Double disadvantage : the influence of ethnicity over socioeconomic position on childhood overweight and obesity: findings from an inner urban population of primary school children

Objective: To examine the relationship between overweight/obesity in children, socioeconomic status and ethnicity/cultural background.

Design: Cross-sectional survey of children aged 4–13 years.

Setting: A total of 23 primary (elementary) schools in an inner urban municipality of Melbourne, Australia.

Participants: A total of 2685 children aged 4–13 years and their parents.

Main exposure measures: Ethnicity/cultural background – maternal region of birth; socioeconomic position (SEP) indicators – maternal and paternal educational attainment, family employment status, possession of a healthcare card, ability to buy food, indicator of disadvantage (Socioeconomic Index for Areas, SEIFA) score for school; parental weight status.

Main outcome measure: Prevalence of overweight/obesity.

Results: Prevalence of overweight/obesity approached 1 in 3 (31%) in this sample. Prevalence of overweight/obesity was greater for children of both North Africa and Middle Eastern background and children of Southern, South Eastern and Eastern European background compared with children of Australian background. This difference remained after adjusting for age, sex, height, clustering by school, SEP indicators and parental weight status; odds ratio, OR=1.57 (95% confidence interval, CI 1.12–2.19) and 1.88 (95%CI 1.24–2.85), respectively.

Conclusions: There is a clear independent effect of ethnicity above and beyond the effect of socioeconomic status on overweight and obesity in children. Further research is required to explore the mediators of this gradient.

Prevalence of visual impairment and uncorrected refractive error - report from a Canadian urban population-based study

The prevalence of visual impairment due to uncorrected refractive error has not been previously studied in Canada. A population-based study was conducted in Brantford, Ontario. The target population included all people 40 years of age and older. Study participants were selected using a randomized sampling strategy based on postal codes. Presenting distance and near visual acuities were measured with habitual spectacle correction, if any, in place. Best corrected visual acuities were determined for all participants who had a presenting distance visual acuity of less than 20/25. Population weighted prevalence of distance visual impairment (visual acuity <20/40 in the better eye) was 2.7% (n = 768, 95% confidence interval (CI) 1.8–4.0%) with 71.8% correctable by refraction. Population weighted prevalence of near visual impairment (visual acuity <20/40 with both eyes) was 2.2% (95% CI 1.4–3.6) with 69.1% correctable by refraction. Multivariable adjusted analysis showed that the odds of having distance visual impairment was independently associated with increased age (odds ratio, OR, 3.56, 95% CI 1.22–10.35; ≥65 years compared to those 39–64 years), and time since last eye examination (OR 4.93, 95% CI 1.19–20.32; ≥5 years compared to ≤2 years). The same factors appear to be associated with increased prevalence of near visual impairment but were not statistically significant. The majority of visual impairment found in Brantford was due to uncorrected refractive error. Factors that increased the prevalence of visual impairment were the same for distance and near visual acuity measurements.

Perceptions of subjective economic well-being and support for market reform among China's urban population

This article examines whether subjective economic assessments have any impact on support for further market reforms among China's urban population, utilising a large survey of 10,716 people across 32 cities. The effect of subjective economic well-being on support for market reforms is an important issue for the Chinese government as it seeks to sell the benefits of increased globalisation and marketisation to its citizens. Our main finding is that people's assessment of the overall economic situation helps to explain support for market reform, although the relationship is weak, while people's assessment of their own economic circumstances does not influence support for reform. The findings are compared with those of similar studies for Central and Eastern Europe. © 2005 Centre for Research into Post-Communist Economies.

Who wants safer cities? Perceptions of public safety and attitudes to migrants among China's urban population

Most extant research in the economics of crime literature has focused on explaining variations in crime rates. Public action to prevent crime, however, is often dependent on the level of concern about public safety that is expressed in public perceptions surveys. The economics of crime literature has largely overlooked responses to such surveys as data sources and therefore it has not accounted for the role that public opinion might have in mobilizing public action against crime. We use a unique survey administered in 2003 in 32 Chinese cities to examine the determinants of perceptions of public safety among China's urban population. One of our major findings is that individuals who have a negative perception of rural-urban migrants living in their city have a poor perception of public safety. We also find that the unemployment rate, the masculinity ratio and expenditure on armed police in the city in which the individual resides, whether the individual lives in the coastal region as opposed to the central or western region and average changes in housing prices and average changes in rental prices in the city in which the individual lives are important predictors of perceptions of public safety. © 2007 Elsevier Inc. All rights reserved.

