Health-risk behaviours in deprived urban neighbourhoods: a comparison between Slovak and Dutch cities
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International comparisons of the associations of area-level socioeconomic position (SEP) and health-risk behaviours (HRBs) are for the most part lacking. The aims of this study were to compare Slovakia and the Netherlands regarding differences in the prevalence of HRBs by neighbourhood and individual deprivation, and to determine whether area differences could be explained by the SEP of residents.
We obtained data on residents aged 19–64 from Slovak and Dutch cities from the FP7 EURO-URHIS2 project and employed multilevel logistic regression.
The association between neighbourhood-level unemployment and HRBs differed between countries. In the Netherlands, the prevalence of almost all HRBs was higher in deprived areas, except for the consumption of fruits and vegetables. These area effects diminished after controlling for individual-level SEP. In Slovakia, no area effects were observed, although Slovak residents showed a higher risk for most HRBs. At the individual level, an inverse SE gradient was found for almost all HRBs in both countries.
Local analyses of small area health differences and health determinants are critical for efficient implementation of neighbourhood-based interventions.
KeywordsHealth-risk behaviours Area deprivation Socioeconomic inequalities Urban health
This research project has been supported by the European Commission under the 7th Framework Programme through the Collaborative Project FP7-HEALTH-2007-B Contract No. 223711 (20 %). Furthermore, this work was supported by the Slovak Research and Development Agency under Contract Nos. APVV-0220-10 (70 %) and DO7RP-0035-11 (10 %). The authors would like to thank Henriëtte Dijkshoorn for providing data for Amsterdam and for her comments on the manuscript.
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