Publications

Photo contributed by Sheila Dubroy

Environmental Health Justice
Chronic Disease Prevention and Management
Youth Sexual Health
Neighbourhoods
Physical Environment
Food Security and Urban Agriculture

Abstracts

Environmental Health Justice

Donald Cole

Masuda, J.R., Zupancic, T., Poland, B., and Cole, D. (2008) Environmental health and vulnerable populations in Canada: mapping an integrated equity-focused research agenda. The Canadian Geographer 54(4): 427-450.
Abstract

Jeffrey Masuda

Masuda, J.R., Creighton, G, Nixon, S., and Frankish, C.J. (2009) Building capacity for community-based, participatory research for health disparities in Canada. Health Promotion Practice

Masuda, J.R., Robinson, K., Elliot, S.J., and Eyles, J. (2009) Disseminating Chronic Disease Prevention ‘to or with’ Canadian Public Health Systems. Health Education and Behaviour

Blake Poland

Chronic Disease Prevention and Management

Guy Faulkner

Faulkner, G., Gorczynski, P., & T. Cohn (2009). Psychiatric illness and obesity: Recognizing the 'obesogenic' nature of psychiatric services. Psychiatric Services, 60, 538–541.
Abstract

Gorczynski, P., Faulkner, G., Zeglen, L., & Cohn, T. (2008). Dissecting the 'obesogenic' environment of a psychiatric hospital. Journal of Sport and Exercise Psychology, 30, S172.
Abstract

Enza Gucciardi

Gucciardi E, DeMelo M, Booth G, Tomlinson G, Stewart DE. Individual and Contextual Factors Associated with Follow-up Use of Diabetes Self-management Education Programs: A Multi-site Prospective Analysis. Diabetic Medicine (In Press).
Abstract

Gucciardi E, Vogt JA, DeMaelo M, Stewart DE. (2009). Exploration of the Relationship between Household Food Insecurity and Diabetes in Canada" Diabetes Care 32(12): 2218-24.

Wendy Young

Kennedy S., Young W., Schull M., Isaac W. The Need for a Pan-Canadian Emergency Services Database. Canadian Journal of Emergency Medicine, 10(2),120-124,2008.
Abstract

Bowes D., Marquis M., Young W., Holowaty P., Isaac W. Process Evaluation of a School-based Intervention. Health Promot Pract first published on March 18, 2008 as doi:10.1177/1524839907307886
Abstract

Youth Sexual Health

Sarah Flicker

Flicker S, Maley O, Ridgley A, Biscope S, Skinner H. (2008) e-PAR: Using Technology and Participatory Action Research to Engage Youth in Health Promotion. Journal of Action Research . 6(3): 285-303. DOI: 10.1177/1476750307083711
Abstract

Flicker S, Guta, A., Larkin, J., Flynn, S., Alicia Fridkin, Pole, J., Travers, R., Layne, C., & Chan., K. (2008) Survey Design from the Ground-Up: The Toronto Teen Survey CBPR Approach. Health Promotion Practice ePUB Mar 2008; vol. 0: pp. 1524839907309868v1
Abstract

Flicker S, Guta A. (2008) Ethical Approaches to Protecting Adolescent Participants in Sexual Health Research: Alternatives to Parental Consent. Journal of Adolescent Health 42(1): 3-10
Abstract

Flicker, S, Larkin, J, Smillie-Adjarkwa, C, Restoule, JP, Barlow, K, Dagnino, M., Ricci, C, Koleszar-Green, R., & Mitchell, C., (2008). “It’s Hard to Change Something When You Don’t Know Where to Start”: Unpacking HIV Vulnerability with Aboriginal Youth in Canada. Special Issue of PIMATISIWIN: A Journal of Indigenous and Aboriginal Community Health 5(2):175–200
Abstract

June Larkin

Claudia Mitchell

Jason Pole

Jean Paul Restoule

Robb Travers

Neighbourhoods

Brent Berry

Berry, B. 2007. Disparities in Leisure Time Inactivity in the United States: Trends and Explanations. Sociological Perspectives 50(2): 177-208.
Abstract

Berry, B. 2007. A Repeated Visual Observation Approach for Estimating the Street Homeless Population. Evaluation Review 31(2): 166-199.
Abstract

Berry, B. 2006. Friends for Better or for Worse: Interracial Friendships in the U.S. as Seen through Wedding Party Photos. Demography 43(3): 491-510.
Abstract

Berry, B. 2006. What Accounts for Race and Ethnic Differences in Family Financial Transfers to Adult Children in the U.S.? Journal of Family Issues 27(11): 1583-1604.
Abstract

James Dunn

Schuurman, N., Bell, N., Dunn, J.R. and Oliver, L.N. 2007. Deprivation Indices, Population Health and Geography: Evaluation of the Spatial Effectiveness of Indices at Multiple Scales. Journal of Urban Health, 84(4); 591-603.
Abstract

Breslin, F.C., Smith, P., Dunn, J.R. 2007. An Ecological Study of Regional Variation in Work Injuries Among Young Workers. BMC Public Health, 7(91).
Abstract

Oliver, L., Dunn, J.R., Kohen, D. and Hertzman, C. 2007. Do Neighbourhoods Influence the Readiness to Learn of Kindergarten Children in Vancouver? A Multilevel Analysis of Neighbourhood Effects. Environment & Planning A, 39(4): 848-868.
Abstract

Frohlich, K., Dunn, J.R., McLaren, L., Sheill, A., Potvin, L., Hawe, P., Dassa, C., and Thurston, W.E. 2007. Understanding Place and Health: A Heuristic for Using Administrative Data. Health & Place, 13(2): 299-309.
Abstract

Matheson, F.I., Moineddin, R., Dunn, J.R., Creatore, M.I., Gozdyra, P. and Glazier, R. 2006. Urban Neighbourhood, Chronic Stress, Gender and Depression: A Factorial Ecology. Social Science and Medicine, 63(10): 2604-2616.
Abstract

Ostry, A., Maggi, S., Tansey, J., Dunn, JR. Hershler, R., Chen, L., Louie, A. and Hertzman, C. 2006. The Impact of Fathers Physical and Psychosocial Work Conditions on Attempted and Completed Suicide Among their Children. BMC Public Health. 6:77.
Abstract

Bierman, A. and Dunn, J.R. 2006. Swimming Upstream: Access, Health Outcomes, and the Social Determinants of Health. Journal of General Internal Medicine 21(1): 99-100.
No abstract available

Dunn, J.R., Veenstra, G. and Ross, N.A. 2006. Psychosocial and Neo-material Dimensions of SES and Health Revisited: Predictors of self-rated Health in a Canadian National Survey. Social Science & Medicine 62(6): 1465-1473.
Abstract

Ross, N.A., Dorling, D., Dunn, J.R., Henriksson, G., Glover, J., Lynch, J.W., and Ringback Weitoft, G. 2005. Metropolitan Income Inequality and Working Age Mortality: A Cross-sectional Analysis Using Comparable Data from Five Countries. Journal of Urban Health 82(1): 101-110.
Abstract

Lynch, J.W., Harper, S., Davey Smith, G., Ross, N., Wolfson, M., and Dunn, J.R. 2004. US Regional and National Cause-Specific Mortality and Trends in Income Inequality: Descriptive Findings. Demographic Research S2-8: 183-228.
Abstract

Kyle, T. and Dunn, J.R. 2008. Effects of Housing Circumstances on Health, Quality of Life and HealthCare Use for People with Severe Mental Illness: A Review. Health and Social Care in the Community 16(1): 1-15.
Abstract

Gasher, M., Hayes, M.V., Ross, I., Hackett, R.A., Gutstein, D., and Dunn, J.R. 2007. Spreading the News: Social Determinants of health Reportage in Canadian Daily Newspapers. Canadian Journal of Communication [Online] 32(3): 557-575
Abstract

Nick Holt

N.L. Holt, J.C. Spence, Z.L. Sehn, N. Cutumisu. 2008. Neighborhood and Developmental Differences in Children’s Perceptions of Opportunities for Play and Physical Activity. Health & Place 14: 2–14
Abstract

John Myles

Myers, K., Myles, J. 2007. Who Gets What and Why? Answers from Sociology. American Behavioral Scientist 50(5): 579-583.
No abstract available

Myles, J. 2006. Welfare States and Public Opinion: Comment on Brooks and Manza. American Sociological Review 71(3): 495-498.
Abstract

Myles, J. 2006. Do Egalitarians Have a Future? Review of Income and Wealth 52(1): 145-151.
No abstract available

Hou, F., Myles, J. 2005. Neighbourhood Inequality, Neighbourhood Affluence and Population Health. Social Science and Medicine 60(7): 1557-1569.
Abstract

Hou, F., Myles, J. 2004. Changing Colours: Spatial Assimilation and New Racial Minority Immigrants. Canadian Journal of Sociology 29(1): 29-58.
Abstract

Myles, J. 2003. What Justice Requires: Pension Reform in Ageing Societies. Journal of European Social Policy 13(3): 264-269.
No abstract available

Myles, J. 2003. Where Have All the Sociologists Gone? Explaining Economic Inequality. Canadian Journal of Sociology 28(4): 553-561.
Abstract

Morissette, R., Myles, J., Picot, G. 2003. Low Income Intensity During the 1990s: The Role of Economic Growth, Employment Earnings, and Social Transfers. Canadian Public Policy 29, Supplement: S15-S40.
Abstract

Myles, J., Quadagno, J. 2002. Political Theories of the Welfare State. Social Service Review 76(1): 34-57.
Abstract

Patricia O’Campo

Muntaner, C., Li, Y., Xue, X., Thompson, T., O’Campo, P., Chung, H., Eaton, W. 2006. County Level Socioeconomic Position, Work Organization and Depression Disorder: A Repeated Measures Cross-classified Multilevel Analysis of Low-income Nursing Home Workers. Health and Place 12(4): 688-700.
Abstract

Caughy, M., and O'Campo, P. 2006. Neighbourhood Poverty, Social Capital, and the Cognitive Development of African American Preschoolers. American Journal of Community Psychology 37(1-2): 141-154.
Abstract

Rajaratnam, J.K., Burke, J.G., O’Campo, P. 2006. Maternal & Child Health and Neighborhood Context: The Selection and Construction of Area-Level Variables. Health and Place 12(4): 547-556.
Abstract

Burke, J.G., O’Campo, P., Peak, G., Gielen, A., McDonnell, K.A., and Trochim, W. 2005. An Introduction to Concept Mapping as a Participatory Public Health Research Method. Qualitative Health Research 15(10): 1392-1410.
Abstract

O’Campo, P., Burke, J., Peak, G.L., McDonnell, K.A., and Gielen, A.C. 2005. Uncovering The Neighborhood Influences On Intimate Partner Violence Using Concept Mapping. Journal of Epidemiology and Community Health 59(7): 603-8.
Abstract

Pallitto, C. and O’Campo, P. 2005. Community Level Effect of Gender Inequality on Intimate Partner Violence and Unintended Pregnancy in Colombia: Testing the Feminist Perspective. Social Science and Medicine 60(10): 2205-16.
Abstract

McDonnell, K.A., Gielen, A.C., O’Campo, P., and Burke, J.G. 2005. Abuse, HIV Status, and Health Related Quality of Life Among Low Income Women. Quality of Life Research 14(4): 945-57.
Abstract

Physical Environment

Anne Bell

Dyment, J.E. and Bell, A.C. 2006. ‘Our Garden is Colour Blind, Inclusive and Warm’: Reflections on Green School Grounds and Social Inclusion. International Journal of Inclusive Education 10(1):1-15.
Abstract

