<p>This thesis presents the results of a study exploring the health status and health determinants in two farming groups in Waterloo, Ontario, Canada: Old Order Mennonites (OOMs) and non-OOM farmers. Physical health and mental health are examined, and Canada’s 12 health determinants (excluding genetics) are included in the analysis. A survey was distributed to both groups in 2010 to obtain information on health status and determinants. Comparing the two groups reduces the likely impact of contextual features impacting both, such as local economic conditions. The mental component summary (MCS) and physical component summary (PCS) of the SF-12 were used to measure mental and physical health. The study compares health in the two populations, and uses ordinary least squares (multiple) regression to determine the relative importance of the determinants in shaping health. The study found that mental health is better in OOMs, mainly due to OOM women’s strong mental health. Physical health was worse in OOMs, and while true for both genders, OOM women appear to be particularly disadvantaged. There is overlap between the groups in the determinants shaping physical and mental health. In both groups, mental health is shaped by social interaction, stress and coping; and physical health by age, childhood disease history, coping and body mass index. This suggests these factors may be important across many populations facing different life circumstances, thus representing priorities for policy action. Interestingly, the key determinants shaping physical health in both groups do not include social factors such as social capital, although social factors do shape mental health (especially in OOMs). This may be due to the rural or farming status of the two groups, or differences between physical and mental health. Determining which is more likely requires reconciling the results of this study with others, an effort hampered by differences in models, methods and health outcomes employed.</p> / Doctor of Philosophy (PhD)

This dissertation examined risk factors for hypertensive disorders of pregnancy (HDP) — specifically whether neighborhood socioeconomic deprivation exacerbates individual socioeconomic disadvantage (deprivation amplification) to increase the likelihood of developing HDP. To select the optimal areal unit at which to investigate HDP, geographic proxies for neighborhoods were explored. A thematic review qualitatively examined nontraditional neighborhood boundaries identified through internet sources. Data from 2008–2012 Miami-Dade County, Florida birth records (n=121,421) and the U.S. Census Bureau were used for the remaining analyses. Ordinary least squares (OLS) and geographically weighted regression (GWR) analysis empirically compared the proportion of HDP prevalence explained by six areal units: census block groups, census tracts, ZIP code tabulation areas (ZCTAs), and three types of natural neighborhood — census units clustered based on an eight-item Neighborhood Deprivation Index. Multilevel logistic regression examined relationships between HDP, neighborhood deprivation, and individual-level factors. Odds ratios (OR) and adjusted odds ratios (aOR) were calculated. The thematic review found 22 potential alternatives to census boundaries developed through techniques such as crowd-sourcing and qualitative research. In the sensitivity analysis, census tracts aggregated at the scale of ZCTAs performed twice as well as any other model (GWR2 = 0.27) and were used as the Aim 3 unit of analysis. In the multilevel logistic regression, HDP was associated with moderate (aOR=1.13; CI: 1.05, 1.21) and high neighborhood deprivation (aOR=1.16; CI: 1.07, 1.26). Compared with mothers with private insurance, uninsured women (aOR=1.69; CI: 1.56, 1.84) and Medicaid recipients (aOR=1.12; CI: 1.05, 1.18) had higher HDP odds. Non-Hispanic Black women’s HDP odds were 1.58 times those of non-Hispanic White women. Cross-level interactions — between neighborhood deprivation and educational attainment and neighborhood deprivation and insurance status — did not reach statistical significance. Private sector neighborhood boundaries hold promise for developing new public health tools. Because they are relatively easy to generate from census data, natural neighborhoods may balance tradition and innovation. While no evidence of deprivation amplification was found, results suggested that individual-level and neighborhood deprivation are HDP risk factors. Interventions that target expectant mothers in deprived neighborhoods — particularly non-Hispanic Black and Hispanic women who lack health insurance — may help reduce HDP prevalence and disparities.

This thesis is focused on a situation of sexually transmitted infections in Prague (and in The Czech Republic shallowly) and analyzes this issue relatively to the social epidemiology. The thesis tries to identify the most vulnerable groups of a population. These groups contain homosexual men, individuals having unprotected sex and promiscuous people. Further more, the thesis tries to identify a relation between a high-risk factor and an exposition of a particular infection. For example, it was found out that sexual related risks are mostly determinated by a sexual behavior and a region where the individuals come from. Also, men are more vulnerable group of people than women according to findings of this thesis. A gonorrhoea infection is the most reported sexually transmitted infection in Prague (59,1 % of all cases). Syphilis is the second most common infection of this kind. The highest prevalence of sexually transmitted infections was reported for people with (finished or unfinished) basic education. This group of people represents 14,3 % of all reported cases. Its prevalence is 67,7 patients per ten thousand individuals. A group of people aged 20 - 29 years is another group with high prevalence. Further identification of a sexual behavior in The Czech Republic was one of the main goals of this...