We examine how the choice of areal unit affects the estimation of neighbourhood effects on mortality using two different areal units. We used register data of 70,936 individuals aged 25-64 years residing in the capital region of Helsinki, Finland. Results from the multilevel Poisson regression show that the clustering of mortality was slightly stronger when using smaller area units. The differences disappear when account was taken of known individual-level characteristics of the residents. This was also the case for the effect of the proportion of manual workers in the area on mortality. Our results imply that the choice of area scale will not lead to serious underestimation of neighbourhood effects in mortality.
Country-of-birth data contained in registers are often aggregated to create broad ancestry group categories. We examine how measures of residential segregation vary according to levels of aggregation.
We use Swedish register data to calculate pairwise dissimilarity indices from 1990 to 2012 for ancestry groups defined at four nested levels of aggregation: (1) micro-groups containing 50 categories, (2) meso-groups containing 16 categories, (3) macro-groups containing six categories and (4) a broad Western/non-Western binary.
We find variation in segregation levels between ancestry groups that is obscured by data aggregation.
This study demonstrates that the practice of aggregating country-of-birth statistics in register data can hinder the ability to identify highly segregated groups and therefore design effective policy to remedy both intergroup and intergenerational inequalities.
Previous studies show contradictory findings on the relationship between health and intergenerational living arrangements (ILAs), which may be due to variation in who selects themselves into and out of ILA. Addressing the selectivity into ILA and the health of the older generation, we assess whether there is a health-protective or health-damaging effect of ILA. We locate our study in the Russian context, where ILA is prevalent and men's health has become a public health issue.
We apply a fixed-effects logistic regression to self-rated health status of 11?546 men aged 25 years or older who participated in at least two waves in the Russian Longitudinal Monitoring Survey from 1994 to 2015. To further isolate the health effect of ILA, we observe only associations after transitioning into or out of ILA.
A transition into co-residence with an unhealthy older generation increases men's odds of reporting poor health (OR=0.64, CI 0.44 to 0.93). A transition out of co-residence with a healthy older generation decreases men's odds of reporting fine health by 63% (OR=0.37, CI 0.28 to 0.50), whereas continuing to live with an unhealthy older generation decreases the odds by half (OR=0.49, CI 0.38 to 0.63).
We reveal a health interlinkage between co-residing generations by finding a detrimental health effect of co-residence with an unhealthy older generation. No longer living with an older generation who was in fine health also negatively affects men's health. Future studies should address heterogeneity related to the health of older generations, unobserved time-constant characteristics of younger generations and selectivity into/out of ILA.
Estimate the number of awakenings additional to spontaneous awakenings, induced by the nighttime aircraft movements at an international airport in Montreal, in the population residing nearby in 2009.
Maximum sound levels (LAS,max) were derived from aircraft movements using the Integrated Noise Model 7.0b, on a 28 x 28 km grid centred on the airport and with a 0.1 x 0.1 km resolution. Outdoor LAS,max were converted to indoor LAS,max by reducing noise levels by 15 dB(A) or 21 dB(A). For all grid points, LAS,max were transformed into probabilities of additional awakening using a function developed by Basner et al. (2006). The probabilities of additional awakening were linked to estimated numbers of exposed residents for each grid location to assess the number of aircraft-noise-induced awakenings in Montreal.
Using a 15 dB(A) sound attenuation, 590 persons would, on average, have one or more additional awakenings per night for the year 2009. In the scenario using a 21 dB(A) sound attenuation, on average, no one would be subjected to one or more additional awakenings per night due to aircraft noise.
Using the 2009 flight patterns, our data suggest that a small number of Montreal residents are exposed to noise levels that could induce one or more awakenings additional to spontaneous awakenings per night.
Comment In: Can J Public Health. 2013 May-Jun;104(3):e27523823900
Comment In: Can J Public Health. 2013 May-Jun;104(3):e27623823901
The aim of this study was to map dentist' work location and put it in relation to the place where they went to secondary school. All dentists in Sweden who graduated from Swedish dental schools in 1983/84, 1984/85 and 1985/86 were studied. For all these the place where they went to secondary school and the place where they work as dentists were registered. Sweden was divided into 14 areas: central, middle and remote with respect to urbanisation, location of dental schools etc. All dentists were placed in one of the 14 areas according to their secondary school education and where they worked as active dentists. This clearly showed that dentists very often go back to the area where they have had their secondary school education.
The Vancouver Area Neighbourhood Deprivation Index (VANDIX) is a census-based measure of socio-economic status (SES). It was designed to serve as an accessible and representative proxy marker of population health status without requiring more extensive health data. This paper describes the structure and previous applications of the VANDIX for measuring relative variations in health outcomes in British Columbia, Canada.
The VANDIX was constructed from a 2005 survey of provincial medical health officers asking them to comment on the best census markers of health status in British Columbia. The VANDIX is based on the weighted summation of seven socio-economic variables from the census, including in order of weighted importance: proportion without high school completion; proportion without university completion; unemployment rate; proportion of lone-parent families; average income; proportion of home owners; and employment ratio.
The VANDIX has been applied in numerous research and policy settings across the province against several distributions of health status, including self-rated health, injury and access to health care services. In each assessment, the VANDIX has shown that socio-economic inequities parallel health inequities.
SES is one of the most influential factors that shape population patterns of health outcomes. Census-based indicators of SES such as the VANDIX can serve as easily accessible and representative markers of population health status, and have application for policy, research and public health promotion.