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Dive into the research topics where Kate E. Pickett is active.

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Featured researches published by Kate E. Pickett.


Journal of Epidemiology and Community Health | 2001

Multilevel analyses of neighbourhood socioeconomic context and health outcomes: a critical review

Kate E. Pickett; M Pearl

PURPOSE Interest in the effects of neighbourhood or local area social characteristics on health has increased in recent years, but to date the existing evidence has not been systematically reviewed. Multilevel or contextual analyses of social factors and health represent a possible reconciliation between two divergent epidemiological paradigms—individual risk factor epidemiology and an ecological approach. DATA SOURCES Keyword searching of Index Medicus (Medline) and additional references from retrieved articles. STUDY SELECTION All original studies of the effect of local area social characteristics on individual health outcomes, adjusted for individual socioeconomic status, published in English before 1 June 1998 and focused on populations in developed countries. DATA SYNTHESIS The methodological challenges posed by the design and interpretation of multilevel studies of local area effects are discussed and results summarised with reference to type of health outcome. All but two of the 25 reviewed studies reported a statistically significant association between at least one measure of social environment and a health outcome (contextual effect), after adjusting for individual level socioeconomic status (compositional effect). Contextual effects were generally modest and much smaller than compositional effects. CONCLUSIONS The evidence for modest neighbourhood effects on health is fairly consistent despite heterogeneity of study designs, substitution of local area measures for neighbourhood measures and probable measurement error. By drawing public health attention to the health risks associated with the social structure and ecology of neighbourhoods, innovative approaches to community level interventions may ensue.


The American Journal of Clinical Nutrition | 2000

Pregnancy weight gain: still controversial

Barbara Abrams; Sarah L Altman; Kate E. Pickett

During the 20th century, recommendations for maternal weight gain in pregnancy were controversial, ranging from rigid restriction to encouragement of ample gain. In 1990, the Institute of Medicine (IOM) recommended weight-gain ranges with the primary goal of improving infant birth weight. These guidelines were widely adopted but not universally accepted. Critics have argued that the IOMs recommendations are unlikely to improve perinatal outcomes and may actually increase the risk of negative consequences to both infants and mothers. We systematically reviewed studies that examined fetal and maternal outcomes according to the IOMs weight-gain recommendations in women with a normal prepregnancy weight. These studies showed that pregnancy weight gain within the IOMs recommended ranges is associated with the best outcome for both mothers and infants. However, weight gain in most pregnant women is not within the IOMs ranges. All of the studies reviewed were observational and there is a compelling need to conduct experimental studies to examine interventional strategies to improve maternal weight gain with the objective of optimizing health outcomes.


American Journal of Public Health | 2002

Maternal Smoking During Pregnancy and Severe Antisocial Behavior in Offspring: A Review

Lauren S. Wakschlag; Kate E. Pickett; Edwin H. Cook; Neal L. Benowitz; Bennett L. Leventhal

OBJECTIVES Recent research suggests that in utero exposure to maternal smoking is a risk factor for conduct disorder and delinquency. We review evidence of causality, a controversial but important public health question. METHODS We analyzed studies of maternal prenatal smoking and offspring antisocial behavior within a causal framework. RESULTS The association is (1) independent of confounders, (2) present across diverse contexts, and (3) consistent with basic science. Methodological limitations of existing studies preclude causal conclusions. CONCLUSIONS Existing evidence provides consistent support for, but not proof of, an etiologic role for prenatal smoking in the onset of antisocial behavior. The possibility of identifying a preventable prenatal risk factor for a serious mental disorder makes further research on this topic important for public health.