Population, behavioural and physiological responses of an urban population of black swans to an intense annual noise event

Wild animals in urban environments are exposed to a broad range of human activities that have the potential to disturb their life history and behaviour. Wildlife responses to disturbance can range from emigration to modified behaviour, or elevated stress, but these responses are rarely evaluated in concert. We simultaneously examined population, behavioural and hormonal responses of an urban population of black swans Cygnus atratus before, during and after an annual disturbance event involving large crowds and intense noise, the Australian Formula One Grand Prix. Black swan population numbers were lowest one week before the event and rose gradually over the course of the study, peaking after the event, suggesting that the disturbance does not trigger mass emigration. We also found no difference in the proportion of time spent on key behaviours such as locomotion, foraging, resting or self-maintenance over the course of the study. However, basal and capture stress-induced corticosterone levels showed significant variation, consistent with a modest physiological response. Basal plasma corticosterone levels were highest before the event and decreased over the course of the study. Capture-induced stress levels peaked during the Grand Prix and then also declined over the remainder of the study. Our results suggest that even intensely noisy and apparently disruptive events may have relatively low measurable short-term impact on population numbers, behaviour or physiology in urban populations with apparently high tolerance to anthropogenic disturbance. Nevertheless, the potential long-term impact of such disturbance on reproductive success, individual fitness and population health will need to be carefully evaluated.

Bone mineral density and incidence of hip fracture in Swedish urban and rural women 1987–2002

Background and purpose Although the incidence of hip fracture during the past 50 years has increased, a break in this trend has been reported in the last decade. Whether this change is attributable to changes in bone mineral density (BMD) or whether it varies between urban and rural regions is unknown.

Methods We evaluated changes in annual hip fracture incidence in women aged ≥ 50 years in one urban population (n = 51,757) and one rural population (n = 26,446) from 1987 to 2002. We also examined secular differences in BMD (mg/cm2), evaluated by single-photon absorptiometry at the distal radius, prevalence of osteoporosis, and several other risk factors for hip fracture in one population-based sample of urban women and one sample of rural women aged 50–80 years at two time points: 1988/89 (n = 257 and n = 180, respectively) and 1998/99 (n = 171 and n = 118, respectively).

Results No statistically significant changes were evident in annual age-adjusted hip fracture incidence per 104 when analyzing all women (–0.01 per year (95% CI: –0.37, 0.35)), rural women (–0.38 per year (-1.05, 0.28)), or urban women (0.19 per year (–0.28, 0.67)). BMD (expressed as T-score) was similar in 1988/99 and 1998/99 when analyzing all women (–0.09 (–0.26, 0.09)), urban women (–0.04 (–0.27, 0.19)), or rural women (–0.15 (–0.42, 0.13)) women.

Interpretation Since no changes in age-adjusted hip fracture incidence and no differences in BMD were found during the study period, changes evident in the other risk factors for hip fracture that we investigated (such as gait velocity and balance) are either of minor importance or are counteracted by changes in other risk factors.

Future Asian space : projecting the urban space of new East Asia

The idea of "Asian space" is undergoing a transformation as a result of rapid technological, economic, social and cultural changes. Following the shift to a global economy and an urban population explosion, Asian cities have been presented as a mainstay of progress, national pride, identity, and positioning on the global stage. The extraordinary pace and intensity of the changes have created a situation unique in the history of urban development. Despite the immense diversity of Asian countries, "Asia-ness" is often treated as a distinctive quality that has emerged from unique recent circumstances affecting Asian urbanizations as a whole. In Future Asian Space, 15 authors explore broad concepts relating to the creation and re-creation of "Asian space" and contemporary Asian identity, and their examination of different sites and research approaches highlights the difficulty of pinpointing what Asia-ness is, or might become. Appropriate design and planning of cities is a critical element in building a sustainable future and coping with environmental, social and cultural problems. Future Asian Space is designed to stimulate interest and engagement in discussions of the Asian city, and its trajectories in architecture and urbanism. The authors' conclusions are important for academics, theorists and practitioners, but they will also intrigue anyone interested in the future of cities and urban life in Asia.

A comparison of Australian rural and metropolitan cardiovascular risk and mortality: the Greater Green Triangle and North West Adelaide population surveys

Objectives:
Cardiovascular (CVD) mortality disparities between rural/regional and urban-dwelling residents of Australia are persistent. Unavailability of biomedical CVD risk factor data has, until now, limited efforts to understand the causes of the disparity. This study aimed to further investigate such disparities.

Peak oxygen uptake of 12-18-year-old boys living in a densely populated urban environment

The purposes of this study were to provide data on the peak Vo 2 of 12-18-year-old boys from Hong Kong, a densely populated urban environment; to compare these data with those for other similarly aged populations; and to examine the correlations between peak Vo 2 and various anthropometric parameters of this group. A stratified, random sample of 86 ethnic Chinese boys had their peak Vo 2 determined using an on-line gas analysis system during incremental, treadmill running. The mean peak 17o2 of the boys was 2.7 SD 0.44 1- rain - 1 or, when expressed in relation to body mass, 52.0 SD 5-8 ml- kg- 1. min - 1. Peak Vo 2 (1. min - 1) was significantly correlated with body mass (r = 0.72, p < 0.001, age (r = 0.49, p < 0.001) and height (r = 0.71, p = 0-001). Peak Vo 2 (ml 'kg- 1. min- 1) showed no correlation with age or height. These data suggest that this population group has peak Vo 2 values very similar to those observed in boys from most other population groups.

