Explaining sleep duration in adolescents: The impact of socio-demographic and lifestyle factors and working status

Previous studies found students who both work and attend school undergo a partial sleep deprivation that accumulates across the week. The aim of the present study was to obtain information using a questionnaire on a number of variables (e.g., socio-demographics, lifestyle, work timing, and sleep-wake habits) considered to impact on sleep duration of working (n = 51) and non-working (n = 41) high-school students aged 14-21 yrs old attending evening classes (19:00-22:30h) at a public school in the city of Sao Paulo, Brazil. Data were collected for working days and days off. Multiple linear regression analyses were performed to assess the factors associated with sleep duration on weekdays and weekends. Work, sex, age, smoking, consumption of alcohol and caffeine, and physical activity were considered control variables. Significant predictors of sleep duration were: work (p < 0.01), daily work duration (8-10h/day; p < 0.01), sex (p = 0.04), age 18-21 yrs (0.01), smoking (p = 0.02) and drinking habits (p = 0.03), irregular physical exercise (p < 0.01), ease of falling asleep (p = 0.04), and the sleep-wake cycle variables of napping (p < 0.01), nocturnal awakenings (p < 0.01), and mid-sleep regularity (p < 0.01). The results confirm the hypotheses that young students who work and attend school showed a reduction in night-time sleep duration. Sleep deprivation across the week, particularly in students working 8-10h/day, is manifested through a sleep rebound (i.e., extended sleep duration) on Saturdays. However, the different roles played by socio-demographic and lifestyle variables have proven to be factors that intervene with nocturnal sleep duration. The variables related to the sleep-wake cyclenaps and night awakeningsproved to be associated with a slight reduction in night-time sleep, while regularity in sleep and wake-up schedules was shown to be associated with more extended sleep duration, with a distinct expression along the week and the weekend. Having to attend school and work, coupled with other socio-demographic and lifestyle factors, creates an unfavorable scenario for satisfactory sleep duration.

A multilevel study of area socio-economic status and food purchasing behaviour

Objective: This study examined the association between area socioeconomic status (SES) and food purchasing behaviour.----- Setting: Melbourne city, Australia, 2003.----- Participants: Residents of 2,564 households located in 50 small areas.----- Design: Data were collected by mail survey (64.2% response rate). Area SES was indicated by the proportion of households in each area earning less than Aus$400 per week, and individual-level socioeconomic position was measured using education, occupation, and household income. Food purchasing was measured on the basis of compliance with dietary guideline recommendations (for grocery foods) and variety of fruit and vegetable purchase. Multilevel regression examined the association between area SES and food purchase after adjustment for individual-level demographic (age, sex, household composition) and socioeconomic factors.----- Results: Residents of low SES areas were significantly less likely than their counterparts in advantaged areas to purchase grocery foods that were high in fibre and low in fat, salt, and sugar; and they purchased a smaller variety of fruits. There was no evidence of an association between area SES and vegetable variety.----- Conclusions In Melbourne, area SES was associated with some food purchasing behaviours independent of individual-level factors, suggesting that areas in this city may be differentiated on the basis of food availability, accessibility, and affordability, making the purchase of some types of foods more difficult in disadvantaged areas.

Is the association between temperature and mortality modified by age, gender and socio-economic status?

Background: A number of studies have examined the relationship between high ambient temperature and mortality. Recently, concern has arisen about whether this relationship is modified by socio-demographic factors. However, data for this type of study is relatively scarce in subtropical/tropical regions where people are well accustomed to warm temperatures. Objective: To investigate whether the relationship between daily mean temperature and daily all-cause mortality is modified by age, gender and socio-economic status (SES) in Brisbane, Australia. Methods: We obtained daily mean temperature and all-cause mortality data for Brisbane, Australia during 1996–2004. A generalised additive model was fitted to assess the percentage increase in all deaths with every one degree increment above the threshold temperature. Different age, gender and SES groups were included in the model as categorical variables and their modification effects were estimated separately. Results: A total of 53,316 non-external deaths were included during the study period. There was a clear increasing trend in the harmful effect of high temperature on mortality with age. The effect estimate among women was more than 20 times that among men. We did not find an SES effect on the percent increase associated with temperature. Conclusions: The effects of high temperature on all deaths were modified by age and gender but not by SES in Brisbane, Australia.

