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Jenny Godley

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Johnna Montgomerie

Goldsmiths, University of London

Armando Marques-Guedes

UNL - New University of Lisbon

University of the Basque Country, Euskal Herriko Unibertsitatea

Università Degli Studi Di Roma Tre

Middlesex University

Farzana Dudhwala

University of Oxford

Godfrey M Musila

Independent Researcher

Christian Quendler

University of Innsbruck

Università Suor Orsola Benincasa di Napoli

Roberto Cippitani

Indepac

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Papers by Jenny Godley

Impact of a farmers’ market healthy food subsidy on the diet quality of adults with low incomes in British Columbia, Canada: a pragmatic randomized controlled trial

The American Journal of Clinical Nutrition

Modifiable Risk Factors Mediate Associations Between Socioeconomic Position and Cardiovascular Disease Morbidity and Mortality

Current Developments in Nutrition

Objectives Morbidity and mortality from cardiovascular diseases (CVDs) are higher among individua... more Objectives Morbidity and mortality from cardiovascular diseases (CVDs) are higher among individuals with a lower, compared to those with a higher socioeconomic position (SEP). However, the contribution of modifiable risk factors to these inequities is not known. This study aimed to examine whether and to what extent modifiable risk factors mediate associations between SEP and CVD morbidity and mortality in a nationally representative sample of Canadian adults. Methods We used a population-based prospective observational cohort design whereby participants who completed the Canadian Community Health Survey (2000–2011; n = 289,800) were followed longitudinally for CVD morbidity and mortality using administrative health and mortality data in the Discharge Abstract Database and the Canadian Mortality Database until 31 March 2013. Participants were included if they were at least 35 years of age and did not self-report CVD at the time of survey administration. The exposure of interest was ...

The Contribution of Modifiable Risk Factors to Socioeconomic Inequities in Cardiovascular Disease Morbidity and Mortality: A Nationally Representative Population-Based Cohort Study

SSRN Electronic Journal

Fr231 VARIATION IN TISSUE TRANSGLUTAMINASE TESTING AND THE INCIDENCE OF CELIAC DISEASE AUTOIMMUNITY: A POPULATION-BASED STUDY IN ALBERTA, CANADA

Gastroenterology, 2021

Quantifying the contribution of modifiable risk factors to socio-economic inequities in cancer morbidity and mortality: a nationally representative population-based cohort study

International Journal of Epidemiology, 2021

Background Compared with those with a higher socio-economic position (SEP), individuals with a lo... more Background Compared with those with a higher socio-economic position (SEP), individuals with a lower SEP have higher cancer morbidity and mortality. However, the contribution of modifiable risk factors to these inequities is not known. This study aimed to quantify the mediating effects of modifiable risk factors to associations between SEP and cancer morbidity and mortality. Methods This study used a prospective observational cohort design. We combined eight cycles of the Canadian Community Health Survey (2000/2001–2011) as baseline data to identify a cohort of adults (≥35 years) without cancer at the time of survey administration (n = 309 800). The cohort was linked to the Discharge Abstract Database and the Canadian Mortality Database for cancer morbidity and mortality ascertainment. Individuals were followed from the date they completed the Canadian Community Health Survey until 31 March 2013. Dates of individual first hospitalizations for cancer and deaths due to cancer were cap...

Incidence of Celiac Disease Is Increasing Over Time: A Systematic Review and Meta-analysis

American Journal of Gastroenterology, 2020

OBJECTIVES: To conduct a systematic review and meta-analysis that defines the worldwide incidence... more OBJECTIVES: To conduct a systematic review and meta-analysis that defines the worldwide incidence of celiac disease (CD) and examines temporal trends. METHODS: MEDLINE and EMBASE were searched for population-based studies reporting the incidence of CD in the overall population, children, or adults. No limits were placed on year or language of publication. Studies solely examining at-risk populations (e.g., patients with type 1 diabetes) were excluded. Random-effects models were performed to meta-analyze sex- and age-specific incidence in the 21st century. Temporal trend analyses assessed the average annual percent change in CD incidence over time. RESULTS: Of 11,189 citations, 86 eligible studies were identified for inclusion, of which 50 were deemed suitable for analyses. In the 21st century, the pooled female incidence of CD was 17.4 (95% confidence interval [CI]: 13.7, 21.1) (I2 = 99.5%) per 100,000 person-years, compared with 7.8 (95% CI: 6.3, 9.2) (I2 = 98.6%) in males. Child-s...

Socioeconomic disadvantage within a neighborhood, perceived financial security and self-rated health

Health & Place, 2009

We examine whether perceived financial security mediates the association between social deprivati... more We examine whether perceived financial security mediates the association between social deprivation and self-rated health, using data from a 2004 survey of residents of one neighborhood in Calgary (N ¼ 441) and 2001 Census data on the 26 Census Dissemination Areas (DAs) that make up this neighborhood. Net of sociodemographic characteristics of residents, DA disadvantage had significant associations with being in fair/poor or very good health as compared to excellent health. Perceived financial security explained part of this association and influenced health over and above individual-and DA-level sociodemographic characteristics. These findings suggest social deprivation and perceptions of financial security are potentially useful intervention targets.

