COMPASS

Against the background of increasing concern about levels of physical activity among young people, this paper reports the results of a cross-national comparison between two longitudinal studies of young people in Glasgow, Scotland and Dunedin, New Zealand, which used similar methods of assessment at 15 and 18 years of age. The comparison revealed that, on average, young people in Dunedin participated in a greater range of activities, encompassing both organised sports and informal activities such as cycling, and with greater frequency than those in Glasgow at both ages, but particularly so at age 18. The difference was especially marked for females, among whom one in three in Glasgow reported no physical activity at all at age 18. By contrast, in both sexes among those who did participate, much less difference in levels of involvement was observed between the two locations. Of 35 activities, only in respect of soccer, and only for males, did participation and involvement in Glasgow exceed that of Dunedin. Neither climatic factors, natural features of the environment, socio-economic composition, nor different proportions in singlesex/co-educational schooling explain the difference in levels of participation between the two locations. Participation rates in selected physical activities do, however, reflect different opportunity structures in Dunedin and Glasgow, with an advantage accruing to the former in respect of both school and post-school provision. Cultural factors, which underpin such differences, also appear to have an additional influence on participation, most notably in relation to the gender gap in physical activities, much bigger in Glasgow than Dunedin. To redress these differences requires an increase in levels of participation generally, particularly among females, which depends as much on a shift in values about physical activity as on the provision of better resources. #

Though there is much agreement on the importance of the social determinants of health, debate continues on suitable empirically-based models to underpin efforts to tackle health and health care disparities. We demonstrate an approach that uses a dynamic micro-simulation model of the early life course, based on longitudinal data from a New Zealand cohort of children born in 1977, and counterfactual reasoning applied to a range of outcomes. The focus is on health service use with a comparison to outcomes in non-health domains, namely educational attainment and antisocial behaviour. We show an application of the model to test scenarios based on modifying key determinants and assessing the impact on putative outcomes. We found that appreciable improvement was only effected by modifying multiple determinants; structural determinants were relatively more important than intermediary ones as potential policy levers; there was a social gradient of effect; and interventions bestowed the greatest benefit to the most disadvantaged groups with a corresponding reduction in disparities between the worst-off and the best-off. Our findings provide evidence on how public policy initiatives might be more effective acting broadly across sectors and across social groups, and thus make a real difference to the most disadvantaged.

To compare the health of the Dunedin Multidisciplinary Health and Development Study members with people of the same age in the nationally representative New Zealand Health and National Nutrition Surveys. Where similar information was obtained, means or proportions and confidence intervals were generated for both the age 26 assessment of the Dunedin sample and for the 25-26 year old participants in the national surveys. The populations were considered to differ when confidence intervals did not overlap. For smoking habit, body mass index, waist-hip ratio, general practitioner and medical specialist consultations, and hospital admissions, the findings of the Dunedin Study were not significantly different to the nationally representative surveys. The Dunedin Study members also did not differ from their national counterparts on SF-36 subscales measuring physical functioning, bodily pain, general health, vitality, and mental health. They had better scores on the three interference subsca...