Parent's socio-economic status and social support as risks for child mortality : consideration of health equity in The Gambia

A matched case-control study of mortality to children under age five was conducted to consider associations with parents' socio-economic status and social support in the Farafenni Demographic Surveillance Site (DSS). Cases and controls were selected from Farafenni DSS, matched on date of birth, and parents were interviewed about personal resources and social networks. Parents with the lowest personal socio-economic status and social support were identified. Multivariate multinomial regression was used to consider whether the children of these parents were at increased risk of either infant or 1-4 mortality, in separate models using either parents' characteristics. There was no benefit found for higher SES or better social support with respect to child mortality. Children of fathers who had the poorest social support had lower 1-4 mortality risk (OR=0.52, p=0.037). Given that socio-economic status was not associated with child mortality, it seems unlikely that the explanation for the link between father's social support and mortality is linked to resource availability. Explanations for the risk effect of father's social ties may lie in decision-making around health maintenance and health care for children.

Socio-economic status and malaria-related outcomes in Mvomero District, Tanzania.

While policies often target malaria prevention and treatment - proximal causes of malaria and related health outcomes - too little attention has been given to the role of household- and individual-level socio-economic status (SES) as a fundamental cause of disease risk in developing countries. This paper presents a conceptual model outlining ways in which SES may influence malaria-related outcomes. Building on this conceptual model, we use household data from rural Mvomero, Tanzania, to examine empirical relationships among multiple measures of household and individual SES and demographics, on the one hand, and malaria prevention, illness, and diagnosis and treatment behaviours, on the other. We find that access to prevention and treatment is significantly associated with indicators of households' wealth; education-based disparities do not emerge in this context. Meanwhile, reported malaria illness shows a stronger association with demographic variables than with SES (controlling for prevention). Greater understanding of the mechanisms through which SES and malaria policies interact to influence disease risk can help to reduce health disparities and reduce the malaria burden in an equitable manner.

Socio-demographic factors, smoking, symptoms, morbidities and pulmonary function and quality of life in individuals with a heavy smoking history

Objective: To determine which socio-demographic, exposure, morbidity and symptom variables are associated with health-related quality of life among former and current heavy smokers. Methods: Cross sectional data from 2537 participants were studied. All participants were at ≥2% risk of developing lung cancer within 6 years. Linear and logistic regression models utilizing a multivariable fractional polynomial selection process identified variables associated with health-related quality of life, measured by the EQ-5D. Results: Upstream and downstream associations between smoking cessation and higher health-related quality of life were evident. Significant upstream associations, such as education level and current working status and were explained by the addition of morbidities and symptoms to regression models. Having arthritis, decreased forced expiratory volume in one second, fatigue, poor appetite or dyspnea were most highly and commonly associated with decreased HRQoL. Discussion: Upstream factors such as educational attainment, employment status and smoking cessation should be targeted to prevent decreased health-related quality of life. Practitioners should focus treatment on downstream factors, especially symptoms, to improve health-related quality of life.

The measurement of socio-economic status: investigation of gender-and age-specific indicators in Australia: national health survey 1995

Objective: To investigate thecorrelations between age- and gender-specificmeasures of socio-economic status versus healthstatus as measured by the SF-36.

Design: Population based study.

Participants: 38187 people aged between18 to 79 years who participated in the NationalHealth Survey in 1995.

Results: Factor analysis producedconsistent results that were interpreted interms of five conceptually meaningful domains(employment, housing, migration, family unitand education). The relative rank of thefactors differs between groups and in somecases factor composition requires items to beadded or deleted from the conceptual domains.

Conclusions: Age- and gender-specific SESscores based on these factors had strongerassociations with the physical and mentalcomponents of SF-36 than either an area basedindex or scores derived from males aged 40–44years. Overall the results supported thehypothesis that SES measures composed of socialand demographic items exhibit important age-and gender-specific differences which arerelevant for health.

Socio-demographic characteristics of children experiencing socioeconomic disadvantage who meet physical activity and screen-time recommendations : the READI study

