The influence of neighbourhood formality status and socio-economic position on self-rated health among adult men and women: a multilevel, cross sectional, population study from Aleppo, Syria

Background There is substantial evidence from high income countries that neighbourhoods have an influence on health independent of individual characteristics. However, neighbourhood characteristics are rarely taken into account in the analysis of urban health studies from developing countries. Informal urban neighbourhoods are home to about half of the population in Aleppo, the second largest city in Syria (population>2.5 million). This study aimed to examine the influence of neighbourhood socioeconomic status (SES) and formality status on self-rated health (SRH) of adult men and women residing in formal and informal urban neighbourhoods in Aleppo. Methods The study used data from 2038 survey respondents to the Aleppo Household Survey, 2004 (age 18–65 years, 54.8% women, response rate 86%). Respondents were nested in 45 neighbourhoods. Five individual-level SES measures, namely education, employment, car ownership, item ownership and household density, were aggregated to the level of neighbourhood. Multilevel regression models were used to investigate associations. Results We did not find evidence of important SRH variation between neighbourhoods. Neighbourhood average of household item ownership was associated with a greater likelihood of reporting excellent SRH in women; odds ratio (OR) for an increase of one item on average was 2.3 (95% CI 1.3-4.4 (versus poor SRH)) and 1.7 (95% CI 1.1-2.5 (versus normal SRH)), adjusted for individual characteristics and neighbourhood formality. After controlling for individual and neighbourhood SES measures, women living in informal neighbourhoods were less likely to report poor SRH than women living in formal neighbourhoods (OR= 0.4; 95% CI (0.2- 0.8) (versus poor SRH) and OR=0.5; 95%; CI (0.3-0.9) (versus normal SRH). Conclusions Findings support evidence from high income countries that certain characteristic of neighbourhoods affect men and women in different ways. Further research from similar urban settings in developing countries is needed to understand the mechanisms by which informal neighbourhoods influence women’s health.

Icelandic occupational therapists' attitudes toward educational and professional issues

The entire population of Icelandic occupational therapists were surveyed concerning characteristics and attitudes toward professionalism and educational goals. There were 87 questionnaires sent out and 80 (92%) were returned and used for analysis. This data will have a positive impact upon the development of the first Icelandic occupational therapy curriculum. Icelandic occupational therapists, in general, value academic skills over technical skills, are active in their association, willing to take on duties for the advancement of the profession and are interested in conducting research. The attitudes of the Icelandic occupational therapists were generally quite uniform. T- tests and one-way ANOVAs (p < .05) revealed some significant differences in a number of attitudes by education level, length of professional experience and country of education. The results show the importance of providing Icelandic occupational therapy practitioners with the opportunity to take part in research. This study will serve as a foundation for future studies on Icelandic occupational therapists and provide reference data for later comparison.