Small area contextual effects on self-reported health: Evidence from Riverside, Calgary

BMC Public Health, 2010

Background: We study geographic variation within one community in the City of Calgary using a mor... more Background: We study geographic variation within one community in the City of Calgary using a more fine-grained geographic unit than the Census tract, the Census Dissemination Area (DA). While most Riverside residents consider their neighbourhood to be a fairly cohesive community, we explore the effect of socioeconomic variation between these small geographic areas on individuals' self-reported health, net of individual level determinants. Methods: We merge data from the 2001 Census for Riverside, Calgary with a 2004 random telephone survey of Riverside residents. Our data are unique in that we have information on individuals from every DA wholly contained in the Riverside community. These data enable us to conduct multinomial logistic regression analyses of self-reported health using both individual-level and DA-level variables as predictors. Results: We find significant variation in measures of DA socioeconomic status within the Riverside community. We find that individual self-reported health is affected by variation in an index of DA-level socioeconomic disadvantage, controlling for individual variation in gender, age, and socioeconomic status. We investigate each aspect of the DA index of disadvantage separately, and find that average education and the percent of households that are headed by a lone parent are most important. Conclusions: These findings demonstrate that, even within a cohesive community, contextual effects on health can be located at a smaller geographic level than the Census tract. Research on the effects of local area socioeconomic disadvantage on health that combines administrative and survey data enables researchers to develop more comprehensive measures of social and material deprivation. Our findings suggest that both social and material deprivation affect health at the local level.

Understanding Interdisciplinary Collaborations as Social Networks

American Journal of Community Psychology, 2010

The dynamics of interdisciplinary collaboration invite further investigation if we are to make th... more The dynamics of interdisciplinary collaboration invite further investigation if we are to make this endeavour more rewarding and productive. We are using social network analysis to track the development of a new interdisciplinary collaboration on complex interventions to improve population health. It involves nineteen scholars across four countries. We report the Baseline network of formal relationships among the scholars, along with the impact of the collaboration on these relationships in the first 18 months. We observed statistically significant increases in the density of six types of relationship networks: citing publications by other members of the collaboration, email contact, meeting with each other (outside of the formal annual meeting), visiting one another&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s institution, submitting research grants together and working on research projects together. The initial strategic role in the network of key &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;gate keepers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; has not altered substantially (betweenness centralization of the networks), but reciprocity has increased, that is, people are more likely to cite those who have cited them and work together. Increased collaboration is also reflected in the rise in number of subgroups over time and the increase in the average number of subgroup memberships. Use of social network analysis to understand the dynamics of interdisciplinary collaborations is a relatively new field. It invites reflection about what the optimal network structures for interdisciplinary collaborations would look like.

Survey Research on Health Inequalities: Exploring the Availability of Indicators of Multiple Forms of Capital in Canadian Datasets

International Journal of Public Health, 2021

Objective: Much of the extensive quantitative research linking socio-economic position (SEP) and ... more Objective: Much of the extensive quantitative research linking socio-economic position (SEP) and health utilizes three common indicators: income, occupation and education. Existing survey data may enable researchers to include indicators of additional forms of capital in their analyses, permitting more nuanced consideration of the relationship between SEP and health. Our objective was to identify the breadth of survey questions related to economic, cultural, and social capital available through Statistics Canada surveys, and the extent to which those surveys also include health measures.Methods: We compiled a list of all population-based Statistics Canada surveys, and developed a broad list of potential indicators of forms of capital. We systematically searched the surveys for those indicators and health measures, analyzing their co-occurrence.Results: Traditional SEP indicators were present in 73% of surveys containing health measures, while additional indicators of social and cult...

Social class, gender, and time use: implications for the social determinants of body weight?

Health reports, 2009

The social gradient in body weight (for example, obesity) departs from the social gradient in oth... more The social gradient in body weight (for example, obesity) departs from the social gradient in other health outcomes. Innovative approaches are needed to understand the observed patterns. This study examines time-use patterns by indicators of socio-economic position, and considers the implications of variations in time use for the social gradient in weight reported in other studies. The data are from respondents aged 25 to 64 to Canada's 1986 and 2005 General Social Surveys, which focused on time use. Participation in various activities was examined by sex, and by personal income and education, stratified by sex, in both years. Higher-income men and women were more likely than those of lower income to spend time in paid work, commuting and eating out, and less likely to spend time sleeping. Men and women with higher education were more likely than those with lower education to spend time in physical activity (2005 only) and reading. These time-use patterns plausibly contribute to...

