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Community SES, perceived environment, and physical activity during home-based cardiac rehabilitation: is there a need to consider the urban vs. rural distinction?

https://arctichealth.org/en/permalink/ahliterature126295
Source
J Urban Health. 2012 Apr;89(2):285-95
Publication Type
Article
Date
Apr-2012
Author
Chris Blanchard
Daniel Rainham
Jill McSweeney
John Spence
Lisa McDonnell
Ryan Rhodes
Robert Reid
Kerry McGannon
Nancy Edwards
Author Affiliation
Dalhousie University, Halifax, Nova Scotia, Canada. chris.blanchard@dal.ca
Source
J Urban Health. 2012 Apr;89(2):285-95
Date
Apr-2012
Language
English
Publication Type
Article
Keywords
Canada
Environment
Exercise
Female
Home Care Services - statistics & numerical data
Humans
Male
Middle Aged
Motor Activity
Patient Satisfaction - statistics & numerical data
Questionnaires
Rural Population - statistics & numerical data
Social Class
Urban Population - statistics & numerical data
Abstract
Physical activity (MVPA) levels during home-based cardiac rehabilitation (CR) remain problematic. Consequently, the present study examined the association between MVPA and urban vs. rural residential status and the perceived environment in patients attending home-based CR. A total of 280 patients completed a questionnaire assessing demographic, clinical, MVPA, and perceived environmental variables measured at baseline and 3 months later. Patient addresses were geocoded and linked to the 2006 Canadian census to establish the urban/rural distinction. Results showed that urban and rural patients had similar baseline MVPA and improvements in MVPA by 3 months. Several perceived environmental variables were significantly related to MVPA throughout home-based CR that were common and urban/rural-specific. Therefore, although there does not appear to be an urban vs. rural advantage in MVPA levels during home-based CR, there does appear to be environmental/MVPA-specific relationships specific to urban and rural patients that may warrant attention.
Notes
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PubMed ID
22402918 View in PubMed
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Do differences in health make a difference? A review for health policymakers.

https://arctichealth.org/en/permalink/ahliterature162965
Source
Health Policy. 2007 Dec;84(2-3):123-32
Publication Type
Article
Date
Dec-2007
Author
Daniel Rainham
Author Affiliation
Centre for Population Health Risk Assessment, Institute of Population Health, University of Ottawa, One Stewart Street, Ottawa, Canada K1N 6N5. drain067@uottawa.ca
Source
Health Policy. 2007 Dec;84(2-3):123-32
Date
Dec-2007
Language
English
Publication Type
Article
Keywords
Health Policy
Health Status Disparities
Humans
National Health Programs
Ontario
Policy Making
Abstract
While many societies have made remarkable progress in population health improvements, health inequalities remain as a central concern to health policy. There is substantial evidence to show that differences in health achievements and access to health care are increasing both within and among societies. Socio-economic and environmental health determinants are strongly associated to population health status regardless of what risk factor or technological advance is in vogue. Understanding the fundamental causes underlying the existence of health inequalities is useful for guiding health policy as it provides a direction to guide resource allocation and the targeting of policy interventions. The purpose of this paper is to review current perspectives and methods in the assessment of health inequalities with particular relevance to public health policymakers and practitioners.
PubMed ID
17573143 View in PubMed
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Fast food and deprivation in Nova Scotia.

