Introdução - A exposição à poluição do ar é responsável por diversos efeitos à saúde e se distribui de forma diferenciada na população conforme o nível sócio-econômico. Objetivos - Explorar relações entre internações hospitalares por tipos de câncer e indicadores ambientais e sócioeconômico, na escala de áreas de pequeno tamanho, no município de São Paulo. Métodos - Revisaram-se estudos ecológicos sobre desigualdades sócio-econômicas em câncer e estudos sobre os efeitos da poluição ambiental do ar relacionada ao tráfego sobre o risco de câncer, publicados entre 1998 e 2008. Empreendeu-se a seguir estudo ecológico, com uso de unidade delimitada por grid (500 por 500 metros) e setor censitário, englobando todos os indivíduos internados em hospitais públicos ou privados com diagnóstico principal de neoplasia primária invasiva, no período de 2004 a 2006. As internações foram georreferenciadas e alocadas às unidades de estudo, sendo cada caso contado apenas uma vez. A densidade de tráfego foi calculada para cada unidade da grid a partir de dados de contagem veicular. Utilizaram-se modelos de regressão logística para explorar as associações entre densidade de tráfego, Índice de Desenvolvimento Humano e taxas de internação hospitalar. Resultados - O estudo de revisão mostrou que o nível sócio-econômico se associou de modo distinto de acordo com o tipo de neoplasia maligna. A maioria dos estudos observaram associação positiva da poluição ambiental do ar com câncer, com achados mais consistentes para exposição a material particulado inalável e câncer de pulmão. Do estudo ecológico verificou-se risco aumentado de internação por neoplasias respiratórias em adultos e hematológicas em crianças e adolescentes associado a morar em áreas com maior densidade de tráfego por veículos totais, movidos a gasolina e a diesel, com claro gradiente dose-resposta. O nível sócio-econômico da área 6 de moradia esteve associado positivamente e em gradiente com as medidas de densidade de tráfego e com os cânceres de mama e de próstata. Conclusões - Investigações se fazem necessárias em megacidades de países em desenvolvimento sobre os riscos à saúde relacionados à poluição ambiental do ar devida ao tráfego e sobre o modo como se desenvolveu a rede viária e o tráfego de veículos em sua relação com os locais ocupados historicamente pelas diferentes classes sociais. Estudos que contornem as limitações aqui encontradas poderão fornecer estimativas mais precisas e acuradas / Introduction - Exposure to air pollution is responsible for various health effects and is distributed differently in the population according to socioeconomic status. Objectives - To explore relationships between hospital admissions for cancers and socio-economic and environmental indicators, on a small-area scale, in São Paulo city. Methods - First we reviewed ecological studies on socioeconomic inequalities in cancer and studies on the effects of traffic-related air pollution on the risk of cancer, published between 1998 and 2008. Then an ecological study was undertaken, using a unit defined by grid (500 by 500 meters) and census tract, and embraced all individuals admitted to public or private hospitals with a main diagnosis of primary invasive cancer during the period 2004 to 2006. Hospitalizations were georeferenced and allocated to units of study, each case counted only once. The traffic density was calculated for each grid unit from vehicle count data. We used logistic regression models to explore the associations between traffic density, Human Development Index and rates of hospitalization. Results - The review showed that the socioeconomic status was associated differently according to the type of malignancy. Most studies found a positive association of environmental air pollution with cancer, the most consistent findings for exposure to inhalable particulate matter and lung cancer. The ecological study found an increased risk of hospitalization for respiratory cancers in adults and for hematologic cancers in children and adolescents associated with living in areas with higher total, gasoline and diesel traffic density, with a clear dose-response gradient. The socioeconomic status of the living area was positively associated in gradient with measures of traffic density and with breast and prostate cancers. 8 Conclusions - Investigations are necessary in megacities of developing countries about the health risks of traffic-related environmental air pollution and about how the development of the road network and vehicle traffic relates to sites historically occupied by different social classes. Studies that circumvent the limitations found here may provide more precise and accurate estimates

