Project update …
I n s i d e
t h i s I s s u e :
Residential perceptions of
local area features
2
Physiotherapy Honours
Student: Thomas Orschulok
2
Area-level relationships of
Metabolic Syndrome
3
ISBNPA Conference Report 3
Social Epidemiology and
Evaluation Research Group
4
International Collaborations 4
Project Chief Investigators 4
Contact Details 4
Public open space and cardiometabolic risk
Place and Metabolic Syndrome Project A u g u s t 2 0 1 1 V o l u m e 1 , I s s u e 2
Linking research
to better health.
The Place and Metabolic
Syndrome (PAMS) project has
been underway for just over
12 months. There has been
excellent progress since the
initiation of this research within
the Social Epidemiology and
Evaluation Research Group,
University of South Australia.
Activities since our last
newsletter have included:
Advisory Group meeting held
in November 2010;
Individual and group
meetings with key research
partners;
Establishment of core
environmental and health
outcome data sources on
over 4000 study participants;
Preliminary analyses initiated
to explore key questions
about the social or built
environment and metabolic
syndrome;
Development of two PhD
projects and one Honours
project;
Presentations at several
international and national
conferences ;
In this edition of the PAMS
newsletter our reports focus
on current research being
undertaken by our team
specifically on public open
space and cardiometabolic risk.
We express appreciation to our
many partners for their
support of this important
research project. We look
forward to working with many
of you in the coming months as
we undertake another phase of
consultation and engagement
with partners.
PAMS undertakes research across
the metropolitan region of Adelaide
The availability of public open space (POS) as well as
its greenness, type (sporting facilities present or
not) and size have been associated with physical
activity. Whilst the attributes of POS are similarly
assumed to extend a beneficial impact to
cardio-metabolic health, few studies have reported
on associations between POS characteristics and
cardiometabolic risk markers.
Dr Catherine Paquet recently presented a poster at
the 2011 annual meeting of the International Society
of Behavioural Nutrition and Physical Activity
(ISBNPA) in Melbourne. Analysis undertaken within
the north-west region of metropolitan Adelaide
indicated a high availability of POS. For residents of
this area greater availability of POS was not related
to cardiometabolic risk. Locally available POS classi-
fied as greener, larger and designed for undertaking
physical activity was, however, associated with
lower cardiometabolic risk. These findings suggest
that the characteristics, not the number, of locally
available POS may be relevant to cardiometabolic
health. Our team is currently investigating the
mechanisms that may explain these associations.
Experience. The Difference.
Public Open Space promotes physical activity and well-being
Professor Mark Daniel
Research Chair: Social Epidemiology
For the full publication, visit:
unisa.edu.au/sansominstitute/pams
“We shape our buildings,
and afterwards, our
buildings shape us ”
- Winston Churchill
Urban landscapes
promote well-being as
well as physical activity
Residential perceptions of local area features Katherine Baldock commenced her PhD in 2009
researching “The mediating role of environmental
perceptions linking residential areas to
cardiometabolic outcomes”.
Associations between where people live and health
are well documented. What remains unclear is how
environments influence health. Katherine’s doctoral
research being undertaken as part of the PAMS
project will endeavour to further explore the
mechanisms of these place and health
relationships. This cross-sectional research aims to
identify whether residents’ perceptions of specific
features within their local area are a possible
mechanism linking objectively measured attributes
and cardiometabolic outcomes. Environmental data
extracted from a geographic information system are
being analysed in relation to environmental
perceptions and the cardiometabolic health
outcomes of participants in the North West
Adelaide Health Study (NWAHS) in metropolitan
Adelaide.
Preliminary results from Katherine’s research
suggest that people who perceive their local area to
be aesthetically pleasing have a lower risk of
having metabolic syndrome. A subset of NWAHS
participants (n=1337) completed a questionnaire
assessing six items relating to their perceptions
of neighbourhood aesthetics, including: greenery
(e.g., trees, bushes, gardens); tree cover or
canopy along footpaths; interesting environmental
features; attractive buildings/homes; pleasant
natural features; and speed of traffic on street of
residence (40km/h or less). The analysis showed
that for every one point increase in the
neighbourhood aesthetics score, there was a 12%
reduction in risk for metabolic syndrome. This
research has also tested whether this relationship
could be explained by residents’ walking behaviour.
The results indicated that walking behaviour
acts as a link between resident perceptions of
their neighbourhood and metabolic syndrome.
This information is important in developing
environmental interventions that can lead to
improvements in health. The results from this
analysis suggest that residential areas that are more
aesthetically pleasing can lead to residents walking
more, which in turn, can lead to improvements
in cardiometabolic health and reduced risk for
metabolic syndrome.
