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Biomedical subjects

Nick Wilson

Publications and source records attributed to Nick Wilson.

At least 55 records · Page 3Linked to original sources
PubMed2005

Advertising and availability of 'obesogenic' foods around New Zealand secondary schools: a pilot study.

AIMS: To examine the extent and content of outdoor food advertisements and food availability from outlets in the vicinity of secondary schools. METHODS: The sample of schools (n=10) was randomly selected from a sample frame of schools in both an urban and rural region (Wellington and Wairarapa regions respectively) and at each extreme of the socioeconomic status (SES) distribution (based on school characteristics). An area of 1-km radius around the schools was examined for food and non-food product advertisements and shops/outlets. RESULTS: Out of 1408 outdoor advertisements for products, 61.5% were for food (i.e. 28 per square kilometre). The major categories were soft drinks (21.6%), frozen confectionary (16.2%), savoury snacks (11.4%), and alcohol (8.1%). Overall, 70.2% of food advertisements were for foods classified as 'unhealthy' (i.e. inconsistent with the national nutritional guidelines for adolescents). A majority of the 224 outlets sold food (i.e. 56.3%). Those that primarily sold food were (on average) closer than other outlets to the secondary schools (p=0.03). Out of those schools that sold meals, the proportion of these that advertised a salad option was significantly lower in the low SES neighbourhoods (p=0.006). Other significantly different patterns for food outlet distribution, and category of advertised food were found by SES and rurality. CONCLUSION: Although only a pilot study, the information obtained suggests that food advertising and food outlets are prevalent in the vicinity of secondary schools and that the advertising is generally not compatible with nutritional guidelines for adolescents. Larger studies into such advertising are needed as well as consideration of policy options to control aspects of the 'obesogenic environment.'

Adolescent↗
PubMed2005

Tobacco tax as a health protecting policy: a brief review of the New Zealand evidence.

AIM: To review the evidence relating to tobacco taxation as a health and equity protecting policy for New Zealand. METHODS: Searches of Medline, EconLit, ECONbase, Index NZ, and library databases for literature on tobacco taxation. RESULTS: The New Zealand evidence indicates that increases in tobacco prices are associated with decreases in tobacco consumption in the general population over the long term. This finding comes from multiple studies relating to: tobacco supplies released from bond, supermarket tobacco sales, household tobacco expenditure data, trends in smoking prevalence data, and from data on calls to the Quitline service. For the 1988-1998 period, the overall price elasticity of demand for all smoking households was estimated to be such that a 10% price increase would lower demand by 5% to 8%. Two studies are suggestive that increased tobacco affordability is also a risk factor for higher youth smoking rates. There is evidence from two studies that tobacco price increases reduce tobacco consumption in some low-income groups and one other study indicates that tobacco taxation is likely to be providing overall health benefit to low-income New Zealanders. These findings are broadly consistent with the very large body of scientific evidence from other developed countries. CONCLUSIONS: There is good evidence that tobacco taxation is associated with reduced tobacco consumption in the New Zealand setting, and some limited evidence for equity benefits from taxation increases. Substantial scope exists for improving tobacco taxation policy in New Zealand to better protect public health and to improve equity.

Commerce↗
PubMed2005

Smoky homes: a review of the exposure and effects of secondhand smoke in New Zealand homes.

AIMS: To review the evidence of exposure to secondhand smoke (SHS) in New Zealand homes and its effects on health. METHODS: A search for relevant literature was made in April-May 2004, using Medline and other databases, and via inquiries to official and other agencies. Data on the types of households with smoking members were obtained by an analysis of 1996 Census data. RESULTS: National survey data indicate that at least 18% of all New Zealanders and 30% of Maori are exposed to SHS in the home. Surveys of high school students indicate home SHS exposure levels of 30% or more. The exposure appears to have decreased during 1996-2003 for Maori and the general population (p<0.001 for trend for both), with low-income households more likely to be exposed than others. There is an absence of exposure data for many specific population groups including pregnant women and infants. New Zealand evidence from two large cohort studies indicates an increased risk of death of at least 15% for never smokers, aged 45-74, if they live in a household with smokers. Over 250 deaths per year are estimated to be attributable to SHS exposure in New Zealand homes; over double the mortality from SHS exposure at work. CONCLUSIONS: Improved information on SHS exposure in the New Zealand setting is needed. The levels of home SHS exposure and estimated mortality burden justify a substantial Government and health-agency investment to reduce this exposure, particularly for children, Maori, and those in low-income households.

Adolescent↗
PubMed2005

Rethinking the regulatory framework for tobacco control in New Zealand.

Tobacco is a particularly unusual consumer product in that it is highly addictive, kills over half its long-term users, and is a major cause of premature death and health inequalities in New Zealand. We therefore examined the place of regulatory frameworks in advancing tobacco control, and suggest the formation of a Government Tobacco Authority. Such an authority could enable the Government to specify the design of tobacco products (to maximise harm reduction), to eliminate the marketing for profit of branded products, and to appropriately control the introduction of alternative nicotine delivery devices or less hazardous alternative tobacco products. As the authority could be funded through levies on the tobacco industry, it has the potential advantage of delivering major population health gains while costing the taxpayer nothing.

Commerce↗
PubMed2005

Attitudes to, and knowledge of, secondhand smoke in New Zealand homes and cars.