Dyment, J.E. and Bell, A.C. 2007. Report on Results of the Pilot Study on School Grounds and Health
Funded by the Centre for Urban Health Initiatives. Report prepared for Evergreen.
Abstract

Miriam Diamond

Harrad, S., and Diamond, M.L. 2006. New Directions: Exposure to Polybrominated Diphenyl Ethers (PBDEs) and Polychlorinated Biphenyls (PCBs): Current and Future Scenarios. Atmospheric Environment 40(6): 1187-1188.
No abstract available

Simpson, A.J., Lam, B., Diamond, M.L., Donaldson, D.J., Lefebvre, B., Moser, A., Williams, A., Larin, N., and Kvasha, M. 2006. Assessing the Organic Composition of Urban Surface Films Using Nuclear Magnetic Resonance Spectroscopy. Chemosphere 63(1): 142-152.
Abstract

Motelay-Massei, A., Harner, T., Shoeib, M., Diamond, M., Stern , G., and Rosenberg, B. 2005. Using Passive Air Samplers To Assess Urban-Rural Trends for Persistent Organic Pollutants and Polycyclic Aromatic Hydrocarbons. 2. Seasonal Trends for PAHs, PCBs, and Organochlorine Pesticides. Environmental Science & Technology 39(15): 5763 -5773.
Abstract

Jones-Otazo, H., Clarke, J., Diamond, M., Archbold, J., Ferguson, G., Harner, T., Richardson, M., Ryan, J., and Wilford, B. 2005. Is House Dust the Missing Exposure Pathway for PBDEs? An Analysis of Urban Fate and Human Exposure to PBDEs. Environmental Science & Technology 39(14): 5121-5130.
Abstract

Harner, T., Shoeib, M., Diamond, M., Stern, G., and Rosenberg, B. 2004. Using Passive Air Samplers to Assess Urban-rural Trends for Persistent Organic Pollutants (POPs): 1. Polychlorinated Biphenyls (PCBs) and Organochlorine Pesticides (OCPs). Environmental Science & Technology 38(17): 4474-4483.
Abstract

Wong, F., Harner, T., Liu, Q-T., and Diamond, M. 2004. Using Experimental and Forest Soils to Investigate the Uptake of Polycyclic Aromatic Hydrocarbons (PAH) Along an Urban-rural Gradient. Environmental Pollution. 129(3): 387-398.
Abstract

Butt, C., Diamond, M., Truong, J., Ikonomou, M., and Ter Schure, A.F.H. 2004. Spatial Distribution of Polybrominated Diphenyl Ethers in Southern Ontario as Measured in Indoor and Outdoor Window Organic Films. Environmental Science & Technology 38(3): 724-731.
Abstract

Lam, B., Diamond, M.L., Simpson, A.J., Makar, P.A., Truong, J., Hernandez-Martinez, N.A. 2005. Chemical Composition of Surface Films on Glass Windows and Implications for Atmospheric Chemistry. Atmospheric Environment 39(35): 6578-6586.
Abstract

Paul Hess

Hess, P.M., Milroy, B.M. 2006. Making Toronto’s Streets. Funded by The Centre for Urban Health Initiatives, University of Toronto.
Abstract

Audrey Smargiassi

Takser, L., Mergler, D., Baldwin, M., de Grosbois, S., Smargiassi, A., and Lafond, D. 2005. Thyroid Hormones in Pregnancy in Relation to Environmental Exposure to Organochlorine Compounds and Mercury. Environmental Health Perspectives 113(8):1039-45.
Abstract

Smargiassi, A., Baldwin, M., Pilger, C., Dugandzic, R., and Brauer, M. 2005. Small Scale Spatial Variability of Particle Concentrations and Traffic Levels in Montreal: A Pilot Study. Science of the Total Environment 338: 243-251.
Abstract

John Spence

Tomic, K., Spence, J.C., and Amrhein, C. 2006. Food Desserts in the Prairies? Supermarket Accessibility and Neighborhood Need in Edmonton, Canada. Professional Geographer 58(3): 307-362.
Abstract

Duncan, M.J., Spence, J.C., and Mummery, W.K. 2005. Perceived Environment and Physical Activity: A Meta-Analysis of Selected Environmental Characteristics. International Journal of Behavioural Nutrition and Physical Activity 2(11).
Abstract

Food Security and Urban Agriculture

Donald Cole

Masuda, J.R., Zupancic, T., Poland, B., and Cole, D. (2008) “Environmental health and vulnerable populations in Canada: mapping an integrated equity-focused research agenda.” The Canadian Geographer 54(4): 427-450. pol

Cole, D.C., Robson, L., Lemieux-Charles, L., McGuire, W., Sicotte, C., and Champagne, F. 2005. Quality of Working Life Indicators in Canadian Healthcare Organizations: A Tool for Healthy Healthcare Workplaces? Occupational Medicine 55(1):54-59.
Abstract

Sarah Wakefield

Wakefield, S. and Poland, B. 2005. Family, Friend or Foe? Critical Reflections on the Relevance and Role of Social Capital in Health Promotion and Community Development. Social Science and Medicine 60(12): 2819-2832.
Abstract

Wakefield, S., Yeudall, F., Taron, C., Reynolds, J., Skinner, A. 2007. Growing Urban Health: Community Gardening in South-east Toronto. Health Promotion International 22(2): 92-101.
Abstract

Wakefield, S., S.J. Elliott., D. Cole, and J.D. Eyles. 2006. Taking Environmental Action: The Role of Composition, Context, and Collective. Environmental Management. 37(1): 40-53.
Abstract

Wakefield, S., Yeudall, F., Taron, C., Reynolds, J., Skinner, A. 2006. UGROW: Seeds, Soil & Stories: A Pilot Study of Community Gardening in Southeast Toronto.
No abstract available

Wakefield, S., Bienefeld, M. and Jermyn, L. Preliminary Report of the Multicultural Yard, Health and Environment Project (MYHEP). 2007.
Abstract

Fiona Yeudall

Yeudall F, Gibson RS, Cullinan TR, Mtimuni B. 2005. Efficacy of a Community-Based Dietary Intervention to Enhance Micronutrient Adequacy of High-Phytate Maize-Based Diets of Rural Malawian Children. Public Health Nutrition 8(7): 826-836.
Abstract

Abstracts

“Environmental health and vulnerable populations in Canada: mapping an integrated equity-focused research agenda”

Masuda, J.R., Zupancic, T., Poland, B., and Cole, D.

The uneven distribution of environmental hazards across space and in vulnerable populations reflects underlying societal inequities. Fragmented research has led to gaps in comprehensive understanding of and action on environmental health inequities in Canada and there is a need to gain a better picture of the research landscape in order to integrate future research. This paper provides an initial assessment of the state of the environmental health research field as specifically focused on vulnerable populations in Canada. We present a meta-narrative literature review to identify under-integrated areas of knowledge across disciplinary fields. Through systematic searching and categorization, we assess the abstracts of a total of 308 studies focused on the past 30 years of Canadian environmental health inequity research in order to describe temporal, geographical, contextual and epistemological patterns.
The results reveal that there has been significant growth in Canadian research documenting the uneven distributions and impacts of environmental hazards across locations and populations since the 1990s, but its focus has been uneven. Notably, there is a lack of research aimed at integrating evidence-based and policy-relevant evaluation of environmental health inequities and how they are created and sustained. Areas for future research are recommended including more interdisciplinary, multimethod and preventive approaches to resolve the environmental burden placed on vulnerable populations and to promote environmental health equity.
Keywords: environmental health inequity, vulnerable populations, systematic review, Canada

“Psychiatric illness and obesity: Recognizing the 'obesogenic' nature of psychiatric services”

Faulkner, G., Gorczynski, P., & T. Cohn

OBJECTIVE: The prevalence of obesity and obesity-related diseases is higher among individuals with psychiatric illness than in the general population. This study examined environmental factors that contribute to obesity in one psychiatric hospital in Canada.

METHODS: Semistructured interviews were conducted with 25 key stakeholders from multiple professional disciplines at the hospital. Transcribed interviews were analyzed through content analysis with the analysis grid for environments linked to obesity (ANGELO) framework as a categorical template.

RESULTS: Factors contributing to obesity in this setting were related to increased energy intake, such as easy access to high-calorie snacks and beverages, and reduced energy expenditure, such as lack of access to staircases.

CONCLUSIONS: Psychiatric settings may contribute to the high prevalence of obesity among individuals with psychiatric illness. Ecologically framed interventions are required to address obesity in this population.

“Dissecting the 'obesogenic' environment of a psychiatric hospital”

Gorczynski, P., Faulkner, G., Zeglen, L., & Cohn, T.

There is a higher prevalence of obesity and obesity-related diseases in individuals with serious mental illness in comparison to the general population. The purpose of this study was to examine the “obesogenic” factors, environmental influences on diet and physical activity that contribute to obesity, in the inpatient setting at one large psychiatric hospital. A qualitative approach was adopted and 25 semistructured interviews were conducted with a range of key stakeholders at the hospital. Interviews were audio-recorded and transcribed verbatim. Transcripts were analyzed through content analysis using the analysis grid for environments linked to obesity (ANGELO) framework as a categorical template (Swinburn, Egger, & Raza, 1999). In total, 54 factors related to food consumption and 30 factors related to physical activity or sedentary behavior were reported. Five valid, relevant, and modifiable factors included: (1) staff shortages; (2) inconsistent treatment delivery across all units; (3) a lack of educational programs for clients about diet and physical activity; (4) the nature of food services delivery; and (5) the client and survivor run food operations. Overall, interviewees noted that obesogenic factors related to diet had a greater impact on weight gain than sedentary behavior. However, many stressed the importance of addressing both in order to decrease obesity in the service user population. Obesogenic factors were extremely interconnected and mutually reinforcing. This highlights the need for greater interprofessional collaboration in reducing obesity prevalence in psychiatric settings.

“Individual and Contextual Factors Associated with Follow-up Use of Diabetes Self-management Education Programs: A Multi-site Prospective Analysis”

Gucciardi E, DeMelo M, Booth G, Tomlinson G, Stewart DE.

Aims: Although a considerable body of research supports the efficacy of diabetes self-management education (DSME), these programmes are often challenged by high attrition rates. Little is known about factors influencing follow-up use of DSME services, thus the aim of this study was to identify these factors.
Methods: In this multisite prospective analysis, adults with Type 2 diabetes (n = 268) who attended one of two diabetes management centres (DMCs) were followed over a 1-year period from their initial visit. The influence of individual and contextual factors on the number of contacts with DMC providers was examined. Data were analysed within the context of the Health Behavioral Model of Health Services Utilization.
Results: In a multivariable negative binomial regression model, the number of contacts over 1 year was greater for those who were female, non-smokers, unemployed, self-referred to the DMC, lived closer to the DMC, had a lower body mass index, or had a longer known duration of diabetes. Follow-up use of services differed significantly between the two sites. Provider contacts were greater at the centre that offered flexible hours of services and a variety of optional educational modules.
Conclusions: Healthcare professionals need to encourage ongoing use of DSME, particularly for individuals prone to lower follow-up use of these services. Providing services that are accessible, convenient, and can easily fit into patients' schedules may increase follow-up use. Further exploration into how operations and delivery of these services influence utilization patterns is strongly recommended.

“The Need for a Pan-Canadian Emergency Services Database”

Kennedy S., Young W., Schull M., Isaac W.