Social Science & Medicine | 2015

Income inequality and health: A causal review

Kate E. Pickett; Richard G. Wilkinson

There is a very large literature examining income inequality in relation to health. Early reviews came to different interpretations of the evidence, though a large majority of studies reported that health tended to be worse in more unequal societies. More recent studies, not included in those reviews, provide substantial new evidence. Our purpose in this paper is to assess whether or not wider income differences play a causal role leading to worse health. We conducted a literature review within an epidemiological causal framework and inferred the likelihood of a causal relationship between income inequality and health (including violence) by considering the evidence as a whole. The body of evidence strongly suggests that income inequality affects population health and wellbeing. The major causal criteria of temporality, biological plausibility, consistency and lack of alternative explanations are well supported. Of the small minority of studies which find no association, most can be explained by income inequality being measured at an inappropriate scale, the inclusion of mediating variables as controls, the use of subjective rather than objective measures of health, or follow up periods which are too short. The evidence that large income differences have damaging health and social consequences is strong and in most countries inequality is increasing. Narrowing the gap will improve the health and wellbeing of populations.


Journal of Epidemiology and Community Health | 2005

Wider income gaps, wider waistbands? An ecological study of obesity and income inequality

Kate E. Pickett; Shona Kelly; Eric Brunner; Tim Lobstein; Richard G. Wilkinson

Objectives: To see if obesity, deaths from diabetes, and daily calorie intake are associated with income inequality among developed countries. Design: Ecological study of 21 developed countries. Countries: Countries were eligible for inclusion if they were among the top 50 countries with the highest gross national income per capita by purchasing power parity in 2002, had a population over 3 million, and had available data on income inequality and outcome measures. Main outcome measures: Percentage of obese (body mass index >30) adult men and women, diabetes mortality rates, and calorie consumption per capita per day. Results: Adjusting for gross national per capita income, income inequality was positively correlated with the percentage of obese men (r = 0.48, p = 0.03), the percentage of obese women (r = 0.62, p = 0.003), diabetes mortality rates per 1 million people (r = 0.46, p = 0.04), and average calories per capita per day (r = 0.50, p = 0.02). Correlations were stronger if analyses were weighted for population size. The effect of income inequality on female obesity was independent of average calorie intake. Conclusions: Obesity, diabetes mortality, and calorie consumption were associated with income inequality in developed countries. Increased nutritional problems may be a consequence of the psychosocial impact of living in a more hierarchical society.


Ethnicity & Health | 2008

People like us: ethnic group density effects on health

Kate E. Pickett; Richard G. Wilkinson

Studies examining the effects of neighbourhood characteristics have reported what has been called a ‘group density’ effect on health, such that members of low status minority communities living in an area with a higher proportion of their own racial or ethnic group tend to have better health than those who live in areas with a lower proportion. In this paper we survey published research on ethnic group density and health with the aim of stimulating further research. We situate the research question in the context of contemporary social epidemiology and provide a narrative review of studies of ethnic density and health. We go on to discuss processes which may underlie ethnic density effects, and highlight gaps in the literature and opportunities for further research. Although first recognised in studies of mental illness, ‘group density’ effects on physical health have been shown more recently. Generally, given individual material circumstances, living in a poorer area is associated with worse health. Members of ethnic minorities who live in areas where there are few like themselves are likely to be materially better off, and living in better neighbourhoods, than those who live in areas with a higher concentration. However, through the eyes of the majority community, they may be made more aware of belonging to a low status minority group, and the psychosocial effects of stigma may offset any advantage. If the psychological effects of stigma are sometimes powerful enough to override material advantage, this may have implications for our understanding of how low social status affects health more generally. As well as highlighting the importance of low social status, cultural isolation and social support to health and quality of life, this paper shows how an understanding of group density effects also has something to offer to our understanding of issues of prejudice, segregation, assimilation and integration in diverse societies.


