Relationship between body mass index and residential segregation in large cities of Latin America.

BACKGROUND: Obesity is a global health problem, and its connection with social and environmental factors is well-established. Social factors, such as urban segregation, may impact obesity through various mechanisms, including food and physical activity environments, as well as social norms and networks. This multilevel study aims to examine the effect of socio-economic residential segregation of Latin American cities on the obesity of individuals within those cities. METHODS: We analyzed data from national surveys for a total of 59,340 individuals of 18-70 years of age, conducted in 156 cities across Brazil, Chile, Colombia, and Mexico between 2007 and 2013. We adjusted two-level linear mixed models for body mass index (BMI) stratified by sex and country, controlling for age, educational level and poverty. Separate models were built for dissimilarity and isolation segregation indices. RESULTS: The relationships between segregation indices and BMI were mostly not statistically significant, and in some cases, they were opposite to what was expected. The only significant relationships were observed in Colombian men, using the dissimilarity index (-7.5 [95% CI: -14.4, -0.5]) and in Colombian women, using the isolation index (-7.9 [95% CI: -14.1, -1.7]). CONCLUSIONS: While individual-level factors cannot fully explain differences among people in the same city, segregation indices may help. However, we found that in some cases, the relationship between BMI and segregation indices is opposite to what is expected based on prior literature. This should be considered in examining the phenomenon. Further research on obesogenic environments in segregated neighborhoods could provide valuable evidence.

Racial Inequities in the Control of Hypertension and the Explanatory Role of Residential Segregation: a Decomposition Analysis in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

The mechanisms underlying racial inequities in uncontrolled hypertension have been limited to individual factors. We investigated racial inequities in uncontrolled hypertension and the explanatory role of economic segregation in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). All 3897 baseline participants with hypertension (2008-2010) were included. Uncontrolled hypertension (SBP ≥ 140 mmHg or DBP ≥ 90 mmHg), self-reported race (White/Brown/Black people), and neighborhood economic segregation (low/medium/high) were analyzed cross-sectionally. We used decomposition analysis, which describes how much a disparity would change (disparity reduction; explained portion) and remain (disparity residual; unexplained portion) upon removing racial differences in economic segregation (i.e., if Black people had the distribution of segregation of White people, how much we would expect uncontrolled hypertension to decrease among Black people). Age- and gender-adjusted prevalence of uncontrolled hypertension (39.0%, 52.6%, and 54.2% for White, Brown, and Black participants, respectively) remained higher for Black and Brown vs White participants, regardless of economic segregation. Uncontrolled hypertension showed a dose-response pattern with increasing segregation levels for White but not for Black and Brown participants. After adjusting for age, gender, education, and study center, unexplained portion (disparity residual) of race on uncontrolled hypertension was 18.2% (95% CI 13.4%; 22.9%) for Black vs White participants and 12.6% (8.2%; 17.1%) for Brown vs White participants. However, explained portion (disparity reduction) through economic segregation was - 2.1% (- 5.1%; 1.3%) for Black vs White and 0.5% (- 1.7%; 2.8%) for Brown vs White participants. Although uncontrolled hypertension was greater for Black and Brown vs White people, racial inequities in uncontrolled hypertension were not explained by economic segregation.

A segregação residencial socioeconômica está associada aos problemas do sono? Insights do ELSA-Brasil / Is socioeconomic residential segregation associated with sleep problems? Insights from ELSA-Brasil / ¿Está asociada la segregación residencial socioeconómica con problemas de sueño? Insights de ELSA-Brasil

Resumo: O sono é influenciado por diversos fatores e é essencial para a saúde. O papel do contexto socioeconômico da vizinhança na saúde do sono foi estudado nos últimos anos, mas os resultados são inconsistentes. O objetivo deste estudo foi investigar a associação entre a segregação residencial socioeconômica e os problemas do sono. Utilizou-se dados da 2ª avaliação (2012-2014) de 9.918 servidores públicos participantes do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). A segregação residencial socioeconômica foi avaliada por meio da estatística Getis-Ord Local Gi*, e a duração e privação do sono, as queixas de insônia e a sonolência diurna foram obtidas por meio de entrevistas. Para as estimativas da odds ratio (OR), foram utilizados modelos de regressão logística binomial e multinomial. Em relação ao sono, 49% tinham curta duração e 3% longa duração, 23% relataram queixas de insônia, 45% relataram privação do sono, 42% relataram sonolência diurna e 48% relataram ≥ 2 problemas do sono. No modelo ajustado por variáveis demográficas e socioeconômicas, houve associação entre alta segregação residencial socioeconômica e duração curta do sono (OR = 1,22; IC95%: 1,07; 1,40), privação do sono (OR = 1,20; IC95%: 1,05; 1,37), sonolência diurna (OR = 1,17; IC95%: 1,03; 1,34) e ≥ 2 problemas associados do sono (OR = 1,24; IC95%: 1,08; 1,41). Indivíduos que vivem em vizinhanças com alta segregação residencial socioeconômica apresentam maior chance de terem curta duração, privação do sono, sonolência diurna e ≥ 2 problemas associados ao sono. Essas informações reforçam que políticas públicas para reduzir as desigualdades socioeconômicas podem contribuir para melhorar a saúde do sono da população.