Objective - To identify socio-demographic characteristics of children from socioeconomically disadvantaged neighbourhoods who meet physical activity and screen recommendations.
Method - Children aged 5–12 years (n = 373; 45% boys) were recruited in 2007 from socioeconomically disadvantaged urban and rural areas of Victoria, Australia. Children's physical activity, height and weight were objectively measured. Mothers reported their highest level of education, and proxy-reported their child's usual screen-time. Odds ratios (OR) and 95% confidence intervals (95% CI) examined odds of meeting physical activity (> 60 minutes/day) and screen (≤ 120 minutes/day) recommendations according to socio-demographic characteristics.
Results - Approximately 84% of children met physical activity and 43% met screen recommendations. Age was inversely associated with odds of meeting physical activity and screen recommendations, and overweight/obese status was associated with lower odds of meeting screen recommendations (boys: OR = 0.39, 95%CI = 0.16–0.95; girls: OR = 0.47, 95%CI = 0.26–0.83). Among boys, living in a rural area was positively associated with meeting screen recommendations (OR = 3.08, 95%CI = 1.42–6.64). Among girls, high levels of maternal education were positively associated with meeting screen recommendations (OR = 2.76, 95%CI = 1.33–5.75).
Conclusion - Specific socio-demographic characteristics were associated with odds of meeting physical activity and screen recommendations. Identifying factors associated with such ‘resilience’ among this group may provide important learnings to inform future physical activity promotion initiatives.

Family support and ease of access link socio-economic status and sports club membership in adolescent girls : a mediation study

Background Much research has been conducted into the determinants of physical activity (PA) participation among adolescent girls. However, the more specific question of what are the determinants of particular forms of PA participation, such as the link between participation through a sports club, has not been investigated. Accordingly, the aim of this study was to investigate the relationships between participation in a sports club and socio-economic status (SES), access to facilities, and family and peer support, for female adolescents.

Methods A survey of 732 female adolescent school students (521 metropolitan, 211 non-metropolitan; 489 Year 7, 243 Year 11) was conducted. The survey included demographic information (living arrangements, ethnicity indicators, and indicators of SES such as parental education and employment status and locality); access to facilities; and family and peer support (travel, encouragement, watching, praise, joint participation). For each characteristic, sports club participants and non-participants were compared using chi-square tests. Multiple mediation analyses were used to investigate the role of access, family and peer support in the link between SES and sport participation.

Results There were significant associations (p<0.05) between sports club participation and: all demographic characteristics; all measures of family and peer support; and access to sport-related facilities. Highest levels of participation were associated with monolingual Australian-born families, with two parents, at least one of whom was well-educated, with both parents employed, and high levels of parental assistance, engagement and support. Participation in club sport among both younger and older adolescent girls was significantly positively associated with the SES of both their neighbourhoods and their households, particularly in metropolitan areas. These associations were most strongly mediated by family support and by access to facilities.

Conclusions To facilitate and promote greater participation in club sport among adolescent girls from low SES neighbourhoods and households, strategies should target modifiable determinants such as facility access and parental support. This will involve improving access to sports facilities and promoting, encouraging and assisting parents to provide support for their daughters’ participation in sport clubs.

Socio-demographic and work setting correlates of poor mental health in a population sample of working Victorians: application in evidence-based intervention priority setting

Interventions to promote mental health in the workplace are rapidly gaining acceptability as a means to prevent, screen, treat and effectively manage the growing disease burden of depression and anxiety among working people. The objective of this study was to identify socio-demographic and work setting correlates of poor mental health to consider alongside other evidence in priority setting for workplace mental health promotion (MHP). Multiple logistic regression was used to model the probability of poor mental health (SF-12) in relation to socio-demographic (gender, age, education, marital status and occupational skill level) and employment factors (workplace size and type, industrial sector, employment arrangement and working hours) in a population-based cross-sectional survey of 1051 working Victorians. As a result, poor mental health was (21% prevalence overall) higher in working females than in males and decreased with increasing age. Only one employment factor was significant in demographically adjusted multivariate analyses, showing an increase in the odds of poor mental health with increasing working hours. It is concluded that based on the prevalence of poor mental health, Victorian work settings with high proportions of younger workers, and younger working women in particular, should be prioritized for workplace MHP. Thus, together with other research demonstrating particularly poor psychosocial working conditions for young working women, sectors with an over-representation of this group (e.g. service sector) could be prioritized for workplace MHP alongside young and blue-collar males (also a priority due to low mental healthcare service use).

