Equity-Specific Effects of 26 Dutch Obesity-Related Lifestyle Interventions

Magnée, Tessa; Burdorf, Alex; Brug, Johannes; Kremers, Stef; Oenema, Anke; Assema, Patricia van; Ezendam, Nicole P. M.; Genugten, Lenneke van; Hendriksen, Ingrid J.M.; Hopman-Rock, M.; Jansen, Wilma; Jong, Johan de; Kocken, P.L.; Kroeze, Willemieke; Kwak, Lydia; Lechner, Lilian; Nooijer, Jascha de; Poppel, Mireille N. M. van; Robroek, Suzan J W; Schreurs, Hanneke; Sluijs, Esther M. F. van; Steenhuis, I.H.M.; Stralen, Maartje M. van; Tak, Nannah I; Velde, Saskia J. te; Vermeer, Willemijn M.; Wammes, Birgitte; Wier, Matthew; Lenthe, Frank J. van

doi:10.1016/j.amepre.2012.11.041

Cited by 66 publications

(98 citation statements)

References 56 publications

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“…For the very old, the northwest southeast divide is much less apparent and the relationship with deprivation disappears for LE though is still present for DFLE as is the greater gains in less-deprived areas. That gains in LE and DFLE at birth are greater in less-deprived quintiles might result from public health interventions being more successful for the affluent and healthier population or less effective for people in lower socioeconomic status,25 26 but, as our analysis is at an area level, migration (eg, healthier people moving to already ‘healthier areas’) may also have an effect 27…”

Section: Discussionmentioning

confidence: 98%

Drivers of inequality in disability-free expectancy at birth and age 85 across space and time in Great Britain

Wohland

Rees

Gillies

et al. 2014

J Epidemiol Community Health

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BackgroundAlthough mortality and health inequalities at birth have increased both geographically and in socioeconomic terms, little is known about inequalities at age 85, the fastest growing sector of the population in Great Britain (GB).AimTo determine whether trends and drivers of inequalities in life expectancy (LE) and disability-free life expectancy (DFLE) at age 85 between 1991 and 2001 are the same as those at birth.MethodsDFLE at birth and age 85 for 1991 and 2001 by gender were calculated for each local authority in GB using the Sullivan method. Regression modelling was used to identify area characteristics (rurality, deprivation, social class composition, ethnicity, unemployment, retirement migration) that could explain inequalities in LE and DFLE.ResultsSimilar to values at birth, LE and DFLE at age 85 both increased between 1991 and 2001 (though DFLE increased less than LE) and gaps across local areas widened (and more for DFLE than LE). The significantly greater increases in LE and DFLE at birth for less-deprived compared with more-deprived areas were still partly present at age 85. Considering all factors, inequalities in DFLE at birth were largely driven by social class composition and unemployment rate, but these associations appear to be less influential at age 85.ConclusionsInequalities between areas in LE and DFLE at birth and age 85 have increased over time though factors explaining inequalities at birth (mainly social class and unemployment rates) appear less important for inequalities at age 85.

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Section: Discussionmentioning

confidence: 98%

Drivers of inequality in disability-free expectancy at birth and age 85 across space and time in Great Britain

Wohland

Rees

Gillies

et al. 2014

J Epidemiol Community Health

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“…This finding represents one example of an intervention that is successful at a population level, yet may potentially increase inequalities through disproportionately benefiting the least deprived adolescents. The fact that the intervention under evaluation was a downstream intervention, focusing on individual behaviour change, chimes with current thinking around intervention generated inequalities [15, 46]. However, this example should be treated as illustrative as it only presents one study and there was no evidence of subgroup difference between the low SES and high SES groups.…”

Section: Discussionmentioning

confidence: 99%

“…Researchers have cited similar difficulties in being able to find studies that conduct subgroup analyses, that measure socioeconomic variables at baseline or that are powered to detect differences by demographic groups [11, 15, 22, 46]. The TEENAGE project reanalysed interventions targeting any of four risk behaviours (smoking, diet, physical activity and alcohol) for differential effects by SES, but was limited by the small number of studies that collected demographic information [26, 47].…”