Abstract: Several factors influence sleep, which is essential for health. While the role of neighborhood socioeconomic context on sleep health has been studied in recent years, results are inconsistent. The study aimed to investigate the association between socioeconomic residential segregation and sleep problems, using data from the second evaluation (2012-2014) of 9,918 public servants participating in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Socioeconomic residential segregation was assessed using the Getis-Ord Local Gi* statistic. Sleep duration and deprivation, complaints of insomnia, and daytime sleepiness were obtained through interviews. Binomial and multinomial logistic regression models were used to estimate the odds ratio (OR). Regarding sleep, 49% had short duration and 3% long duration, 23% reported complaints of insomnia, 45% sleep deprivation, 42% daytime sleepiness, and 48% reported ≥ 2 sleep problems. In the model adjusted for demographic and socioeconomic variables, there was an association between high socioeconomic residential segregation and short sleep duration (OR = 1.22; 95%CI: 1.07; 1.40), sleep deprivation (OR = 1.20; 95%CI: 1.05; 1.37), daytime sleepiness (OR = 1.17; 95%CI: 1.03; 1.34) and ≥ 2 associated sleep problems (OR = 1.24; 95%CI: 1.08; 1.41). Individuals living in neighborhoods with high socioeconomic residential segregation are more likely to have short sleep duration, sleep deprivation, daytime sleepiness, and ≥ 2 associated sleep problems. This information reinforces that public policy measures to reduce socioeconomic inequalities can improve the population's sleep health.

Resumen: El sueño se influye por varios factores y es esencial para la salud. Se estudió el papel del contexto socioeconómico del barrio en la salud del sueño en los últimos años, pero los resultados son inconsistentes. El objetivo del estudio fue investigar la asociación entre la segregación residencial socioeconómica y los problemas de sueño. Se utilizó datos de la 2ª evaluación (2012-2014) de 9918 servidores públicos participantes del Estudio Longitudinal de Salud del Adulto (ELSA-Brasil). Se evaluó la segregación residencial socioeconómica a través de la estadística Getis-Ord Local Gi*. La duración y privación del sueño, las quejas de insomnio y somnolencia diurna se obtuvieron a través de entrevista. Se utilizaron modelos de regresión logística binomial y multinominal para estimar el odds ratio (OR). Con respecto al sueño, el 49% tenía una duración corta y el 3% tenía una duración larga, el 23% relató quejas de insomnio, el 45% relató privación de sueño, el 42% relató somnolencia diurna y el 48% relató ≥ 2 problemas de sueño. En el modelo ajustado por variables demográficas y socioeconómicas, hubo una asociación entre la alta segregación residencial socioeconómica y la duración corta de sueño (OR = 1,22; IC95%: 1,07; 1,40), la privación de sueño (OR = 1,20; IC95%: 1,05; 1,37), la somnolencia diurna (OR = 1,17; IC95%: 1,03; 1,34) y ≥ 2 problemas asociados con el sueño (OR = 1,24; IC95%: 1,08; 1,41). Personas que viven en barrios con una alta segregación residencial socioeconómica presentan una mayor probabilidad de tener duración corta del sueño, privación de sueño, somnolencia diurna y ≥ 2 problemas asociados con el sueño. Estas informaciones resaltan que medidas de políticas públicas para reducir las desigualdades socioeconómicas pueden contribuir a mejorar la salud del sueño en la población.

Assessing racial residential segregation as a risk factor for severe maternal morbidity.