In February 2007, the Health Council of Canada, in its third annual report, emphasized the need for pan-Canadian data on our health care system. To date, no studies have examined the strengths and weaknesses of emergency health services (EHS) administrative databases, as perceived by researchers. The authors undertook a qualitative study to determine, from a researcher's perspective, the strengths and weaknesses of EHS administrative databases. The study also elicited researchers' suggestions to improve these databases.

The authors conducted taped interviews with four Canadian health services researchers. The transcriptions were subsequently examined for common concepts, which were finalized after discussion with all the investigators.

Five common themes emerged from the interviews: clinical detail, data quality, data linkage, data use and population coverage. Data use and data linkages were considered strengths. Clinical detail, data quality and population coverage were considered weaknesses.

The five themes that emerged from this study all serve to reinforce the call from the Health Council of Canada for national data on emergency services, which could be readily captured through a national EHS administrative database. The investigators feel that key stakeholders involved in emergency services across Canada should work together to develop a strategy to implement an accurate, clinically detailed, integrated and comprehensive national EHS database.

“Process Evaluation of a School-based Intervention”

Bowes D., Marquis M., Young W., Holowaty P., Isaac W.

Increases in schoolyard bullying and physical inactivity have become important issues to many stakeholders. Peers Running Organized Play Stations (PROPS) is a program designed to address these two issues in elementary schools. Using a "train the trainer" approach, PROPS was introduced to 41 schools. Results of a process evaluation indicate that the implementation rate was 39%. Resources were identified by some respondents as an implementation facilitator. A variety of barriers to implementation were identified: The PROPS program was not a component of anyone's job at the school level, teachers or parent volunteers are needed to run the program, and there is no funding to purchase equipment or storage bins for the equipment. In addition, support for PROPS is vulnerable to changing environments. This process evaluation points to some needed changes for long-term sustainability of the program while highlighting challenges associated with implementing a program in the elementary school setting.

Keywords: process evaluation, bullying, physical inactivity, school-based intervention, train the trainer

“Using Technology and Participatory Action Research to Engage Youth in Health Promotion”

Flicker S, Maley O, Ridgley A, Biscope S, Skinner H.

There is increasing interest in `moving upstream' in youth health promotion efforts to focus on building youth self-esteem, self-efficacy and civic engagement. Participatory Action Research (PAR) can be a powerful mechanism for galvanizing youth to become active agents of this change. Engaging youth in PAR and health promotion, however, is not always an easy task. This article describes a model (e-PAR) for using technology and Participatory Action Research to engage youth in community health promotion. The e-PAR Model was developed iteratively in collaboration with 57 youth and five community partners through seven projects. The Model is designed to be used with a group of youth working with a facilitator within a youth-serving organization. In addition to outlining the theoretical basis of the e-PAR Model, this article provides an overview of how the Model was developed along with implications for practice and research.

Keywords: activism, Community Based Participatory Research, engagement, health promotion, media arts

“Survey Design from the Ground-Up: The Toronto Teen Survey CBPR Approach”

Flicker S, Guta, A., Larkin, J., Flynn, S., Alicia Fridkin, Pole, J., Travers, R., Layne, C., & Chan., K.

The Toronto Teen Survey is a community-based participatory research study whose aim is to gather information on the accessibility and relevance of sexual health services for diverse groups of urban youth (13 to 17 years of age). This information will be used to develop a proactive, citywide strategy to improve sexual health outcomes for Toronto adolescents. In this article, the authors focus on the processes of collaboratively developing a survey tool with youth, academics, and community stakeholders. An overview of the project and examples from the design stage are provided. In addition, recommendations are given toward developing best practices when working with young people on research and survey design.

“Ethical Approaches to Protecting Adolescent Participants in Sexual Health Research: Alternatives to Parental Consent”

Flicker S, Guta A.

Purpose
In this paper we make the case for the importance of adolescent sexual health research, and argue that requiring parental consent for adolescent participation may (a) be unwarranted, (b) be inconsistent with the principles of justice and inclusiveness, (c) be confusing, and (d) serve to silence young people who most need to have a voice in sexual health research.

Methods
Through a case study of the Toronto Teen Survey, we offer concrete suggestions and alternatives for protecting adolescent health research participants in community-based settings and promoting ethical research approaches.

Results
Strategies suggested include: (1) adopting a community-based participatory research approach, (2) careful attention to youth-friendly protocols and consent procedures, (3) proper training of all research staff and peer researchers, (4) partnering with experienced community based youth-serving agencies, (5) paying maximum attention to issues of confidentiality and anonymity, and (6) valuing participation appropriately.

Conclusions
Institutional review boards and researchers should be encouraged to adopt localized context-dependent strategies that attend to the unique vulnerabilities of their particular study populations. Attention to flexibility, vulnerability, and community-specific needs is necessary to ensure appropriate ethical research practices that attend to the health and well-being of young people.

Keywords: Adolescent health; Sexual health; Research; Ethics; Parental consent; Community-based participatory research; Ethical review

“It’s Hard to Change Something When You Don’t Know Where to Start”: Unpacking HIV Vulnerability with Aboriginal Youth in Canada”

Flicker, S, Larkin, J, Smillie-Adjarkwa, C, Restoule, JP, Barlow, K, Dagnino, M., Ricci, C, Koleszar-Green, R., & Mitchell, C.,

Background
As a result of social and economic inequities, Indigenous youth globally
are disproportionately vulnerable to HIV/AIDS. Canada’s First Nations, Inuit,
and Métis people are among them. In this paper, we discuss the collaborative
community-based approach we adopted to uncover new possibilities for
HIV prevention with Aboriginal youth that account for systemic inequities.
This project is part of a larger Gendering Adolescent AIDS Prevention (GAAP)
research agenda.

Methods
We conducted 6 focus groups with 61 Aboriginal youth in Quebec and
Ontario. An inductive approach guided analyses. Data were coded using
Nud*ist qualitative data management software and collaboratively analyzed
for main themes.

Findings
Youth discussed their divergent understandings of the links between colonialism,
traditional knowledge(s), and HIV risk in relation to gender inequities,
stigma, and involving multiple stakeholders in the HIV response.

Interpretation
New prevention approaches relating HIV risk to colonial legacies are necessary.
Recommendations for future research and intervention development
include: an analysis of systemic inequities in HIV prevention education, focusing
on stigma reduction, building wide-spread community support, acknowledging
diversity across Aboriginal peoples, and increasing active youth (peer) engagement.

“Disparities in Free Time Inactivity in the United States: Trends and Explanations”

Brent Berry

What accounts for trends in socioeconomic disparities in physical activity during free time? Results from four national time-use studies between 1965 and 1999 suggest that there are increasing socioeconomic disparities in passive but not active free-time activities. The author evaluates several explanations for these trends. First, the least educated adults had more free time in 1999 than in 1965, and they spend nearly all this extra free time in home settings where the most common passive activities occur (e.g., television viewing). Second, less educated adults had less income per minute of free time in 1999 than in 1965, a trend that combines with increasing supply and reduced price of important passive choices to create economic incentives for passive activity. Third, the difference between low and high educated adults in the mediation of children’s viewing habits has increased, an indication of rising socioeconomic disparities in tastes and stigma for this passive activity choice. Finally, historical data suggest that these changes in the use of free time are not simply free market outcomes but also consequences of political decisions favoring television infrastructure, auto-dependent built environments, and disinvestment in public recreation.

Keywords: activity choices, educational disparities, free time, physical activity, television viewing, time use

“A Repeated Observation Approach for Estimating the Street Homeless Population”

Brent Berry

Risks of life on the street caused by inclement weather, harassment, and assault threaten the unsheltered homeless population. We address some challenges of enumerating the street homeless population by testing a novel capture-recapture (CR) estimation approach that models individuals’ intermittent daytime visibility. We tested walking and vehicle-based variants of CR in downtown Toronto in March. Estimates that assume individual variability of sighting probabilities are most consistent with our knowledge of the homeless and achieve the most favorable confidence intervals, estimated detection probabilities, and coefficient of variation. Estimation bias from interobserver discrepancies, duplicate counting, and violation of the closed population assumption were minimized with uniform identification criteria, training, and sampling design. Bias caused by the social grouping of the homeless was small. Despite the limitations of visual identification, CR approaches as part of a multiple-method program can aid community responses to immediate needs on the street, especially during the harsh winter months.

Keywords: capture-recapture, ecometrics, enumeration methodology, population estimation, street homeless, visual data

“Friends for Better or for Worse: Interracial Friendship in the United States As Seen Through Wedding Party Photos”

Brent Berry

Friendship patterns are instrumental for testing important hypotheses about assimilation processes and group boundaries. Wedding photos provide an opportunity to directly observe a realistic representation of close interracial friendships and race relations. An analysis of 1,135 wedding party photos and related information shows that whites are especially unlikely to have black friends who are close enough to be in their wedding party. Adjusting for group size, whites and East and Southeast Asians (hereafter, E/SE Asians) are equally likely to be in each other's weddings, but whites invite blacks to be in their wedding parties only half as much as blacks invite whites, and E/SE Asians invite blacks only one-fifth as much as blacks invite E/SE Asians. In interracial marriages, both E/SE Asian and black spouses in marriages to whites are significantly less likely than their white spouses to have close friendships with members of their spouse's race.

Keywords: friendship, interracial relationships, photographs, studies, weddings

“What Accounts for Race and Ethnic Differences in Parental Financial Transfers to Adult Children in the United States?”

Brent Berry

Financial assistance that parents give to their young adult children is part of the bundle of flows that constitutes intergenerational support. Are there racial and ethnic differences in this financial assistance, and if so, why? Wave 2 data from the Health and Retirement Study (N = 17,996) suggest group differences in both the incidence and amount of annual support given to nonresident adult children. Structural inequalities in the form of economic resources, family structure, and health account for most group differences, a finding counter to recent research emphasizing culture and behavioral practices. Economic resources most strongly account for less giving in African American families than in other groups. For Latinos, income and parental education are most vital. Parental health and family size are also important predictors of group differences. African American and Latino families help compensate for the differences in financial transfers with coresidence, extended family exchange, and proximity.

“Deprivation Indices, Population Health and Geography: An Evaluation of the Spatial Effectiveness of Indices at Multiple Scales”

Nadine Schuurman, Nathaniel Bell, James R. Dunn, and Lisa Oliver

Area-based deprivation indices (ABDIs) have become a common tool with which to investigate the patterns and magnitude of socioeconomic inequalities in health. ABDIs are also used as a proxy for individual socioeconomic status. Despite their widespread use, comparably less attention has been focused on their geographic variability and practical concerns surrounding the Modifiable Area Unit Problem (MAUP) than on the individual attributes that make up the indices. Although scale is increasingly recognized as an important factor in interpreting mapped results among population health researchers, less attention has been paid specifically to ABDI and scale. In this paper, we highlight the effect of scale on indices by mapping ABDIs at multiple census scales in an urban area. In addition, we compare self-rated health data from the Canadian Community Health Survey with ABDIs at two census scales. The results of our analysis confirm the influence of spatial extent and scale on mapping population health—with potential implications for health policy implementation and resource distribution.

Keywords: deprivation indices, MAUP, population health, scale

”An Ecological Study of Regional Variation in Work Injuries among Young Workers”

F Curtis Breslin, Peter Smith and James R. Dunn

Background: The investigation of geographic variation in occupational injuries has received little attention. Young workers 15 to 24 years are of particular concern because they consistently show elevated occupational injury rates compared to older workers. The present study sought to: (a) to describe the geographic variation of work injuries; (b) to determine whether geographic variation remained after controlling for relevant demographic and job characteristics; (c) to identify the region-level factors that correlate with the geographic variation.