AIMS: To review the evidence on knowledge and attitudes among the New Zealand public concerning secondhand smoke (SHS) and smoking in homes and cars. METHODS: A literature search for published and unpublished material relevant to New Zealand. RESULTS: While New Zealanders' knowledge about SHS effects has improved since 1989, with 90% or more of the adult population aware of a risk to health, this knowledge may be shallow. Wellington area surveys indicate that significant proportions of the population are not aware of both the major consequences of SHS, that is, strokes and heart disease. Survey data indicates increasing public support for smokefree homes during 1999-2003, particularly among Maori who showed a 68% increase in support during that period. In 2003, over 80% of New Zealand smokers indicated that people have a right to smokefree homes. However, these attitudes do not necessarily result in smokefree homes. Of those 14-15 year olds with at least one parent who smoked, less than 45% reported having a smokefree home. CONCLUSIONS: Improved tobacco control and increased investment in mass media campaigns on SHS issues are needed to strengthen healthy norms around smokefree homes and cars.

Adult↗
PubMed2005

The global distribution of risk factors by poverty level.

OBJECTIVE: To estimate the individual-level association of income poverty with being underweight, using tobacco, drinking alcohol, having access only to unsafe water and sanitation, being exposed to indoor air pollution and being obese. METHODS: Using survey data for as many countries as possible, we estimated the relative risk association between income or assets and risk factors at the individual level within 11 medium- and low-income subregions of WHO. WHO and The World Bank data on the prevalence of risk factors and income poverty (defined as living on < US$ 1.00 per day, US$ 1-2.00 per day and > US$ 2.00 per day) were analysed to impute the association between poverty and risk factors for each subregion. The possible effect of poverty reduction on the prevalence of risk factors was estimated using population-attributable risk percentages. FINDINGS: There were strong associations between poverty and malnutrition among children, having access only to unsafe water and sanitation, and being exposed to indoor air pollution within each subregion (relative risks were twofold to threefold greater for those living on < US$ 1.00 per day compared with those living on > US$ 2.00 per day). Associations between poverty and obesity, tobacco use and alcohol use varied across subregions. If everyone living on < US$ 2.00 per day had the risk factor profile of those living on > US$ 2.00 per day, 51% of exposures to unimproved water and sanitation could be avoided as could 37% of malnutrition among children and 38% of exposure to indoor air pollution. The more realistic, but still challenging, Millennium Development Goal of halving the number of people living on < US$ 1.00 per day would achieve much smaller reductions. CONCLUSION: To achieve large gains in global health requires both poverty eradication and public health action. The methods used in this study may be useful for monitoring pro-equity progress towards Millennium Development Goals.

Health Services Accessibility↗
PubMed2005

Tobacco taxation and public health: ethical problems, policy responses.

This article aims to describe the major ethical issues surrounding tobacco taxation, and to identify policy responses to minimise any ethical dilemmas. It uses the standard ethical framework for biomedicine (covering beneficence, non-maleficence, respect for autonomy and justice), in conjunction with relevant data on tobacco taxation from various developed countries. Tobacco taxation contributes substantial benefits at the population level by protecting health (i.e., by deterring the uptake of smoking by youth, by promoting quitting, and by reducing harm from exposure to second-hand smoke (SHS)). However, tobacco taxes can contribute to financial hardship among low-socioeconomic status populations where smoking persists. Such taxes can contribute to autonomy, by reducing SHS exposure to non-smokers, and by allowing freedom from nicotine-dependency for those who quit smoking or do not start regular smoking as a result of high tobacco prices. Furthermore, increases in tobacco taxation may reduce health inequalities and so contribute to justice. Nevertheless, the additional tax burden imposed on smokers who wish to continue to smoke, or are unable to quit, can be considered unjust. The autonomy of such smokers may be partly impaired. Although tobacco tax can be regarded as ethically justifiable because of its substantial overall benefit to society, there is substantial scope for policy changes to further reduce any harms and injustices for those populations who continue to smoke.

Beneficence↗
PubMed2005

Epidemiology of international terrorism involving fatal outcomes in developed countries (1994-2003).

We aimed to describe the public health burden and epidemiology of international terrorism (i.e. involving foreign nationals) with fatal outcomes in developed countries. Data was abstracted from a United States Department of State database for 21 'established market economy' countries and 18 'former socialist economies of Europe' for 1994-2003. To put the findings in a wider context, comparisons were made with WHO data on all homicides for each country. A total of 32 international terrorist attacks causing fatalities were identified over the 10-year period. These resulted in 3299 deaths, giving a crude annual mortality rate of 0.3 per million population. The mortality burden attributable to international terrorism in these countries was 208 times less than that attributable to other homicide. Even for the country with the highest mortality burden from international terrorism (the United States), this ratio was 60. There was no statistically significant trend in the number of attacks over time, but the attack severity (in terms of deaths per attack) was higher in the latter part of the 10-year period. A number of limitations with this data set were identified. If a more rigorous definition of 'international terrorism' was used, then this would substantially reduce the total number of such attacks defined in this way. In conclusion, there is a need for better quality data and improved classification systems for describing international terrorism. Nevertheless, the available data indicates that the mortality burden from international terrorism in developed countries is small compared to that from other homicide.

Developed Countries↗