatial, location-based, and artificial intelligence technologies to investigate the long-term effects of environmental, behavioural, psychosocial, and biological factors on health-related states and events and the underlying mechanisms. With the growing number of studies reporting findings from this field and the critical need for public health and policy decisions to be based on the strongest science possible, transparency and clarity in reporting in spatial lifecourse epidemiologic studies is essential. A task force supported by the International Initiative on Spatial Lifecourse Epidemiology (ISLE) identified a need for guidance in this area and developed a Spatial Lifecourse Epidemiology Reporting Standards (ISLE-ReSt) Statement. The aim is to provide a checklist of recommendations to improve and make more consistent reporting of spatial lifecourse epidemiologic studies. The STrengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement for cohort studies was identified as an appropriate starting point to provide initial items to consider for inclusion. Reporting standards for spatial data and methods were then integrated to form a single comprehensive checklist of reporting recommendations. The strength of our approach has been our international and multidisciplinary team of content experts and contributors who represent a wide range of relevant scientific conventions, and our adherence to international norms for the development of reporting guidelines. As spatial, location-based, and artificial intelligence technologies used in spatial lifecourse epidemiology continue to evolve at a rapid pace, it will be necessary to revisit and adapt the ISLE-ReSt at least every 2-3 years from its release.


Assuntos
Inteligência Artificial , Estudos Epidemiológicos , Internacionalidade , Saúde Pública , Análise Espacial , Comitês Consultivos , Lista de Checagem , Estudos de Coortes , Nível de Saúde , Humanos , Projetos de Pesquisa/normas
19.
Int J Public Health ; 64(4): 625-635, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31006826

RESUMO

OBJECTIVES: To investigate risk factors for women with obesity of childbearing age. METHODS: A cross-sectional survey of New Zealand women (15-49 years) with measured height and weight was used [unweighted (n = 3625) and weighted analytical sample (n = 1,098,372)] alongside sociodemographic-, behavioural- and environmental-level predictors. Multilevel logistic regression weighted for non-response of height and weight data was used. RESULTS: Meeting physical activity guidelines (AOR (adjusted odds ratio) 0.66, 95% CI 0.54-0.80), Asian (AOR 0.15, 95% CI 0.10-0.23) and European/other ethnicity (AOR 0.46, 95% CI 0.36-0.58) and an increased availability of public greenspace (Q4 AOR 0.55, 95% CI 0.41-0.75) were related to decreased obesity risk. Older age (45-49 years AOR 3.01, 95% CI 2.17-4.16), Pacific ethnicity (AOR 2.81, 95% CI 1.87-4.22), residing in deprived areas (AOR 1.65, 95% CI 1.16-2.35) or secondary urban areas (AOR 1.49, 95% CI 1.03-2.18) were related to increased obesity risk. When examined by rural/urban classification, private greenspace was only related to increased obesity risk in main urban areas. CONCLUSIONS: This study highlights factors including but not limited to public greenspace, which inform obesity interventions for women of childbearing age in New Zealand.


Assuntos
Obesidade/epidemiologia , Vigilância da População , População Urbana/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Nova Zelândia/epidemiologia , Razão de Chances , Prevalência , Fatores de Risco , População Rural/estatística & dados numéricos , Adulto Jovem
20.
Environ Health ; 7: 16, 2008 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-18479529

RESUMO

BACKGROUND: Adverse respiratory effects of particulate air pollution have been identified by epidemiological studies. We aimed to examine the health effects of ambient particulate air pollution from wood burning on school-age students in Christchurch, New Zealand, and to explore the utility of urine and exhaled breath condensate biomarkers of exposure in this population. METHODS: A panel study of 93 male students (26 with asthma) living in the boarding house of a metropolitan school was undertaken in the winter of 2004. Indoor and outdoor pollution data was continuously monitored. Longitudinal assessment of lung function (FEV1 and peak flow) and symptoms were undertaken, with event studies of high pollution on biomarkers of exposure (urinary 1-hydroxypyrene) and effect (exhaled breath condensate (EBC) pH and hydrogen peroxide concentration). RESULTS: Peak levels of air pollution were associated with small but statistically significant effects on lung function in the asthmatic students, but not healthy students. No significant effect of pollution could be seen either on airway inflammation and oxidative stress either in healthy students or students with asthma. Minor increases in respiratory symptoms were associated with high pollution exposure. Urinary 1-hydroxypyrene levels were raised in association with pollution events by comparison with low pollution control days. CONCLUSION: There is no significant effect of ambient wood-smoke particulate air pollution on lung function of healthy school-aged students, but a small effect on respiratory symptoms. Asthmatic students show small effects of peak pollution levels on lung function. Urinary 1-hydroxypyrene shows potential as a biomarker of exposure to wood smoke in this population; however measurement of EBC pH and hydrogen peroxide appears not to be useful for assessment of population health effects of air pollution.Some of the data presented in this paper has previously been published in Kingham and co-workers Atmospheric Environment, 2006 Jan; 40: 338-347 (details of pollution exposure), and Cavanagh and co-workers Sci Total Environ. 2007 Mar 1;374(1):51-9 (urine hydroxypyrene data).


Assuntos
Poluição do Ar/efeitos adversos , Asma/epidemiologia , Tosse/epidemiologia , Material Particulado/toxicidade , Madeira , Adolescente , Poluição do Ar/análise , Asma/metabolismo , Asma/fisiopatologia , Biomarcadores/urina , Testes Respiratórios , Criança , Tosse/metabolismo , Tosse/fisiopatologia , Volume Expiratório Forçado/efeitos dos fármacos , Calefação , Humanos , Peróxido de Hidrogênio/metabolismo , Masculino , Nova Zelândia/epidemiologia , Pico do Fluxo Expiratório/efeitos dos fármacos , Pirenos/metabolismo , Estudantes
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