bluuebunny/crossref_metadata_2025_split huggingface dataset:
OP34 Assessing the Social Determinants of Teenage Pregnancy: A Time-Space Analysis using an Obstetric Database from 1950-2010
Authors: McCall S J T , Bhattacharya S , Macfarlance G J , Okpo E 
Published: September 2013

BackgroundTeenage-pregnancy is a known social problem and has remained at the forefront of policy within the UK. The social aetiology of teenage pregnancy is known to be linked with deprivation. However, deprivation is a multifaceted term making it difficult to quantify, this is shown by the large number of measures that have been created in the UK. This study compared the discriminating ability of these measures with respect to teenage pregnancy. Furthermore, this project also examined the temporal-spatial patterns of teenage-conceptions within Aberdeen City.MethodsThis was a population based study from 1950–2010, using registry based data from the Aberdeen Maternity Neonatal Databank (AMND). The AMND holds information on fertility and obstetric related events since 1951 to the present. The main outcome variable was a conception age of less than twenty years. This outcome was compared by a number of deprivation measures, these were the Scottish Index of Multiple Deprivation (SIMD), Carstairs Index, and Registrar General’s Occupation based social class. Each measure was commenced at different times resulting in a varying sample size for each of the measures. Logistic regression models showing the strength of the association and receiver operating characteristic (ROC) curves showing the discriminating ability of the measure were constructed as part of the analysis. Spatial analysis comprised of creating post code based maps of teenage pregnancies.ResultsThere was a decline in teenage-conceptions over the sixty year period. All the measures of socio-economic status were highly associated with teenage-pregnancy and given as Odd Ratios. For example the adjusted association between SIMD and teenage conception had an OR of 10.36 (95% CI 8.46, 12.68) which compared the most deprived decile to the least deprived decile. The ROC curves showed that socioeconomic measures performed better than chance at determining teenage conceptions (X2= 158.7, P < 0.0001). They further showed that the SIMD performed best at predicting teenage pregnancies by having the largest area under the curve with a value of 0.73.ConclusionDespite a slight decline in teenage pregnancies over past decades, there is still an evident association between deprivation and teenage pregnancy. Moreover, this study shows that the SIMD measure is the most suitable measure at determining teenage-conceptions. As the SIMD is the most recent and multifaceted measure of socioeconomic status, this supports its future use in health inequality research.
OP36 Socioeconomic and Geographic differences in Adolescent Sexual Behaviour: A Multilevel Cross-Sectional Study of 15 year Olds in Scotland
Authors: Levin K A , Henderson M 
Published: September 2013

BackgroundScotland has one of the highest rates of early sexual activity among 15-year-old girls compared with other countries in Europe and North America, and diagnosis of STDs in Scotland has increased over the last decade. As there are known socioeconomic and geographic inequalities in adult health, the aim of this study is to describe socioeconomic and urban-rural differences in sexual behaviour of 15-year old boys and girls in Scotland in 2010.MethodsData from the 2010 Scotland Health Behaviour in School-Aged Children survey, boosted to provide a representative sample of rural and remote areas, were modelled using multilevel logistic modelling for outcome ‘has/has not had sexual intercourse’. Individual’s family affluence, type of school (state versus private) and area level deprivation (SIMD 2012 quintiles) were included in the analyses as measures of socioeconomic status. The Scottish Household Survey Rurality indicator was also included in the analyses.ResultsPrevalence of having had sex was higher among girls (33% [95% CI 30, 36]) than boys (25% [22, 28]). Similarly, prevalence among those with low family affluence (FAS) was higher than those with high FAS. However, when modelled, adjusting for school type and area-level deprivation, FAS was no longer significant. Girls living in SIMD 1 and SIMD 2 (most deprived quintiles) had higher odds of having had sex (OR 1.74 [95% CI 0.99, 3.07] and 1.87 [1.19, 2.95] respectively) relative to those living in SIMD 5. This was also true for boys, although odds were lower, approximately 1.3 in the 2 most deprived quintiles, relative to SIMD 5. School type was significantly associated with sex among girls, with higher odds in state schools (1.96 [1.01, 3.82]). When rurality was added to the models, this was not significant in the boys’ model. However, girls living in Accessible and Remote Towns (i.e. towns of between 3,000 and 10,000 residents) had higher odds of having sexual intercourse (OR 1.73 and 1.61 respectively), as did those living in Accessible Rural areas (settlements of less than 3,000 people, less than 30 minute drive time from an urban centre) (OR 1.64) relative to those living in the 4 Cities.ConclusionArea-level deprivation and school type were stronger predictors of having had sexual intercourse than family affluence. Although rurality was not associated with boy’s sexual behaviour, girls from Accessible and Remote Towns and Accessible Rural Scotland were more likely to have had sexual intercourse.
OP42 Mental Disorders Across the Adult Lifecourse and Future Coronary Heart Disease: Evidence for General Susceptibility
Authors: Gale C R , Batty G D , Osborn D P J , Tynelius P , Rasmussen F 
Published: September 2013