Methods: Using workers compensation claims and census data, we estimated claim rates per 100 full-time equivalents for 15 to 24 year olds in 46 regions in Ontario. A total of 21 region-level indicators were derived primarily from Census and Labour Force Survey data to reflect social and material deprivation of the region as well as demographic and employment characteristics of youth living in those areas.

Results: Descriptive findings showed substantial geographic variation in young worker injury rates, even after controlling for several job and demographic variables. Region-level characteristics such as greater residential stability were associated with low work injury rates. Also, regions with the lowest claim rates tended to have proportionally fewer cuts and burns than high-claim-rate regions.

Conclusion: The finding of substantial geographic variation in youth claim rates even after controlling for demographic and job factors can aid in targeting prevention resource. The association between region-level indicators such as residential stability and youth work injury suggests that work injury prevention strategies can be integrated with other local economic development measures. The findings partially support the notion that work safety measures may be unevenly distributed with respect to regional socio-economic factors

“Do Neighbourhoods Influence the Readiness to Learn of Kindergarten Children in Vancouver? A Multilevel Analysis of Neighbourhood Effects”

Lisa N. Oliver, James R. Dunn, Dafna E. Kohen, Clyde Hertzman

A growing body of literature has examined the effects of neighbourhood characteristics on child health and well-being and the mechanisms through which such effects may operate. Research investigating neighbourhood effects on children is based on the notion that individuals and families who live in a neighbourhood collectively create a social context that influences the developing child. In this paper we investigate the relationship between individual and neighbourhood socioeconomic characteristics and kindergarten children's readiness to learn in Vancouver, Canada (n. 3736), using multilevel modeling techniques and 1996 census data for Vancouver neighbourhoods (n. 68). Findings suggest that although family-level characteristics carry the most weight in shaping children's readiness to learn, neighbourhood-level factors are independently associated with early developmental outcomes, particularly physical health and well-being, language and cognitive development, and communications skills and general knowledge. The strongest neighbourhood characteristics associated with readiness to learn were median income and the percentage of single-parent families. Also important were the percentage of the population who had not moved in the previous five years and the percentage of the population whose mother tongue was non-English. The latter neighbourhood characteristic was an especially strong predictor of communication skills and general knowledge. The findings suggest that neighbourhood-based policies to improve physical health and well-being, language and cognitive development, and communications skills may also meet with some success.

“Understanding Place and Health: A Heuristic for Using Administrative Data”

Katherine L. Frohlich, James R. Dunn, Lindsay McLarene, Alan Shielle, Louise Potvin, Penelope Hawee, Clement Dassa, Wilfreda E. Thurston

The increasing availability, use and limitations of administrative data for place-based population health research, and a lack of theory development, created the context for the current paper. We developed a heuristic to interrogate administrative data sets and to help us develop explanatory pathways for linking place and health. Guided by a worked example, we argue that some items in administrative data sets lend themselves to multiple theories, creating problems of inference owing to the implications of using inductive versus deductive reasoning during the research process, and that certain types of theories are privileged when used administrative data bases.

Keywords: administrative data, health and place, theory

“Urban Neighborhoods, Chronic Stress, Gender and Depression”

Flora I. Matheson, Rahim Moineddin, James R. Dunn, Maria Isabella Creatore, Piotr Gozdyra, Richard H. Glazier

Using multilevel analysis we find that residents of ‘‘stressed’’ neighborhoods have higher levels of depression than residents of less ‘‘stressed’’ neighborhoods. Data for individuals are from two cycles of the Canadian Community Health Survey, a national probability sample of 56,428 adults living in 25 Census Metropolitan Areas in Canada, with linked information about the respondents’ census tracts. Depression is measured with the Center for Epidemiologic Studies-

Depression Scale Short Form and is based on a cutoff of 4+ symptoms. Factor analysis of census tract characteristics identified two measures of neighborhood chronic stress—residential mobility and material deprivation—and two measures of population structure—ethnic diversity and dependency. After adjustment for individual-level gender, age, education, marital and visible minority status and neighborhood-level ethnic diversity and dependency, a significant contextual effect of neighborhood chronic stress survives. As such, the daily stress of living in a neighborhood where residential mobility and material deprivation prevail is associated with depression. Since gender frames access to personal and social resources, we explored the possibility that women might be more reactive to chronic stressors manifested in higher risk of depression. However, we did not find random variation in depression by gender across neighborhoods.

Keywords: Canada, chronic stress, depression, gender, neighborhood

“The Impact of Fathers' Physical and Psychosocial Work Conditions on Attempted and Completed Suicide among their Children”

Aleck Ostry, Stefania Maggi, James Tansey, James R. Dunn, Ruth Hershler, Lisa Chen, Amber Louie and Clyde Hertzman

Background: Adverse employment experiences, particularly exposure to unemployment and the threat of unemployment, have been strongly associated with several adverse mental and physical health outcomes including suicide. However, virtually no research has been conducted on the trans-generational impact of parental working conditions on attempted or completed suicide among their children.

Methods: We conducted a nested case control study based on a cohort, gathered in the western

Canadian province of British Columbia, of male sawmill workers and a second cohort of their children. Physical and psychosocial work conditions to which fathers were exposed during the first

16 years of their children's lives, measured using the demand/control model, were linked to hospital suicide records (attempted and completed) among their children.

Results: Two hundred and fifty children in the cohort attempted or committed suicide between 1985 and 2001. Multivariate models, with partial control for father's mental health outcomes prior to their child's suicide demonstrate, 1) a strong association between low duration of father's employment at a study sawmill and attempted suicide for their male children, 2) elevated odds for attempted suicide among female children of fathers' employed in a sawmill job with low control and, 3) a strong association between fathers in jobs with low psychological demand and completed suicides among male children.

Conclusion: Exposure of fathers to adverse psychosocial work conditions during the first 16 years of their children's life was associated with greater odds for attempted and completed suicide among their children.

“Psychosocial and Neo-material Dimensions of SES and Health Revisited: Predictors of self-rated Health in a Canadian National Survey”

James R. Dunn, Gerry Veenstra, and Nancy A. Ross

This study addresses questions concerning psychosocial processes of relative comparison in the production of socioeconomic inequalities in health. Specifically, the importance for health of perceptions of status, different ‘reference groups’ and ‘reference points’ in such comparisons is problematized and investigated empirically. Using data from a cross-sectional telephone survey of the Canadian population in 2000 ðn ¼ 1331Þ, the paper investigates relationships between self-rated health status (SRHS) and: (1) ‘actual’ absolute socio-economic standing, (2) perceived relative socioeconomic standing (relative to other Canadians and to Canadians of the previous generation), and (3) ‘actual’ relative socio-economic standing (relative to others in respondents’ province of residence and neighbourhood of residence). Measures of actual absolute socio-economic status (SES) (household income, personal income and education) were strongly related to SRHS. Results for perceived relative SES were mixed. Perceived SES relative to all Canadians was a strong predictor of SRHS before and after controlling for age and gender while perceived SES relative to the previous generation was unrelated to SRHS. Actual relative income was strongly related to SRHS for all reference points (10th, 50th and 90th percentiles) in both reference groups analysed (neighbourhoods and provinces). Within neighbourhoods, however, comparisons with those at the top of the income ladder appeared to be somewhat more salient for SRHS than were comparisons to other levels. We conclude that there is some evidence of the importance of both psychosocial and neo-material aspects of SES for Canadians’ self-rated health, but that further empirical research is needed that accounts for the numerous ways in which psychosocial processes of relative social comparison may take place.

Keywords: Canada, health inequalities, Psychosocial comparisons, reference groups, self-related health status, socio-economic status

“Metropolitan Income Inequality and Working Age Mortality: A Cross-sectional Analysis Using Comparable Data from Five Countries”

Nancy A. Ross, Danny Dorling, James R. Dunn, Göran Henriksson, John Glover, John W. Lynch, and Gunilla Ringback Weitoft

The relationship between income inequality and mortality has come into question as of late from many within-country studies. This article examines the relationship between income inequality and working-age mortality for metropolitan areas

(MAs) in Australia, Canada, Great Britain, Sweden, and the United States to provide a fuller understanding of national contexts that produce associations between inequality and mortality. An ecological cross-sectional analysis of income inequality (as measured by median share of income) and working-age (25–64) mortality by using census and vital statistics data for 528 MAs (population >50,000) from five countries in 1990–1991 was used. When data from all countries were pooled, there was a significant relationship between income inequality and mortality in the 528 MAs studied. A hypothetical increase in the share of income to the poorest half of households of 1% was associated with a decline in working-age mortality of over 21 deaths per 100,000. Within each country, however, a significant relationship between inequality and mortality was evident only for MAs in the United States and Great Britain. These two countries had the highest average levels of income inequality and the largest populations of the five countries studied. Although a strong ecological association was found between income inequality and mortality across the 528 MAs, an association between income inequality and mortality was evident only in within-country analyses for the two most unequal countries: the United States and Great Britain. The absence of an effect of metropolitan-scale income inequality on mortality in the more egalitarian countries of Canada, Australia, and Sweden is suggestive of national-scale policies in these countries that buffer hypothetical effects of income inequality as a determinant of population health in industrialized economies.

Keywords: Australia, Canada, Great Britain, income inequality, mortality, Sweden, United States

“US Regional and National Cause-Specific Mortality and Trends in Income Inequality: Descriptive Findings”

John W. Lynch, Sam Harper, George Davey Smith, Nancy A. Ross, Michael Wolfson and James R. Dunn

We examined the concordance of income inequality trends with 30-year US regional trends in cause-specific mortality and 100-year trends in heart disease and infant mortality. The evidence suggests that any links between income inequality and population health trends is likely to be complex. The descriptive findings here imply that income inequality would have to be linked and de-linked across different time periods, with different exposures to generate the observed heterogeneous regional and national levels and trends in different causes of death.

“Effects of Housing Circumstances on Health, Quality of Life and HealthCare Use for People with Severe Mental Illness: A Review”

Tania Kyle and James R. Dunn

Individuals with severe and persistent mental illness (SPMI) identify housing as an important factor in achieving and maintaining their health. However, many live in substandard accommodations that are physically inadequate, crowded, noisy and located in undesirable neighbourhoods. In much of the research on housing for persons with SPMI, the central outcome of interest is remaining housed; however, it is worth investigating whether housing has other benefits. This paper is a systematic review of studies that investigated the relationship between housing-related independent variables and health-related dependent variables. Ten online databases were searched for studies published since 1980 that had study populations of adults with SPMI, analysed primary or secondary empirical data, and measured housing-related independent variables and health-related dependent variables. Clearly defined epidemiological criteria were used to assess the strength of evidence of the selected studies. Twenty-nine studies met the suitability criteria, of which 14 reported healthcare utilisation outcomes; 12 examined mental status outcomes; and 9 reported quality-of-life outcomes. The findings of the review suggest that there is good evidence that housing interventions benefit the homeless population; however more research is needed about housing solutions for individuals with SPMI who are housed, but in precarious or inappropriate housing situations. Study methodologies could be improved by emphasising longitudinal designs that focus on participant retention and by implementing matched control groups or randomised interventions to strengthen internal validity. Ensuring that a person is adequately housed upon discharge from hospital should be a treatment priority. When housing eligibility is not dependent on psychiatric treatment compliance and sobriety, providing permanent housing minimises harm and may free people to voluntarily seek treatment. Housing that offers an unlimited length of stay is recommended because SPMI is a chronic and fluctuating condition that requires stable surroundings to maintain health.

