Small area influences on the individual unhealthy lifestyle behaviors: A multilevel analysis of discriminatory accuracy

Galán, Iñaki; Rodríguez‐Blázquez, Carmen; Simón, Lorena; Ortíz, Cristina; Merlo, Juan

doi:10.1016/j.healthplace.2021.102506

Cited by 5 publications

(4 citation statements)

References 58 publications

(95 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Compared to Spanish urban areas, rural areas exhibit similar levels of smoking and leisure-time sedentarism, higher prevalence of high-risk alcohol consumption, while reporting a more balanced diet. This distribution would explain the small impact of adjusting for lifestyle variables on the risk estimates ( Galán et al, 2021 ). Similarly, no changes were observed when the model included the use of health services.…”

Section: Discussionmentioning

confidence: 99%

Rural-urban gradients and all-cause, cardiovascular and cancer mortality in Spain using individual data

Ayuso-Álvarez

Ortíz²,

López-Cuadrado³

et al. 2022

SSM - Population Health

Self Cite

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Rural-urban gradients and all-cause, cardiovascular and cancer mortality in Spain using individual data

Ayuso-Álvarez

Ortíz²,

López-Cuadrado³

et al. 2022

SSM - Population Health

Self Cite

View full text Add to dashboard Cite

“…A few existing studies 12,13 on between-areas variation in process quality have relied on single-level analysis, such as national or state levels, which may conceal inequalities at lower levels. Previous studies [14][15][16][17][18][19][20][21] have, however, shed light on small area variation within districts in other indicators, such as undernutrition and low birth weight in India, emphasizing the importance of more precise targeting of interventions.…”

Section: Introductionmentioning

confidence: 99%

Small Area Variation in the Quality of Maternal and Newborn Care in India

et al. 2022

View full text Add to dashboard Cite

ImportanceIn India, the district serves as the primary policy unit for implementing and allocating resources for various programs aimed at improving key developmental and health indicators. Recent evidence highlights that high-quality care for mothers and newborns is critical to reduce preventable mortality. However, the geographic variation in maternal and newborn health service quality has never been investigated.ObjectiveTo examine the variation between smaller areas within districts in the quality of maternal and newborn care in India.Design, Setting, and ParticipantsThis cross-sectional study assessed data from women aged 15 to 49 years on the most recent birth (singleton or multiples) in the 5 years that preceded the fifth National Family Health Survey (June 17, 2019, to April 30, 2021).ExposuresMaternal and newborn care in 36 states and union territories (UTs), 707 districts, and 28 113 clusters (small areas) in India.Main Outcomes and MeasuresThe composite quality score of maternal and newborn care was defined as the proportion of components of care received of the total 11 essential components of antenatal and postnatal care. Four-level logistic and linear regression was used for analyses of individual components of care and composite score, respectively. Precision-weighted prevalence of each component of care and mean composite score across districts as well as their between–small area SD were calculated.ResultsThe final analytic sample for the composite score was composed of 123 257 births nested in 28 113 small areas, 707 districts, and 36 states/UTs. For the composite score, 58.3% of the total geographic variance was attributable to small areas, 29.3% to states and UTs, and 12.4% to districts. Of 11 individual components of care, the small areas accounted for the largest proportion of geographic variation for 6 individual components of care (ranging from 42.3% for blood pressure taken to 73.0% for tetanus injection), and the state/UT was the largest contributor for 4 components of care (ranging from 41.7% for being weighed to 52.3% for ultrasound test taken). District-level composite score and prevalence of individual care components and their variation across small areas within the districts showed a consistently strong negative correlation (Spearman rank correlation ρ = −0.981 to −0.886). Low-quality scores and large between–small area disparities were not necessarily concentrated in aspirational districts (mean district composite score [SD within districts], 92.7% [2.1%] among aspirational districts and 93.7% [1.8%] among nonaspirational districts).Conclusions and RelevanceThe findings of this cross-sectional study suggest that the policy around maternal and child health care needs to be designed more precisely to consider district mean and between–small area heterogeneity in India. This study may have implications for other low- and middle-income countries seeking to improve maternal and newborn outcomes, particularly for large countries with geographic heterogeneity.

show abstract

“…Poor physical and social environment aspects (home or school environments and their surroundings) are often topics of interest for experts in relation to health-risk behaviours of adolescents (Jang & Johnson, 2001;Duncan, 2002;Galán et al, 2021). Addiction research confirms that early and intensive addictive substance abuse by adolescents leads to numerous physical, social and mental problems, not only during the adolescence but also later in the adulthood (Newcomb, 1997).…”

Section: Introductionmentioning

confidence: 99%

The influence of home and school environments on alcoholic beverages, tobacco and marijuana consumption by adolescents in Prague and Brno

Honsnejmanová¹,

Jarolímek²

2021

Geographica Pannonica

View full text Add to dashboard Cite

Excessive use of alcoholic beverages, tobacco or marijuana is problematic not only for adults, but in some countries, it is a significant problem for children. However, the reasons for differences in children's risk behavior, as well as the reasons for risk behavior itself, are not yet fully understood. In this article we focused on the association between the quality of the school and home environment (and their surroundings) as perceived by children themselves and their risk behavior in relation to the use of selected substances. We worked with group of 343 9th grade primary school pupils in different types of neighborhoods. The results of our research show that at least some aspects of the quality of the physical environment have an impact on children's risk behavior.

show abstract

Small area influences on the individual unhealthy lifestyle behaviors: A multilevel analysis of discriminatory accuracy

Cited by 5 publications

References 58 publications

Rural-urban gradients and all-cause, cardiovascular and cancer mortality in Spain using individual data

Rural-urban gradients and all-cause, cardiovascular and cancer mortality in Spain using individual data

Small Area Variation in the Quality of Maternal and Newborn Care in India

The influence of home and school environments on alcoholic beverages, tobacco and marijuana consumption by adolescents in Prague and Brno

Contact Info

Product

Resources

About