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1.  Association between area level socioeconomic deprivation and a cluster of behavioural risk factors: Cross sectional, population based study 
Background
The Commission on Social Determinants of Health has urged governments across the world to promote health equity by reducing the gap between the most and least deprived individuals in society. Some of this gap can be bridged by promoting healthy lifestyles through targeted public health policy and interventions.
Methods
Cross-sectional analyses of data on behavioural risk factors, individual socioeconomic factors, and neighbourhood deprivation score collected from 26,290 adults aged over 16 years who participated in the 2008 East of England Lifestyle Survey.
Results
After adjustment for individual socioeconomic factors, across quintiles of increasing neighbourhood deprivation, participants were more likely to smoke and less likely to consume five portions of fruit and vegetables on five or more days of the week (least deprived versus most deprived quintile- odds ratios for not smoking 0.45 [0.41 to 0.50]; and fruit and vegetable consumption 0.70 [0.64 to 0.76] p-trend <0.0001). Greater neighbourhood deprivation and lower occupational social class were independently associated with a lower summary healthy lifestyle score (both p-trend <0.0001).
Conclusions
Public health interventions aimed at reducing health inequalities by targeting behavioural risk factors may focus in particular on reducing smoking and increasing fruit and vegetable consumption in more deprived communities.
doi:10.1093/pubmed/fdq072
PMCID: PMC3714999  PMID: 20884643
2.  Public health professionals' perceptions toward provision of health protection in England: a survey of expectations of Primary Care Trusts and Health Protection Units in the delivery of health protection 
BMC Public Health  2006;6:297.
Background
Effective health protection requires systematised responses with clear accountabilities. In England, Primary Care Trusts and the Health Protection Agency both have statutory responsibilities for health protection. A Memorandum of Understanding identifies responsibilities of both parties, but there is a potential lack of clarity about responsibility for specific health protection functions. We aimed to investigate professionals' perceptions of responsibility for different health protection functions, to inform future guidance for, and organisation of, health protection in England.
Methods
We sent a postal questionnaire to all health protection professionals in England from the following groups: (a) Directors of Public Health in Primary Care Trusts; (b) Directors of Health Protection Units within the Health Protection Agency; (c) Directors of Public Health in Strategic Health Authorities and; (d) Regional Directors of the Health Protection Agency
Results
The response rate exceeded 70%. Variations in perceptions of who should be, and who is, delivering health protection functions were observed within, and between, the professional groups (a)-(d). Concordance in views of which organisation should, and which does deliver was high (≥90%) for 6 of 18 health protection functions, but much lower (≤80%) for 6 other functions, including managing the implications of a case of meningitis out of hours, of landfill environmental contamination, vaccination in response to mumps outbreaks, nursing home infection control, monitoring sexually transmitted infections and immunisation training for primary care staff. The proportion of respondents reporting that they felt confident most or all of the time in the safe delivery of a health protection function was strongly correlated with the concordance (r = 0.65, P = 0.0038).
Conclusion
Whilst we studied professionals' perceptions, rather than actual responses to incidents, our study suggests that there are important areas of health protection where consistent understanding of responsibility for delivery is lacking. There are opportunities to clarify the responsibility for health protection in England, perhaps learning from the approaches used for those health protection functions where we found consistent perceptions of accountability.
doi:10.1186/1471-2458-6-297
PMCID: PMC1712342  PMID: 17156421

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