Keywords: healthcare utilisation, housing, mental health status, quality of life, severe and persistent mental illness

“Spreading the News: Social Determinants of health Reportage in Canadian Daily Newspapers”

Mike Gasher, Michael V. Hayes, Ian Ross, Robert A. Hackett, Donald Gutstein and James R. Dunn

As part of a research program called CHAMP (Canadian Health and Media Project) devoted to examining health literacy in Canadian daily newspapers, and operating from a theoretical framework that posits journalism as a practice of representation, this article is based on a series of formal interviews with English-language and French-language health reporters. The interviews sought answers to three central questions about health reportage: how do journalists demarcate such a vast topic as health? where do they find their stories? and to what extent are they familiar with research into the social determinants of health? It concludes that in spite of their dependence upon published scholarly research as a source of news stories, Canadian health reporters overemphasize the roles of the health care system and personal health habits in the production of Canadians’ health, and they underemphasize the role of social determinants.

Keywords: communication research, health care industry, health education, journalism, newspapers, public health

“Welfare States and Public Opinion: Comment on Brooks and Manza”

John Myles

First, they establish an intellectual link to the growing body of political science literature on this topic (for reviews, see Burstein 1998 and Manza and Cook 2002). Second, they challenge comparative welfare state scholars to attend to an issue that has been mostly dormant since they turned against the "national values" tradition associated with Lipset (1963) and others. To my knowledge, their study is the first attempt to embed the public opinion thesis within a multivariate model that does the following: (a) tests for the presence of (short-term) endogeneity (i.e., does public opinion simply reflect current levels of social spending?); and (b) controls for a set of other likely suspects that account for welfare state variation.

Keywords: policy making, political science, politics, public opinion, theory, welfare

“Neighbourhood Inequality, Neighbourhood Affluence and Population Health”

Feng Hou and John Myles

While there is now considerable evidence that the neighbourhood income levels (poverty/affluence) exert an independent effect on health, there is little evidence that neighbourhood income inequality is consequential, net of individual-level socio-economic resources. We show that the usual explanation for the absence of an independent effect of neighbourhood inequality—the assumption of economic homogeneity at the neighbourhood level—cannot account for this result. The authors use hierarchical models that combine individual micro-data from Statistics Canada’s 1996/97 National Population Health Survey (NPHS) with neighbourhood and city-level socio-economic characteristics from the 1996 Census of Canada to estimate the effects of neighbourhood affluence and income inequality on self-reported health status. The findings indicate that the negative ‘‘ecological’’ correlation between average neighbourhood health and neighbourhood income inequality is the result not only of compositional differences among individuals but also of contextual neighbourhood effects associated with low and high inequality neighbourhoods

Keywords: Canada, health, income inequality, neighbourhood, poverty

“Changing Colours: Spatial Assimilation and New Racial Minority Immigrants”

Feng Hou and John Myles

Critiques of spatial assimilation theory are typically associated with important historical changes that are thought to limit its applicability to more recent immigrant populations. Unlike earlier, mainly European, migrant waves, contemporary immigrants come mainly from Asia, Africa, the Middle East, the Caribbean and Central and South America. For many receiving nations among the traditional "settler societies" (Australia, Canada) and now in Europe, the appearance of large numbers of "people of colour" (non-whites) on the urban landscape is an historical novelty dating from the 1960s or later.(3) The result is considerable scepticism that patterns of spatial assimilation familiar from the past will be reproduced among contemporary immigrants. Urban concentrations of poor Bangladeshis in Birmingham, Turks in Rotterdam and Berlin, Algerians in Paris and Blacks in Toronto readily invoke images of the enduring racialized black ghettoes characteristic of American cities (Musterd and Winter, 1998) rather than the transitory immigrant enclaves associated with the spatial assimilation model. Urban American blacks do move to more affluent neighbourhoods as their incomes rise but tend to be concentrated in black neighbourhoods that are less affluent than those of comparable whites (Alba, Logan and Stults, 2000:591). So-called "place stratification" theory (Logan and Molotch, 1987) highlights the constraints on choice that may result when majority groups use mechanisms of exclusion to maintain social distance between themselves and ethnic or racial minorities.

The implications of seemingly small differences in segregation levels for Toronto's urban landscape are striking (Table 3). The residential patterns of Toronto Blacks are those one would associate with the spatial assimilation model and the immigrant enclave. Most "black neighbourhoods" are quite poor but relatively few Blacks live in these neighbourhoods. Only 38 census tracts have a black population that exceeds 20 percent and these neighbourhoods account for only 17 percent of Toronto's black population. The Chinese, in contrast make up 20 percent or more of the population in 83 tracts, accounting for 51 percent of the Chinese population. Half of the black population lives in neighbourhoods with fewer than 10 percent Blacks while only a third of the Chinese live in tracts with fewer than 10 percent of their co-ethnics. Relative to black neighbourhoods, those with a substantial Chinese population are relatively affluent suggesting they are more likely to retain their more successful members. The South Asian distributions fall between these extremes. These gross differences in neighbourhood outcomes suggest that rather different processes may be at work but is it so? To answer this question we turn to the results of our regression models.

Differences in socioeconomic resources are at the heart of spatial assimilation theory. In Massey and Denton's (1985:94) summary statement the key claim of spatial assimilation theory is that "as social status rises... minorities attempt to convert their socioeconomic achievements into an improved spatial position, which usually implies assimilation with majority groups." With few exceptions, the results are consistent with this expectation. The exceptions, however, prove to be important.

“Where Have All the Sociologists Gone? Explaining Economic Inequality”

John Myles

Sociology's shared legacy, one inherited from 19[Symbol Not Transcribed] century political economy, is that the structure of inequality is built on the division of labour. Frank Parkin (1971) called this the "positional" approach to the study of inequality. Wealth, power or prestige are attached to positions, not to the individuals who occupy those positions. The trick to understanding inequalities is to understand how the structure of empty places -- let's call it the "class structure" -- is organized. Then, and only then, can we begin to ask second order questions about how people are allocated to these positions.

Grusky and Sorensen (1998) catalogue a number of different responses to this development. The revisionist impulse, shared by the present author (Clement and Myles 1994) among many others, was to refurbish and revamp the traditional approach with new and presumably improved occupational or class aggregations. The result has been an "embarrassment of choice" among boundary-mapping schemes with no clear standard for evaluating among them. The postmodern deconstructionists who announced the "death of class" were at the other end of the continuum (Pakulski and Waters 1996). Their claim was that all types of "structural" divisions are eroding and that new social cleavages are cultural in origin, hence the emergent dialogue with the humanities.

In my view, however, most of the recent efforts to "salvage" class analysis are flawed because their starting point is flawed. It begins by theorizing the independent variable -- classes -- rather than with the outcome to be explained -- trends in economic inequality in advanced capitalist societies. The aim of the exercise is still to explain who gets what and why. Marx's labour theory of value may have been wrong but it did start in the right place. Sorensen's (2000) effort to revive class analysis based on a theory of "rents" is also in the right spirit. In particular, he attempts to account for the contemporary pattern of growing inequality within classes and occupational groups (Sorensen, 2000: 1552), including university professors (Sorensen 2000:1548). But to date, neither he nor any other sociologist has shown how one might actually analyse contemporary changes in the structure of earnings and wage inequality from a class-based perspective.

“Low Income Intensity During the 1990s: The Role of Economic Growth, Employment Earnings, and Social Transfers”

R. Morissette, J. Myles, G. Picot

This paper assesses the role played by changes in economic growth, employment earnings, and government transfers in the patterns of low-income intensity in Canada during the 1980s and the 1990s. We find that lowincome intensity was higher in most provinces during the 1990s than during the 1980s (comparing comparable positions in the business cycle). During the 1990s changes in government transfers did not offset the fall in employment earnings among lower-income families, as they did during the 1980s, resulting in an increase in low-income intensity. Whether or not the relationship between economic growth and low-income intensity weakened in any kind of permanent way during the 1990s as compared to the 1980s is unclear from this analysis.

“Political Theories of the Welfare State”

John Myles and Jill Quadagno

We review the main theoretical conclusions from a quarter century of comparative studies of welfare states in the affluent democracies. We contrast early debates over the relative importance of industrialization, economic growth, and social classes for explaining welfare state differences with contemporary claims about the role of globalization, postindustrialism, and gender relations in shaping their futures. We evaluate the claims against recent empirical evidence with the aim of highlighting both important lessons from the past and promising directions for future analysis.

“County Level Socioeconomic Position, Work Organization and Depression Disorder: A Repeated Measures Cross-classified Multilevel Analysis of Low-income Nursing Home Workers”

Carles Muntaner, Yong Li, Xiaonan Xue, Theresa Thompson, Patricia J. O’Campo, Haejoo Chung, William W. Eaton

This study simultaneously tests the effect of county, organizational, workplace, and individual level variables on depressive disorders among low-income nursing assistants employed in US nursing homes. A total of 482 observations are used from two waves of survey data collection, with an average two-year interval between initial and follow-up surveys. The overall response rate was 62 percent. The hierarchically structured data was analyzed using multilevel modeling to account for cross-classifications across levels of data. Nursing assistants working in nursing homes covered by a single union in three states were asked about aspects of their working conditions, job stress, physical and mental health status, individual and family health-care needs, household economics and household strain.

Participants: The 241 nursing assistants who participated in this study were employed in 34 nursing homes and lived in 49 counties of West Virginia, Ohio and Kentucky.

Main results: The study finds that emotional strain, related to providing direct care to elderly and disabled clients, is associated with depressive disorder, as is nursing home ownership type (for-profit versus not-for-profit). However, when controlling for county level socioeconomic variables (Gini index and proportion of African Americans living in the county), neither workplace nor organizational level variables were found to be statistically significant associated with depressive disorder.

Conclusions: This study supports previous findings that emotional demand in health-care environments is an important correlate of mental health. It also adds empirical evidence to support a link between financial strain and depression in US women. While this study does not find that lack of a seniority wage benefits—a factor that can conceivably exacerbate financial strain over time—is associated with depressive disorder among low-income health-care workers, it does find county level measures of poverty to be statistically significant predictors of depressive disorder. Longitudinal county level measures of low-income as predictors of depression may even offer a methodological advantage in that they are presumably more stable indicators of cumulative exposure of low income than are more transient workplace indicators.

“Neighbourhood Poverty, Social Capital, and the Cognitive Development of African American Preschoolers”

Margaret O’Brien Caughy and Patricia J. O'Campo

In this investigation, we examine the impact of the ecological context of the residential neighborhood on the cognitive development of children by considering social processes not only at the family-level but also at the neighborhood-level. In a socioeconomically diverse sample of 200 African American children living in 39 neighborhoods in Baltimore, we found that neighborhood poverty was associated with poorer problem-solving skills over and above the influence of family economic resources and level of positive parent involvement. Sampson has theorized that neighborhood poverty affects child well-being by altering levels of neighborhood social capital as well as family social capital. Although we found that indicators of neighborhood and family social capital were associated with cognitive skills, these factors did not explain the association between neighborhood poverty and problem-solving ability. Implications for future research in the area of neighborhoods and child development are discussed.

Keywords: African Americans, cognitive development, neighborhoods, poverty, social capital

“Maternal & Child Health and Neighborhood Context: The Selection and Construction of Area-Level Variables”

Julie K. Rajaratnam, Jessica G. Burke and Patricia J. O’Campo

Background: Increasingly, maternal and child health researchers are employing the statistical approach of multilevel modeling analysis to simultaneously examine the relationship between contextual and individual determinants and maternal and child health outcomes. This review addresses the following questions: (1) What categories of neighborhood characteristics have been addressed? (2) How were those neighborhood characteristics operationalized?

