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Biomedical subjects

Sally Macintyre

Publications and source records attributed to Sally Macintyre.

At least 19 recordsLinked to original sources
PubMed2006

Is social participation associated with cardiovascular disease risk factors?

There is increasing interest in the idea that social participation (operationalised as taking part in formal groups and associations) is an important determinant of health and survival. However, although a large body of literature exists which supports the notion that social contact is associated with good health, few studies have examined whether participation in specific groups and associations is related to specific risk factors, which are in turn linked to a major cause of death. In this paper, we focus on risk markers (BMI, waist-hip ratio, blood pressure, resting heart rate, anxiety and depression) for cardiovascular disease (CVD), which contributes around a third to all cause mortality in the UK. Using survey data (n=2334 individuals) from the West of Scotland Twenty-07 Study, we examine, separately by sex, cross-sectional associations between participation in groups and associations and CVD risk markers. There is no consistent patterning in the results. For some types of groups, there is a relationship between participation and risk factors in one sex but not the other, or better functioning on one health measure but worse in another. The most consistent results are found for psychological distress where, with the exception of church-related activities, participation in groups and associations is related to less distress (although more strongly in men than in women). Our findings do not therefore lend unequivocal support to the notion of social participation having a strong relationship with CVD risk factors at a cross-sectional level.

Adult↗
PubMed2006

Neighbourhood fast food environment and area deprivation-substitution or concentration?

It has been hypothesised that deprived neighbourhoods have poorer quality food environments which may promote the development of obesity. We investigated associations between area deprivation and the location of the four largest fast-food chains in Scotland and England. We found statistically significant increases in density of outlets from more affluent to more deprived areas for each individual fast-food chain and all chains combined. These results provide support for a 'concentration' effect whereby plausible health-damaging environmental risk factors for obesity appear to be 'concentrated' in more deprived areas of England and Scotland.

Diet↗
PubMed2006

Lay concepts of the relative importance of different influences on health; are there major socio-demographic variations?

There is an extensive literature within anthropology, sociology and psychology about lay concepts of determinants of health and illness. Many of these studies have used single sex or social class samples, often in narrow age bands, and many are qualitative in approach. We asked respondents in a health survey to say how important (on a five-point scale) they thought seven potential influences on health (habits, self-care, the environment, family relationships, one's constitution, money and luck) were. The first three were regarded as very important, the second three as less important and luck as least important. Responses were consistent with current public health and epidemiological knowledge; these respondents endorsed prevailing views about personal responsibility for health and about the role of the physical and social environment in influencing health. In mutually adjusted models, there were no significant gender differences, social class differences and neighbourhood differences in three out of seven influences, and age differences in four out of seven influences. Thus, socio-demographic differences were less marked than might be inferred from studies of specific social groups, indicating a need for caution in health education and health promotion practice against always assuming socio-demographic differences.

Adolescent↗
PubMed2006

Nowhere to play? The relationship between the location of outdoor play areas and deprivation in Glasgow.

Childhood obesity is rising and this rise has been linked to a decrease in physical activity. Access to appropriate facilities for physical activity is a key determinant of participation. This paper investigates the provision of outdoor play areas for children in relation to area deprivation in Glasgow, Scotland. Analysis of the distribution of outdoor play areas showed significantly higher mean number of play areas per 1000 child population in more deprived areas. However, despite the apparent advantage of deprived areas in terms of actual number of play areas, the quality of play areas in different types of areas may warrant further exploration.

Adolescent↗
PubMed2006

Family socioeconomic position at birth and future cardiovascular disease risk: findings from the Aberdeen Children of the 1950s cohort study.

OBJECTIVES: We assessed the association of father's social class, recorded at the time of birth, with coronary heart disease and stroke in a British cohort of 11106 individuals born in the 1950s. METHODS: Survival analysis was used to relate social class at birth to the occurrence of either fatal or nonfatal coronary heart disease or stroke. RESULTS: Rates of coronary heart disease and stroke increased across the social class distribution from highest to lowest, and patterns of association were similar for the 2 outcomes. The gender-adjusted hazard ratio of experiencing either coronary heart disease or stroke comparing the manual and nonmanual social class categories was 1.52 (95% confidence interval [CI]=1.14, 2.02). This ratio fell to 1.41 (95% CI = 1.05, 1.88) after adjustment for indicators of intrauterine and childhood growth. Further adjustment for educational attainment reduced the ratio to 1.28 (95% CI=0.94, 1.75). CONCLUSIONS: We found that social class at birth was associated with risk of fatal and nonfatal cardiovascular disease among individuals born in the 1950s, a period of relative prosperity and after the introduction of the welfare state in Britain. This relation appeared to be mediated in part through educational attainment.