Social Class and BMI Among Canadian Adults: A Focus on Occupational Prestige

Obesity, 2009

The objective was to examine BMI of working‐age Canadian adults in relation to occupational prest... more The objective was to examine BMI of working‐age Canadian adults in relation to occupational prestige, adjusting for other aspects of social class including household income and respondent's education. We analyzed data from 49,252 adults (age 25–64) from Cycle 2.1 of the Canadian Community Health Survey, a cross‐sectional self‐report survey conducted in 2003. Multiple linear regression was used to examine the relation between BMI and occupational prestige, adjusting for other sociodemographic variables. For women, higher ranking occupations showed lower average BMI relative to the lowest ranking occupations, but this effect was largely eliminated when adjusting for education. For men, occupation effects endured in adjusted models and we detected some evidence of a pattern whereby men in occupations characterized by management/supervisory responsibilities were heavier than those in the lowest ranking occupations (i.e., elemental sales and service). Results are interpreted in light...

Socioeconomic Status and Body Mass Index in Canada: Exploring Measures and Mechanisms

Canadian Review of Sociology/Revue canadienne de sociologie, 2010

Nous examinons la relation entre le statut socio‐économique (SES), les caractéristiques socio‐éco... more Nous examinons la relation entre le statut socio‐économique (SES), les caractéristiques socio‐économiques (SES), le style de vie (consommation de fruits et légumes, exercice physique, usage du tabac, et consommation d'alcool) et l'indice de masse corporelle (IMC) sur la base des données de l'Enquête sur la santé dans les collectivités canadiennes 2.1. Nous explorons deux différentes mesures socio‐économiques, éducation et revenu, afin d'élucider les explications matérielles et culturelles de la relation SES‐IMC. Les résultats varient de manière significative entre les genres, dégageant la complexité de la relation entre SES, les facteurs socio‐démographiques et de style de vie, et l'IMC. Nous suggérons que la masse corporelle demeure un symbole de statut qui diffère entre les genres, et que les facteurs culturaux et psycho‐sociaux sont peut‐être plus importants que les facteurs matériaux en perpétuant cette inégalité dans le domaine de la santé.

A social network analysis of Canadian food insecurity policy actors

Canadian journal of dietetic practice and research : a publication of Dietitians of Canada = Revue canadienne de la pratique et de la recherche en dietetique : une publication des Dietetistes du Canada, Jun 1, 2018

This paper aims to: (i) visualize the networks of food insecurity policy actors in Canada, (ii) i... more This paper aims to: (i) visualize the networks of food insecurity policy actors in Canada, (ii) identify potential food insecurity policy entrepreneurs (i.e., individuals with voice, connections, and persistence) within these networks, and (iii) examine the political landscape for action on food insecurity as revealed by social network analysis. A survey was administered to 93 Canadian food insecurity policy actors. They were each asked to nominate 3 individuals whom they believed to be policy entrepreneurs. Ego-centred social network maps (sociograms) were generated based on data on nominees and nominators. Seventy-two percent of the actors completed the survey; 117 unique nominations ensued. Eleven actors obtained 3 or more nominations and thus were considered policy entrepreneurs. The majority of actors nominated actors from the same province (71.5%) and with a similar approach to theirs to addressing food insecurity (54.8%). Most nominees worked in research, charitable, and othe...

Income, education, and hospitalization in Canada: results from linked census and administrative data

Discover Social Science and Health

Background Addressing population health inequities begins with quantifying how social factors aff... more Background Addressing population health inequities begins with quantifying how social factors affect the health and health care utilization of individuals. Such quantification relies on the availability of detailed health and demographic data. Unfortunately, administrative health care data rarely includes detailed demographic information. Data linkage, which combines administrative health data with national-level census or survey data, enables researchers to examine socio-economic inequalities in health care utilization in greater detail. Data and methods With access to a unique Canadian dataset linking data from the Hospital Discharge Abstract Database (DAD) from 2006 to 2007 with detailed individual-level socio-demographic data from the 2006 Canadian Census, we are able to examine the patterning of hospitalization in Canada in the early 2000s across a variety of socio-demographic variables. We examine the association of education and income, controlling for immigration status, rur...

Associations of friendship and children’s physical activity during and outside of school: A social network study

SSM - Population Health, 2018

Friendships play a significant role in child development and may influence children's physical ac... more Friendships play a significant role in child development and may influence children's physical activity (PA). Using a whole-network approach, this study examined whether school-based friends are more similar in their pedometer-measured PA compared to children who are not friends, and whether these patterns vary by gender, strength of friendship (best vs. close friends), and during vs. outside of school. The analytical sample included 706 grade 5 students (10-to 11-years-old) in 27 schools who were participating in the APPLE Schools project (Alberta Project Promoting healthy Living for Everyone in schools) in Edmonton and Fort McMurray, Alberta, Canada in the spring of 2013. Data collected included student and parent survey responses, time-stamped pedometer data for nine consecutive days, and close and best within-school and within-grade friendship nominations. We used Multiple Regression-Quadratic Assignment Procedure (MR-QAP) to examine the effect of friendship ties on PA similarity overall, and for during and outside of school periods, controlling for covariates and clustering within schools. When all friendships (i.e., close and best) were considered, female friends exhibited more similar levels of overall PA than non-friends, and these findings held for school days, the duringschool period, and non-school days. When close and best friends were examined separately in the same model (non-friends as the referent), both close and best friends were more similar than non-friends. The close friendship findings held for non-school days, and the best friendship findings held for school days, including the duringschool and before-and after-school periods. For males, only reciprocated best friends had more similar levels of overall PA compared to unreiprocated friendships and non-friends. Programs and policies that focus on increasing PA in children may benefit from incorporating friendship-based strategies and programming, especially for females.