Methods: A literature review identified 31 relevant articles published between January 1999 and March 2004. The articles were read with special attention toward the measurement of neighborhood characteristics.

Results: Twelve categories of neighborhood characteristics represented in the articles include income/wealth, employment, family structure, population composition, housing, mobility, education, occupation, social resources, violence and crime, deviant behavior and physical conditions. A wide diversity of approaches was used to measure these characteristics. The most widely utilized source of data was that of administrative records from the census or local government authorities. Although most authors provided theoretical explanations of their choice to examine broad neighborhood constructs, few were explicit about why certain indicators were selected to measure these constructs.

Conclusions: There are theoretical, methodological and practical barriers in the measurement of the neighborhood context which must be addressed for the field to move forward. These barriers are discussed and recommendations are made for addressing them in future research.

Keywords: context, maternal and child health, measurement, multilevel

“An Introduction to Concept Mapping as a Participatory Public Health Research Method”

Jessica G. Burke, Patricia J. O’Campo, Geri L. Peak, Andrea C. Gielen, Karen A. McDonnell and William M.K. Trochim

In this article, the authors introduce concept mapping as a useful participatory research method for public health researchers interested in generating hypotheses and developing theory. The authors first provide an overview of concept mapping, which combines qualitative approaches with quantitative analytical tools to produce visual displays of the relationship between ideas. Then, they present an illustrative research application of the method to the exploration of women’s perceptions of the relationship between residential neighborhood factors and intimate partner violence experiences. They give attention to the data collection and analysis procedures and to demonstrating the intricacies of using concept mapping for public health research purposes. Finally, the article concludes with a discussion of the unique contributions and challenges associated with concept mapping.

Keywords: hypothesis generation, methodology, theory development

“Uncovering the Neighborhood Influences on Intimate Partner Violence Using Concept Mapping”

Patricia J. O’Campo, Jessica G. Burke, Geri L. Peak, Karen A. McDonnell and Andrea C. Gielen

While neighbourhood influences on the risk of intimate partner violence have been reported, this body of research has suffered from a lack of strong theoretical and conceptual guidance, and few studies have examined the potential pathways from neighbourhoods to intimate partner violence. This paper used concept mapping methods with 37 women who were residents of Baltimore City to obtain cluster maps representing the important neighbourhood domains that affect the prevalence, perpetration, severity, and cessation of intimate partner violence. Domains important for intimate partner severity and perpetration differed from those important for cessation of intimate partner violence. Finally, diagrams of the domains, drawn by the concept mapping participants, illustrated the pathways by which neighbourhood characteristics potentially influence intimate partner violence severity, perpetration, and cessation. These results can be used to generate testable hypotheses regarding neighbourhood influences on intimate partner violence in future quantitative research and to inform the design of public health intimate partner violence programmes.

“Community Level Effect of Gender Inequality on Intimate Partner Violence and Unintended Pregnancy in Colombia: Testing the Feminist Perspective”

Christina C. Pallitto and Patricia J. O’Campo

Violence against women, especially by intimate partners, is a serious public health problem that is associated with physical, reproductive, and mental health consequences. The effect of intimate partner violence on women’s ability to control their fertility and the mechanisms through which these phenomena are related merit further investigation. Building on findings from a previous analysis in which a statistically significant relationship between intimate partner violence and unintended pregnancy in Colombia was found, this analysis examines the effect of gender inequality on this association using data from the 2000 Colombian Demographic and Health Survey. Specifically, the objective of this analysis is to explore whether gender inequality (as measured by women’s autonomy, women’s status, male patriarchal control, and intimate partner violence) in municipalities partially explains the association between intimate partner violence and unintended pregnancy in Colombia. Results of logistic regression analysis with multi-level data show that living in a municipality with high rates of male patriarchal control significantly increased women’s odds of having an unintended pregnancy by almost four times. Also, living in a municipality with high rates of intimate partner violence increased one’s odds of unintended pregnancy by more than 2.5 times, and non-abused women living in municipalities with high rates of intimate partner violence were at a significantly increased risk of unintended pregnancy. In addition, abused women living in a municipality with high personal female decision-making autonomy had more than a fourfold increased risk of having an unintended pregnancy. These findings demonstrate the need for reproductive health programs to target areas at particularly high risk for unintended pregnancy by reducing intimate partner violence and gender inequality.

Keywords: Colombia, intimate partner violence, patriarchy, unintended pregnancy

“Abuse, HIV Status, and Health Related Quality of Life among Low Income Women”

Karen A. McDonnell, Andrea C. Gielen, Patricia J. O’Campo and Jessica G. Burke

The assessment of a person’s quality of life as it relates to health, HIV status and intimate partner violence (IPV) among women has been limited in its scope of investigation. Consequently, little is known about the adjusted and combined effects of IPV and HIV on women’s health status and QOL. 445 women (188 HIV + 257 HIV )) residing in an urban low income area were interviewed regarding current IPV experiences (no IPV, IPV more than 1 year ago, IPV in last year), HIV status (positive and negative), use of illicit drugs, and presence of instrumental social support. Health-related QOL (HRQOL) was measured using the MOS-HIV. Stratified bivariate analyses demonstrate that living with HIV or having experienced IPV in the past year was significantly associated with poorer levels of HRQOL. Multiple logistic regression models indicate a robust negative relationship between the experience of IPV in the past year, living with HIV, use of illicit drugs and a protective effect of social support on women’s reported HRQOL. The results of the bivariate and multivariate analyses provide evidence that there are independent and adjusted detrimental associations of the experience of IPV and living with HIV with women’s HRQOL. As HRQOL is a good indicator of physical and mental health, these findings should alert health care and other service providers to their responsibility to screen and treat women experiencing intimate partner violence and living with HIV.

Keywords: health-related quality of life, HIV, violence

“’Our Garden is Colour Blind, Inclusive and Warm’: Reflections on Green School Grounds and Social Inclusion”

Janet E. Dyment and Anne C. Bell

In the interest of enhancing children’s environments, communities around the world are ‘greening’ school grounds, replacing asphalt and manicured grass with a diversity of design elements such as trees, shrubs, gardens, water features, artwork and gathering areas. Despite a growing body of research from a number of disciplines exploring the potential of these spaces, very little is known about the ways they can promote social inclusion with respect to gender, class, race and ability. This paper explores the relationship between school ground greening and social inclusion in a Canadian public school board where approximately 20% of more than 500 schools have begun the greening process. A mixed methods approach was used: (1) 149 questionnaires were completed by administrators, teachers and parents associated with 45 school ground greening initiatives; and (2) 21 follow-up interviews were conducted with administrators, teachers and parents at five schools across a range of socio-economic statuses. The study revealed that green school grounds are more inclusive of people who may feel isolated on the basis of gender, class, race and ability, suggesting that these spaces promote, in a very broad sense, social inclusion.

“Report on Results of the Pilot Study on School Grounds and Health”

Janet E. Dyment and Anne C. Bell

In 2007, Evergreen received seed grant funding from the Centre for Urban Health Initiatives to identify, test and refine appropriate research methods for a future, in-depth study investigating the influence of school ground design on children’s physical activity and related health benefits. This report presents the results of that work, based on a literature review and a pilot study, and provides insights, recommendations and logistical information to guide further research by Evergreen in this area. The results of the literature review are presented in section 2. The results of the pilot study are presented in sections 3 – 9. Each method is presented in a separate section that includes a description of the method, the protocol used, insights about the strengths and weaknesses of the method, and recommendations for future research. In addition, data gathered using each method are also presented and discussed. Other logistical information that would be useful to include in future studies is presented in section 10. This includes sample letters and consent forms and suggestions for organizing future research. The conclusion presents a summary of the recommendations for future research.

“Assessing the Organic Composition of Urban Surface Films Using Nuclear Magnetic Resonance Spectroscopy”

Andre J. Simpson, Buuan Lam, Miriam L. Diamond, D. James Donaldson, Brent A. Lefebvre, Arvin Q. Moser, Antony J. Williams, Nicolay I. Larin and Mikhail P. Kvasha

Recently it has been shown that urban surfaces are covered with a thin film which mediates the fate, distribution and accumulation of semi-volatile organic compounds in the environment. In this study we apply a combination of solution, semi-solids, and solid state nuclear magnetic resonance (NMR) methods to provide a general overview of the organic constituents. In surface film collected from 30 m2 of outside windows over an area of 12 km2 in downtown Toronto, we roughly estimate that the organic carbon is _35% carbohydrate, _35% aliphatics, _20% aromatics, and _10% carbonyl groups. Various aliphatic groups can be identified including a number of acids, alcohols, alkanes, and alkenes. Also, numerous intact aliphatic esters are apparent that have not been observed before, as well as carbohydrates. The aromatic species include a small portion that appears to be derived from a polymer of styrene, in addition a larger fraction is consistent with polyhydroxylated PAH derived material, although this assignment is tentative and based solely on 1-D NMR data only. In addition, signals from polybutadiene are present and while accurate quantification is not possible, it appears that this polymer may be up to a few percents by weight of the total organic material.

Keywords: contaminant fate, nuclear magnetic resonance spectroscopy, organic composition, surface films, urban centers

“Using Passive Air Samplers To Assess Urban-Rural Trends for Persistent Organic Pollutants and Polycyclic Aromatic Hydrocarbons. 2. Seasonal Trends for PAHs, PCBs, and Organochlorine Pesticides”

Anne Motelay-Massei, Tom Harner, Mahiba Shoeib, Miriam L. Diamond, Gary Stern and Bruno Rosenberg

This is the second of two papers demonstrating the feasibility of using passive air samplers to investigate persistent organic pollutants along an urban-rural transect in Toronto. The first paper investigated spatial trends for polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs). This second paper investigates the seasonality of air concentrations for polycyclic aromatic hydrocarbons (PAHs), PCBs, and OCPs along this transect. Air samplers, consisting of polyurethane foam (PUF) disks housed in stainless steel domed chambers, were deployed for three 4-month integration periods from June 2000 to July 2001. The seasonal variations of derived air concentrations for PAHs, PCBs, and OCPs reflected the different source characteristics for these compounds. PAHs showed a strong urban-rural gradient with maximum concentrations at urban sites during the summer period (July-October). These high summer values in Toronto were attributed to increases in evaporative emissions from petroleum products such as asphalt. PCBs also exhibited a strong urban-rural gradient with maximum air concentrations (~2-3 times higher) during the spring period (April-June). This was attributed to increased surface-air exchange of PCBs that had accumulated in the surface layer over the winter. R-HCH was fairly uniformly distributed, spatially and temporally, as expected. This pattern and the derived air concentration of ~35 to ~100 pg m^-3 agreed well with high volume air data from this region, adding confidence to the operation of the passive samplers and showing that site-to-site differences in sampling rates was not an issue. For other OCPs, highest concentrations were observed during the spring period. This was associated with either (i) their local and/or regional application (γ-HCH, endosulfan) and (ii) their revolatilization (chlordanes, DDT isomers, dieldrin, and toxaphene). Principal component analysis resulted in clusters for the different target chemicals according to their chemical class/source type. The results of this study demonstrate how such a simple sampling technique can provide both spatial and seasonal information. These data, integrated over seasons, can be used to evaluate contaminant trends and the potential role of large urban centers as sources of some semivolatile compounds to the regional environment, including the Great Lakes ecosystem.

