Findings from a community-based 5-year cluster randomised trial
Masamitsu Kamada, I-Min Lee and Ichiro Kawachi
Despite the well-known health benefits of physical activity, physical inactivity remains highly prevalent globally. Effective population strategies to promote physical activity are needed to reduce the global burden of non-communicable diseases stemming from physical inactivity. But the question is: how do we effectively promote physical activity at the population level, such as in entire communities?
Reducing child mortality remains one of the key objectives of the Sustainable Development Goals. Remarkable progress has been made over the past 25 years, with the global number of deaths of children aged under 5 falling from 13 million in 1990 to six million in 2015. Yet little is known about the relative contributions of specific public health interventions and general improvements in socioeconomic status and educational attainment over the same period.
Elias Nosrati, Michael Ash, Michael Marmot, Martin McKee and Lawrence P King
Health inequalities are on the rise in the United States: the gap in life expectancy between those at the top and the bottom of the income spectrum has increased rapidly since the dawn of the century, to the point where the lives of the poor are cut short by up to a decade and a half compared with those of the wealthy. Moreover, while the rich tend to live longer everywhere, life expectancy among the poor varies significantly by geographical region.
In our article recently published in the IJE, we show that these patterns of health are the product of powerful political and economic forces. Over the past few decades, neoliberal politics, the decline of unions and economic globalisation have resulted in rapid industrial restructuring and economic dislocation in the US. Organised labour has been eroded in the industrial heartland, and manufacturing operations have been shifted to the non-unionised south and to foreign countries.
Johanna Metsälä, Jaakko Nevalainen and Suvi M Virtanen
Traditionally, asthma and type 1 diabetes have been considered distinct immune-mediated diseases in which the underlying immune responses counteract each other, resulting in an inverse association between the diseases. In our study, recently published in the IJE, we explored the association between asthma and type 1 diabetes in childhood in a novel way, and observed that the direction of the association is dependent on the order of appearance of the diseases.
Dementia is the most feared aspect of ageing and is a major global health challenge, so identifying lifestyle factors that can reduce memory decline, and possibly prevent dementia from occurring, is a research priority. In our study, recently published in the IJE, we explored whether having more frequent contact with friends and family, or being married, is linked to better memory and language in older age.
We found that having more social contact and being married in mid-life were both linked to having better cognitive performance over the next 20 years. In particular, we found that verbal fluency was the cognitive area with the strongest link to social contact.
Daniel H Simon, Andrea M Tilstra and Ryan K Masters
Rising mortality among young and middle-aged White Americans has alarmed researchers, public health professionals and the broader public. These concerns were amplified by a 2015 study in which the authors attributed rising mortality rates among White Americans to increases in deaths from chronic liver disease, suicide and drug overdoses. The authors argued that increased mortality from these causes of death is likely a result of the “same underlying epidemic” that is affecting a “lost generation” of Americans. The underlying epidemic was said to be “deaths of despair”, originating from rising distress, economic insecurity and chronic pain.
Only a few years ago, doctors would advise their patients that elevated blood levels of high-density lipoprotein cholesterol (HDL-C), then termed the “good cholesterol”, were beneficial and would protect them against coronary heart disease. This belief has been called into question, however, as neither genetics nor clinical trials could demonstrate that raising HDL-C levels would protect against cardiovascular disease. Our study, published recently in the IJE, casts further doubt on this “not-so-good-anymore” cholesterol by showing that genetic variants that cause higher HDL-C levels also increase the risk for age-related macular degeneration (AMD).
Tanja AJ Houweling, David Osrin, Kishwar Azad, Dharma S Manandhar, Prasanta Tripathy, Tambosi Phiri, Joanna Morrison and Anthony Costello
In low- and middle-income countries, the odds of surviving the first 28 days of life are grossly unequal between infants born in deprived and better-off families, even among children living in the same community. In our study, recently published in the IJE, we have shown that women’s groups are able to address this problem. Under the guidance of a facilitator, women came together every month to discuss problems during pregnancy, delivery and the newborn period, and then designed and implemented strategies to overcome these problems with the help of the entire community.
Eleonora Uphoff, Neil Small, Rosie McEachan and Kate Pickett
For some years, our research has been based in the city of Bradford in northern England. We are often asked to justify our research setting. There seems to be a concern that a cohort population that is not representative of the nation as a whole or of the ‘average person’ cannot produce valuable insights beyond its local setting.
While such concerns are not new, they now seem more present, perhaps due to the rise of Big Data or the increased sharing of and access to data from national surveys and cohorts. Do these reservations represent a push for representativeness and generalisability in epidemiology? If so, this might come at the expense of research aiming to paint a more detailed picture of population health.
Vicente Martínez-Vizcaíno, Celia Álvarez-Bueno and Iván Cavero-Redondo
Our study, recently published in the IJE, looks at the relationship between pre-gestational weight status and children’s neurodevelopment. It shows that children born to mothers who were normal weight before pregnancy scored better on cognition tests than children born to obese women. An original aspect of our study is that it summarises the evidence provided by 15 previous follow-up studies, including samples from seven different countries, and provides information for both cognition tests and general intelligence scores.