Birth Weight↗
PubMed2006

Does IQ explain socioeconomic inequalities in health? Evidence from a population based cohort study in the west of Scotland.

OBJECTIVE: To test the hypothesis that IQ is a fundamental cause of socioeconomic inequalities in health. DESIGN: Cross sectional and prospective cohort study, in which indicators of IQ were assessed by written test and socioeconomic position by self report. SETTING: West of Scotland. PARTICIPANTS: 1347 people (739 women) aged 56 in 1987. MAIN OUTCOME MEASURES: Total mortality and coronary heart disease mortality (ascertained between 1987 and 2004); respiratory function, self reported minor psychiatric morbidity, long term illness, and self perceived health (all assessed in 1988). RESULTS: In sex adjusted analyses, indices of socioeconomic position (childhood and current social class, education, income, and area deprivation) were significantly associated with each health outcome. Thus the greatest risk of ill health and mortality was evident in the most socioeconomically disadvantaged groups, as expected. After adjustment for IQ, a marked attenuation in risk occurred for poor mental health (range of attenuation in risk ratio across the five socioeconomic indicators: 15-58%), long term illness (25-53%), poor self perceived health (41-56%), respiratory function (44-66%), coronary heart disease mortality (31-111%), and total mortality (45-131%). Despite the clear reduction in the magnitude of these effects after controlling for IQ, in half of the associations examined the risk of ill health in socioeconomically disadvantaged people was still at least twice that of advantaged people. Statistical significance was lost for only 5/25 separate socioeconomic health gradients that showed significant relations in sex adjusted analyses. CONCLUSIONS: Scores from the IQ test used here did not completely explain the socioeconomic gradients in health. However, controlling for IQ did lead to a marked reduction in the magnitude of these gradients. Further exploration of the currently scant information about IQ, socioeconomic position, and health is needed.

Coronary Disease↗
PubMed2006

Childhood IQ and life course socioeconomic position in relation to alcohol induced hangovers in adulthood: the Aberdeen children of the 1950s study.

OBJECTIVE: To examine the association between scores on IQ tests in childhood and alcohol induced hangovers in middle aged men and women. DESIGN, SETTING, AND PARTICIPANTS: A cohort of 12 150 people born in Aberdeen (Scotland) who took part in a school based survey in 1962 when IQ test scores were extracted from educational records. Between 2000 and 2003, 7184 (64%) responded to questionnaire inquiries regarding drinking behaviour. MAIN OUTCOME MEASURES: Self reported hangovers attributable to alcohol consumption on two or more occasions per month. RESULTS: Higher IQ scores at 11 years of age were associated with a lower prevalence of hangovers in middle age (OR(per one SD advantage in IQ score); 95% CI: 0.80; 0.72, 0.89). This relation was little affected by adjustment for childhood indicators of socioeconomic position (0.82; 0.74, 0.91) but was considerably attenuated after control for adult variables (fully adjusted model: 0.89; 0.79, 1.01). CONCLUSIONS: Higher childhood IQ was related to a lower prevalence of alcohol induced hangovers in middle aged men and women. The IQ-hangover effect may at least partially explain the link between early life IQ and adult mortality. This being the first study to examine this relation, more evidence is required.

Adult↗
PubMed2005

Does the primary school attended influence self-reported health or its risk factors in later life? Aberdeen Children of the 1950s Study.

BACKGROUND: Adult health and its determinants are influenced by the environment in childhood. The school attended is known to affect the health behaviours of pupils while still at school. Little is known about the long-term influence of school attended on health. METHODS: A total of 7,095 respondents (mean age 47 years) to a follow-up questionnaire who attended primary school in Aberdeen, UK, provided information on self-reported health; self-reported high blood pressure; GHQ-4; smoking status; alcohol intake; and obesity. Variance partition coefficients (VPCs) summarized the variation in adult health outcomes and behaviours across schools. Multilevel logistic regression was used to estimate the contribution of school to variation in the outcomes taking into account individual-level and school-level factors. RESULTS: There was some variation across schools in the proportion of adults reporting poor self-rated health (VPC = 0.020) and smoking (0.019). Higher VPCs were found for factors potentially confounded with school: paternal social classes (I&II) (0.45) and gender (0.44). Age at leaving secondary education (0.28) and income (0.10) varied across schools. The effects of primary school diminished after adjusting for individual-level childhood risk factors. The further addition of adult risk factors attenuated these childhood effects. After full adjustment there was no effect of the primary school attended for high blood pressure, current smoking, alcohol intake, and obesity, and negligible effects for the other outcomes. CONCLUSIONS: Contrary to our expectations, we found little evidence of any relationship between primary school and adult self-reported health or behaviour. This is surprising given the extent to which characteristics known to be associated with adult health were clustered within schools.