Association between subjective social status and cardiovascular disease and cardiovascular risk factors: a systematic review and meta-analysis

BMJ Open, 2016

To determine the association between subjective social status (SSS), or the individual's percepti... more To determine the association between subjective social status (SSS), or the individual's perception of his or her position in the social hierarchy, and the odds of coronary artery disease (CAD), hypertension, diabetes, obesity and dyslipidaemia. Study Design: Systematic review and meta-analysis. Methods: We searched PubMed, MEDLINE, EMBASE, CINAHL, PsycINFO, SocINDEX, Web of Science and reference lists of all included studies up to October 2014, with a verification search in July 2015. Inclusion criteria were original studies in adults that reported odds, risk or hazard ratios of at least one outcome of interest (CAD, hypertension, diabetes, obesity or dyslipidaemia), comparing 'lower' versus 'higher' SSS groups, where SSS is measured on a self-anchoring ladder. ORs were pooled using a random-effects model. Results: 10 studies were included in the systematic review; 9 of these were included in the meta-analysis. In analyses unadjusted for objective socioeconomic status (SES) measures such as income, education or occupation, the pooled OR comparing the bottom versus the top of the SSS ladder was 1.82 (95% CI 1.10 to 2.99) for CAD, 1.88 (95% CI 1.27 to 2.79) for hypertension, 1.90 (95% CI 1.25 to 2.87) for diabetes, 3.68 (95% CI 2.03 to 6.64) for dyslipidaemia and 1.57 (95% CI 0.95 to 2.59) for obesity. These associations were attenuated when adjusting for objective SES measures, with the only statistically significant association remaining for dyslipidaemia (OR 2.10, 95% CI 1.09 to 4.06), though all ORs remained greater than 1. Conclusions: Lower SSS is associated with significantly increased odds of CAD, hypertension, diabetes and dyslipidaemia, with a trend towards increased odds of obesity. These trends are consistently present, though the effects attenuated when adjusting for SES, suggesting that perception of one's own status on a social hierarchy has health effects above and beyond one's actual income, occupation and education.

Networks of trainees: examining the effects of attending an interdisciplinary research training camp on the careers of new obesity scholars

Journal of Multidisciplinary Healthcare, 2014

Students training in obesity research, prevention, and management face the challenge of developin... more Students training in obesity research, prevention, and management face the challenge of developing expertise in their chosen academic field while at the same time recognizing that obesity is a complex issue that requires a multidisciplinary and multisectoral approach. In appreciation of this challenge, the Canadian Obesity Network (CON) has run an interdisciplinary summer training camp for graduate students, new career researchers, and clinicians for the past 8 years. This paper evaluates the effects of attending this training camp on trainees' early careers. We use social network analysis to examine the professional connections developed among trainee Canadian obesity researchers who attended this camp over its first 5 years of operation (2006-2010). We examine four relationships (knowing, contacting, and meeting each other, and working together) among previous trainees. We assess the presence and diversity of these relationships among trainees across different years and disciplines and find that interdisciplinary contact and working relationships established at the training camp have been maintained over time. In addition, we evaluate the qualitative data on trainees' career trajectories and their assessments of the impact that the camp had on their careers. Many trainees report that camp attendance had a positive impact on their career development, particularly in terms of establishing contacts and professional relationships. Both the quantitative and the qualitative results demonstrate the importance of interdisciplinary training and relationships for career development in the health sciences.

Sex Differences in the Mediating Effects of Modifiable Risk Factors in Associations Between Socioeconomic Position and Cardiovascular Disease Morbidity and Mortality

Current Developments in Nutrition

Objectives Socioeconomic inequities in cardiovascular diseases (CVDs) are greater in females than... more Objectives Socioeconomic inequities in cardiovascular diseases (CVDs) are greater in females than males. However, the mechanisms underpinning the excess CVD risk conferred by low socioeconomic position (SEP) in females remain unclear. This study aimed to quantify the mediating effects of modifiable risk factors to associations between SEP and CVD morbidity and mortality. Methods We combined eight cycles of the nationally-representative cross-sectional Canadian Community Health Survey (2000–2011) to identify a cohort of adults (≥35 years) without CVD at the time of survey administration (n = 289,800). Survey data were linked to administrative health (Hospital Discharge Abstract Database) and mortality (Canadian Mortality Database) records for 2000–2012. SEP was captured by a latent variable consisting of self-reported educational level and household income. Self-reported modifiable risk factors, including smoking, physical inactivity, obesity, diabetes, and hypertension were conside...