https://arctichealth.org/en/permalink/ahliterature152244
Source
Can J Public Health. 2009 Jan-Feb;100(1):32-5
Publication Type
Article
Author
Jennifer Jones
Mikiko Terashima
Daniel Rainham
Author Affiliation
Environmental Programmes, Dalhousie University, Halifax, NS.
Source
Can J Public Health. 2009 Jan-Feb;100(1):32-5
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Censuses
Databases, Factual
Environment Design - economics
Female
Food Habits - classification - psychology
Geographic Information Systems
Health Status Indicators
Humans
Male
Maps as Topic
Middle Aged
Nova Scotia - epidemiology
Overweight - economics - epidemiology - etiology
Poverty Areas
Prevalence
Public Health Informatics
Residence Characteristics - classification - statistics & numerical data
Restaurants - standards - statistics & numerical data
Rural Health
Urban health
Vulnerable Populations - psychology - statistics & numerical data
Young Adult
Abstract
To examine the relationship between density of fast food restaurants and measures of social and material deprivation at the community level in Nova Scotia, Canada.
Census information on population and key variables required for the calculation of deprivation indices were obtained for 266 communities in Nova Scotia. The density of fast food restaurants per 1000 individuals for each community was calculated and communities were divided into quintiles of material and psychosocial deprivation. One-way analysis of variance was used to investigate associations between fast food outlet densities and deprivation scores at the community level.
A statistically significant inverse association was found between community-level material deprivation and the mean number of fast food restaurants per 1000 people for Nova Scotia (p
PubMed ID
19263973 View in PubMed
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Is francophone language status associated with differences in the health services use of rural Nova Scotians?

https://arctichealth.org/en/permalink/ahliterature126941
Source
Can J Public Health. 2012 Jan-Feb;103(1):65-8
Publication Type
Article
Author
Donald Langille
Daniel Rainham
Steve Kisely
Author Affiliation
Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS. donald.langille@dal.ca
Source
Can J Public Health. 2012 Jan-Feb;103(1):65-8
Language
English
Publication Type
Article
Keywords
Cardiovascular Diseases - ethnology - therapy
Diabetes Mellitus - ethnology - therapy
Health Services Accessibility
Healthcare Disparities
Humans
Incidence
Language
Mental Disorders - ethnology - therapy
Minority Groups - statistics & numerical data
Neoplasms - ethnology - therapy
Nova Scotia - epidemiology
Retrospective Studies
Rural Health Services - utilization
Abstract
Research suggests that Canadian francophones living in minority contexts have little access to health services in French and are more likely to receive poorer health services. We examined whether francophones in one Nova Scotia (NS) community showed different patterns of health service use from anglophones in similar rural communities, or the NS population overall.
We used administrative data to calculate 10-year cumulative incidence rate ratios for the period 1996-2005 for treated cancers, circulatory diseases, diabetes and psychiatric disorders in Clare (population 8,815, predominantly francophone) and compared these with six predominantly Anglophone communities (total population 38,147) using data for the province overall as the reference standard. We also compared 10-year treated incidence rate ratios for visits to family physicians and specialists and for admissions to hospital.
Treatment incidence rates for all four disease groups in all rural areas were dominated by family physician visits and hospital visits; visits to specialists for some disease outcomes were often lower in rural communities. Visits to psychiatric specialists were especially low in rural communities, irrespective of language status, being 30% less than for the province overall. No significant differences in treated disease incidence were detected between Clare and the comparison anglophone communities. Treated incidence rate ratios for diabetes and circulatory diseases were significantly higher in Clare and the rural anglophone communities relative to the province overall.
The patterns of health care use and treated disease incidence seen in Clare and the comparison areas are more likely a function of rurality than they are of language.
PubMed ID
22338331 View in PubMed
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Nature appropriation and associations with population health in Canada's largest cities.

