Tom Clemens

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OBJECTIVES A relationship between ambient air pollution and adverse birth outcomes has been found in a large number of studies that have mainly used a nearest monitor methodology. Recent research has suggested that the effect size may have been underestimated in these studies. This paper examines associations between birth outcomes and ambient levels of(More)
OBJECTIVE To determine whether government efforts in reducing inequalities in health in European countries have actually made a difference to mortality inequalities by socioeconomic group. DESIGN Register based study. DATA SOURCE Mortality data by level of education and occupational class in the period 1990-2010, usually collected in a census linked(More)
BACKGROUND There is a strong association between unemployment and mortality, but whether this relationship is causal remains debated. This study utilizes population-level administrative data from Scotland within a propensity score framework to explore whether the association between unemployment and mortality may be causal. METHODS The study examined a(More)
Testing whether unemployment causes health deterioration is complicated because failing health may increase the probability of unemployment. In some previous studies of unemployment and mortality a 'wear-off' period is used to exclude any deaths occurring in the first few years after employment status was observed. It is assumed that selection effects will(More)
BACKGROUND Income is predictive of many health outcomes and is therefore an important potential confounder to control for in studies. However it is often missing or poorly measured in epidemiological studies because of its complexity and sensitivity. This paper presents and validates an alternative approach to the survey collection of reported income(More)
Background Patterns of adverse birth outcomes vary spatially and there is evidence that this may relate to features of the physical environment such as air pollution. However, other social characteristics of the environment such as levels of crime are relatively understudied. This study examines the association between crime rates and birth weight and(More)
BACKGROUND Season and vitamin D are indirect and direct correlates of ultraviolet (UV) radiation and are associated with pregnancy outcomes. Further to producing vitamin D, UV has positive effects on cardiovascular and immune health that may support a role for UV directly benefitting pregnancy. OBJECTIVES To investigate the effects of UV exposure on(More)
BACKGROUND Maternal ambient air pollution exposure is associated with reduced birthweight. Few studies have examined the effect on growth in utero and none have examined the effect of exposure to particulates less than 2.5µm (PM2.5) and possible effect modification by smoking status. OBJECTIVES Examine the effect of maternal exposure to ambient(More)
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