Impact of a farmers’ market healthy food subsidy on the diet quality of adults with low incomes in British Columbia, Canada: a pragmatic randomized controlled trial

The American Journal of Clinical Nutrition

Modifiable Risk Factors Mediate Associations Between Socioeconomic Position and Cardiovascular Disease Morbidity and Mortality

Current Developments in Nutrition

Objectives Morbidity and mortality from cardiovascular diseases (CVDs) are higher among individua... more Objectives Morbidity and mortality from cardiovascular diseases (CVDs) are higher among individuals with a lower, compared to those with a higher socioeconomic position (SEP). However, the contribution of modifiable risk factors to these inequities is not known. This study aimed to examine whether and to what extent modifiable risk factors mediate associations between SEP and CVD morbidity and mortality in a nationally representative sample of Canadian adults. Methods We used a population-based prospective observational cohort design whereby participants who completed the Canadian Community Health Survey (2000–2011; n = 289,800) were followed longitudinally for CVD morbidity and mortality using administrative health and mortality data in the Discharge Abstract Database and the Canadian Mortality Database until 31 March 2013. Participants were included if they were at least 35 years of age and did not self-report CVD at the time of survey administration. The exposure of interest was ...

The Contribution of Modifiable Risk Factors to Socioeconomic Inequities in Cardiovascular Disease Morbidity and Mortality: A Nationally Representative Population-Based Cohort Study

SSRN Electronic Journal

Fr231 VARIATION IN TISSUE TRANSGLUTAMINASE TESTING AND THE INCIDENCE OF CELIAC DISEASE AUTOIMMUNITY: A POPULATION-BASED STUDY IN ALBERTA, CANADA

Gastroenterology, 2021

Quantifying the contribution of modifiable risk factors to socio-economic inequities in cancer morbidity and mortality: a nationally representative population-based cohort study

International Journal of Epidemiology, 2021

Background Compared with those with a higher socio-economic position (SEP), individuals with a lo... more Background Compared with those with a higher socio-economic position (SEP), individuals with a lower SEP have higher cancer morbidity and mortality. However, the contribution of modifiable risk factors to these inequities is not known. This study aimed to quantify the mediating effects of modifiable risk factors to associations between SEP and cancer morbidity and mortality. Methods This study used a prospective observational cohort design. We combined eight cycles of the Canadian Community Health Survey (2000/2001–2011) as baseline data to identify a cohort of adults (≥35 years) without cancer at the time of survey administration (n = 309 800). The cohort was linked to the Discharge Abstract Database and the Canadian Mortality Database for cancer morbidity and mortality ascertainment. Individuals were followed from the date they completed the Canadian Community Health Survey until 31 March 2013. Dates of individual first hospitalizations for cancer and deaths due to cancer were cap...

Incidence of Celiac Disease Is Increasing Over Time: A Systematic Review and Meta-analysis

American Journal of Gastroenterology, 2020

OBJECTIVES: To conduct a systematic review and meta-analysis that defines the worldwide incidence... more OBJECTIVES: To conduct a systematic review and meta-analysis that defines the worldwide incidence of celiac disease (CD) and examines temporal trends. METHODS: MEDLINE and EMBASE were searched for population-based studies reporting the incidence of CD in the overall population, children, or adults. No limits were placed on year or language of publication. Studies solely examining at-risk populations (e.g., patients with type 1 diabetes) were excluded. Random-effects models were performed to meta-analyze sex- and age-specific incidence in the 21st century. Temporal trend analyses assessed the average annual percent change in CD incidence over time. RESULTS: Of 11,189 citations, 86 eligible studies were identified for inclusion, of which 50 were deemed suitable for analyses. In the 21st century, the pooled female incidence of CD was 17.4 (95% confidence interval [CI]: 13.7, 21.1) (I2 = 99.5%) per 100,000 person-years, compared with 7.8 (95% CI: 6.3, 9.2) (I2 = 98.6%) in males. Child-s...

Socioeconomic disadvantage within a neighborhood, perceived financial security and self-rated health

Health & Place, 2009

We examine whether perceived financial security mediates the association between social deprivati... more We examine whether perceived financial security mediates the association between social deprivation and self-rated health, using data from a 2004 survey of residents of one neighborhood in Calgary (N ¼ 441) and 2001 Census data on the 26 Census Dissemination Areas (DAs) that make up this neighborhood. Net of sociodemographic characteristics of residents, DA disadvantage had significant associations with being in fair/poor or very good health as compared to excellent health. Perceived financial security explained part of this association and influenced health over and above individual-and DA-level sociodemographic characteristics. These findings suggest social deprivation and perceptions of financial security are potentially useful intervention targets.