https://arctichealth.org/en/permalink/ahliterature115201
Source
Int J Environ Res Public Health. 2013 Apr;10(4):1268-83
Publication Type
Article
Date
Apr-2013
Author
Daniel Rainham
Rory Cantwell
Timothy Jason
Author Affiliation
Environmental Science, Faculty of Science, Dalhousie University, Halifax, Nova Scotia B3H 4R2, Canada. daniel.rainham@dal.ca
Source
Int J Environ Res Public Health. 2013 Apr;10(4):1268-83
Date
Apr-2013
Language
English
Publication Type
Article
Keywords
Canada
Cities
Environmental monitoring
Human Activities
Humans
Hypertension
Logistic Models
Longevity
Models, Biological
Obesity
Public Health
Risk factors
Abstract
Earth is a finite system with a limited supply of resources. As the human population grows, so does the appropriation of Earth's natural capital, thereby exacerbating environmental concerns such as biodiversity loss, increased pollution, deforestation and global warming. Such concerns will negatively impact human health although it is widely believed that improving socio-economic circumstances will help to ameliorate environmental impacts and improve health outcomes. However, this belief does not explicitly acknowledge the fact that improvements in socio-economic position are reliant on increased inputs from nature. Gains in population health, particularly through economic means, are disconnected from the appropriation of nature to create wealth so that health gains become unsustainable. The current study investigated the sustainability of human population health in Canada with regard to resource consumption or "ecological footprints" (i.e., the resources required to sustain a given population). Ecological footprints of the 20 largest Canadian cities, along with several important determinants of health such as income and education, were statistically compared with corresponding indicators of human population health outcomes. A significant positive relationship was found between ecological footprints and life expectancy, as well as a significant negative relationship between ecological footprints and the prevalence of high blood pressure. Results suggest that increased appropriation of nature is linked to improved health outcomes. To prevent environmental degradation from excessive appropriation of natural resources will require the development of health promotion strategies that are de-coupled from ever-increasing and unsustainable resource use. Efforts to promote population health should focus on health benefits achieved from a lifestyle based on significantly reduced consumption of natural resources.
Notes
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Cites: Am J Clin Nutr. 2008 Apr;87(4):801-918400700
Cites: MMWR Morb Mortal Wkly Rep. 2008 Nov 14;57(45):1226-819008791
Cites: Nat Rev Cancer. 2009 Sep;9(9):655-6419693096
Cites: Epidemiology. 2001 Jan;12(1):28-3211138815
PubMed ID
23531492 View in PubMed
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Physical activity and nutrition among youth in rural, suburban and urban neighbourhood types.

https://arctichealth.org/en/permalink/ahliterature128373
Source
Can J Public Health. 2012;103(9 Suppl 3):eS55-60
Publication Type
Article
Date
2012
Author
Cindy Shearer
Chris Blanchard
Sara Kirk
Renee Lyons
Trevor Dummer
Robert Pitter
Daniel Rainham
Laurene Rehman
Chris Shields
Meaghan Sim
Author Affiliation
Atlantic Health Promotion Research Centre, Dalhousie University, Halifax, NS. cindy.shearer@dal.ca
Source
Can J Public Health. 2012;103(9 Suppl 3):eS55-60
Date
2012
Language
English
Publication Type
Article
Keywords
Adolescent
Child
Diet - standards
Female
Humans
Male
Motor Activity
Nova Scotia
Residence Characteristics - statistics & numerical data
Rural Population
Socioeconomic Factors
Urban Population
Abstract
Physical activity and nutrition are essential to healthy living and particularly important during youth, when growth and development are key. This study examined rates of physical activity (PA) and diet quality (DQ) among youth in grades 7 to 9 in Halifax, Nova Scotia, during the 2008/09 school year and tested differences among students in rural, urban and suburban neighbourhood types of high and low socio-economic status (SES).
Youth in grades 7 through 9 (aged 12-16; 53% male) from six schools (N=380), stratified by neighbourhood type (urban, suburban, rural) and SES, wore accelerometers for up to 7 days (mean=4.14, standard deviation=1.49) and completed a nutritional survey.
The findings suggest important differences in PA and DQ across SES and neighbourhood type. Specifically, rates of moderate to vigorous physical activity among youth from schools in lower socio-economic areas were higher in urban than in suburban or rural settings. Furthermore, DQ was better among youth in higher than in lower socio-economic urban settings.
Understanding these differences in PA and DQ across rural, urban and suburban environments of high and low SES may highlight subgroups and targeted geographic areas for the design of interventions to improve rates of PA and health nutrition.
PubMed ID
23618091 View in PubMed
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Risk communication and public response to industrial chemical contamination in Sydney, Nova Scotia: a case study.