Alcohol Drinking↗
PubMed2005

Out-of-home food outlets and area deprivation: case study in Glasgow, UK.

BACKGROUND: There is a popular belief that out-of-home eating outlets, which typically serve energy dense food, may be more commonly found in more deprived areas and that this may contribute to higher rates of obesity and related diseases in such areas. METHODS: We obtained a list of all 1301 out-of-home eating outlets in Glasgow, UK, in 2003 and mapped these at unit postcode level. We categorised them into quintiles of area deprivation using the 2004 Scottish Index of Multiple Deprivation and computed mean density of types of outlet (restaurants, fast food restaurants, cafes and takeaways), and all types combined, per 1000 population. We also estimated odds ratios for the presence of any outlets in small areas within the quintiles. RESULTS: The density of outlets, and the likelihood of having any outlets, was highest in the second most affluent quintile (Q2) and lowest in the second most deprived quintile (Q4). Mean outlets per 1,000 were 4.02 in Q2, 1.20 in Q4 and 2.03 in Q5. With Q2 as the reference, Odds Ratios for having any outlets were 0.52 (CI 0.32-0.84) in Q1, 0.50 (CI 0.31 - 0.80) in Q4 and 0.61 (CI 0.38 - 0.98) in Q5. Outlets were located in the City Centre, West End, and along arterial roads. CONCLUSION: In Glasgow those living in poorer areas are not more likely to be exposed to out-of-home eating outlets in their neighbourhoods. Health improvement policies need to be based on empirical evidence about the location of fast food outlets in specific national and local contexts, rather than on popular 'factoids'.

Journal Article↗
PubMed2005

Are there socioeconomic differences in responses to a commonly used self report measure of chronic illness?

BACKGROUND: Single questions on self-reported morbidity are commonly used in social or health surveys. It has been suggested that these may underestimate socioeconomic gradients in health because more disadvantaged social groups may have higher thresholds for defining illness. Method Face-to-face interviews by research nurses with community-based respondents in the West of Scotland, using a specially designed suite of prompts following up on responses to the UK General Household Survey (GHS) long-standing illness question. Participants were 858 respondents born in the early 1930s and 852 respondents born in the early 1950s (mean age at interview 59 and 40, respectively) classified by occupational social class and area deprivation. RESULTS: Adjusted for age and sex, the Relative Index of Inequality (RII) for reporting any condition in response to the GHS question was 2.14 (95% CIs 1.49-3.08) for social class and 2.01 (1.41-2.87) for Depcat. Among those not reporting any conditions to the GHS question, the RII for reporting conditions to any further prompts was 1.54 (0.87-2.70) for social class and 0.86 (0.50-1.46) for Depcat. The RIIs for reporting any condition after the initial question and all prompts were 2.16 (1.40-3.33) for social class and 1.50 (0.98-2.29) for Depcat. Across a range of conditions defined as more serious, and conditions classified by different ICD categories, socioeconomic status (SES) gradients after the initial question and all prompts were similar to, or less steep than, those produced by the GHS question alone. CONCLUSIONS: These data do not support the hypothesis that poorer social groups are more stoical and more likely to need detailed prompting in order to elicit morbidity. Nor do they support the hypothesis that SES gradients in morbidity are underestimated by using the GHS question rather than more detailed questioning. This suggests that responses to this type of question can be used in epidemiology and health needs assessment without major socioeconomic bias.

Adult↗
PubMed2005

Who is more likely to experience common disorders: men, women, or both equally? Lay perceptions in the West of Scotland.