BackgroundDepression, anxiety, and psychotic disorders have been associated with an increased risk of developing coronary heart disease (CHD). The underlying mechanisms are uncertain. It is unclear whether the association between mental health and risk of CHD is present across a wider range of mental disorders, and whether it varies according to the chronicity of the disorder. We used data on over a million Swedish men who underwent psychiatric and medical assessment in early adulthood and were followed up for hospital admission for mental disorder and CHD. Our first objective was to investigate whether the risks of incident CHD associated with a range of mental disorders diagnosed in early adulthood were similar to those associated with subsequent hospital admission for these disorders. Our second objective was to examine the extent to which risk factors measured in early adulthood (blood pressure, body mass index (BMI), smoking, alcohol intake and intelligence) together with socioeconomic circumstances in childhood or later adult life, explained these associations.MethodsParticipants were 1,095,249 Swedish men conscripted for military service at a mean age of 18.3 years. Schizophrenia, other non-affective psychotic disorders, bipolar disorders, depressive disorders, neurotic and adjustment disorders, personality disorders, alcohol-related and other substances use disorders were assessed by psychiatric interview on conscription and data on hospital admissions for these mental disorders and for CHD (fatal and non-fatal) were obtained from national registers during a mean follow-up period of 22.6 years.ResultsIncreased risk of incident CHD was evident across the range of mental disorders whether diagnosed at conscription or on later hospital admission. Age-adjusted HRs (95% CIs) according to diagnoses at conscription ranged from 1.27 (1.03, 1.58) (depressive disorders) to 1.92 (1.60, 2.31) (alcohol-related disorders). The equivalent figures according to diagnoses during hospital admission were higher, ranging from 1.49 (1.22, 1.79) (schizophrenia) to 2.87 (2.58, 3.20) (other substance use disorders). Associations were little changed by adjustment for early-life socioeconomic status, BMI and blood pressure, but were partially attenuated by adjustment for smoking, alcohol intake, intelligence, education and late-life socioeconomic position. Risk of CHD rose with exposure to more chronic and perhaps more severe mental disorder (p for linear trend < 0.0001).ConclusionIncreased risk of incident CHD is present across a range of mental disorders and is observable when disorders are diagnosed at a young age. Men with early onset mental disorder who subsequently require psychiatric hospital admission are at particularly high risk.
OP45 Walking, Cycling and Driving to Work in the English and Welsh 2011 Census: Trends, Socio-Economic Patterning and Relevance to Travel Behaviour in General
Authors: Goodman A , Koupil I 
Published: September 2013

BackgroundIncreasing walking and cycling, and reducing motorised vehicle use, are increasingly recognised as health and environmental priorities. This paper examines levels and trends in the use of different commute modes in England and Wales, both overall and with respect to small-area deprivation. It also examines how far commute modal share can serve as a proxy for travel behaviour more generally.Methods25.1 million adult commuters reported their usual main mode of travelling to work in the 2011 England and Wales census; similar data were available for 1971-2001. Indices of Multiple Deprivation were used to examine socio-economic patterning. The UK National Travel Survey 2002-2010 was used to examine correlations between commute modal share and modal share of total travel time in 150 non-overlapping populations defined by region, year band and income.ResultsAmong commuters in 2011, 67.1% used private motorised travel as their usual main commute mode (-1.8% change since 2001); 17.3% public transport (+1.4% change); 11.3% walking (+0.4% change); and 3.0% cycling (0.0% change). Walking and, to a marginal extent, cycling were more common among those from deprived areas, but these gradients had flattened over the previous decade to the point of having essentially disappeared for cycling. In the National Travel Survey, commute modal share and total modal share were highly correlated for private motorised transport (r = 0.94), public transport (r = 0.96) walking (r = 0.88 excluding London) and cycling (r = 0.77).ConclusionEngland and Wales remain car-dependent, but the trends are slightly more encouraging. Unlike many health behaviours, it is more common for socio-economically disadvantaged groups to commute using physically active modes, but this association is weakening and may soon reverse for cycling. At a population level, commute modal share is reasonably highly correlated with total modal share, enhancing the value of the census data in characterising background trends and evaluating interventions.
OP47 Is Active Commuting Good for Our Health?
Authors: Flint E , Cummins S , Sacker A 
Published: September 2013

