Dataset Information

Neighborhood Disadvantage, Greenness, and Population Density as Predictors of Breastfeeding Practices: A Population Cohort Study from Finland.

ABSTRACT:

Background

Many environmental factors are known to hinder breastfeeding, yet the role of the family living environment in this regard is still poorly understood.

Objectives

We used data from a large cohort to identify associations between neighborhood characteristics and breastfeeding behavior.

Methods

Our observational study included 11,038 children (0-2 years) from the Southwest Finland Birth Cohort. Participant information was obtained from the Medical Birth Register and municipal follow-up clinics. Neighborhood socioeconomic disadvantage, greenness, and population density were measured for a period of 5 years prior to childbirth within the residential neighborhood on a 250 × 250-m grid. Any breastfeeding and breastfeeding at 6 months were the primary outcomes. Binary logistic regression models were adjusted for maternal health and socioeconomic factors.

Results

Adjusted analyses suggest that mothers living in less populated areas were less likely to display any breastfeeding (OR: 0.46; 95% CI: 0.36, 0.59) and breastfeeding at 6 months (OR: 0.37; 95% CI: 0.34, 0.40). Mothers living in highly disadvantaged neighborhoods were less likely to display any breastfeeding if the neighborhood was less populated (OR: 0.54; 95% CI: 0.30, 0.95) but more likely to breastfeed at 6 months if the neighborhood was highly populated (OR: 3.74; 95% CI: 1.92, 7.29). Low greenness was associated with higher likelihood of any breastfeeding (OR: 3.82; 95% CI: 1.53, 9.55) and breastfeeding at 6 months (OR: 4.41; 95% CI: 3.44, 5).

Conclusions

Our results suggest that neighborhood characteristics are associated with breastfeeding behavior in Finland. Unravelling breastfeeding decisions linked to the living environment could help identify interventions that will allow the appropriate support for all mothers and infants across different environmental challenges.

SUBMITTER: Galante L

PROVIDER: S-EPMC9258599 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:BACKGROUND:Given the high global prevalence of physical inactivity, there is a need to design cities that support active modes of transportation. High density diverse neighborhoods with good access networks have been associated with enhanced walking and cycling, but there is a lack of large-scale longitudinal studies utilizing a life course perspective to model residential relocation trajectories. The objectives of the present longitudinal study were to model and visualize residential relocation trajectories between 31 and 46 years of age based on neighborhood density, mixed land use and access networks (DMA), and to assess neighborhood DMA as a predictor of self-reported regular walking and cycling and objectively measured physical activity. METHODS:Based on data from the Northern Finland Birth Cohort 1966 (N = 5947), we used self-reported regular walking and cycling and objectively measured physical activity as outcome variables and objectively assessed neighborhood DMA as the main explanatory variable. We conducted sequence analysis to model residential relocation trajectories, and generalized linear mixed models and Fisher's exact test were used to explore longitudinal associations between neighborhood DMA and physical activity. RESULTS:Over 80% of the participants lived in a neighborhood with the same level of neighborhood DMA during the follow-up. Relocation occurred more often from higher to lower DMA neighborhoods than reverse. Increased neighborhood DMA was associated with increased regular walking (OR 1.03; 95% CI: 1.00, 1.05; p = 0.023) and cycling (OR 1.17; 95% CI: 1.12, 1.23; p < 0.001). Residential relocation trajectory from lower to highest neighborhood DMA increased the odds of starting regular walking (OR 3.15; 95% CI: 1.50, 7.14; p = 0.001) and cycling (OR 2.63; 95% CI: 1.23, 5.79; p = 0.009) as compared to higher to lower neighborhood DMA trajectory. CONCLUSIONS:The results strongly support the hypothesis that increasing urban DMA can enhance regular walking and cycling at population level and so improve public health. The findings have implications for zoning and transportation policies, favoring the creation of dense and diverse neighborhoods with good access networks to support regular walking and cycling.

Project description:BackgroundNeighborhood characteristics are robust predictors of overall health and mortality risk for residents. Though there has been some investigation of the role that molecular indicators may play in mediating neighborhood exposures, there has been little effort to incorporate newly developed epigenetic biomarkers into our understanding of neighborhood characteristics and health outcomes.MethodsUsing 157 participants of the Detroit Neighborhood Health Study with detailed assessments of neighborhood characteristics and genome-wide DNA methylation profiling via the Illumina 450K methylation array, we assessed the relationship between objective neighborhood characteristics and a validated DNA methylation-based epigenetic mortality risk score (eMRS). Associations were adjusted for age, race, sex, ever smoking, ever alcohol usage, education, years spent in neighborhood, and employment. A secondary model additionally adjusted for personal neighborhood perception. We summarized 19 neighborhood quality indicators assessed for participants into 9 principal components which explained over 90% of the variance in the data and served as metrics of objective neighborhood quality exposures.ResultsOf the nine principal components utilized for this study, one was strongly associated with the eMRS (β = 0.15; 95% confidence interval = 0.06-0.24; P = 0.002). This principal component (PC7) was most strongly driven by the presence of abandoned cars, poor streets, and non-art graffiti. Models including both PC7 and individual indicators of neighborhood perception indicated that only PC7 and not neighborhood perception impacted the eMRS. When stratified on neighborhood indicators of greenspace, we observed a potentially protective effect of large mature trees as this feature substantially attenuated the observed association.ConclusionObjective measures of neighborhood disadvantage are significantly associated with an epigenetic predictor of mortality risk, presenting a potential novel avenue by which neighborhood-level exposures may impact health. Associations were independent of an individual's perception of their neighborhood and attenuated by neighborhood greenspace features. More work should be done to determine molecular risk factors associated with neighborhoods, and potentially protective neighborhood features against adverse molecular effects.

