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      Asociación entre determinantes socioeconómicos y exposición al humo ambiental del tabaco en niños Translated title: Association between socioeconomic determinants and environmental tobacco smoke exposure in children

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          Abstract

          Resumen Objetivo Valorar la asociación entre la prevalencia de exposición al humo ambiental del tabaco (HAT) en los niños y niñas españoles y diferentes determinantes socioeconómicos. Método Se analizó información de 5495 menores de 15 años incluidos en la Encuesta Nacional de Salud de España 2011-2012. Se realizaron análisis crudos de las variables de interés y se ajustó un modelo de regresión logística multivariante para evaluar la relación de variables socioeconómicas con la exposición al HAT total, en el hogar y en medios de transporte y lugares públicos cerrados. Resultados La prevalencia de exposición al HAT total en menores de 15 años fue del 11,8%. Laodds ratiode la prevalencia (ORP) de exposición en el hogar resultó el doble para los/las mayores de 5 años (ORP: 2,19 para 6-9 años y 2,28 para 10-14 años) que para los/las más pequeños/as. Un nivel de estudios de los progenitores inferior y medio se asoció con mayor exposición (ORP: 1,97 y 1,29), al igual que las clases sociales IV-VI (ORP: 1,42). Una composición del hogar diferente a «pareja con hijos/as» y residir en viviendas más pequeñas también se relacionó con una mayor exposición. Los resultados de exposición total son muy similares a los de exposición en el hogar (11,5%) debido a la baja prevalencia de exposición en medios de transporte y lugares públicos cerrados (0,8%). Conclusión En España, los/las menores de 15 años con peor situación socioeconómica presentan mayor prevalencia de exposición al HAT. Estas desigualdades deben considerarse al establecer y desarrollar estrategias de salud pública.

          Translated abstract

          Abstract Objective To assess the association between exposure to environmental tobacco smoke (ETS) and different socioeconomic determinants among Spanish children. Method We analyzed the data of 5495 children included in the 2011-2012 Spanish National Health Survey. We estimated the prevalence of exposure to ETS and adjusted logistic regression models to identify variables related to exposure to ETS: total exposure and exposure in the home in addition to ETS exposure in enclosed public places/transport. Results Total exposure to ETS among children aged 15 and younger was 11.8%, 11.5% of whom were exposed at home and 0.8% in enclosed public places/transport. The prevalence odds ratio (POR) of exposure at home increased with age (6-9 years: 2.19; 10-14 years: 2.28), in children with parents of low or medium education levels (1.97 and 1.29), of social class IV-VI (1.42), among those living in a household with a composition other than a "couple with children" (1.43), and in smaller-sized homes (1.39). Total exposure results were similar to home exposure results. Conclusion The prevalence of ETS is higher among children younger than 15 years with a more difficult economic situation. These inequalities must be considered in the establishment and development of public health policies.

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          Do low-income neighbourhoods have the least green space? A cross-sectional study of Australia’s most populous cities

          Background An inequitable distribution of parks and other ‘green spaces’ could exacerbate health inequalities if people on lower incomes, who are already at greater risk of preventable diseases, have poorer access. Methods The availability of green space within 1 kilometre of a Statistical Area 1 (SA1) was linked to data from the 2011 Australian census for Sydney (n = 4.6 M residents); Melbourne (n = 4.2 M); Brisbane (n = 2.2 M); Perth (n = 1.8 M); and Adelaide (n = 1.3 M). Socioeconomic circumstances were measured via the percentage population of each SA1 living on < $21,000 per annum. Negative binomial and logit regression models were used to investigate association between the availability of green space in relation to neighbourhood socioeconomic circumstances, adjusting for city and population density. Results Green space availability was substantively lower in SA1s with a higher percentage of low income residents (e.g. an incidence rate ratio of 0.82 (95% confidence interval (95% CI) 0.75, 0.89) was observed for SA1s containing ≥20% versus 0-1% low income residents). This association varied between cities (p < 0.001). Adelaide reported the least equitable distribution of green space, with approximately 20% greenery in the most affluent areas versus 12% availability in the least affluent. Although Melbourne had a smaller proportion of SA1s in the top quintile of green space availability (13.8%), the distribution of greenery was the most equitable of all the cities, with only a 0.5% difference in the availability of green space between SA1s containing 0-1% low income households versus those with ≥20%. Inequity of access, however, was reported across all cities when using logit regression to examine the availability of at least 20% (odds ratio 0.74, 95% CI 0.59, 0.93) or 40% (0.45, 0.29, 0.69) green space availability in the more disadvantaged versus affluent neighbourhoods. Conclusion Affirmative action on green space planning is required to redress the socioeconomic inequity of access to this important public health resource.
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            Vital Signs: Disparities in Nonsmokers’ Exposure to Secondhand Smoke — United States, 1999–2012