https://arctichealth.org/en/permalink/ahliterature187323
Source
J Environ Health. 2002 Dec;65(5):26-32, 34, 25
Publication Type
Article
Date
Dec-2002
Author
Daniel Rainham
Author Affiliation
University of Ottawa, 451 Smyth Road, Ottawa, Ontario KIH 8M5, Canada. drain067@uottawa.ca
Source
J Environ Health. 2002 Dec;65(5):26-32, 34, 25
Date
Dec-2002
Language
English
Publication Type
Article
Keywords
Communication
Community Health Planning
Consumer Participation
Environmental Exposure
Hazardous Waste
Humans
Industrial Waste
Mass Media
Nova Scotia - epidemiology
Organizational Case Studies
Risk assessment
Social Perception
Water Pollutants, Chemical
Abstract
The town of Sydney, located on the north coast of Nova Scotia, is Canada's most contaminated community. The local tidal estuary, called the tar ponds, was used as a receptacle for industrial waste from a century of coke production and steel making and is estimated to contain more than 700,000 metric tons of polycyclic aromatic hydrocarbons, 50,000 metric tons of polychlorinated biphenyls, and many other residuals including arsenic, naphthalene, and toluene. Many residents have expressed consternation over the potential for exposure and subsequent health effects from the ponds. Recent epidemiological studies estimate a 30 to 40 percent increased incidence in several types of cancer within the community. This paper examines the claims and responses made by a variety of interested parties about the chemical contamination in Sydney. It also considers how those claims, in addition to a number of other mediating factors, may have influenced the local community in the mobilization of a response to the contamination.
PubMed ID
12491851 View in PubMed
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Screening-level microbial risk assessment of acute gastrointestinal illness attributable to wastewater treatment systems in Nunavut, Canada.

https://arctichealth.org/en/permalink/ahliterature298340
Source
Sci Total Environ. 2019 Mar 20; 657:1253-1264
Publication Type
Journal Article
Date
Mar-20-2019
Author
Kiley Daley
Rob Jamieson
Daniel Rainham
Lisbeth Truelstrup Hansen
Sherilee L Harper
Author Affiliation
Centre for Water Resources Studies, Dalhousie University, 1360 Barrington Street, Halifax, Nova Scotia B3H 4R2, Canada. Electronic address: kiley.daley@dal.ca.
Source
Sci Total Environ. 2019 Mar 20; 657:1253-1264
Date
Mar-20-2019
Language
English
Publication Type
Journal Article
Keywords
Environmental Exposure - analysis
Gastrointestinal Diseases - epidemiology - microbiology
Humans
Incidence
Nunavut
Recreation
Risk assessment
Waste Management - methods
Waste Water - microbiology
Water Purification
Wetlands
Abstract
Most arctic communities use primary wastewater treatment systems that are capable of only low levels of pathogen removal. Effluent potentially containing fecally derived microorganisms is released into wetlands and marine waters that may simultaneously serve as recreation or food harvesting locations for local populations. The purpose of this study is to provide the first estimates of acute gastrointestinal illness (AGI) attributable to wastewater treatment systems in Arctic Canada. A screening-level, point estimate quantitative microbial risk assessment model was developed to evaluate worst-case scenarios across an array of exposure pathways in five case study locations. A high annual AGI incidence rate of 5.0 cases per person is estimated in Pangnirtung, where a mechanical treatment plant discharges directly to marine waters, with all cases occurring during low tide conditions. The probability of AGI per person per single exposure during this period ranges between 1.0?×?10-1 (shore recreation) and 6.0?×?10-1 (shellfish consumption). A moderate incidence rate of 1.2 episodes of AGI per person is estimated in Naujaat, where a treatment system consisting of a pond and tundra wetland is used, with the majority of cases occurring during spring. The pathway with the highest individual probability of AGI per single exposure event is wetland travel at 6.0?×?10-1. All other risk probabilities per single exposure are
PubMed ID
30677892 View in PubMed
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Using Global Positioning Systems (GPS) and temperature data to generate time-activity classifications for estimating personal exposure in air monitoring studies: an automated method.

