Ana Paula Belon

Perceived community environmental influences on eating behaviors: A Photovoice analysis

People’s perceptions of local food environments influence their abilities to eat healthily. PhotoVoice participants from four communities in Alberta, Canada took pictures of barriers and opportunities for healthy eating and shared their stories in one-on-one semi-structured interviews. Using a socioecological framework, emergent themes were organized by type and size of environment. Findings show that, while availability and access to food outlets influence healthy eating practices, these factors may be eclipsed by other non-physical environmental considerations, such as food regulations and sociocultural preferences. This study identifies a set of meta-themes that summarize and illustrate the interrelationships between environmental attributes, people’s perceptions, and eating behaviors: a) availability and accessibility are interrelated and only part of the healthy eating equation; b) local food is synonymous with healthy eating; c) local food places for healthy eating help define community identity; d) communal dining (commensality) does not necessarily mean healthy eating; e) rewarding an achievement or celebrating special occasions with highly processed foods is socially accepted; f) food costs seemed to be driving forces in food decisions; g) macro-environmental influences are latent in food decisions. Recognizing the interrelationship among multiple environmental factors may help efforts to design effective community-based interventions and address knowledge gaps on how sociocultural, economic, and political environments intersect with physical worlds.

Possibilities and challenges for physical and social environment research in Brazil: a systematic literature review on health behaviors

This systematic review analyzed articles focused on the relationship between environment (physical, built, perceived, and social) and smoking, alcohol drinking, physical activity, diet, and obesity in Brazil. Studies published between 19952011 were retrieved from seven databases and hand searches. Based on the 42 articles reviewed, gaps were identified and recommendations were made for future research. Despite a growing number of studies, the Brazilian literature is still limited. The increase of articles in 2010-2011 coincided with the diversification of lifestyles studied, although physical activity domain remains predominant. Most studies analyzed neighborhood settings and used subjective measures for lifestyle and for environment. The presence of recreational facilities was the main physical environment aspect studied, while safety from crime was the prominent social environment factor. More research is needed to yield a rich body of evidence that leads to theoretical and methodological advances, and that supports interventions aimed at creating healthy environments.

Canadian policy perspectives on promoting physical activity across age-friendly communities: lessons for advocacy and action

ABSTRACT Population ageing combined with physical inactivity has critical implications for the public health of communities in the twenty-first century. In the last decade, the World Health Organization launched the age-friendly cities agenda, aiming to address population ageing through whole-systems, rights-based, health equity-focused approaches. An important intervention for age-friendly communities is modifying built environments to support population-level physical activity. Physical activity can help mitigate impacts of chronic diseases and social isolation on older adults. Need for advocacy and action in this area raises questions of how to develop supportive environments for physical activity across age-friendly community types. In Canada, a substantial proportion of older adults live outside large urban municipalities, for which scant research exists on fostering age-friendly built environments. To this end, we conducted qualitative research involving semi-structured interviews with 21 municipal policy influencers in Alberta, Canada to gather perspectives on development and early implementation of an age-friendly policy framework in the small urban and rural context. Our findings are organised by three main themes providing key lessons for advocacy and action, namely pursuing comprehensive planning, promoting public engagement and prioritising the needs of older adults. This research informs advocacy and action priorities in promoting built environment modification for routine physical activity as part of an age-friendliness agenda for small urban and rural regions of Canada and other countries.

Posibilidades y desafíos para la investigación sobre el entorno físico y social en Brasil: una revisión sistemática de la literatura sobre conductas de salud

This systematic review analyzed articles focused on the relationship between environment (physical, built, perceived, and social) and smoking, alcohol drinking, physical activity, diet, and obesity in Brazil. Studies published between 19952011 were retrieved from seven databases and hand searches. Based on the 42 articles reviewed, gaps were identified and recommendations were made for future research. Despite a growing number of studies, the Brazilian literature is still limited. The increase of articles in 2010-2011 coincided with the diversification of lifestyles studied, although physical activity domain remains predominant. Most studies analyzed neighborhood settings and used subjective measures for lifestyle and for environment. The presence of recreational facilities was the main physical environment aspect studied, while safety from crime was the prominent social environment factor. More research is needed to yield a rich body of evidence that leads to theoretical and methodological advances, and that supports interventions aimed at creating healthy environments.

Possibilidades e desafios para pesquisas sobre ambiente físico e social no Brasil: uma revisão sistemática da literatura sobre comportamentos de saúde

This systematic review analyzed articles focused on the relationship between environment (physical, built, perceived, and social) and smoking, alcohol drinking, physical activity, diet, and obesity in Brazil. Studies published between 19952011 were retrieved from seven databases and hand searches. Based on the 42 articles reviewed, gaps were identified and recommendations were made for future research. Despite a growing number of studies, the Brazilian literature is still limited. The increase of articles in 2010-2011 coincided with the diversification of lifestyles studied, although physical activity domain remains predominant. Most studies analyzed neighborhood settings and used subjective measures for lifestyle and for environment. The presence of recreational facilities was the main physical environment aspect studied, while safety from crime was the prominent social environment factor. More research is needed to yield a rich body of evidence that leads to theoretical and methodological advances, and that supports interventions aimed at creating healthy environments.

SP6-24 Social inequalities in adult mortality in Brazil

Introduction To assess health inequalities is an important issue in a country like Brazil with one of the highest income inequities in the world. The aim of this study was to analyse the magnitude of social inequalities in mortality among population aged 20 and older, living in a city of one million people in Southeastern Brazil, in 2004–2008. Methods The 49 areas of healthcare units were classified into 3 homogeneous strata using 2000 Census small-area socioeconomic indicators. Mortality rates by age group, cause of death (ICD10 codes) and sex were calculated for each stratum. Rates ratio (RR) and 95% CIs were estimated for low and middle stratum in relation to the highest. Results In general, age-group-specific rates had a social gradient with declining risks of death from higher to lower stratum. In overall mortality, inequalities among strata were statistically significant. Inequalities between Low and High stratum were higher among females, except for external causes of injury. The greatest differences among males were recorded for homicides (RR=2.4), traffic accidents (RR=1.6) and cerebrovascular diseases (RR=1.6). Among women, cerebrovascular and chronic lower respiratory diseases showed the greatest inequalities, both with risk of death 2.2 times higher in the lower stratum. Only breast cancer had a reversed social gradient. Conclusion Since unfavourable living conditions are related to unhealthy behaviours and to difficulties in access to health services, to reduce the health disparities, the National Health System should assure greater access to health services and promotion of healthier lifestyle among vulnerable groups.