            Background Exposure to secondhand smoke (SHS) from burning tobacco causes disease and death in nonsmoking children and adults. No risk-free level of SHS exposure exists. Methods National Health and Nutrition Examination Survey (NHANES) data from 1999–2012 were used to examine SHS exposure among the nonsmoking population aged ≥3 years. SHS exposure among nonsmokers was defined as a serum cotinine level (a metabolite of nicotine) of 0.05–10 ng/mL. SHS exposure was assessed overall and by age, sex, race/ethnicity, poverty level, education, and whether the respondent owned or rented their housing. Results Prevalence of SHS exposure in nonsmokers declined from 52.5% during 1999–2000 to 25.3% during 2011–2012. During this period, declines were observed for all population subgroups, but disparities exist. During 2011–2012, SHS was highest among: children aged 3–11 years (40.6%), non-Hispanic blacks (46.8%), persons living below the poverty level (43.2%), and persons living in rental housing (36.8%). Among children aged 3–11 years, 67.9% of non-Hispanic blacks were exposed to SHS compared with 37.2% of non-Hispanic whites and 29.9% of Mexican Americans. Conclusion Overall, SHS exposure in the United States has been reduced by half since 1999–2000. However, 58 million persons were still exposed to SHS during 2011–2012, and exposure remains higher among children, non-Hispanic blacks, those living in poverty, and those who rent their housing. Implications for Public Health Practice Eliminating smoking in indoor spaces fully protects nonsmokers from SHS exposure; separating smokers from nonsmokers, cleaning the air and ventilating buildings cannot completely eliminate exposure. Continued efforts to promote implementation of comprehensive statewide laws prohibiting smoking in workplaces and public places, smoke-free policies in multiunit housing, and voluntary smoke-free home and vehicle rules are critical to protect nonsmokers from this preventable health hazard in the places they live, work, and gather.
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              Approaching Environmental Health Disparities and Green Spaces: An Ecosystem Services Perspective

              Health disparities occur when adverse health conditions are unequal across populations due in part to gaps in wealth. These disparities continue to plague global health. Decades of research suggests that the natural environment can play a key role in sustaining the health of the public. However, the influence of the natural environment on health disparities is not well-articulated. Green spaces provide ecosystem services that are vital to public health. This paper discusses the link between green spaces and some of the nation’s leading health issues such as obesity, cardiovascular health, heat-related illness, and psychological health. These associations are discussed in terms of key demographic variables—race, ethnicity, and income. The authors also identify research gaps and recommendations for future research.
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                Author and article information

                Journal
                gs
                Gaceta Sanitaria
                Gac Sanit
                Ediciones Doyma, S.L. (Barcelona, Barcelona, Spain )
                0213-9111
                August 2020
                : 34
                : 4
                : 334-339
                Affiliations
                [1] Santiago de Compostela A Coruña orgnameHospital Clínico Universitario de Santiago de Compostela orgdiv1Servicio de Medicina Preventiva España
                [4] orgnameCIBER de Epidemiología y Salud Pública (CIBERESP) España
                [2] Santiago de Compostela A Coruña orgnameXunta de Galicia orgdiv1Consellería de Sanidade orgdiv2Servicio de Epidemiología, Dirección Xeral de Saúde Pública España
                [3] Santiago de Compostela A Coruña orgnameUniversidad de Santiago de Compostela orgdiv1Facultad de Medicina orgdiv2Departamento de Medicina Preventiva y Salud Pública España
                Article
                S0213-91112020000400005 S0213-9111(20)03400400005
                10.1016/j.gaceta.2018.12.007
                30833114
                7bed8096-b8fa-4e47-86ff-6a01c9c43e82

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 10 December 2018
                : 08 August 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 34, Pages: 6
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                SciELO Spain

                Categories
                Originales

                Environmental tobacco smoke exposure,Children,Prevalence,Socioeconomic determinants,Health inequalities,Exposición al humo ambiental del tabaco,Niños,Niñas,Prevalencia,Determinantes socioeconómicos,Desigualdades en salud

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