International Festival of Public Health

S1 - Health Promotion and Improvement

The impact of distance from green space on obesity

Presenter: Omer Ali, University of Manchester

Abstract Text: Background: Almost 4 out of 10 people in the world are now overweight or obese. Excess weight has been linked to asthma, diabetes, multiples cancers, arthritis and other chronic diseases resulting in unprecedented burdens on health systems worldwide. No country in the world has been able to reduce levels of obesity to date. As the cause is multifactorial, solutions using existing resources are essential. A systematic review of the literature was carried out to see if the distance of green space to one's house was linked to weight as measured by BMI

Methods: Medline, EMBASE, PsycInfo, the Cochrane Library, and the NHS EED were searched for articles dating up to May 2014. 119 articles were identified and 9 met the search criteria and were reviewed. Only studies measuring BMI values of all participants and centred around adults of 18-65 years were included.

Results: The results were equivocal, four of the studies showed that people living further away from a green space were more likely to be overweight, whereas four other did not show such an effect. One study found that an effect in women but not in men.

Conclusion: The studies have used varying methodologies, from self reported distances to Geographical Information Systems (GIS). This makes it difficult to compare the results. However, other factors may be more important than a crude measure of distance. These could include the walkability of an area, safety, tidiness of the green space and activities present.

Comparing determinants of falls and fear of falling among European countries

Presenter: Carmen Franse, Erasmus MC, University Medical Center, Rotterdam

Other author(s): None

Abstract Text: Introduction: Every year around 30% of community dwelling elderly over age 65 will fall. Falls place a high burden on the health of older people and on public health resources. The incidence of falls appears to vary among countries. However not many international studies have compared fall incidence and fall risk in the underlying populations. The aim of this study was to describe the variation in falls and fear of falling across fourteen European countries.

Methods: Data of 33,735 community-dwelling persons aged ≥ 65 years, from fourteen countries in the Survey of Health, Ageing and Retirement in Europe (SHARE) were analyzed. Logistic regression analyses were conducted to calculate the association between socio-demographic factors (sex, age, education level, marital status, living situation and country born) and a previous fall and fear of falling. In order to account for the sampling design and item non-response we applied country-specific sampling weights.

Results: The proportion of persons who reported falling in the past 6 months varied between 7.1% in Denmark to 16.3% in Spain, and for fear of falling between 8.9% in the Netherlands to 31.4% in Spain. Persons from East- and South- European countries more often reported falling or fear of falling. When controlling for socio-demographics, these differences remained largely the same.

Conclusion: In Europe, persons from Southern and Eastern countries are at increased risk of falling compared to Northern and Western countries. Socio-demographic factors can for a small part explain these differences.

Promoting health: journeys into and beyond volunteering

Presenter: Anne Mills, University of Bournemouth

Other author(s): None

Abstract Text: Much volunteering research to date is concerned with people who already possess a range of personal, social and economic resources (Musick and Wilson 2003, 2008, Strauss 2008). This study captures the stories of 6 people, who had experienced social exclusion, due to addiction or mental ill health. Their narratives encapsulate their life experiences and journeys into and beyond the Personal Best Volunteer Training Programme (PBVTP). The aim of the research was to understand the health and wellbeing outcomes of the bespoke training, which was designed for 16 -19 year olds who were not in employment, education or training and for economically inactive people over the age of 20. The course provided a level 1 qualification in Event Volunteering and opportunities for students to gain the skills necessary to volunteer at the 2012 Olympics. The study findings demonstrate a wide range of personal health and wellbeing benefits, enhanced communication and team working skills, improved and extended social networks and the development of employability skills. A significant benefit of volunteering for these individuals was the development of positive self-concept and enhanced self-esteem. The study recommended that socially excluded people should not merely be the recipients of volunteer services but have the opportunity to become proficient and actively involved in the delivery of such services.

European Urban Health Centre project (UHCE): Creating Elderly Support Groups in public social services of the Municipality of Pallini

Presenter: Elena Konstantinou, Municipality of Pallini, Greece

Other author(s): Anastaios Rentoumis, Georgios Tentis and Athina Markaki

Abstract Text: The European Urban Health Centre project (UHCE), co-funded by E.U. funds, is being implemented and evaluated in five European cities, Rjeka, Pallini, Valencia, Manchester and Rotterdam. It is an integrated care approach that combines the needs and preferences of elderly people and their carers, as well as the health and social services in urban settings. It consists of the following care pathways: early detection of frailty, self-management of polypharmacy, adherence to medication and prevention of falls. During the first phase of the project, the needs' detection has revealed that elderly people very often feel lonely, isolated, stressed and in despair. They highly evaluate love, human relationships, companionship, trust and the feeling of secure. These outcomes were common in all five European cities and they led to the creation of an additional pathway, the loneliness pathway. For the loneliness pathway, Elderly Support Groups will be implemented in Pallini. They will follow a semi-structured approach and the topics of discussion will be jointly decided by the trainer and the elderly. In addition, to further analyze patterns in experienced loneliness, assessment of emotional and social loneliness of the elderly included in the pathway will be performed using the UCLA Loneliness Scale, Greek version.

Heart disease: is it a question of power?

Presenter: Fatima Saeed, University of Manchester

Other author(s): Gina Galli

Abstract Text: Background: Cardiovascular disease (CVD) carries a heavy health and economic burden worldwide. Prenatal hypoxia is a common occurrence during pregnancy which leads to intra-uterine growth restriction (IUGR). IUGR is linked to CVD in adulthood. This process is called programming and its mechanism is currently unknown. As the cardiomyocyte's largest energy producer and due to its established role in cardiac dysfunction, the mitochondria have gained prominence. Preliminary data is limited to observational studies of high-altitude pregnancies, and animal studies confounded by decreased maternal nutrition. Primary aim: study the function of mitochondria in murine hearts exposed to prenatal hypoxia. Secondary aims: 1) determine the impact of hypoxia on foetal weight; independent of maternal nutrition 2) study any gender differences 3) measure reactive oxygen species generation. Design: Pregnant mice (C57BL/6J) were incubated during days 15 to 21 of gestation in a hypoxia (HPX) chamber (10.5% oxygen). Parallel incubations for nutrient restriction (21% oxygen, NR) and normoxia (21% oxygen, NMX) were also carried out. At week 1 and 12, hearts were isolated for respirometry analysis. Significance: This study aims to bridge the gap between prenatal insult and lifelong post-natal changes by defining the role of the mitochondria in the programming of the heart following exposure to prenatal hypoxia in murine hearts. Conclusions: Despite ongoing research to combat CVD, therapy remains limited by factors largely outside the clinician's control. Prevention is better than cure. Determining the pathways by which cardiac programming is effected is essential to identifying at-risk populations and directing early intervention.