Project description:BackgroundThere are few studies on the health effects of long-term exposure to neighborhood greenness in a longitudinal setting, especially in Asian countries with high population densities.ObjectivesThis study investigates the association between long-term exposure to neighborhood greenness and hypertension among adults in Taiwan.MethodsWe selected 125,537 participants (≥18 years of age) without hypertension from Taiwan who had joined the standard medical examination program between 2001 and 2016. Neighborhood greenness was estimated using the normalized difference vegetation index (NDVI), derived from satellite images at a resolution of 250 m2. The 2-y average NDVI value within a 500-m circular buffer around participants' residences was calculated. A time-varying Cox regression model was used to investigate the association between neighborhood greenness and incident hypertension. Mediation analyses were performed to examine whether the association was explained by air pollution, leisure-time physical exercise, or body mass index (BMI).ResultsCompared with living in areas within the first quartile of neighborhood greenness, living in areas within the second, third, and fourth quartiles of neighborhood greenness was found to be associated with a lower risk of hypertension, with hazard ratios (HRs) and 95% confidence intervals (CIs) of 0.95 (95% CI: 0.91, 1.00), 0.95 (95% CI: 0.90, 0.99), and 0.93 (95% CI: 0.88, 0.97), respectively. Each 0.1-unit increase in the NDVI was associated with a 24% lower risk of developing hypertension (HR=0.76; 95% CI: 0.66, 0.87), with this associations being stronger among males and those with higher education levels. This association was slightly mediated by BMI but not by air pollution or leisure-time physical exercise.DiscussionOur findings suggest the protective effects of neighborhood greenness on hypertension development, especially in males and well-educated individuals. Our results reinforced the importance of neighborhood greenness for supporting health. https://doi.org/10.1289/EHP13071.

Project description:BACKGROUND:Studies in sub-Saharan Africa indicated the overall prevalence of optimal breast feeding ranged between a lowest of 17.63% in East Africa and a highest of 46.37% in West Africa. It's estimated that 823,000 deaths of children could be prevented every year through optimal breastfeeding practices. However optimal breastfeeding practices is low in most setting of Ethiopia. Therefore, this study aimed to assess optimal breastfeeding practices and associated factors in Worabe town. METHOD:A community-based analytical cross-sectional study was conducted from April 15th-25th, 2018. A systematic sampling technique was applied on 347 sampled mothers who had children greater than or equal to 2 years old. The data was entered into EpiData (version 3.1) and subsequently exported to SPSS Statistics (version 22) for analysis. Descriptive statistics were used for presenting summary data using tables and graph. Bivariate and multi variable logistic regression analysis to identify were used to identify associated factors. The statistical significance was declared at P<0.05. RESULT:Optimal breastfeeding was exhibited by 42.1% of mothers. Government employees (AOR = 8.0; 95% CI: 1.7, 36.4), families with a household income of 1,500-3,000 Ethiopian birr (AOR = 4.6; 95% CI: 1.0, 20.1), individuals knowledgeable about optimal breastfeeding practices (AOR: 5.5 95% CI: 1.6, 18.1), individuals counselled about breastfeeding practices during postnatal follow-ups (AOR = 4.940, 95% CI: 1.313, 10.195), and individuals that had a caesarean section delivery (AOR = 4.2, 95% CI: 1.2, 14.1) had a higher chance of practicing optimal breastfeeding. However, mothers who did not attend or have access to antenatal care follow-ups (AOR = 0.1, 95% CI: 0.04, 0.5) were less likely to practice optimal breastfeeding. CONCLUSIONS:Less than half of mothers breastfed their children optimally. Factors that influenced this included knowledge of optimal breastfeeding practices, total household income, the woman's occupation, access to breastfeeding counselling during postnatal care follow-ups, access to antenatal care follow-ups, and mode of delivery. It is strongly recommended that optimal breastfeeding awareness programs through health education be done in collaboration with health extension workers, and zonal health offices.