Since the 1980s, ecological models of health promotion have generated a great deal of enthusiasm among researchers and interventionists. These models emerged from conceptual developments in other fields, and only selected elements of the ecological approach have been integrated into them. In this article, we describe the tenets of the ecological approach and highlight those aspects that have been integrated into ecological models used in health promotion. We also analyze how ecological models have been applied to the study of two important public health issues, namely physical activity promotion and the increased consumption of fruits and vegetables, by conducting an archival study of published research. Finally, we make a statement regarding the usefulness of ecological models for research and practice and propose recommendations for future research, program planning, and evaluation.

To map out area effects on health research, this study had the following aims: (1) to inventory multilevel investigations of area effects on self rated health, cardiovascular diseases and risk factors, and mortality among adults; (2) to describe and critically discuss methodological approaches employed and results observed; and (3) to formulate selected recommendations for advancing the study of area effects on health. Overall, 86 studies were inventoried. Although several innovative methodological approaches and analytical designs were found, small areas are most often operationalised using administrative and statistical spatial units. Most studies used indicators of area socioeconomic status derived from censuses, and few provided information on the validity and reliability of measures of exposures. A consistent finding was that a significant portion of the variation in health is associated with area context independently of individual characteristics. Area effects on health, although significant in most studies, often depend on the health outcome studied, the measure of area exposure used, and the spatial scale at which associations are examined.

Alongside community involvement, promoting social participation has been identified as a key strategy of fostering empowerment, one of the central tenets of the health promotion movement. Engagement in social and productive activities appears to be particularly beneficial to older adults, as it has been found to be associated with positive outcomes on a variety of health indicators. It is therefore critical to identify factors that might lead to greater social participation within these age groups. The objective of this study was to investigate the relationship between perceptions of neighbourhood user-friendliness and social participation while controlling for personal characteristics in a sample of seniors living in an urban environment. A convenience sample of older adults (n = 282) was recruited through community organizations located in high- average- and low-income Montreal neighbourhoods. Data were collected via an interviewer-administered questionnaire assessing social participation and various variables at the neighbourhood level (e.g. housing and social environment, walking environment and transportation, and services and amenities) and at the individual-level (e.g. health status and socio-demographic characteristics). Five variables emerged as independent predictors of social participation. Positive predictors retained in the final regression model included frequent walking episodes (almost every day), higher Vitality and General Health SF-12v2 scores, and perceived accessibility to key resources for older adults. Also included was a negative predictor: age (R² of the final model = 0.28). Implications of the findings for research and action pertaining to ecological, health promotion interventions for older adults are identified.

Objectives. We examined the extent to which differential traffic volume and road geometry can explain social inequalities in pedestrian, cyclist, and motor vehicle occupant injuries across wealthy and poor urban areas. Methods. We performed a multilevel observational study of all road users injured over 5 years (n = 19 568) at intersections (n = 17 498) in a large urban area (Island of Montreal, Canada). We considered intersection-level (traffic estimates, major roads, number of legs) and area-level (population density, commuting travel modes, household income) characteristics in multilevel Poisson regressions that nested intersections in 506 census tracts. Results. There were significantly more injured pedestrians, cyclists, and motor vehicle occupants at intersections in the poorest than in the richest areas. Controlling for traffic volume, intersection geometry, and pedestrian and cyclist volumes greatly attenuated the event rate ratios between intersections in the poorest and richest areas for injured pedestrians (−70%), cyclists (−44%), and motor vehicle occupants (−44%). Conclusions. Roadway environment can explain a substantial portion of the excess rate of road traffic injuries in the poorest urban areas.