Socio-economic disparities in Australian adolescents' eating behaviours

Objective: To assess the association between socio-economic position (SEP) and poor eating behaviours in a large representative sample of Australian secondary school students.
Design: Cross-sectional survey of students’ vegetable, fruit, sugar-sweetened beverage and fast-food consumption assessed using validated instruments and collected via a web-based self-report format.
Setting: Secondary schools across all Australian states and territories.
Subjects: Secondary-school students (n 12 188; response rate: 54 %) aged 12–17 years participating in the 2009–10 National Secondary Students’ Diet and Activity (NaSSDA) survey.
Results: Overall, 25% of students reported consuming <1 serving of vegetables/d and 29% reported eating <1 serving of fruit/d. Fourteen per cent of students reported drinking at least 1–2 cups of sugar-sweetened beverages/d while 9% reported eating fast food <3 times/week. After adjusting for other demographic factors, students of lower-SEP areas were more likely to report low intake of vegetables (F (4, 231) = 3.61, P = 0.007) and high frequency of consumption of sugar-sweetened beverages (F (4, 231) =8.41, P < 0.001) and fast food (F (4, 231) = 4.59, P =0.001) compared with students of high-SEP neighbourhoods. A positive SEP association was found for fruit consumption among female students only (F (4, 231) = 4.20, P = 0.003). Those from lower-SEP areas were also more likely to engage in multiple poor eating behaviours (F (4, 231) = 5.80, P, < 0.001).
Conclusions: Results suggest that socio-economic disparities in Australian adolescents’ eating behaviours do exist, with students residing in lower-SEP neighbourhoods faring less well than those from high-SEP neighbourhoods. Reducing social inequalities in eating behaviours among young people should be a key consideration of future preventive strategies.

Type 2 diabetes care in North Karelia Finland: do area-level socio-economic factors affect processes and outcomes?

This research assessed the impact of area-level socio-economic factors on the prevalence and outcomes of type 2 diabetes in North Karelia, Finland.

Socio-economic differences in predictors of frequent dairy food consumption among Australian adolescents: a longitudinal study

Sufficient dairy food consumption during adolescence is necessary for preventing disease. While socio-economically disadvantaged adolescents tend to consume few dairy foods, some eat quantities more in line with dietary recommendations despite socio-economic challenges. Socio-economic variations in factors supportive of adolescents' frequent dairy consumption remain unexplored. The present study aimed to identify cross-sectional and longitudinal associations between intrapersonal, social and environmental factors and adolescents' frequent dairy consumption at baseline and two years later across socio-economic strata, and to examine whether socio-economic position moderated observed effects.

The association between socio-economic position and diet quality in Australian adults

Objective: We aimed to investigate the association between multiple measures of socio-economic position (SEP) and diet quality, using a diet quality index representing current national dietary guidelines, in the Australian adult population. Design: Cross-sectional study. Linear regression analyses were used to estimate the association between indicators of SEP (educational attainment, level of income and area-level disadvantage) and diet quality (measured using the Dietary Guideline Index (DGI)) in the total sample and stratified by sex and age (≤55 years and >55 years). Setting: A large randomly selected sample of the Australian adult population. Subjects: Australian adults (n 9296; aged ≥25 years) from the Australian Diabetes, Obesity and Lifestyle Study. Results: A higher level of educational attainment and income and a lower level of area-level disadvantage were significantly associated with a higher DGI score, across the gradient of SEP. The association between indicators of SEP and DGI score was consistently stronger among those aged ≤55 years compared with their older counterparts. The most disadvantaged group had a DGI score between 2 and 5 units lower (depending on the marker of SEP) compared with the group with the least disadvantage. Conclusions: A higher level of SEP was consistently associated with a higher level of diet quality for all indicators of SEP examined. In order to reduce socio-economic inequalities in diet quality, healthy eating initiatives need to act across the gradient of socio-economic disadvantage with a proportionate focus on those with greater socio-economic disadvantage.

Welcome from the policies, socio-economic aspects, and health systems research section

At BMC Obesity, the Policies, Socio-economic Aspects, and Health Systems Research Section provides an opportunity to submit research focussed on what we need to know to support implementation of obesity policies most likely to achieve substantial, sustainable and equitable reductions in the prevalence of obesity globally. Here, we present the aims and objectives of this section, hearing from each of the Associate Editors in turn. The ambition of the Policies, Socio-economic Aspects, and Health Systems Research Section is to foster innovative research combining scientific quality with real world experience. We envisage this will include research addressing the structural drivers of obesity, solution oriented research, research addressing socio-economic inequalities in obesity and obesity prevention in low and middle income countries. We look forward to stimulating research to advance both the methods and substance required to drive uptake of effective and equitable obesity reduction policies globally.

