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            "title": "Proportionate universalism in practice? A quasi-experimental study (GoWell) of a UK neighbourhood renewal programme's impact on health inequalities",
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                    "firstName": "Matt",
                    "lastName": "Egan"
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                    "creatorType": "author",
                    "firstName": "Srinivasa V.",
                    "lastName": "Katikireddi"
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            "abstractNote": "Recommendations to reduce health inequalities frequently emphasise improvements to socio-environmental determinants of health. Proponents of 'proportionate universalism' argue that such improvements should be allocated proportionally to population need. We tested whether city-wide investment in urban renewal in Glasgow (UK) was allocated to 'need' and whether this reduced health inequalities. We identified a longitudinal cohort (n = 1006) through data linkage across surveys conducted in 2006 and 2011 in 14 differentially disadvantaged neighbourhoods. Each neighbourhood received renewal investment during that time, allocated on the basis of housing need. We grouped neighbourhoods into those receiving 'higher', 'medium' or 'lower' levels of investment. We compared residents' self-reported physical and mental health between these three groups over time using the SF-12 version 2 instrument. Multiple linear regression adjusted for baseline gender, age, education, household structure, housing tenure, building type, country of birth and clustering. Areas receiving higher investment tended to be most disadvantaged in terms of baseline health, income deprivation and markers of social disadvantage. After five years, mean mental health scores improved in 'higher investment' areas relative to 'lower investment' areas (b = 4.26; 95% CI = 0.29, 8.22; P = 0.036). Similarly, mean physical health scores declined less in high investment compared to low investment areas (b = 3.86; 95% CI = 1.96, 5.76; P < 0.001). Relative improvements for medium investment (compared to lower investment) areas were not statistically significant. Findings suggest that investment in housing-led renewal was allocated according to population need and this led to modest reductions in area-based inequalities in health after five years. Study limitations include a risk of selection bias. This study demonstrates how non-health interventions can, and we believe should, be evaluated to better understand if and how health inequalities can be reduced through strategies of allocating investment in social determinants of health according to need.",
            "publicationTitle": "Social Science & Medicine (1982)",
            "publisher": "",
            "place": "",
            "date": "Mar 2016",
            "volume": "152",
            "issue": "",
            "section": "",
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            "partTitle": "",
            "pages": "41-49",
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                    "tag": "Cross-Sectional Studies",
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                    "tag": "Female",
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                    "tag": "Great Britain",
                    "type": 1
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            "title": "Is obesity at individual and national level associated with lower age at menarche? Evidence from 34 countries in the Health Behaviour in School-aged Children Study",
            "creators": [
                {
                    "creatorType": "author",
                    "firstName": "Candace",
                    "lastName": "Currie"
                },
                {
                    "creatorType": "author",
                    "firstName": "Naman",
                    "lastName": "Ahluwalia"
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                {
                    "creatorType": "author",
                    "firstName": "Emmanuelle",
                    "lastName": "Godeau"
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                    "creatorType": "author",
                    "firstName": "Saoirse",
                    "lastName": "Nic Gabhainn"
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                    "creatorType": "author",
                    "firstName": "Pernille",
                    "lastName": "Due"
                },
                {
                    "creatorType": "author",
                    "firstName": "Dorothy B.",
                    "lastName": "Currie"
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            ],
            "abstractNote": "PURPOSE: A unique standardized international data set from adolescent girls in 34 countries in Europe and North America participating in the Health Behaviour in School-aged Children Study (HBSC) is used to investigate the contribution of body mass index (BMI) at individual and country level to cross-national differences in age at menarche.\nMETHODS: Two independent nationally representative survey data sets from 15-year-olds (n = 27,878, in 34 countries, year = 2005/2006) and 11-year-olds (n = 18,101, in 29 countries, year = 2001/2002) were analyzed. The survey instrument is a self-report questionnaire. Median age at menarche and 95% confidence intervals (CIs) were estimated using Kaplan-Meier analysis. Hierarchical models were used to assess the relationship between BMI and age at menarche (months). \"Country-level obesity\" was measured by prevalence of overweight/obesity (%) in each country.\nRESULTS: Country-level median age at menarche ranged between 12 years and 5 months and 13 years and 5 months. Country-level prevalence of overweight among 15-year-old girls ranged from 4% to 28%. Age at menarche was inversely associated with individual BMI (unstandardized regression coefficient beta = -1.01; 95% CI, -1.09 to -.94) and country-level aggregate overweight at age 11 (unstandardized regression coefficient beta = -.25; 95% CI, -.43 to -.08). Individual- and country-level measures of BMI account for 40% of the country-level variance in age at menarche.\nCONCLUSIONS: The findings add to the evidence that obesity in childhood is a risk factor for early puberty in girls and accounts for much of the cross-national variation in age at menarche. Future HBSC surveys can track this relationship in the wake of the obesity \"epidemic.\"",
            "publicationTitle": "The Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine",
            "publisher": "",
            "place": "",
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            "volume": "50",
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            "pages": "621-626",
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                    "tag": "Body Mass Index",
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            "title": "Socioeconomic inequalities in adolescent health 2002-2010: a time-series analysis of 34 countries participating in the Health Behaviour in School-aged Children study",
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                    "creatorType": "author",
                    "firstName": "Frank J.",