Katherine is co-supervised by Prof Mark Daniel &
Dr Catherine Paquet. Her Associate Supervisor is
Prof Graeme Hugo (Adelaide Uni).
Physiotherapy Honours Student
Thomas Orschulok
Tom commenced his Bachelor of
Physiotherapy Honours in 2010
researching “Are cardiometabolic
disease risk factors related
to availability of neighbourhood
public open spaces and their
characteristics?”
Tom’s research project has been
evaluating associations between
certain aspects of neighbourhood
public open space (size, greenness,
type and availability) and
overall cardiometabolic risk.
Cardiometabolic risk is expressed
as the total count of a number of
cardiometabolic risk factors that
apply to any given individual.
Tom’s hypothesis is that people
who live closer to or have more
parks located close to them that
are larger, greener, more attractive
and which provide facilities
for sporting activities will have
a lower number of cardiometabolic
risk factors and thus a reduced
risk of developing cardiometabolic
diseases.
Tom is supervised by Dr Catherine
Paquet, Prof Mark Daniel, and Mr
Neil Coffee.
P l a c e a n d M e t a b o l i c S y n d r o m e P r o j e c t
More aesthetically
pleasing perception
of residential area
Increased walking
time per week
Decreased risk for
metabolic syndrome
Professor Mark Daniel presented within an ISBNPA Symposium, led by the National Cancer Institute (US), “Understanding and overcoming
key barriers to assessing the relevance of the food environment to diet and health”. Mark presented within this symposium on the
“Challenges in use and results of analyses of secondary data on food environments”. The presentation framed challenges and emerging
tensions in research on food environments using geographic information systems (GIS)-based secondary data, including linking constructs to
measures, validity of indirect measures, and coherence of relationships between food-source availability, composition and context, eating
behaviour, and cardiometabolic outcomes .
Mrs Katherine Baldock, PhD Candidate, presented results of preliminary analyses testing associations between the perceived environment,
sense of community, and metabolic syndrome. Findings indicated that a greater number of locally available services and resources was
associated with a greater sense of community. In addition, a greater sense of community was associated with a lower risk of having metabolic
syndrome. Knowledge of the specific features of residential environments that may potentially improve residents’ sense of community and
cardiometabolic health could inform environmental interventions to improve population health.
Mr Peter Lekkas, PhD Candidate, attended a satellite meeting “Advancing research on the built environment and active living: working with
policy makers and designing natural experiments”, hosted by the Centre for Built Environment and Health, University of Western Australia.
The aim of this satellite meeting was to advance knowledge of natural experiments. Using real case studies of urban regeneration programs
awaiting formal development approval, participants were challenged to formulate robust evaluations to capture the prospective
influence of changes to the built environment on ‘active living’, health and wellbeing. The meeting was convened by Professors Billie
Giles-Corti and Fiona Bull with expert guidance on the conduct of natural experiments for public health provided by Professor David Ogilvie
(MRC Epidemiology Unit & the UKCRC Centre for Diet and Activity Research (CEDAR) Cambridge, UK). Central to the learning process was the
involvement of industry stakeholders from local government and urban developers.
www.isbnpa2011.org
2011 Annual Meeting of the International Society for
Behavioral Nutrition and Physical Activity, Melbourne
Residents living within disadvantaged areas have
worse health than those living in advantaged
areas. Figure 1 outlines an example of variation in the
prevalence of metabolic syndrome across a social
gradient. North West Adelaide Health Study
(NWAHS) participants living within the most
disadvantaged local communities display the highest
prevalence of metabolic syndrome. Metabolic
syndrome was calculated for NWAHS participants at
Wave 1 (2000-03) using the International Diabetes
Federation (IDF) definition:
Waist Girth:
≥80cm females or ≥94cm males
Plus any two of the following:
Blood Pressure:
Systolic ≥ 130 mmHg or Diastolic ≥85 mmHg
Raised triglycerides:
≥1.7 mmol/L or treatment for lipid abnormality
Reduced HDL-Cholesterol:
≤1.03 mmol/L females or ≤1.29 mmol/L males
Fasting Plasma Glucose :
≥ 5.6 mmol/L or diagnosed Diabetes
The work of the PAMS project will investigate the
basis of these social relationships with metabolic
syndrome. Specifically, the PAMS project will analyse
how behavioural and psycho-social factors influence
the development of metabolic syndrome over time
for the NWAHS population.