Truths and half truths: China's socio-economic reforms (1978-2010)

Truths and Half Truths is aimed at economic and social science academics and students who are interested in the dynamics of China's institutional development and societal transformation. Covering the complexity of the social, economic, and governance reforms behind the economic miracles achieved by China since its reform in 1978, and particularly in the past twenty years, this book provides much needed insight and critical thinking on major aspects of China's reform. Topics include employment, environment, anti-poverty; urbanization and rural development; education, corruption, political regime and media. Readers will be able to re-evaluate the costs and benefits of China's modernization from a point-of-view of sustainability. © 2011 Woodhead Publishing Limited. All rights reserved.

Socio-economic differences in eating-related attitudes, behaviours and environments of adolescents

OBJECTIVE: The aim of the present study was to investigate the relationship between area-level socio-economic status and healthy and less healthy eating behaviours among adolescents and to determine whether the relationship between area-level socio-economic status and dietary behaviours was related to the relevant attitudes and environments. DESIGN: Data were collected as part of Youth'07, a nationally representative survey of the health and well-being of New Zealand youth. SETTING: New Zealand secondary schools, 2007. SUBJECTS: A total of 9107 secondary-school students in New Zealand. RESULTS: Students from more deprived areas perceived more supportive school environments and cared as much about healthy eating as students in more affluent areas. However, these students were significantly more likely to report consuming fast food, soft drinks and chocolates. CONCLUSIONS: Addressing area-level socio-economic disparities in healthy eating requires addressing the availability, affordability and marketing of unhealthy snack foods, particularly in economically deprived areas.

An internet-supported physical activity intervention delivered in secondary schools located in low socio-economic status communities : study protocol for the activity and motivation in physical education (AMPED) cluster randomized controlled trial

BACKGROUND: School-based physical education is an important public health initiative as it has the potential to provide students with regular opportunities to participate in moderate-to-vigorous physical activity (MVPA). Unfortunately, in many physical education lessons students do not engage in sufficient MVPA to achieve health benefits. In this trial we will test the efficacy of a teacher professional development intervention, delivered partially via the Internet, on secondary school students' MVPA during physical education lessons. Teaching strategies covered in this training are designed to (i) maximize opportunities for students to be physically active during lessons and (ii) enhance students' autonomous motivation towards physical activity. METHOD: A two-arm cluster randomized controlled trial with allocation at the school level (intervention vs. usual care control). Teachers and Year 8 students in government-funded secondary schools in low socio-economic areas of the Western Sydney region of Australia will be eligible to participate. During the main portion of the intervention (6 months), teachers will participate in two workshops and complete two implementation tasks at their school. Implementation tasks will involve video-based self-reflection via the project's Web 2.0 platform and an individualized feedback meeting with a project mentor. Each intervention school will also complete two group peer-mentoring sessions at their school (one per term) in which they will discuss implementation with members of their school physical education staff. In the booster period (3 months), teachers will complete a half-day workshop at their school, plus one online implementation task, and a group mentoring session at their school. Throughout the entire intervention period (main intervention plus booster period), teachers will have access to online resources. Data collection will include baseline, post-intervention (7-8 months after baseline) and maintenance phase (14-15 months after baseline) assessments. Research assistants blinded to group allocation will collect all data. The primary outcome will be the proportion of physical education lesson time that students spend in MVPA. Secondary outcomes will include leisure-time physical activity, subjective well-being, and motivation towards physical activity.
DISCUSSION: The provision of an online training platform for teachers could help facilitate more widespread dissemination of evidence-based interventions compared with programs that rely exclusively on face-to-face training.

The impact of a tax on sugar-sweetened beverages according to socio-economic position: a systematic review of the evidence

OBJECTIVE: A tax on sugar-sweetened beverages (SSB) has been proposed to address population weight gain but the effect across socio-economic position (SEP) is unclear. The current study aimed to clarify the differential impact(s) of SSB taxes on beverage purchases and consumption, weight outcomes and the amount paid in SSB taxes according to SEP.

DESIGN: Databases (OVID and EMBASE) and grey literature were systematically searched in June 2015 to identify studies that examined effects of an SSB price increase on beverage purchases or consumption, weight outcomes or the amount paid in tax across SEP, within high-income countries.

RESULTS: Of the eleven included articles, three study types were identified: (i) those that examined the association between variation in SSB taxes and SSB consumption and/or body weight (n 3); (ii) price elasticity estimation of SSB demand (n 1); and (iii) modelling of hypothetical SSB taxes by combining price elasticity estimates with population SEP-specific beverage consumption, energy intake or body weight (n 7). Few studies statistically tested differences in outcomes between SEP groups. Nevertheless, of the seven studies that reported on changes in weight outcomes for the total population following an increase in SSB price, all reported either similar reductions in weight across SEP groups or greater reductions for lower compared with higher SEP groups. All studies that examined the average household amount paid in tax (n 5) reported that an SSB tax would be regressive, but with small differences between higher- and lower-income households (0·10-1·0 % and 0·03 %-0·60 % of annual household income paid in SSB tax for low- and high-income households, respectively).