“Is House Dust the Missing Exposure Pathway for PBDEs? An Analysis of Urban Fate and Human Exposure to PBDEs”

Heather A. Jones-Otazo, John P. Clarke, Miriam L. Diamond, Josephine A. Archbold, Glenn Ferguson, Tom Harner, G. Mark Richardson, John J. Ryan and Bryony Wilford

Polybrominated diphenyl ether (PBDE) body burdens in North America are 20 times that of Europeans and some “high accumulation” individuals have burdens up to 1-2 orders of magnitude higher than median values, the reasons for which are not known. We estimated emissions and fate of ªPBDEs (minus BDE-209) in a 470 km2 area of Toronto, Canada, using the Multi-media Urban Model (MUMFate). Using a combination of measured and modeled concentrations for indoor and outdoor air, soil, and dust plus measured concentrations in food,weestimated exposure to ªPBDEs via soil, dust, and dietary ingestion and indoor and outdoor inhalation pathways. Fate calculations indicate that 57-85% of PBDE emissions to the outdoor environment originate from within Toronto and that the dominant removal process is advection by air to downwind locations. Inadvertent ingestion of house dust is the largest contributor to exposure of toddlers through to adults and is thus the main exposure pathway for all life stages other than the infant, including the nursing mother, who transfers PBDEs to her infant via human milk. The next major exposure pathway is dietary ingestion of animal and dairy products. Infant consumption of human milk is the largest contributor to lifetime exposure. Inadvertent ingestion of dust is the main exposure pathway for a scenario of occupational exposure in a computer recycling facility and a fish eater. Ingestion of dust can lead to almost 100- fold higher exposure than “average” for a toddler with a high dust intake rate living in a home in which PBDE concentrations are elevated.

“Using Passive Air Samplers to Assess Urban-rural Trends for Persistent Organic Pollutants (POPs): 1. Polychlorinated Biphenyls (PCBs) and Organochlorine Pesticides (OCPs)”

Tom Harner, Mahiba Shoeib, Miriam L. Diamond, Gary Stern and Bruno Rosenberg

Passive air samplers were used to investigate urbanrural differences of polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) over an integrated time period. Samplers consisting of polyurethane foam (PUF) disks and semi-permeable membrane devices (SPMDs) were housed in protective chambers and deployed at six sites for a 4 month duration in the summer of 2000. The sampling transect originated in downtown Toronto and extended ~75 km northward into a rural region. Results for the two types of samplers agreed well with one another. Higher blank levels were encountered for the SPMDs, especially for the OCPs, whereas blanks were very low for the PUF disks. Passive sampler-derived air concentrations were consistent with previous measurements of PCBs and OCPs in the region. The largest urban-rural gradient was observed for PCBs (~5-10 times). Chlordanes also showed an urban-rural gradient, possibly reflecting past usage of chlordane on residential lawns and emissions from treated house foundations. Other OCPs exhibited a ruralurban gradient (dieldrin, endosulfan 1, and DDT isomers), which was attributed either to off-gassing from previously treated agricultural soils (dieldrin and DDTs) or to continued usage in agriculture (endosulfan 1). The results of this study demonstrated the feasibility of using such devices to determine air concentrations of persistent organic pollutants (POPs) and to assess their spatial distribution for timeintegrated samples. Data such as this is essential for: model validation and for process research and addressing international monitoring strategies on POPs.

“Using Experimental and Forest Soils to Investigate the Uptake of Polycyclic Aromatic Hydrocarbons (PAH) Along an Urban-rural Gradient”

Fiona Wong, Tom Harner, Qin Tao Liu and Miriam L. Diamond

Spatial and temporal variation in the atmospheric deposition of PAHs to soil was examined by deploying experimental soils for ~165 days and conducting a survey of forest soils at several sites along an urban-rural transect extending from downtown Toronto to ~80 km north of the city. PAH concentrations decreased with distance from the urban centre—by a factor of 2 and 60 for the experimental and forest soils respectively. The large gradient for the forest soils is generally consistent with air concentrations of PAHs measured using high volume and passive air samplers. The smaller gradient for the experimental soils was due to kinetic limitations of PAH accumulation and the relatively short deployment period of ~165 days. Mean effective deposition velocities (gas+particle) for the full range of PAHs for the experimental soils at the urban,suburban, and the rural sites were 2, 31 and 26 cm ^s_1,respectively. These were incorporated into a dynamic model that was used to assess the long-term uptake of PAHs in forest soils. Model results indicate that lower molecular weight PAHs may achieve equilibrium and become involved in soil-air exchange whereas higher molecular weight PAHs are accumulated for much longer time periods.

Keywords: deposition, forest soils, PAHs, soil-air exchange

“Spatial Distribution of Polybrominated Diphenyl Ethers in Southern Ontario as Measured in Indoor and Outdoor Window Organic Films”

Craig M. Butt, Miriam L. Diamond, Jennifer Truong, Michael G. Ikonomou and Arnout F.H. Ter Schure

Organic films were collected from indoor and outdoor window surfaces, along an urban-rural transect extending northward from Toronto, Ontario, Canada, and analyzed for 41 polybrominated diphenyl ether congeners (PBDE). For exterior films, urban ªPBDE concentrations were _10_ greater than rural concentrations, indicating an urbanrural gradient and greater PBDE sources in urban areas. Urban films ranged from 2.5 to 14.5 ng/m2 (mean ) 9.0 ng/m2), excluding the regional “hotspot” Electronics Recycling Facility, compared to 1.1 and 0.56 ng/m2 at the Suburban and Rural sites. Interior urban films (mean ) 34.4 ng/m2) were 3 times greater than rural films (10.3 ng/m2) and were representative of variations in building characteristics. Indoor films were 1.5-20 times greater than outdoor films, consistent with indoor sources of PBDEs and enhanced degradation in outdoor films. Congener profiles were dominated by BDE-209 (51.1%), consistent with deca-BDE as the main source mixture, followed by congeners from the penta-BDE mixture (BDE-99:13.6% and -47:9.4%) and some octa-BDE (BDE-183:1.5%). Congener patterns suggest a degradative loss of lower brominated compounds in outdoor films versus indoor films. Gas-phase air concentrations were back-calculated from film concentrations using the film-air partition coefficient (KFA). Mean calculated air concentrations were 4.8 pg/m3 for outdoor and 42.1 pg/m3 for indoor urban sites, indicating that urban indoor air is a source of PBDEs to urban outdoor air and the outdoor regional environment.

“Chemical Composition of Surface Films on Glass Windows and Implications for Atmospheric Chemistry”

Buuan Lam, Miriam L. Diamond, André J. Simpson, Paul A. Makar, Jennifer Truong and Nadia A. Hernandez-Martinez

Atmospherically derived surface films that cover impervious surfaces in cities, have areas comparable to that of atmospheric particulate matter (PM). The films compete with PM for sorption of volatile and semi-volatile organic compounds and alter the functionality of urban surfaces. The determination of surface-film composition is therefore vital to understanding their role in mediating chemical fate and transport within cities. Here, we show the composition of urban surface films collected from windows in downtown Toronto (Ontario, Canada) to be comprised of ~94% inorganic compounds of which 8% are sulfate, 7% nitrate and 18% metals. Approximately 5% of the urban film mass is organic carbon, with ~35% of the organic carbon mass corresponding to carbohydrates, ~35% aliphatics, ~20% aromatics and ~10% carbonyls. The composition of surface films differs significantly from that of PM, suggesting differential accumulation, depositional degradation, and/or processes within films differing from those affecting PM. A rigid polymeric component comprising a small fraction of the organic carbon was also found, which may suggest direct deposition from environmental sources, or possible secondary in situ reactions within the film. Here, we suggest a potential mechanism for the oxidation of surface films to form organic polymers via radical initiation processes. Thus, the composition of surface films has important implications for chemical fate of contaminants within cities and presents a significant aspect of contaminant uptake that has not been considered in many air-quality models.

Keywords: atmospheric deposition, impervious surfaces, NMR, surface-air exchange, urban air chemistry

“Making Toronto’s Streets”

Paul M. Hess and Beth M. Milroy

This project was initiated by questions posed by community activists, Janice Etter and Rhona Swarbrick, authors of Toronto's Pedestrian Charter. They wanted to know why the road classification system developed for road engineering and maintenance purposes has such a powerful effect on how Toronto manages its streets while pedestrianism has so little. The road classification system establishes a hierarchy of arterial, collector and local streets. Each of these categories shapes road widths, carrying capacities, safe speeds, traffic signals, and intersection design through the use of guidelines, standards, and established practices. In this way, the system influences the pedestrian environment and adjoining land uses although those are not its stated purposes. We thank them for encouraging us to do the investigation because we learned a great deal. By passing on the information we hope others will benefit too. A special thanks to interviewees, and many others from whom we sought information, for so willingly sharing their deep intelligence about Toronto streets with us. The study was possible because the Centre for Urban Health Initiatives promotes investigations that connect community concerns and university researchers.

“Thyroid Hormones in Pregnancy in Relation to Environmental Exposure to Organochlorine Compounds and Mercury”

Larissa Takser, Donna Mergler, Mary Baldwin, Sylvie de Grosbois, Audrey Smargiassi and Julie Lafond

Polychlorinated biphenyls (PCBs), chlorinated pesticides, and mercury are global environmental contaminants that can disrupt the endocrine system in animals and humans. However, there is little evidence that they can interfere with endocrine status in pregnant women and neonates at low levels of exposure. The aim of this study was to examine thyroid hormone levels during pregnancy and in cord blood in relation to blood concentrations of organochlorine compounds (OCs) and Hg in healthy women recruited during pregnancy. We found a significant negative correlation between maternal total triiodothyronine levels and three non-coplanar congeners (PCB-138, PCB-153, and PCB-180), three pesticides (p,p′-DDE, cis-nanochlor, and hexachlorobenzene), and inorganic Hg independently, without any other changes in thyroid status. No significant relationships were observed between OCs and cord serum thyroid hormones. Cord serum free thyroxin was negatively correlated with inorganic Hg. These results suggest that at even low levels of exposure, persistent environmental contaminants can interfere with thyroid status during pregnancy.

Keywords: cord blood, environment, mercury, pesticide, polychlorinated biphenyls, pregnancy, thyroid

“Small Scale Spatial Variability of Particle Concentrations and Traffic Levels in Montreal: A Pilot Study”

Audrey Smargiassi, Mary Baldwin, Charles Pilger, Rose Dugandzic and Michael Brauer

Little is known about the particulate exposure of populations living along major urban roads. The objective of this pilot study was to explore the small-scale spatial and temporal variability of the absorption coefficient of PM2.5 filters, as a surrogate for elemental carbon, in relation to levels of PM2.5, at residential sites with varying traffic densities in a large Canadian city. Concurrent 24-h measurements were performed at four residential sites during 7 weeks. A gradient existed across all four sites for the absorption coefficient of the filters (and NO2 levels). In contrast, the levels of PM2.5 were quite similar at all sites. The difference in the filter absorption coefficient of PM2.5 filters, between an urban background and a residential traffic site (with about 30000 vehicles/day), expressed as a percentage of the background site, was 40%. These results indicate that spatial variability in PM2.5 absorption coefficient can be observed with traffic intensity on a small scale within a North American city and suggests that regression modelling approaches similar to those used in European studies could be used to estimate exposure of the general population to traffic-related particles on a local scale in North America.

Keywords: absorption coefficient, elemental carbon, fine particles (PM2.5), outdoor air pollution, traffic, urban

“Food Desserts in the Prairies? Supermarket Accessibility and Neighborhood Need in Edmonton, Canada”

Karen E. Tomic, John C. Spence and Carl Amrhein

The U.S. and U.K. literatures have discussed ‘‘food deserts,’’ reflecting populated, typically urban, low-income areas with limited access to full-service supermarkets. Less is known about supermarket accessibility within Canadian cities. This article uses the minimum distance and coverage methods to determine supermarket accessibility within the city of Edmonton, Canada, with a focus on high-need and inner-city neighborhoods. The results show that for 1999 both of these areas generally had higher accessibility than the remainder of the city, but six high-need neighborhoods had poor supermarket accessibility.We conclude by examining potential reasons for differences in supermarket accessibility between Canadian, U.S., and U.K. cities.