Methods for a population-based study of eye disease: the Melbourne Visual Impairment Project

The methodology of the Melbourne Visual Impairment Project, a major population-based survey of eye disease on 3,500 randomly selected individuals aged 40 years of age and over in the Melbourne metropolitan region, is presented. The aims of the study are to determine the distribution and determinants of eye disease in an urban population; the impact of eye disease on visual function and the activities of daily living; and the accessibility of eye health care services in the community. All procedures are conducted according to a standardised protocol to allow for comparison with other population-based studies, both in Australia and overseas. Information collected from this study will be employed in the development of recommendations related to eye health care service delivery and establishment of priorities for future public education programmes and health research.

Improving the health of Australians by applying evidence from behavioural epidemiology to urban design projects

Rapid urban population growth in Australia requires an expansion of supporting hard and soft infrastructure. In the State of Victoria, directing this growth are a number of urban design and planning mechanisms that provide a ‘blueprint for development and investment’. Although topics revolving around physical health are present in these and other planning related documents, largely absent from this literature are ‘tools’ to assist decision makers in determining whether or not an urban setting supports physical health and provides opportunities for physical activity. Insufficient physical activity is a risk factor contributing to Australia’s growing and significant burden of chronic disease including cardiovascular disease, Type 2 diabetes and overweight/obesity. The potential of the built environment to influence population-level physical activity is well recognised. A key element in Victoria’s planning framework that can help address these health concerns is the provision and redevelopment of open space(s) in urban areas that provide opportunities for people of all ages and abilities to engage in physical activity. However, in the realisation of these settings, evidence informing the design of urban open space(s) that promote opportunities for physical activity is needed to produce evidence based decision making. Using the three geo-spatial visioning layers embedded in Victoria’s planning framework (i.e. Growth Area Framework Plans, Precinct Structure Plans and Planning Permits) as positioning instruments, this paper merges the fields of behavioural epidemiology and urban design to: i) provide a brief overview of current research relating to design of open space to optimise usage and physical activity, ii) consider what type of evidence relating to features of open space is needed to help inform decision makers, iii) consider the methods and procedures practitioners may use to incorporate evidence in to their planning, and iv) discuss the geo-spatial development level that the respective data can best assist decision making to achieve positive gains in physical health.

Gender, age, and educational-attainment differences in Australian adults' participation in vigorous sporting and fitness activities

Background: Participation in regular vigorous physical activity could confer health benefits additional to those derived from moderate-intensity physical activities that are currently the focus of public health strategies.
Methods: Sociodemographic differences in reported participation in vigorous sporting and fitness activities over the past 2 weeks were examined using cross-sectional data from an Australian urban population sample.
Results: Participation at least once in any form of vigorous physical activity and regular participation (six or more sessions) both decreased across successive age groups and from high to low levels of education. The most frequently reported types of vigorous physical activity were cycling (13.3%), jogging (10.1%), swimming (8.4%) for men; and, swimming (8.9%), cycling (8.8%) and aerobics (8.6%) for women.
Conclusion: Rates of regular participation in vigorous activities were low. Interventions might focus on ways to encourage younger adults to engage more regularly in these activities and to maintain participation through the lifespan.

Evidence for healthy cities : reflections on practice, method and theory

The European Healthy Cities project can be characterized as a social movement that employs an extremely wide range of political, social and behavioural interventions for the development and sustenance of urban population health. At all of these levels, the movement is inspired by ideological, theoretical and evidence-based perspectives. The result of this stance is a dynamic, complex and diverse landscape of initiatives, plans, programmes and actions. In quantitative terms (the number of WHO designated cities and associated cities and communities through national networks), ‘Healthy Cities’ can be regarded as an extraordinary accomplishment and a credit for both WHO and cities in the movement. In qualitative terms, however, critics of the movement have maintained that little evidence on its success and effectiveness has been generated. This critique finds its foundations in the mere perceptions of evidence, the politics of science and urban governance, and perspectives on the preferred or professed utilities of evidence-based health notions. The article reviews the nature of evidence and its interface with politics and governance. Applying a conceptual framework combining insights from knowledge utilization theory, theoretical perspectives on (health) policy development, theory-based evaluations and planned intervention approaches, it demonstrates that, although the evidence is overwhelming, there are barriers to the implementation of such evidence that should be further addressed by ‘Healthy Cities’.