BMJ | 2007

Child wellbeing and income inequality in rich societies: ecological cross sectional study

Kate E. Pickett; Richard G. Wilkinson

Objectives To examine associations between child wellbeing and material living standards (average income), the scale of differentiation in social status (income inequality), and social exclusion (children in relative poverty) in rich developed societies. Design Ecological, cross sectional studies. Setting Cross national comparisons of 23 rich countries; cross state comparisons within the United States. Population Children and young people. Main outcome measures The Unicef index of child wellbeing and its components for rich countries; eight comparable measures for the US states and District of Columbia (teenage births, juvenile homicides, infant mortality, low birth weight, educational performance, dropping out of high school, overweight, mental health problems). Results The overall index of child wellbeing was negatively correlated with income inequality (r=−0.64, P=0.001) and percentage of children in relative poverty (r=−0.67, P=0.001) but not with average income (r=0.15, P=0.50). Many more indicators of child wellbeing were associated with income inequality or children in relative poverty, or both, than with average incomes. Among the US states and District of Columbia all indicators were significantly worse in more unequal states. Only teenage birth rates and the proportion of children dropping out of high school were lower in richer states. Conclusions Improvements in child wellbeing in rich societies may depend more on reductions in inequality than on further economic growth.


American Journal of Public Health | 2008

Income Inequality and Socioeconomic Gradients in Mortality

Richard G. Wilkinson; Kate E. Pickett

OBJECTIVES We investigated whether the processes underlying the association between income inequality and population health are related to those responsible for the socioeconomic gradient in health and whether health disparities are smaller when income differences are narrower. METHODS We used multilevel models in a regression analysis of 10 age- and cause-specific US county mortality rates on county median household incomes and on state income inequality. We assessed whether mortality rates more closely related to county income were also more closely related to state income inequality. We also compared mortality gradients in more- and less-equal states. RESULTS Mortality rates more strongly associated with county income were more strongly associated with state income inequality: across all mortality rates, r= -0.81; P=.004. The effect of state income inequality on the socioeconomic gradient in health varied by cause of death, but greater equality usually benefited both wealthier and poorer counties. CONCLUSIONS Although mortality rates with steep socioeconomic gradients were more sensitive to income distribution than were rates with flatter gradients, narrower income differences benefit people in both wealthy and poor areas and may, paradoxically, do little to reduce health disparities.


International Journal of Epidemiology | 2013

Cohort Profile: The Born in Bradford multi-ethnic family cohort study

John Wright; Neil Small; Pauline Raynor; Derek Tuffnell; Raj Bhopal; Noel Cameron; Lesley Fairley; Debbie A. Lawlor; Roger Parslow; Emily S Petherick; Kate E. Pickett; Dagmar Waiblinger; Jane West

Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK, School of Health Studies, University of Bradford, Bradford, UK, Edinburgh Ethnicity and Health Research Group, Centre for Population Health Sciences, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK, School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK, Medical Research Council Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, Bristol, UK, Paediatric Epidemiology Group, Centre for Epidemiology and Biostatistics, Leeds Institute of Genetics, Health and Therapeutics, Faculty of Medicine and Health, University of Leeds, Leeds, UK and Department of Health Sciences, University of York, York, UK


Annals of Epidemiology | 2002

Neighborhood Socioeconomic Status, Maternal Race and Preterm Delivery: A Case-Control Study

Kate E. Pickett; Jennifer Ahern; Steve Selvin; Barbara Abrams

PURPOSE To explore associations between neighborhood socioeconomic context and preterm delivery, independent of maternal and family socioeconomic status, in African-American and white women. METHODS A case-control study of African-American (n = 417) and white (n = 1244) women delivering infants at the University of California, San Franciscos Moffitt Hospital, between 1980 and 1990. RESULTS Neighborhood socioeconomic contexts were associated with preterm delivery but associations were non-linear and varied with race/ethnicity. For African-American women, living in a neighborhood with either high or low median household income was associated with an increased risk of spontaneous preterm delivery, as was living in a neighborhood with large increases or decreases in the proportion of African-American residents during the study decade. Residence in neighborhoods with high and low rates of male unemployment was associated with a decreased risk of preterm delivery. Among white women only large positive and negative changes in neighborhood male unemployment were associated with risk of preterm delivery. CONCLUSIONS Neighborhood factors and changes in neighborhoods over time are related to preterm delivery, although the mechanisms linking local environments to maternal risk remain to be specified.

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John Wright

Bradford Royal Infirmary

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Báltica Cabieses

Universidad del Desarrollo

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Neil Small

University of Bradford

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