Keywords: accessibility, Edmonton, food deserts, supermarkets

“Perceived Environment and Physical Activity: A Meta-Analysis of Selected Environmental Characteristics”

Mitch J. Duncan, John C. Spence and W. Kerry Mummery

Background: Several narrative reviews have been conducted on the literature examining environmental correlates of physical activity (PA). To date these reviews have been unable to provide definitive summaries of observed associations. This study utilizes meta-analytical techniques to calculate summaries of associations between selected environmental characteristics and PA.

Methods: Published studies were identified from electronic databases and searches of personal files. Studies were examined to determine the environmental constructs most frequently studied. Included studies (N = 16) examined at least one identified construct and determined associations between perceived environmental constructs and PA using logistic regression. Data were analyzed separately for crude and adjusted ORs using general-variance based fixed effect models.

Results: No significant associations emerged between environmental characteristics and PA using crude OR. The perceived presence of PA facilities (OR 1.20, 95% 1.06–1.34), sidewalks (OR 1.23,

95% 1.13–1.32), shops and services (OR 1.30, 95% 1.14–1.46) and perceiving traffic not to be a problem (OR 1.22, 95% 1.08–1.37) were positively associated with activity using adjusted ORs. Variance in PA accounted for by significant associations ranged from 4% (heavy traffic not a problem) to 7% (presence of shops and services).

Conclusion: Results of the meta-analysis support the relevance of perceived environmental characteristics for understanding population PA. These results should encourage the use of comprehensive ecological models that incorporate variables beyond basic demographic information.

“Quality of Working Life Indicators in Canadian Healthcare Organizations: A Tool for Healthy Healthcare Workplaces?”

Donald C. Cole, Lynda S. Robson, Louise Lemieux-Charles, Wendy McGuire, Claude Sicotte and Francois Champagne

Background: Quality-of-work-life (QWL) includes broad aspects of the work environment that affect employee learning and health. Canadian health care organizations (HCOs) are being encouraged to monitor QWL, expanding existing occupational health surveillance capacities. Aim To investigate the understanding, collection, diffusion and use of QWL indicators in Canadian HCOs.

Methods: We obtained cooperation from six diverse public HCOs managing 41 sites. We reviewed documentation relevant to QWL and conducted 58 focus groups/team interviews with strategic, support and programme teams. Group interviews were taped, reviewed and analysed for themes using qualitative data techniques. Indicators were classified by purpose and HCO level.

Results: QWL indicators, as such, were relatively new to most HCOs yet the data managed by human resource and occupational health and safety support teams were highly relevant to monitoring of employee wellbeing (119 of 209 mentioned indicators), e.g. sickness absence. Monitoring of working conditions (62/209) was also important, e.g. indicators of employee workload. Uncommon were indicators of biomechanical and psychosocial hazards at work, despite their being important causes of morbidity among HCO employees. Although imprecision in the definition of QWL indicators, limited links with other HCO performance measures and inadequate HCOresources for implementation were common, most HCOs cited ways in whichQWLindicators had influenced planning and evaluation of prevention efforts.

Conclusions: Increase in targeted HCO resources, inclusion of other QWL indicators and greater integration with HCO management systems could all improve HCO decision-makers’ access to information relevant to employee health.

Keywords: health promotion, information systems, occupational health services, performance measurement, personnel management

“Family, Friend or Foe? Critical Reflections on the Relevance and Role of Social Capital in Health Promotion and Community Development”

Sarah E.L. Wakefield and Blake Poland

Social capital has been the focus of considerable academic and policy interest in recent years. Despite this interest, the concept remains undertheorized: there is an urgent need for a critical engagement with this literature that goes beyond summary. This paper lays a foundation for a critical dialogue between social capital and health promotion, by examining problematics in the conceptualization and practice of social capital building and linking these to models of community development, a cornerstone health promotion strategy. In so doing, the paper contributes to the existing literature by providing a theoretical exposition and critique of various threads in social capital discourse, and linking these threads explicitly to community development practice. Distinctions between communitarian, institutional and critical approaches to social capital are elaborated, and the relationships between these three approaches and three models of community development—social planning, locality development, and social action— are discussed. The existing social capital literature is then critically examined in relation to three key themes common to both literatures: community integration, public participation, and power relations. This examination suggests that social capital cannot be conceived in isolation from economic and political structures, since social connections are contingent on, and structured by, access to material resources. This runs counter to many current policy discourses, which focus on the importance of connection and cohesion without addressing fundamental inequities in access to resources. This paper posits that approaches to community development and social capital should emphasise the importance of a conscious concern with social justice. A construction of social capital which explicitly endorses the importance of transformative social engagement, while at the same time recognising the potential negative consequences of social capital development, could help community organizers build communities in ways that truly promote health.

Keywords: community development, health promotion, social capital

“Growing Urban Health: Community Gardening in South-east Toronto”

Sarah E.L. Wakefield, Fiona Yeudall, Carolin Taron, Jennifer Reynolds, Ana Skinner

This article describes results from an investigation of the health impacts of community gardening, using Toronto, Ontario as a case study. According to community members and local service organizations, these gardens have a number of positive health benefits. However, few studies have explicitly focused on the health impacts of community gardens, and many of those did not ask community gardeners directly about their experiences in community gardening. This article sets out to fill this gap by describing the results of a community-based research project that collected data on the perceived health impacts of community gardening through participant observation, focus groups and in-depth interviews. Results suggest that community gardens were perceived by gardeners to provide numerous health benefits, including improved access to food, improved nutrition, increased physical activity and improved mental health. Community gardens were also seen to promote social health and community cohesion. These benefits were set against a backdrop of insecure land tenure and access, bureaucratic resistance, concerns about soil contamination and a lack of awareness and understanding by community members and decision-makers. Results also highlight the need for ongoing resources to support gardens in these many roles.

Keywords: community-based research, community gardens, urban health

“Taking Environmental Action: The Role of Composition, Context, and Collective”

Sarah E.L. Wakefield, Susan J. Elliott, Donald C. Cole and John D. Eyles

This article explores individual and community action taken in response to perceived environmental risks by investigating the determinants of environmental action across a range of action types. A conceptual framework is first presented, which provides a foundation for investigating the role of local compositional (i.e., individual characteristics), contextual (i.e., neighborhood environment), and collective (i.e., social networks) factors in environmental action. To test the utility of the conceptual framework, a quantitative survey was administered to a random sample of households (n = 512) in Hamilton, Canada. The results suggest that the predictors of environmental action vary by action type (i.e., personal change, individual civic action, and cooperative civic action), and that factors related to perceived environmental exposure and social capital generally play a stronger, more consistent role in civic environmental action than sociodemographic or neighborhood factors. The results underscore the role of social connection in responses to perceived environmental risks.

”Preliminary Report of the Multicultural Yard, Health and Environment Project (MYHEP)”

Sarah Wakefield, Monica Bienefeld and Leslie Jermyn

The Multicultural Yard Health and Environment Project (MYHEP) was a research project undertaken jointly by researchers from the University of Toronto, the University of Western Ontario and the City of Toronto Public Health Department, in collaboration with five community groups in Toronto. The goal of the research was to identify and better understand some of the challenges faced by governments in communicating information (particularly environmental health information) to various cultural and linguistic audiences. A second goal was to explore the effectiveness of particular by-law enforcement strategies, on the assumption that effective by-law enforcement enhances health protection (and conversely, that insufficient enforcement in particular communities could lead to unequal health protection).

The City of Toronto’s Pesticide By-law1 limiting residential pesticide use was used as a case example to address the research goals. This case was identified as a result of earlier research that evaluated existing literature about environmental health education strategies and by-law effectiveness (Jermyn 2005). In addition, attempts by City of Toronto staff to evaluate small initiatives such as train-the-trainer workshops and grants to community partners to deliver information about natural gardening methods, showed that specific cultural and linguistic groups tended to have different concerns and questions related to the by-law. These differences appeared to be related through cultural practices to the ways in which their outdoor space was used and perceived. This research project was therefore a first step in beginning to address the important questions raised by this earlier work about communicating environmental health information in ways that are feasible, relevant and protective of public health.

“Efficacy of a Community-Based Dietary Intervention to Enhance Micronutrient Adequacy of High-Phytate Maize-Based Diets of Rural Malawian Children”

Fiona Yeudall, Rosalind S. Gibson, Timothy R. Cullinan, Beatrice Mtimuni

Objective: To evaluate the efficacy of a community-based dietary intervention to reduce risk of micronutrient inadequacies in high-phytate maize-based Malawian diets.

Design: Quasi-experimental post-test design with a non-equivalent control group.

Setting: Four villages in Mangochi District, Southern Malawi.

Participants: Households with children aged 3–7 years in two intervention (n ¼ 200) and two control (n ¼ 81) villages participated in a 6-month intervention employing dietary diversification, changes in food selection patterns, and modifications to food processing to reduce the phytate content of maize-based diets. Baseline comparability between the groups was confirmed via assessment of sociodemographic characteristics, anthropometry, knowledge and practices, morbidity, haemoglobin and hair zinc. After 12 months, knowledge and practices and dietary intakes were assessed by interactive 24-hour recalls, one during the food plenty and a second during the food shortage season. Nutrient adequacy for the two groups was compared via dietary quality indicators and predicted prevalence of inadequate intakes using the probability approach.

Results: Intervention children had diets that were significantly more diverse and of a higher quality than those of controls. Median daily intakes of protein, calcium, zinc (total and available), haem iron, vitamin B12 and animal foods (grams; % of total energy) were higher (P , 0.05) whereas phytate intakes, phytate/zinc and phytate/iron molar ratios were lower (P , 0.01) in the intervention group; some spread of knowledge and practices to controls occurred.

Conclusions: Our community-based dietary strategies reduced the predicted prevalence of inadequate intakes of protein, calcium, zinc and vitamin B12, but not iron, in children from Malawian households with very limited resources.

Keywords: bioavailability, dietary intervention, diets, maize, phytate, zinc

“Neighborhood and Developmental Differences in Children’s Perceptions of Opportunities for Play and Physical Activity”

N.L. Holt, J.C. Spence, Z.L. Sehn, N. Cutumisu.

The purposes of this study were to examine perceptions of places to play and be physically active among children from two different urban neighborhoods, and evaluate these perceptions for age-related developmental differences. One hundred and sixty-eight children from grades K-6 (aged 6–12 years old) completed mental maps depicting places where they could play and be physically active. The children were recruited from schools in two neighborhoods—one a high-walkability (H-W) grid-style neighborhood, the other a low-walkability (L-W) lollipop-style (i.e., cul-de-sacs) neighborhood. Analysis revealed that children in the H-W neighborhood depicted more active transportation and less non-active transportation than children in the L-W neighborhood. Children in the lowest grades (K-2) in the L-W neighborhood depicted more play in the home/yard environment than the oldest children, more good weather image events than children in Grades 3–6, and less play outside the home/yard environment than children in Grades 3 and 4. In the H-W neighborhood, the youngest children (K-2) depicted significantly less play in the home/yard environment and less play outside the home/yard environment than older children (Grades 3–6). Thus, both the type of urban neighborhood and children’s age moderated perceptions of places to play and be physically active.

Keywords: active transportation, drawing techniques, urban form