Immunization remains one of the most successful and cost-effective public health interventions worldwide. The purpose of this study was to examine the individual and socioeconomic factors that influence childhood immunization coverage in Nigeria. The health belief model and the social ecological model were used as the theoretical framework for the study, which examined the effects of individual, parental, and socioeconomic factors on complete immunization among Nigerian children. Univariate, bivariate, and multivariate tests were conducted within a secondary analysis of 2013 Nigerian National Demographic and Health Survey was done. Of 27,571 children aged 0 to 59 months, 22.1% had full vaccination and 29% never received any vaccination. Immunization coverage was significantly related to the socioeconomic status of the child's parents, region, and marital status (p < 0.00). Similarly, child birth order, delivery place, child number, and presence or absence of child health card in the family were significantly related to the level of immunization (p < 0.00). Maternal age, geographical location, education, religion, literacy, wealth index, marital status, and occupation were significantly associated with immunization coverage. Respondent's age, educational attainment, and wealth index remained significantly related to immunization coverage at 95% confidence interval in multivariate analysis. Implications for positive social change include evidence on hindrances to successful immunization programs and relevant information for a more effective, efficient, sustainable and acceptable immunization program for the stakeholders in Nigeria.

<p>Litteraturstudiens syfte var att beskriva om/hur en kvinnas sociala situation och bakgrund inverkar på hennes ohälsosamma alkoholvanor. Datasökningen genomfördes i databasen MedLine (via PubMed). Nio artiklar uppfyllde inklusionskriterierna och bearbetades samt kvalitetsgranskades. Resultatet visade att olika stadier i en kvinnas liv såsom besvärliga uppväxtförhållanden, en tidig alkoholdebut och dåliga relationer i vuxenlivet inverkar negativt på hennes alkoholkonsumtion. Det fanns också ett klass- och genusperspektiv. Resultatet visade att kvinnor som hade en besvärlig uppväxt med våld och övergrepp konsumerade mer alkohol i det vuxna livet än de kvinnor som hade ”normal” uppväxt och vuxenliv. Ohälsosamma alkoholvanor var också relaterat till en tidig alkoholdebut och en tidig alkoholdebut var i sin tur relaterat till flickor som hade en låg självkänsla och ett aggressivt beteende. Kvinnor i relationer där partnern missbrukade, våldtog och misshandlade gjorde att kvinnans alkoholkonsumtion ökade. Klassperspektivet var tydligt sammanlänkat med en högre alkoholkonsumtion hos kvinnor som var skilda eller änkor, kvinnor som hade låg inkomst och låg utbildning, kvinnor som inte hade någon familj eller kvinnor som var deprimerade. Sammanfattningsvis visar resultatet att flera aspekter i en kvinnas liv såsom uppväxtförhållanden och socialsituation inverkar på hennes alkoholvanor. Detta är något som behöver uppmärksammas både i vården och i samhället.</p> / <p>The aim of this literature review was to describe if/how a woman´s social situation and background affects her unhealthy alcohol habits. A search in the Medline database found nine scientific articles. They were thoroughly processed and valued for quality. The results showed that different stages in a woman’s, life, upbringing, age of onset of drinking and relationships in adulthood had a negatively effect on her alcohol consumption. The results also highlighted a class and gender perspective. The results revealed that women, who went through childhood and adulthood with adverse experiences such as, sexually assaulted and abused physically or mentally were more likely to have hazardous high alcohol consumption rates in adulthood. Unhealthy alcohol habits were linked to the age of onset of drinking which also was linked to girls who had an aggressive behavior and a low self-esteem when they grew up. Women who lived in a relationship where the partner abused substance or assaulted her resulted in a more frequent alcohol drinking in more hazardous amounts. The class perspective was strongly associated with a woman’s unhealthy relations’ to alcohol for example; when the woman were widowed, divorced, women with a income around the poverty line, women with low or no education at all, women who had no family or women who were depressed, were more likely to have an high alcohol consumption then women who had a family, a good income and an education. In summary the result showed that several aspects in a woman’s life, upbringing and social situation do affect her alcohol habits. This is knowledge that needs attention both in the health care and in the society.</p>