BACKGROUND: Gender differences in health are commonly observed by epidemiologists. Little is known about lay beliefs concerning the gender patterning of common conditions. METHODS: Using the West of Scotland Twenty-07 Study, we analysed responses to a question in a postal questionnaire asking whether respondents thought men or women (or both equally) were more likely to have heart disease, cancer, mental illness, and accidents, to be fit, and to live longer. This question was answered by 466 females and 353 males, then aged 25, 45, and 65 yr. RESULTS: Responses were in general in accord with epidemiological findings, but females had significantly lower odds than males of perceiving men as being at greater risk of accidents and heart disease, and higher odds than males of perceiving women as being at greater risk of mental illness. CONCLUSIONS: There was a tendency for each gender to think risks were higher for their own sex than did the other gender. This observation needs further exploration, particularly in the light of the research showing 'optimistic bias' in relation to health, and research suggesting that socioeconomically disadvantaged people may be least likely to perceive socially structured health inequalities.

Accidents↗
PubMed2005

Measuring neighbourhood social and material context: generation and interpretation of ecological data from routine and non-routine sources.

Investigating the role of the social and material environment in determining mortality, morbidity and health behaviour has become increasingly popular in epidemiological research. However, despite calls to use more innovative data about areas, there is still a tendency to use 'off the shelf' data derived from pre-existing routine surveys and censuses. Many researchers argue that innovative ecological data about areas is difficult to collect and use effectively, difficult to compare and hard to interpret and analyse. This paper considers an approach to obtaining and interpreting innovative ecological data, and is based on a case study of empirical data collection in the UK. The paper focuses on issues of scale, quality, generation, use and interpretation of data. While it is important to start with a priori theories about the way specific domains of the local environment might influence health, we report that finding robust measures of these domains at the correct spatial scale is difficult and time consuming. However we argue that the attempt to measure specific chains of causation is important enough for public health for this approach to followed and improved upon.

Data Collection↗
PubMed2005

Are rich people or poor people more likely to be ill? Lay perceptions, by social class and neighbourhood, of inequalities in health.

Research in the UK has suggested that people in lower social classes or from poorer neighbourhoods are less likely than their more socially advantaged counterparts to agree that health and life expectancy are worse among more deprived population groups. The small body of previous research has either used qualitative approaches or coded open-ended responses to survey questions about causes of health and illness or of inequalities between areas. We examined lay perceptions by asking a direct question and using a quantitative, multivariate approach. Residents in three age groups (25, 45 and 65 years old) living in two socially contrasting localities in Glasgow, Scotland, were asked who were more likely to have accidents, cancer, heart disease, mental illness, to be fitter, and to live longer: rich people, poor people, or both equally. Across all the health categories, those in lower social classes or from poorer neighbourhoods were equally or less likely than their more socially advantaged counterparts to say the poor had worse health. In a model containing age, sex, class and locality, those in lower social classes and in the poorer locality were significantly less likely to say that richer people live longer (OR: 0.5). We have therefore confirmed earlier observations that those most at risk of ill health may be less likely to acknowledge the social gradient in health. We suggest a need to examine this apparent paradox in other contexts and in more detail, using both quantitative and qualitative approaches.

Accidents↗
PubMed2005

Neighbourhood environment and its association with self rated health: evidence from Scotland and England.

OBJECTIVES: To investigate associations between measures of neighbourhood social and material environment and self rated health. DESIGN: New contextual measures added to cross sectional study of a sample of people from the Health Survey for England and the Scottish Health Survey to provide multilevel data. PARTICIPANTS: 13,899 men and women aged 16 or over for whom data on self rated health were available from the Health Survey for England (years 1994-99) and the Scottish Health Survey (years 1995 and 1998). RESULTS: Fair to very bad self rated health was significantly associated with six neighbourhood attributes: poor physical quality residential environment, left wing political climate, low political engagement, high unemployment, lower access to private transport, and lower transport wealth. Associations were independent of sex, age, social class, and economic activity. Odds ratios were larger for non-employed residents than for employed residents. Self rated health was not significantly associated with five other neighbourhood measures: public recreation facilities, crime, health service provision, access to food shops, or access to banks and buildings societies. CONCLUSIONS: Some, but not all, features of the neighbourhood environment are associated with self rated health and may be indicators of important causal pathways that could provide a focus for public health intervention strategies. Associations were more pronounced for non-employed residents, perhaps because of greater exposure to the local environment compared with employed people. Operationalizing specific measures of the characteristics of local areas hypothesised to be important for living a healthy life provides a more focused approach than general measures of deprivation in the search for area effects.

Adolescent↗