BackgroundPhysical activity reduces the risk of cardiovascular disease and is an important factor in healthy weight maintenance. However, overall levels of physical activity have declined in the developed world, and tackling obesity is a public health priority. Active commuting is thought to be a particularly effective way of getting exercise, as walking and cycling are easily adopted and likely to be maintained as part of one’s daily routine. In addition to improving cardiovascular health and fitness, greater uptake of active travel has been shown to reduce air and noise pollution, traffic congestion and CO2emissions.MethodsUsing data from Understanding Society Wave 2, this study investigates the extent to which active commuting predicts four objectively measured health outcomes: body mass index (BMI); percentage body fat; lung function; and blood pressure. Commuting mode was defined using three categories designed to capture increasing levels of physical activity: private transport (car, motorcycle, taxi); public transport (bus, train, etc); active transport (walking or cycling). The analytic sample was restricted to those who worked outside of the home and had complete data for commuting mode and biological measurements (n = 3352 men; n = 4103 women). Gender-stratified nested multivariate linear regression analyses were utilised, in order to adjust for the following hypothesised confounding covariates: age, age2, distance travelled, limiting illness or disability, occupational social class, work-related physical activity level, participation in sporting activity and diet quality.ResultsIn the age-adjusted analyses, compared with using private transport; public transport and active transport were associated with lower BMI for men (public transport: b -1.1, p < 0.001; active transport: b -0.9, p = 0.002) and women (public transport: b -0.6, p = 0.05; active transport: b -0.6, p = 0.01). Adjustment for all other hypothesised confounders did not greatly attenuate this association for men (public transport: b -1.0, p < 0.001; active transport: b -0.7, p = 0.016) or for female active travellers (public transport: b -0.6, p = 0.09; active transport: b -0.9, p = 0.001). Similar results were found for percentage body fat. Findings for blood pressure and lung function varied by gender and told a more complex story.ConclusionThe results from this investigation corroborate findings from other studies in suggesting that incorporating a greater level of physical activity into the commute may help individuals maintain a healthy weight and body composition. The use of biomeasure outcomes in a large, nationally representative sample increases our confidence in the robustness of these findings.
OP57 The Contribution of Neighbourhoods and Schools to Cognitive Test Performance at Age Seven - Findings from the UK Millennium Cohort Study
Authors: Heilmann A , Kelly Y , Stafford M , Watt R G 
Published: September 2013

BackgroundThe relevance of neighbourhoods for children’s cognitive development, while receiving increasing attention, is still subject to debate. One mechanism that has been proposed is via institutional resources such as schools. Another hypothesis is that neighbourhood aspects influence maternal psychological well-being and parenting practices. However, the contribution of schools to the neighbourhood effect is understudied, and findings regarding the role of maternal mental health and parenting have so far been inconsistent. The aim of this research was twofold: first, to partition the variability in children’s cognitive test performance between neighbourhoods, schools and families, and second, to examine whether maternal psychological distress and parenting practices were on the pathway between neighbourhood characteristics and these outcomes.MethodsWe analysed data from the UK Millennium Cohort Study. Outcome measures were cognitive test performance at age 7 in reading, maths and a pattern construction test. Data were analysed for 9,412 children who had not changed school and lived in the same neighbourhood since age 5, and for whom information was complete. Neighbourhoods were defined as Lower Layer Super Output Areas. Cross-classified multilevel models were used to simultaneously estimate the variability in cognitive test outcomes between neighbourhoods and schools before and after adjusting for family-level covariates; and to examine the contribution of maternal psychological distress and parenting practices.ResultsAt age 7, the percentage of the unadjusted variance in cognitive test performance between neighbourhoods was about 5% for reading, 9% for maths and 7% for pattern construction. The unadjusted variance between schools was about 10% for reading, 12% for maths, and 6% for pattern construction. After allowing for a range of family background characteristics, the neighbourhood variance for reading was no longer statistically significant, while a school effect of about 7% remained. For maths, the remaining variance attributable to neighbourhoods and schools was 7% and 10% respectively, while for pattern construction, this was about 3% at both levels. Reading and math test performance were independently associated with neighbourhood median household income, and pattern construction scores with the IMD education domain in the expected direction. Our data did not support the hypothesis of a mediating effect via maternal psychological distress and parenting practices.ConclusionOur findings highlight the importance of including both neighbourhoods and schools when aiming to determine the contribution of contextual factors to children’s cognitive test performance. Differences between neighbourhoods and schools appear to contribute to inequalities in children’s cognitive development already at this early age.
OP58 Exploring Household Dynamics: The Reciprocal Effects of Parent and Child Characteristics
Authors: Panico L , Webb E A , Becares L 
Published: September 2013