Small area contextual effects on self-reported health: Evidence from Riverside, Calgary

BMC Public Health, 2010

Background: We study geographic variation within one community in the City of Calgary using a mor... more Background: We study geographic variation within one community in the City of Calgary using a more fine-grained geographic unit than the Census tract, the Census Dissemination Area (DA). While most Riverside residents consider their neighbourhood to be a fairly cohesive community, we explore the effect of socioeconomic variation between these small geographic areas on individuals' self-reported health, net of individual level determinants. Methods: We merge data from the 2001 Census for Riverside, Calgary with a 2004 random telephone survey of Riverside residents. Our data are unique in that we have information on individuals from every DA wholly contained in the Riverside community. These data enable us to conduct multinomial logistic regression analyses of self-reported health using both individual-level and DA-level variables as predictors. Results: We find significant variation in measures of DA socioeconomic status within the Riverside community. We find that individual self-reported health is affected by variation in an index of DA-level socioeconomic disadvantage, controlling for individual variation in gender, age, and socioeconomic status. We investigate each aspect of the DA index of disadvantage separately, and find that average education and the percent of households that are headed by a lone parent are most important. Conclusions: These findings demonstrate that, even within a cohesive community, contextual effects on health can be located at a smaller geographic level than the Census tract. Research on the effects of local area socioeconomic disadvantage on health that combines administrative and survey data enables researchers to develop more comprehensive measures of social and material deprivation. Our findings suggest that both social and material deprivation affect health at the local level.

Understanding Interdisciplinary Collaborations as Social Networks

American Journal of Community Psychology, 2010

The dynamics of interdisciplinary collaboration invite further investigation if we are to make th... more The dynamics of interdisciplinary collaboration invite further investigation if we are to make this endeavour more rewarding and productive. We are using social network analysis to track the development of a new interdisciplinary collaboration on complex interventions to improve population health. It involves nineteen scholars across four countries. We report the Baseline network of formal relationships among the scholars, along with the impact of the collaboration on these relationships in the first 18 months. We observed statistically significant increases in the density of six types of relationship networks: citing publications by other members of the collaboration, email contact, meeting with each other (outside of the formal annual meeting), visiting one another&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s institution, submitting research grants together and working on research projects together. The initial strategic role in the network of key &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;gate keepers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; has not altered substantially (betweenness centralization of the networks), but reciprocity has increased, that is, people are more likely to cite those who have cited them and work together. Increased collaboration is also reflected in the rise in number of subgroups over time and the increase in the average number of subgroup memberships. Use of social network analysis to understand the dynamics of interdisciplinary collaborations is a relatively new field. It invites reflection about what the optimal network structures for interdisciplinary collaborations would look like.

Survey Research on Health Inequalities: Exploring the Availability of Indicators of Multiple Forms of Capital in Canadian Datasets

International Journal of Public Health, 2021

Objective: Much of the extensive quantitative research linking socio-economic position (SEP) and ... more Objective: Much of the extensive quantitative research linking socio-economic position (SEP) and health utilizes three common indicators: income, occupation and education. Existing survey data may enable researchers to include indicators of additional forms of capital in their analyses, permitting more nuanced consideration of the relationship between SEP and health. Our objective was to identify the breadth of survey questions related to economic, cultural, and social capital available through Statistics Canada surveys, and the extent to which those surveys also include health measures.Methods: We compiled a list of all population-based Statistics Canada surveys, and developed a broad list of potential indicators of forms of capital. We systematically searched the surveys for those indicators and health measures, analyzing their co-occurrence.Results: Traditional SEP indicators were present in 73% of surveys containing health measures, while additional indicators of social and cult...

Social class, gender, and time use: implications for the social determinants of body weight?

Health reports, 2009

The social gradient in body weight (for example, obesity) departs from the social gradient in oth... more The social gradient in body weight (for example, obesity) departs from the social gradient in other health outcomes. Innovative approaches are needed to understand the observed patterns. This study examines time-use patterns by indicators of socio-economic position, and considers the implications of variations in time use for the social gradient in weight reported in other studies. The data are from respondents aged 25 to 64 to Canada's 1986 and 2005 General Social Surveys, which focused on time use. Participation in various activities was examined by sex, and by personal income and education, stratified by sex, in both years. Higher-income men and women were more likely than those of lower income to spend time in paid work, commuting and eating out, and less likely to spend time sleeping. Men and women with higher education were more likely than those with lower education to spend time in physical activity (2005 only) and reading. These time-use patterns plausibly contribute to...