CONCLUSIONS: Based on the available evidence, a tax on SSB will deliver similar population weight benefits across socio-economic strata or greater benefits for lower SEP groups. An SSB tax is shown to be consistently financially regressive, but to a small degree.

Street vendors in Patna, India: understanding the socio-economic profile, livelihood and hygiene practices

Street food vending is fundamental to daily life in many low and middle income countries where much of the urban population rely on food provided by street vendors. While street vendors are known to be important providers of food; limited research has investigated vendor's hygiene practices and their socioeconomic circumstances in India. The aims of this study were to investigate the hygienic practices of food vendors and the context of their socioeconomic and living circumstances. Structured interviews were conducted with 31 street food vendors in Patna, India. The interviews explored issues around vending, hygiene practices, planning, and financial stability. Findings from this study indicate that food vendors are aware of good basic hygiene practices despite having low levels of literacy, low incomes, and limited job security.

The importance of broadband for socio-economic development: a perspective from rural Australia

Advanced connectivity offers rural communities prospects for socio-economic development. Despite Australia’s national broadband infrastructure plans, inferior availability and quality of rural Internet connections remain persistent issues. This article examines the impact of limited connectivity on rural socio-economic opportunities, drawing from the views of twelve citizens from the Boorowa local government area in New South Wales. The available fixed wireless and satellite connections in Boorowa are slow and unreliable, and remote regions in the municipality are still without any Internet access. Participants identified four key areas in their everyday lives that are impacted by insufficient connectivity: business development, education, emergency communication, and health. Rural citizens often already face challenges in these areas, and infrastructure advancements in urban spaces can exacerbate rural-urban disparities. Participants’ comments demonstrated apprehension that failure to improve connectivity would result in adverse long-term consequences for the municipality. This article suggests that current broadband policy frameworks require strategic adaptations to account for the socio-economic and geographic contexts of rural communities. In order to narrow Australia’s rural-urban digital divide, infrastructure developments should be prioritised in the most underserved regions.

Developing an approach to assess the influence of integrating disaster risk reduction practices into infrastructure reconstruction on socio-economic development

Purpose: Disasters provide physical, social, economic, political and environmental development windows of opportunity particularly through housing and infrastructure reconstruction. The reconstruction process should not be neglected due to the opportunistic nature of facilitating innovation in development. In this respect, post-disaster "infrastructure" reconstruction plays a critical role in development discourse and is often essential to sustain recovery after major disasters. However, reconstruction following a natural disaster is a complicated problem involving social, economic, cultural, environmental, psychological, and technological aspects. There are significant development benefits of well-developed "Disaster Risk Reduction (DRR) Strategies" and, for many reasons, the concept of DRR can be more easily promoted following a disaster. In this respect, a research study was conducted to investigate the effects of integrating DRR strategies into infrastructure reconstruction on enhancing the socio-economic development process from a qualitative stance. The purpose of this paper is to document part of this research study; it proposes an approach that can be used to assess the influence of the application of the DRR concept into infrastructure reconstruction on socio-economic development. Design/methodology/approach: The research methodology included a critical literature review. Findings: This paper suggests that the best way to assess the influence of integrating DRR strategies practices into infrastructure reconstruction on socio-economic development is to assess the level of impact that DRR strategies has on overcoming various factors that form vulnerabilities. Having assessed this, the next step is to assess the influence of overcoming the factors that form vulnerabilities on achieving performance targets of socio-economic development. Originality/value: This paper primarily presents a framework for the concept of socio-economic development and a modelled classification of DRR practices.

Prioritising and tackling socio-economic inequalities in obesity

This article discusses some of the recent trends in obesity and demonstrates why deeper consideration of differences in trends and intervention effectiveness across socioeconomicgroups is critical.

Development of a condition-specific measure of quality of life for children with cerebral palsy: empirical thematic data reported by parents and children

Background: Although there is increasing recognition that quality of life (QOL) and health-related quality of life (HRQOL) are important outcome variables in clinical trials for children with cerebral palsy, there are substantial limitations in existing measures of QOL. This study identify themes of QOL for children with cerebral palsy and their parents to guide the development of a new condition-specific QOL scale. Methods: A qualitative study of parent and child views on QOL composition was conducted, using a grounded theory framework. Families participated in semistructured interviews on QOL until thematic saturation was reached (n = 28 families). Results: Overall, 13 themes emerged from the interviews: physical health, body pain and discomfort, daily living tasks, participation in regular physical and social activities, emotional well-being and self-esteem, interaction with the community, communication, family health, supportive physical environment, future QOL, provision of, and access to services, financial stability, and social well-being. Conclusions: Research with parents and children with cerebral palsy, representative of severity across the disease spectrum and socio-economic status, reinforced and expanded on the traditional themes that have underpinned QOL measurement development. This has implications not only for the development of a new QOL scale for children with cerebral palsy, but also for clinical interventions and community care management.