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            "abstractNote": "BACKGROUND: Information about trends in adolescent health inequalities is scarce, especially at an international level. We examined secular trends in socioeconomic inequality in five domains of adolescent health and the association of socioeconomic inequality with national wealth and income inequality.\nMETHODS: We undertook a time-series analysis of data from the Health Behaviour in School-aged Children study, in which cross-sectional surveys were done in 34 North American and European countries in 2002, 2006, and 2010 (pooled n 492 788). We used individual data for socioeconomic status (Health Behaviour in School-aged Children Family Affluence Scale) and health (days of physical activity per week, body-mass index Z score [zBMI], frequency of psychological and physical symptoms on 0-5 scale, and life satisfaction scored 0-10 on the Cantril ladder) to examine trends in health and socioeconomic inequalities in health. We also investigated whether international differences in health and health inequalities were associated with per person income and income inequality.\nFINDINGS: From 2002 to 2010, average levels of physical activity (3·90 to 4·08 days per week; p<0·0001), body mass (zBMI -0·08 to 0·03; p<0·0001), and physical symptoms (3·06 to 3·20, p<0·0001), and life satisfaction (7·58 to 7·61; p=0·0034) slightly increased. Inequalities between socioeconomic groups increased in physical activity (-0·79 to -0·83 days per week difference between most and least affluent groups; p=0·0008), zBMI (0·15 to 0·18; p<0·0001), and psychological (0·58 to 0·67; p=0·0360) and physical (0·21 to 0·26; p=0·0018) symptoms. Only in life satisfaction did health inequality fall during this period (-0·98 to -0·95; p=0·0198). Internationally, the higher the per person income, the better and more equal health was in terms of physical activity (0·06 days per SD increase in income; p<0·0001), psychological symptoms (-0·09; p<0·0001), and life satisfaction (0·08; p<0·0001). However, higher income inequality uniquely related to fewer days of physical activity (-0·05 days; p=0·0295), higher zBMI (0·06; p<0·0001), more psychological (0·18; p<0·0001) and physical (0·16; p<0·0001) symptoms, and larger health inequalities between socioeconomic groups in psychological (0·13; p=0·0080) and physical (0·07; p=0·0022) symptoms, and life satisfaction (-0·10; p=0·0092).\nINTERPRETATION: Socioeconomic inequality has increased in many domains of adolescent health. These trends coincide with unequal distribution of income between rich and poor people. Widening gaps in adolescent health could predict future inequalities in adult health and need urgent policy action.\nFUNDING: Canadian Institutes of Health Research.",
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                    "lastName": "Moor"
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            "version": 15,
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                    "firstName": "Ngaire",
                    "lastName": "Coombs"
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            "abstractNote": "BACKGROUND: Sedentary behaviour is an emerging cardiometabolic risk factor in young people. Little is known about how socioeconomic position (SEP) and sedentary behaviour are associated in children and adolescents. This study examines associations between SEP and sedentary behaviour in school-age children and adolescents.\nMETHODS: The core sample comprised 3822 Health Survey for England 2008 participants aged 5-15 years with complete information on SEP (household income, head of household occupational social class and area deprivation) and self-reported sedentary time (television viewing and other sitting during non-school times). Accelerometer-measured total sedentary time was measured in a subsample (N=587). We examined multivariable associations between SEP (including a composite SEP score) and sedentary time using generalised linear models, adjusting for age, sex, body mass index, physical activity, accelerometer wear time and mutually adjusting for the other SEP indicators.\nRESULTS: Participants in the highest SEP category spent 16 min/day less (95% CI 6 to 25, p=0.003) watching TV than participants in the lowest SEP category; yet they spent 7 (2 to 16, p=0.010) and 17 (5 to 29, p<0.000) min/day more in non-TV sitting and total (accelerometry-measured) sedentary time, respectively. Associations across individual SEP components varied in strength. Area deprivation was not associated with sedentary time.\nCONCLUSIONS: Low SEP is linked with higher television times but with lower total (accelerometer-measured) sedentary time, and non-TV sitting during non-school time in children and adolescents. Associations between sedentary time and SEP differ by type of sedentary behaviour. TV viewing is not a good proxy for total sedentary time in children.",
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            "title": "Trends in physical activity and sedentary behaviour in adolescence: ethnic and socioeconomic differences",
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                    "firstName": "Naomi Henning",
                    "lastName": "Brodersen"
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                    "lastName": "Steptoe"
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                    "firstName": "David R",
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            "abstractNote": "Objective\nTo assess developmental trends in physical activity and sedentary behaviour in British adolescents in relation to sex, ethnicity and socioeconomic status (SES).\n\nDesign\nA 5‐year longitudinal study of a diverse cohort of students aged 11–12 years at baseline in 1999.\n\nSetting\n36 London schools sampled using a stratified random sampling procedure.\n\nParticipants\nA total of 5863 students categorised as white, black or Asian, and stratified for SES using the Townsend Index.\n\nMain outcome measures\nNumber of days per week of vigorous activity leading to sweating and breathing hard. Hours of sedentary behaviour, including watching television and playing video games. Data were analysed using multilevel, linear, mixed models.\n\nResults\nMarked reductions in physical activity and increases in sedentary behaviour were noticed between ages 11–12 and 15–16 years. Boys were more active than girls, and the decline in physical activity was greater in girls (46% reduction) than in boys (23%). Asian students were less active than whites, and this was also true of black girls but not boys. Black students were more sedentary than white students. Levels of sedentary behaviour were greater in respondents from lower SES. Most differences between ethnic and SES groups were present at age 11 years, and did not evolve over the teenage years.\n\nConclusions\nPhysical activity declines and sedentary behaviour becomes more common during adolescence. Ethnic and SES differences are observed in physical activity and sedentary behaviour in British youth that anticipate adult variations in adiposity and cardiovascular disease risk. These are largely established by age 11–12 years, so reversing these patterns requires earlier intervention.",
            "publicationTitle": "British Journal of Sports Medicine",
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            "pages": "140-144",
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            "shortTitle": "Trends in physical activity and sedentary behaviour in adolescence",
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                    "firstName": "Carlijn B M",
                    "lastName": "Kamphuis"
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