BackgroundStudies show a strong relationship between maternal mental health and child socio-emotional development. This literature is based on examinations of dyadic relationships, where maternal mental health is hypothesised to have a direct effect on children’s development. However, household dynamics are complex, with other household members having an effect both on the mother and the child. Furthermore, the child’s characteristics can also have a feedback effect on their career’s outcomes.MethodsIn this paper, we employ a multilevel structural equation model with cross lagged effects to understand the reciprocal effects of maternal mental health, child socio-emotional development, and quality of parental relationship. Analyses were conducted on longitudinal data from the Millennium Cohort Study, a prospective national birth cohort of children born in the UK 2000–2001. The Millennium Cohort Study has a wealth of information on the socioeconomic background of the household, and has collected data on the mother’s mental health (Kessler 6), the quality of the parents’ relationship (Golombok-Rust), and the children’s socio-emotional development (SDQ). Our results relate to households with two continuously partnered parents, with complete data on the three key variables, producing a sample size of 6570 households. In this work we look at data relating to age 3 and 5 years.ResultsChild socio-emotional development at age 3 has an influence on maternal mental health when their child is age 5 (standardised β = 0.03 [95% CI 0.001, 0.05]) and maternal mental health at age 3 has an influence on child socio-emotional development at age 5 (0.07; 0.05–0.10). Quality of the parental relationship at age 3 has an influence on maternal mental health when their child is age 5 (0.04 [0.02, 0.06]) but does not influence child socio-emotional development at age 5. Neither child socio-emotional development nor maternal mental health at age 3 influence the quality of the parental relationship when their child is age 5.ConclusionWe find complex significant relationships between maternal mental health, child socio-emotional development and quality of parental relationship. This points to the need to consider all household members in order to properly capture household dynamics and to understand drivers of parental and child wellbeing.
OP62 How do Adiposity Trajectories Vary by Birth Cohort and Parental Social Class? Evidence from the West of Scotland Twenty-07 Study
Authors: Shaw R J , Green M , Popham F , Benzeval M 
Published: September 2013

BackgroundOver the last 80 years the association between social class and obesity has changed. In the 1930s obesity rates were low and wealthy people tended to have a higher risk of obesity than poor people. However, rising affluence and industrialisation has lead to both rising rates of obesity and an obesogenic environment in which socioeconomically disadvantaged people have the highest risk of obesity. This study investigates the magnitude of these changes by modelling trajectories of adiposity by social class and cohort using the Twenty-07 study.MethodsThe Twenty-07 study contains three cohorts of people (n = 4510), born in Glasgow in the 1930s, 1950s and 1970s. Two measures of adiposity, BMI and Waist to Height Ratio (WHtR), were recorded at baseline in 1987/8 when study participants were aged 15, 35 or 55, and again on 4 further occasions over 20 years. Parental social class (manual/non-manual) was collected at baseline. For each gender, we apply multilevel models to identify trajectories of adiposity by cohort and social class.ResultsThe trajectories indicated that adiposity increased with age and rates of increase varied by cohort, social class and gender. For any given age the youngest cohort had the fastest rate of increase and the highest predicted adiposity. For example, at age 35 for non-manual men, BMI was 24.2 (95% CI 23.7, 24.8) for the 1950s cohort and 27.2 (26.8, 27.5) for the 1970s cohort. By the end of the study respondents in more recent cohorts had BMI values approximately equivalent to those of people aged 20 years older in an earlier cohort. Cohort variation was much greater than socioeconomic variation. The smallest cohort difference in BMI was 2.10 (0.94, 3.26), a comparison of the 1950 and 1930s cohorts for non-manual men at age 55. In contrast, the largest social class difference in BMI, a comparison of manual and non manual women at age 64, was only 1.18 (0.37, 1.98). Socioeconomic inequalities tended to be smaller for men than women, particularly for the 1930s cohort where there was no evidence of a socioeconomic gradient for men unlike for women. The main difference between WHtR and BMI was that increases in WHtR accelerated with age whilst increases in BMI slowed with age.ConclusionIncreases in adiposity for younger cohorts across all socioeconomic groups dwarf any socioeconomic inequalities in adiposity. This highlights the damaging impact for the whole population of living in an obesogenic environment.