Instrumental activities of daily living performance in healthy and cognitively intact seniors from a Brazilian sample and its relation to age and other socio-demographic variables

Background: Studies on functional capacity in community-dwelling older people have shown associations between declines in instrumental activities of daily living (IADL) and several factors. Among these, age has been the most consistently related to functional capacity independent of other variables. We aimed at evaluating the performance of a sample of healthy and cognitively intact Brazilian older people on activities of daily living and to analyze its relation to social-demographic variables. Methods: We conducted a secondary analysis of data collected for previous epidemiological studies with community-dwelling subjects aged 60 years or more. We selected subjects who did not have dementia or depression, and with no history of neurological diseases, heart attack, HIV, hepatitis or arthritis (n = 1,111). Functional capacity was assessed using the Brazilian version of the Older American Resources and Services Questionnaire (BOMFAQ). ADL performance was analyzed according to age, gender, education, and marital status (Pearson's chi(2), logistic regression). Results: IADL difficulties were present in our sample, especially in subjects aged 80 years or more, with lower levels of education, or widowed. The logistic regression analysis results indicated that "higher age" and "lower education" (p <= 0.001) remained significantly associated with IADL difficulty. Conclusions: Functional decline was present in older subjects even in the absence of medical conditions and cognitive impairment. Clinicians and researchers could benefit from knowing what to expect from older people regarding IADL performance in the absence of medical conditions.

Relationship between religiosity, religious coping and socio-demographic variables among out-patients with depression or diabetes mellitus in Enugu, Nigeria.

Background: Religion is a powerful coping strategy. Diabetes and depression are common conditions in our environment that induce psychological distress, thus requiring coping for better outcome. Studies indicate that increased religiosity is associated with better outcome in clinical and general populations. Therefore, studies of the distribution of religiosity and religious coping among these populations are essential to improve outcome. Objectives: To assess the association between religiosity, religious coping in depression and diabetes mellitus, and selected sociodemographic variables (age, gender and occupational status). Methods:Using simple random sampling we recruited 112 participants with diabetes and an equal number with depression consecutively, matching for gender. Religiosity was determined using religious orientation scale (revised), religious coping with brief religious coping scale and socio-demographic variables with a socio-demographic questionnaire. Results: Intrinsic religiosity was greater among older people with depression than among older people with diabetes(t=5.02,p<0.001); no significant difference among young people with depression and diabetes(t=1.47,p=0.15).Positive religious coping was greater among older people with depression than among older people with diabetes(t=2.31,p=0.02); no difference among young people with depression and diabetes(t=0.80,p=0.43). Females with depression had higher intrinsic religiosity scores than males with depression(t=3.85,p<0.001); no difference in intrinsic religiosity between females and males with diabetes(t=0.99,p=0.32).Positive religious coping was greater among participants with diabetes in the low occupational status(t=2.96,p<0.001) than those in the high occupational status. Conclusion: Religion is indeed a reliable coping method, most commonly used by the elderly and females with depression. Positive religious coping is more common among diabetic patients who are in the low occupational status.

Examination of social demographic status, disease status, health behaviours and quality of life in older Australians using the theory of planned behaviour model

The increase of life expectancy worldwide during the last three decades has increased age-related disability leading to the risk of loss of quality of life. How to improve quality of life including physical health and mental health for older people and optimize their life potential has become an important health issue. This study used the Theory of Planned Behaviour Model to examine factors influencing health behaviours, and the relationship with quality of life. A cross-sectional mailed survey of 1300 Australians over 50 years was conducted at the beginning of 2009, with 730 completed questionnaires returned (response rate 63%). Preliminary analysis reveals that physiological changes of old age, especially increasing waist circumference and co morbidity was closely related to health status, especially worse physical health summary score. Physical activity was the least adherent behaviour among the respondents compared to eating healthy food and taking medication regularly as prescribed. Increasing number of older people living alone with co morbidity of disease may be the barriers that influence their attitude and self control toward physical activity. A multidisciplinary and integrated approach including hospital and non hospital care is required to provide appropriate services and facilities toward older people.

Weekly activity-travel behaviour in rural Northern Ireland : differences by context and socio-demographic

Despite a wide variation in access to goods and services between rural areas, common policy interventions are often proposed in Northern Ireland. Questions remain as to the level and form of policy differentiation that is required, if any, both within and between different rural areas. This issue is investigated in this paper through the analysis of activity-travel patterns of individuals living in two rural areas with different levels of area accessibility and area mobility. Three focus groups, 299 questionnaires and 89 activity-travel diaries for 7 days were collected for individuals from these areas. Regression analyses were employed to explore the degree to which different factors influence activity travel behaviour. The results indicate that individuals from rural areas with a higher level of accessibility are more integrated within their local community and as a result, are potentially less at risk of being excluded from society due to immobility. Differences, however, were also found between different groups within an area (e.g. non-car owning individuals who were more reliant on walking, and low-income individuals who made trips of a shorter distance). Based on the study findings and a review of existing policies, this research highlights the need to tailor policy responses to reflect the particular sets of circumstances exhibited in different areas.