Social Class and BMI Among Canadian Adults: A Focus on Occupational Prestige

Obesity, 2009

The objective was to examine BMI of working‐age Canadian adults in relation to occupational prest... more The objective was to examine BMI of working‐age Canadian adults in relation to occupational prestige, adjusting for other aspects of social class including household income and respondent's education. We analyzed data from 49,252 adults (age 25–64) from Cycle 2.1 of the Canadian Community Health Survey, a cross‐sectional self‐report survey conducted in 2003. Multiple linear regression was used to examine the relation between BMI and occupational prestige, adjusting for other sociodemographic variables. For women, higher ranking occupations showed lower average BMI relative to the lowest ranking occupations, but this effect was largely eliminated when adjusting for education. For men, occupation effects endured in adjusted models and we detected some evidence of a pattern whereby men in occupations characterized by management/supervisory responsibilities were heavier than those in the lowest ranking occupations (i.e., elemental sales and service). Results are interpreted in light...

Socioeconomic Status and Body Mass Index in Canada: Exploring Measures and Mechanisms

Canadian Review of Sociology/Revue canadienne de sociologie, 2010

Nous examinons la relation entre le statut socio‐économique (SES), les caractéristiques socio‐éco... more Nous examinons la relation entre le statut socio‐économique (SES), les caractéristiques socio‐économiques (SES), le style de vie (consommation de fruits et légumes, exercice physique, usage du tabac, et consommation d'alcool) et l'indice de masse corporelle (IMC) sur la base des données de l'Enquête sur la santé dans les collectivités canadiennes 2.1. Nous explorons deux différentes mesures socio‐économiques, éducation et revenu, afin d'élucider les explications matérielles et culturelles de la relation SES‐IMC. Les résultats varient de manière significative entre les genres, dégageant la complexité de la relation entre SES, les facteurs socio‐démographiques et de style de vie, et l'IMC. Nous suggérons que la masse corporelle demeure un symbole de statut qui diffère entre les genres, et que les facteurs culturaux et psycho‐sociaux sont peut‐être plus importants que les facteurs matériaux en perpétuant cette inégalité dans le domaine de la santé.

A social network analysis of Canadian food insecurity policy actors

Canadian journal of dietetic practice and research : a publication of Dietitians of Canada = Revue canadienne de la pratique et de la recherche en dietetique : une publication des Dietetistes du Canada, Jun 1, 2018

This paper aims to: (i) visualize the networks of food insecurity policy actors in Canada, (ii) i... more This paper aims to: (i) visualize the networks of food insecurity policy actors in Canada, (ii) identify potential food insecurity policy entrepreneurs (i.e., individuals with voice, connections, and persistence) within these networks, and (iii) examine the political landscape for action on food insecurity as revealed by social network analysis. A survey was administered to 93 Canadian food insecurity policy actors. They were each asked to nominate 3 individuals whom they believed to be policy entrepreneurs. Ego-centred social network maps (sociograms) were generated based on data on nominees and nominators. Seventy-two percent of the actors completed the survey; 117 unique nominations ensued. Eleven actors obtained 3 or more nominations and thus were considered policy entrepreneurs. The majority of actors nominated actors from the same province (71.5%) and with a similar approach to theirs to addressing food insecurity (54.8%). Most nominees worked in research, charitable, and othe...

Income, education, and hospitalization in Canada: results from linked census and administrative data

Discover Social Science and Health

Background Addressing population health inequities begins with quantifying how social factors aff... more Background Addressing population health inequities begins with quantifying how social factors affect the health and health care utilization of individuals. Such quantification relies on the availability of detailed health and demographic data. Unfortunately, administrative health care data rarely includes detailed demographic information. Data linkage, which combines administrative health data with national-level census or survey data, enables researchers to examine socio-economic inequalities in health care utilization in greater detail. Data and methods With access to a unique Canadian dataset linking data from the Hospital Discharge Abstract Database (DAD) from 2006 to 2007 with detailed individual-level socio-demographic data from the 2006 Canadian Census, we are able to examine the patterning of hospitalization in Canada in the early 2000s across a variety of socio-demographic variables. We examine the association of education and income, controlling for immigration status, rur...

Associations of friendship and children’s physical activity during and outside of school: A social network study

SSM - Population Health, 2018

Friendships play a significant role in child development and may influence children's physical ac... more Friendships play a significant role in child development and may influence children's physical activity (PA). Using a whole-network approach, this study examined whether school-based friends are more similar in their pedometer-measured PA compared to children who are not friends, and whether these patterns vary by gender, strength of friendship (best vs. close friends), and during vs. outside of school. The analytical sample included 706 grade 5 students (10-to 11-years-old) in 27 schools who were participating in the APPLE Schools project (Alberta Project Promoting healthy Living for Everyone in schools) in Edmonton and Fort McMurray, Alberta, Canada in the spring of 2013. Data collected included student and parent survey responses, time-stamped pedometer data for nine consecutive days, and close and best within-school and within-grade friendship nominations. We used Multiple Regression-Quadratic Assignment Procedure (MR-QAP) to examine the effect of friendship ties on PA similarity overall, and for during and outside of school periods, controlling for covariates and clustering within schools. When all friendships (i.e., close and best) were considered, female friends exhibited more similar levels of overall PA than non-friends, and these findings held for school days, the duringschool period, and non-school days. When close and best friends were examined separately in the same model (non-friends as the referent), both close and best friends were more similar than non-friends. The close friendship findings held for non-school days, and the best friendship findings held for school days, including the duringschool and before-and after-school periods. For males, only reciprocated best friends had more similar levels of overall PA compared to unreiprocated friendships and non-friends. Programs and policies that focus on increasing PA in children may benefit from incorporating friendship-based strategies and programming, especially for females.