Section: Discussionmentioning

confidence: 99%

“…Post hoc subgroup analyses can be unreliable and misleading [48]; however, not performing them would be a lost opportunity in terms of investigating health inequalities [46]. Most of the studies were conducted in North America, which makes generalizability difficult due to the different ways SES affects health cross-nationally [11, 46], for instance with regard to the racialisation of inequality in North America [11]. Many of the interventions included in the Cochrane systematic reviews were at least 10 years old so it is possible that the collection and reporting of demographic variables to trace intervention generated inequalities is occurring in more contemporary studies not captured by these reviews.…”

Section: Discussionmentioning

confidence: 99%

“…Another limitation that has been cited in similar studies [46] is that all of the interventions re-analysed were ‘downstream’ interventions. Thus, we are unable to compare upstream and downstream interventions in their impact on health inequalities, which would be preferable as it has been hypothesized that ‘upstream interventions’ may be the most successful in reducing inequality [15].…”

Section: Discussionmentioning

confidence: 99%

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Examining subgroup effects by socioeconomic status of public health interventions targeting multiple risk behaviour in adolescence

et al. 2018

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BackgroundMultiple risk behaviour (MRB) refers to two or more risk behaviours such as smoking, drinking alcohol, poor diet and unsafe sex. Such behaviours are known to co-occur in adolescence. It is unknown whether MRB interventions are equally effective for young people of low and high socioeconomic status (SES). There is a need to examine these effects to determine whether MRB interventions have the potential to narrow or widen inequalities.MethodsTwo Cochrane systematic reviews that examined interventions to reduce adolescent MRB were screened to identify universal interventions that reported SES. Study authors were contacted, and outcome data stratified by SES and intervention status were requested. Risk behaviour outcomes alcohol use, smoking, drug use, unsafe sex, overweight/obesity, sedentarism, peer violence and dating violence were examined in random effects meta-analyses and subgroup analyses conducted to explore differences between high SES and low SES adolescents.ResultsOf 49 studies reporting universal interventions, only 16 also reported having measured SES. Of these 16 studies, four study authors provided data sufficient for subgroup analysis. There was no evidence of subgroup differences for any of the outcomes. For alcohol use, the direction of effect was the same for both the high SES group (RR 1.26, 95% CI: 0.96, 1.65, p = 0.09) and low SES group (RR 1.14, 95% CI: 0.98, 1.32, p = 0.08). The direction of effect was different for smoking behaviour in favour of the low SES group (RR 0.83, 95% CI: 0.66, 1.03, p = 0.09) versus the high SES group (RR 1.16, 95% CI: 0.82, 1.63, p = 0.39). For drug use, the direction of effect was the same for both the high SES group (RR 1.29, 95% CI: 0.97, 1.73, p = 0.08) and the low SES group (RR 1.28, 95% CI: 0.84, 1.96, p = 0.25).ConclusionsThe majority of studies identified did not report having measured SES. There was no evidence of subgroup difference for all outcomes analysed among the four included studies. There is a need for routine reporting of demographic information within studies so that stronger evidence of effect by SES can be demonstrated and that interventions can be evaluated for their impact on health inequalities.

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Exploring subgroup effects by socioeconomic position of three effective school-based dietary interventions: the European TEENAGE project

Lien

Haerens

Velde

et al. 2013

Int J Public Health

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Equity-Specific Effects of 26 Dutch Obesity-Related Lifestyle Interventions

Cited by 66 publications

References 56 publications

Drivers of inequality in disability-free expectancy at birth and age 85 across space and time in Great Britain

Drivers of inequality in disability-free expectancy at birth and age 85 across space and time in Great Britain

Examining subgroup effects by socioeconomic status of public health interventions targeting multiple risk behaviour in adolescence

Exploring subgroup effects by socioeconomic position of three effective school-based dietary interventions: the European TEENAGE project

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