https://arctichealth.org/en/permalink/ahliterature257181
Source
Environ Health. 2014;13(1):33
Publication Type
Article
Date
2014
Author
Elizabeth Nethery
Gary Mallach
Daniel Rainham
Mark S Goldberg
Amanda J Wheeler
Author Affiliation
Water and Air Quality Bureau, HECSB, Health Canada, 269 Laurier Avenue West, AL 4903C, Ottawa, Ontario K1A 0 K9, Canada. elizabeth.nethery@gmail.com.
Source
Environ Health. 2014;13(1):33
Date
2014
Language
English
Publication Type
Article
Keywords
Adolescent
Air Pollutants - analysis
Child
Cities
Environmental Monitoring - methods
Female
Geographic Information Systems
Humans
Humidity
Male
Particulate Matter - analysis
Quebec
Temperature
Time Factors
Abstract
Personal exposure studies of air pollution generally use self-reported diaries to capture individuals' time-activity data. Enhancements in the accuracy, size, memory and battery life of personal Global Positioning Systems (GPS) units have allowed for higher resolution tracking of study participants' locations. Improved time-activity classifications combined with personal continuous air pollution sampling can improve assessments of location-related air pollution exposures for health studies.
Data was collected using a GPS and personal temperature from 54 children with asthma living in Montreal, Canada, who participated in a 10-day personal air pollution exposure study. A method was developed that incorporated personal temperature data and then matched a participant's position against available spatial data (i.e., road networks) to generate time-activity categories. The diary-based and GPS-generated time-activity categories were compared and combined with continuous personal PM2.5 data to assess the impact of exposure misclassification when using diary-based methods.
There was good agreement between the automated method and the diary method; however, the automated method (means: outdoors?=?5.1%, indoors other =9.8%) estimated less time spent in some locations compared to the diary method (outdoors?=?6.7%, indoors other?=?14.4%). Agreement statistics (AC1?=?0.778) suggest 'good' agreement between methods over all location categories. However, location categories (Outdoors and Transit) where less time is spent show greater disagreement: e.g., mean time "Indoors Other" using the time-activity diary was 14.4% compared to 9.8% using the automated method. While mean daily time "In Transit" was relatively consistent between the methods, the mean daily exposure to PM2.5 while "In Transit" was 15.9 µg/m3 using the automated method compared to 6.8 µg/m3 using the daily diary.
Mean times spent in different locations as categorized by a GPS-based method were comparable to those from a time-activity diary, but there were differences in estimates of exposure to PM2.5 from the two methods. An automated GPS-based time-activity method will reduce participant burden, potentially providing more accurate and unbiased assessments of location. Combined with continuous air measurements, the higher resolution GPS data could present a different and more accurate picture of personal exposures to air pollution.
Notes
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PubMed ID
24885722 View in PubMed
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Wastewater treatment and public health in Nunavut: a microbial risk assessment framework for the Canadian Arctic.

https://arctichealth.org/en/permalink/ahliterature280323
Source
Environ Sci Pollut Res Int. 2017 Feb 21;
Publication Type
Article
Date
Feb-21-2017
Author
Kiley Daley
Rob Jamieson
Daniel Rainham
Lisbeth Truelstrup Hansen
Source
Environ Sci Pollut Res Int. 2017 Feb 21;
Date
Feb-21-2017
Language
English
Publication Type
Article
Abstract
Wastewater management in Canadian Arctic communities is influenced by several geographical factors including climate, remoteness, population size, and local food-harvesting practices. Most communities use trucked collection services and basic treatment systems, which are capable of only low-level pathogen removal. These systems are typically reliant solely on natural environmental processes for treatment and make use of existing lagoons, wetlands, and bays. They are operated in a manner such that partially treated wastewater still containing potentially hazardous microorganisms is released into the terrestrial and aquatic environment at random times. Northern communities rely heavily on their local surroundings as a source of food, drinking water, and recreation, thus creating the possibility of human exposure to wastewater effluent. Human exposure to microbial hazards present in municipal wastewater can lead to acute gastrointestinal illness or more severe disease. Although estimating the actual disease burdens associated with wastewater exposures in Arctic communities is challenging, waterborne- and sanitation-related illness is believed to be comparatively higher than in other parts of Canada. This review offers a conceptual framework and evaluation of current knowledge to enable the first microbial risk assessment of exposure scenarios associated with food-harvesting and recreational activities in Arctic communities, where simplified wastewater systems are being operated.
PubMed ID
28224339 View in PubMed
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11 records – page 1 of 2.