Association between subjective social status and cardiovascular disease and cardiovascular risk factors: a systematic review and meta-analysis

BMJ Open, 2016

To determine the association between subjective social status (SSS), or the individual's percepti... more To determine the association between subjective social status (SSS), or the individual's perception of his or her position in the social hierarchy, and the odds of coronary artery disease (CAD), hypertension, diabetes, obesity and dyslipidaemia. Study Design: Systematic review and meta-analysis. Methods: We searched PubMed, MEDLINE, EMBASE, CINAHL, PsycINFO, SocINDEX, Web of Science and reference lists of all included studies up to October 2014, with a verification search in July 2015. Inclusion criteria were original studies in adults that reported odds, risk or hazard ratios of at least one outcome of interest (CAD, hypertension, diabetes, obesity or dyslipidaemia), comparing 'lower' versus 'higher' SSS groups, where SSS is measured on a self-anchoring ladder. ORs were pooled using a random-effects model. Results: 10 studies were included in the systematic review; 9 of these were included in the meta-analysis. In analyses unadjusted for objective socioeconomic status (SES) measures such as income, education or occupation, the pooled OR comparing the bottom versus the top of the SSS ladder was 1.82 (95% CI 1.10 to 2.99) for CAD, 1.88 (95% CI 1.27 to 2.79) for hypertension, 1.90 (95% CI 1.25 to 2.87) for diabetes, 3.68 (95% CI 2.03 to 6.64) for dyslipidaemia and 1.57 (95% CI 0.95 to 2.59) for obesity. These associations were attenuated when adjusting for objective SES measures, with the only statistically significant association remaining for dyslipidaemia (OR 2.10, 95% CI 1.09 to 4.06), though all ORs remained greater than 1. Conclusions: Lower SSS is associated with significantly increased odds of CAD, hypertension, diabetes and dyslipidaemia, with a trend towards increased odds of obesity. These trends are consistently present, though the effects attenuated when adjusting for SES, suggesting that perception of one's own status on a social hierarchy has health effects above and beyond one's actual income, occupation and education.

Networks of trainees: examining the effects of attending an interdisciplinary research training camp on the careers of new obesity scholars

Journal of Multidisciplinary Healthcare, 2014

Students training in obesity research, prevention, and management face the challenge of developin... more Students training in obesity research, prevention, and management face the challenge of developing expertise in their chosen academic field while at the same time recognizing that obesity is a complex issue that requires a multidisciplinary and multisectoral approach. In appreciation of this challenge, the Canadian Obesity Network (CON) has run an interdisciplinary summer training camp for graduate students, new career researchers, and clinicians for the past 8 years. This paper evaluates the effects of attending this training camp on trainees' early careers. We use social network analysis to examine the professional connections developed among trainee Canadian obesity researchers who attended this camp over its first 5 years of operation (2006-2010). We examine four relationships (knowing, contacting, and meeting each other, and working together) among previous trainees. We assess the presence and diversity of these relationships among trainees across different years and disciplines and find that interdisciplinary contact and working relationships established at the training camp have been maintained over time. In addition, we evaluate the qualitative data on trainees' career trajectories and their assessments of the impact that the camp had on their careers. Many trainees report that camp attendance had a positive impact on their career development, particularly in terms of establishing contacts and professional relationships. Both the quantitative and the qualitative results demonstrate the importance of interdisciplinary training and relationships for career development in the health sciences.

Sex Differences in the Mediating Effects of Modifiable Risk Factors in Associations Between Socioeconomic Position and Cardiovascular Disease Morbidity and Mortality

Current Developments in Nutrition

Objectives Socioeconomic inequities in cardiovascular diseases (CVDs) are greater in females than... more Objectives Socioeconomic inequities in cardiovascular diseases (CVDs) are greater in females than males. However, the mechanisms underpinning the excess CVD risk conferred by low socioeconomic position (SEP) in females remain unclear. This study aimed to quantify the mediating effects of modifiable risk factors to associations between SEP and CVD morbidity and mortality. Methods We combined eight cycles of the nationally-representative cross-sectional Canadian Community Health Survey (2000–2011) to identify a cohort of adults (≥35 years) without CVD at the time of survey administration (n = 289,800). Survey data were linked to administrative health (Hospital Discharge Abstract Database) and mortality (Canadian Mortality Database) records for 2000–2012. SEP was captured by a latent variable consisting of self-reported educational level and household income. Self-reported modifiable risk factors, including smoking, physical inactivity, obesity, diabetes, and hypertension were conside...