Litteraturstudiens syfte var att beskriva om/hur en kvinnas sociala situation och bakgrund inverkar på hennes ohälsosamma alkoholvanor. Datasökningen genomfördes i databasen MedLine (via PubMed). Nio artiklar uppfyllde inklusionskriterierna och bearbetades samt kvalitetsgranskades. Resultatet visade att olika stadier i en kvinnas liv såsom besvärliga uppväxtförhållanden, en tidig alkoholdebut och dåliga relationer i vuxenlivet inverkar negativt på hennes alkoholkonsumtion. Det fanns också ett klass- och genusperspektiv. Resultatet visade att kvinnor som hade en besvärlig uppväxt med våld och övergrepp konsumerade mer alkohol i det vuxna livet än de kvinnor som hade ”normal” uppväxt och vuxenliv. Ohälsosamma alkoholvanor var också relaterat till en tidig alkoholdebut och en tidig alkoholdebut var i sin tur relaterat till flickor som hade en låg självkänsla och ett aggressivt beteende. Kvinnor i relationer där partnern missbrukade, våldtog och misshandlade gjorde att kvinnans alkoholkonsumtion ökade. Klassperspektivet var tydligt sammanlänkat med en högre alkoholkonsumtion hos kvinnor som var skilda eller änkor, kvinnor som hade låg inkomst och låg utbildning, kvinnor som inte hade någon familj eller kvinnor som var deprimerade. Sammanfattningsvis visar resultatet att flera aspekter i en kvinnas liv såsom uppväxtförhållanden och socialsituation inverkar på hennes alkoholvanor. Detta är något som behöver uppmärksammas både i vården och i samhället. / The aim of this literature review was to describe if/how a woman´s social situation and background affects her unhealthy alcohol habits. A search in the Medline database found nine scientific articles. They were thoroughly processed and valued for quality. The results showed that different stages in a woman’s, life, upbringing, age of onset of drinking and relationships in adulthood had a negatively effect on her alcohol consumption. The results also highlighted a class and gender perspective. The results revealed that women, who went through childhood and adulthood with adverse experiences such as, sexually assaulted and abused physically or mentally were more likely to have hazardous high alcohol consumption rates in adulthood. Unhealthy alcohol habits were linked to the age of onset of drinking which also was linked to girls who had an aggressive behavior and a low self-esteem when they grew up. Women who lived in a relationship where the partner abused substance or assaulted her resulted in a more frequent alcohol drinking in more hazardous amounts. The class perspective was strongly associated with a woman’s unhealthy relations’ to alcohol for example; when the woman were widowed, divorced, women with a income around the poverty line, women with low or no education at all, women who had no family or women who were depressed, were more likely to have an high alcohol consumption then women who had a family, a good income and an education. In summary the result showed that several aspects in a woman’s life, upbringing and social situation do affect her alcohol habits. This is knowledge that needs attention both in the health care and in the society.

Socioeconomic positions of individuals are clearly associated with the chances of living a healthy long life. In four empirical studies based on Swedish population registers, two topics are examined in this thesis: The relationships between different indicators of social position and mortality, and the importance of family members’ socioeconomic resources for the survival of the individual. The overall conclusion from the separate studies is that no single individual socioeconomic factor gives a complete picture of mortality inequalities. Further, the socioeconomic resources of partners and adult children are important in addition to the individual ones. The specific results from each study include that: I education, social class, social status and income are, to various extent, independently associated with mortality risk. Education and social status are related to women’s mortality, and education, social class, and income to men’s mortality. II one partner’s social position is related to the other partner’s survival, also when individual socioeconomic factors are statistically controlled for. In particular, men’s mortality is linked to their wives’ education and women’s mortality to their husbands’ social class. III adult children’s education is related to their parents’ risk of dying, also when both parents’ socioeconomic resources are taken into consideration. Further, the association between the offspring’s level of education and parental mortality cannot be explained by charac­teristics that parents share with their siblings. IV children’s social class and income are related to parental mortality, but not as strongly as the education of the children. There is no relationship between a mother’s own education and breast cancer mortality, while mothers seem to have better chances of surviving breast cancer if they have well-educated children. / <p>At the time of doctoral defence the following paper was unpublished and had a status as follows: Paper 4: Manuscript</p>

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2005. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2006. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2006. / Härtill 4 uppsatser.

Thesis (Ph. D.)--University of Hawaii at Manoa, 2004. / Includes bibliographical references (leaves 157-169).