The role of area-level deprivation and gender in participation in population-based faecal immunochemical test (FIT) colorectal cancer screening

This study aimed to investigate the effects of sex and deprivation on participation in a population-based faecal immunochemical test (FIT) colorectal cancer screening programme. The study population included 9785 individuals invited to participate in two rounds of a population-based biennial FIT-based screening programme, in a relatively deprived area of Dublin, Ireland. Explanatory variables included in the analysis were sex, deprivation category of area of residence and age (at end of screening). The primary outcome variable modelled was participation status in both rounds combined (with “participation” defined as having taken part in either or both rounds of screening). Poisson regression with a log link and robust error variance was used to estimate relative risks (RR) for participation. As a sensitivity analysis, data were stratified by screening round. In both the univariable and multivariable models deprivation was strongly associated with participation. Increasing affluence was associated with higher participation; participation was 26% higher in people resident in the most affluent compared to the most deprived areas (multivariable RR = 1.26: 95% CI 1.21–1.30). Participation was significantly lower in males (multivariable RR = 0.96: 95%CI 0.95–0.97) and generally increased with increasing age (trend per age group, multivariable RR = 1.02: 95%CI, 1.01–1.02). No significant interactions between the explanatory variables were found. The effects of deprivation and sex were similar by screening round. Deprivation and male gender are independently associated with lower uptake of population-based FIT colorectal cancer screening, even in a relatively deprived setting. Development of evidence-based interventions to increase uptake in these disadvantaged groups is urgently required.

The Shawlies: A study of early neoliberal ‘gender-fication’. The Street Trading Act, 1926, modern gender-fication, and the implications for Cork’s women street traders

For centuries Cork’s Shawlies, working-class women, survived by trading on public streets. My study explores how the first Irish Free State government, and Cork’s local authority, limited the rights of poor women to earn by subsistence trading with The Street Trading Act, 1926. The government insisted this would regulate street trading. In practice it further marginalised the women economically and socially, containing them outside the privileged, commercial city centre. In Cork the legislation facilitated the gradual disappearance of the Shawlies amid entrenched social processes and relations, contingencies that allowed for the abuse of their rights in the service of amalgamated business interests. This study address the role of discourses in deepening this marginalisation. My theoretical framework is designed to demonstrate how a seemingly innocuous piece of legislation would, in practice, do this. I set out the concepts of ‘Thriving State’, ‘Prosperous State’, and state of ‘Best Intentions’ that uses gentrification to meet these goals. The existing knowledge on women in trade is then examined, highlighting the gaps in what is known about the Shawlies. Chapter 3 details the theory behind my genealogical method. The legislation, debate, and other data produced at the national level is then examined, before moving to the local data. Chapter 6 is devoted to the Shawlies, setting their stories in the larger context of the debates. An examination of studies of contemporary women street traders in poor nations follows, along with a brief history of the decline of street trading in New York city under gentrification. Points of convergence between that process and the one in Cork are identified, along with convergences between contemporary traders and the Shawlies. The conclusion sets out my methodological, theoretical and substantive discoveries, and comments on current nostalgic renderings of the Shawlies in Cork’s newly gentrified Corn Market Street.