Lecture 21: The Influence of Neighbourhoods on Population Health

Question 1

where is diagnosed diabetes the highest, and which group is the comparison group?

Answer 1

mangere, comparison group was north shore general electoral district

Question 2

what is neighbourhood deprivation?

Answer 2

1. way of measuring people’s relative position in society
2. measures focus on material deprivation
3. tends to use a deficit approach to describe population health

Question 3

variables in NZDEP2018

Answer 3

communication: no internet
income: aged 18-64 with a benefit
income: equivalised households with income below threshold
employment: 18-64 unemployed
qualification: 18-64 without any qualifications
owned home: people not living in their own home
support: people aged <65 living in a single parent family
living space: ppl living in equivalised households below a bedroom occupancy threshold
damp/mould: people living in households that are always damp.

Question 4

variables in NZDEP2018

Answer 4

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communication: no internet
income: aged 18-64 with a benefit
income: equivalised households with income below threshold
employment: 18-64 unemployed
qualification: 18-64 without any qualifications
owned home: people not living in their own home
support: people aged <65 living in a single parent family
living space: ppl living in equivalised households below a bedroom occupancy threshold
damp/mould: people living in households that are always damp.

Question 4

variables in NZIMD

Answer 4

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employment: degree to which working age people are excluded from employment
income: extent of income deprivation in data zone
crime: risk of personal and material victimizations
housing: ppl living in overcrowded housing + proportion living in rented accommodation
health: areas w high level of ill health/mortality
education: youth disengagement + proportion of wa population without a formal qualification
access: measure cost/inconvenience of travelling to access basic services.

Question 5

IMD vs NZDEP

Answer 5

nzdep is very high, imd is very low:
- more indicators in imd (28/9)
- there are more young people who may not be rich but fit the other indicators that imd includes

high imd, low nzdep
- older population (house domains)

Question 6

appropriate uses of nzdep13?

Answer 6

planning and resource allocation
research
advocacy

Question 7

what is ecological fallacy?

Answer 7

an error that arises when information about groups of people is used to make inferences about individuals

Question 8

what are the three levels of influence (dawm)

Answer 8

1. person (age, sex, biology, behaviour risk factors + attitudes)
2. community (availability of parks/recreation opportunities).
3. environment (physical, built, school, work, home)

Question 9

how to address variations in health?

Answer 9

upstream interventions tend to belong on the outermost arch on dahlgren + whitehead

but interventions can target individual family/community/environment

e.g. gluoridating water at source, taxation schemes, green prescriptions

Question 10

what does a healthy environment constitute of?

Answer 10

physical, social and political settings that prevent disease

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1. clean air + water
2. appropriate housing
3. access to wholesome food (fruit/vegetables)
4. safe community spaces
5. access to transport
6. opportunities to incorporate exercise as part of daily life.

Question 11

what does the built environment constitute of?

Answer 11

buildings, spaces and products that are created/significantly modified by people

1. structures (homes, schools, workplaces)
2. urban design (public areas, business areas, roads)

above ground (electrical transmission lines)
below ground (subways, waste disposal)
along ground (motorways/transportation)

Question 12

how do we measure urban design?

Answer 12

context specific: dependnent on research
urban density: population/employment density
land-use mix: residential, commercial, industrial, educational, wasteland
street connectivity: lollipop neighbourhoods vs well connected streets

Question 13

how can we use urban design to improve active travel/physical activity?

Answer 13

1. street connectivity (reduces distance bt destination)
2. traffic calming: street width, cycle lands. encourage wlaking
3. mix of residential, commercial, business. different uses of land.
4. public open spaces/physical activity spaces. open spaces increases opportunities for physical activity.