Area-level relationships
of Metabolic Syndrome
Socioeconomic Indexes for Areas, Index of Relative Socioeconomic Disadvantage (SEIFA IRSD)
Pre
vale
nce
of
Me
tab
olic
Syn
dro
me
(%
)
Most Disadvantaged Local Communities Least Disadvantaged Local Communities
50.0
45.0
40.0
35.0
30.0
25.0
20.0
15.0
10.0
5.0
0.0
Figure 1: Prevalence of Metabolic Syndrome by area-level disadvantage
North West Adelaide Health Study, Wave 1 (2000-03)
The Socio Economic Indexes for Areas
(SEIFA) is commonly used to describe area-
level disadvantage within the Australian
context and is derived from Australian
Bureau of Statistics (ABS) area-level Census
information. The SEIFA Index of Relative
Socio-economic Disadvantage (IRSD)
comprises indicators on both advantage
and disadvantage. A low score of SEIFA
IRSD represents ‘disadvantage’ and a high
score ‘advantage’. In this analysis the
distribution within the population has been
categorised according to quintiles, as
defined by the following cut-off values:
Quintile 1 & 2 = Most Disadvantaged
Local Communities
Quintile 3 = Middle Quintile
Quintile 4 & 5 = Least Disadvantaged
Local Communities
Defining Area-level Disadvantage?
Research Team National Health and Medical Research Council (NHMRC) Partnership Project (#570150), 2010-2012
“Linking Place to Metabolic Syndrome via Behavioural and Psychosocial Antecedents: Levers for Public Health Intervention”
unisa.edu.au/sansominstitute/pams
Miss Kristy Scherer, Project Co-ordinator e. [email protected] t. +61 8 8302 2629 f: +61 8 8302 2603
Prof Mark Daniel, Chair: Social Epidemiology e. [email protected] t. +61 8 8302 2518
Dr Catherine Paquet, NHMRC Research Fellow e. [email protected] t. +61 8 8302 2615
Dr Margaret Cargo, ARC Future Fellow e. [email protected] t. +61 8 8302 2141
Mr Neil Coffee, Senior Research Fellow e. [email protected] t. +61 8 8302 2632
Dr Natasha Howard, Research Fellow e. [email protected] t. +61 8 8302 2776
Chief Investigators Prof Mark Daniel (UniSA)
Prof Graeme Hugo (Adelaide)
Dr Catherine Paquet (UniSA)
A/Prof Anne Taylor (Adelaide)
Dr Margaret Cargo (UniSA)
A/Prof Robert Adams (Adelaide)
P l a c e a n d M e t a b o l i c S y n d r o m e P r o j e c t
The PAMS project is one of several research projects currently being undertaken within
the Social Epidemiology and Evaluation Research Group (SEERG). Another project
funded by the SA Health Strategic Health Research Program is investigating smoking
reduction strategies and interventions among Aboriginal health workers.
Smoking is prevalent among Aboriginal Health Workers. This affects their health
directly. It also affects their professional practice influencing the delivery of smoking
cessation programs to clients. Addressing this issue requires deep understanding. To do
so we have partnered with the Aboriginal Health Council of South Australia. Critical also
is the use of a participatory mixed-methods approach. By this approach we aim to
contextualise smoking to better understand its basis in individuals and opportunities for
prevention, reduction and cessation. This will enable the development of culturally
sensitive cessation strategies for Aboriginal Health Workers and their communities.
Our website provides further information on the Research Team and current research
activities: unisa.edu.au/sansominstitute/epidemiology
Staff and friends of the Social Epidemiology and
Evaluation Research Group undertaking the
2011 Mutual Community Tour Down Under Challenge
Social Epidemiology and
Evaluation Research Group
Montreal, Quebec, Canada
Utilising MEGAPHONE® within SEERG...
Torbjorn Van Heeswijck commenced his
PhD in 2009 researching “Active transport
environments, active transport behaviour
and cardiovascular mortality”. This research
investigates how Individuals are exposed
to multiple environments as part of their
daily movements. Using Montréal data, the
project is investigating whether the built
and social environment to which individuals
are exposed during their daily commute
is related to active transport behaviour
as well as population-level cardiovascular
disease (CVD) mortality.
The SEERG has many international
collaborations, several of which
involve the l’Université de
Montréal, Quebec, Canada. Much
of this research involves the
application of data derived from a
geographic information system
(GIS) MEGAPHONE® - Montreal
Epidemiological & Geographic Anal-
ysis of Population Health Outcomes
& Neighbourhood Effects. MEGA-
PHONE® was co-developed with
Research Fellow Dr Yan Kestens
during Prof Mark Daniel’s time as
Canada Research Chair at the
Centre de recherche du Centre
hospitalier de l’Université de
Montréal (CR-CHUM).
MEGAPHONE® was developed to
support exposure surveillance and
population health research on
social, built, and physical
environmental features affecting
health across the Montréal
metropolitan region of 3.4 million
residents. It combines a diverse
array of geospatial databases and
analysis tools, a graphical user
interface, and a unique relational
infrastructure to facilitate the
storage, management and use of
health-related geographic data.
International
Collaborations