PURPOSE: To measure associations of area-level racial and economic residential segregation with severe maternal morbidity (SMM). METHODS: We conducted a retrospective cohort study of births at two Philadelphia hospitals between 2018 and 2020 to analyze associations of segregation, quantified using the Index of Concentration at the Extremes (ICE), with SMM. We used stratified multivariable, multilevel, logistic regression models to determine whether associations of ICE with SMM varied by self-identified race or hospital catchment. RESULTS: Of the 25,979 patients (44.1% Black, 35.8% White), 1381 (5.3%) had SMM (Black [6.1%], White [4.4%]). SMM was higher among patients residing outside (6.3%), than inside (5.0%) Philadelphia (P < .001). Overall, ICE was not associated with SMM. However, ICErace (higher proportion of White vs. Black households) was associated with lower odds of SMM among patients residing inside Philadelphia (aOR 0.87, 95% CI: 0.80-0.94) and higher odds outside Philadelphia (aOR 1.12, 95% CI: 0.95-1.31). Moran's I indicated spatial autocorrelation of SMM overall (P < .001); when stratified, autocorrelation was only evident outside Philadelphia. CONCLUSIONS: Overall, ICE was not associated with SMM. However, higher ICErace was associated with lower odds of SMM among Philadelphia residents. Findings highlight the importance of hospital catchment area and referral patterns in spatial analyses of hospital datasets.

Racial Inequities in Self-Rated Health Across Brazilian Cities: Does Residential Segregation Play a Role?

Racial health inequities may be partially explained by area-level factors such as residential segregation. In this cross-sectional study, using a large, multiracial, representative sample of Brazilian adults (n = 37,009 individuals in the 27 state capitals; National Health Survey (Pesquisa Nacional de Saúde), 2013), we investigated 1) whether individual-level self-rated health (SRH) (fair or poor vs. good or better) varies by race (self-declared White, Brown, or Black) and 2) whether city-level economic or racial residential segregation (using dissimilarity index values in tertiles: low, medium, and high) interacts with race, increasing racial inequities in SRH. Prevalence of fair or poor SRH was 31.5% (Black, Brown, and White people: 36.4%, 34.0%, and 27.3%, respectively). Marginal standardization based on multilevel logistic regression models, adjusted for age, gender, and education, showed that Black and Brown people had, respectively, 20% and 10% higher prevalence of fair or poor SRH than did White people. Furthermore, residential segregation interacted with race such that the more segregated a city, the greater the racial gap among Black, Brown, and White people in fair or poor SRH for both income and race segregation. Policies to reduce racial inequities may need to address residential segregation and its consequences for health.

Spatial inequalities of retail food stores may determine availability of healthful food choices in a Brazilian metropolis.

OBJECTIVE: To examine the association between economic residential segregation and food environment. DESIGN: Ecological: Food stores categorised according to the NOVA classification were geocoded, and absolute availability was calculated for each neighbourhood. Segregation was measured using local Gi* statistic, a measure of the sd between the economic composition of a neighbourhood (the proportion of heads of households in neighbourhoods earn monthly income of 0 to 3 minimum wages) and larger metropolitan area, weighted by the economic composition of surrounding neighbourhoods. Segregation was categorised as high (most segregated), medium (integrated) and low (less segregated or integrated). A proportional odds models were used to model the association between segregation and food environment. SETTING: Belo Horizonte, Brazil. PARTICIPANTS: Food stores. RESULTS: After adjustment for covariates, neighbourhoods characterised by high economic segregation had fewer food stores overall compared with neighbourhoods characterised by low segregation (OR = 0·56; 95 % CI (0·45, 0·69)). In addition, high segregated neighbourhoods were 49 % (OR = 0·51; 95 % CI (0·42, 0·61)) and 45 % (OR = 0·55; 95 % CI (0·45, 0·67)) less likely to have a high number of food stores that predominantly marketed ultra-processed foods and mixed food stores, respectively, as compared with their counterparts. CONCLUSIONS: Economic segregation is associated with differences in the distribution of food stores. Both low and high segregation territories should be prioritised by public policies to ensure healthy and adequate nutrition as a right for all communities. The former must continue to be protected from access to unhealthy commercial food outlets, while the latter must be the locus of actions that limit the availability of unhealthy commercial food store.

Disparities in food consumption between economically segregated urban neighbourhoods.

OBJECTIVE: To examine associations between economic residential segregation and prevalence of healthy and unhealthy eating markers. DESIGN: Cross-sectional. A stratified sample was selected in a three-stage process. Prevalence of eating markers and their 95 % CI were estimated according to economic residential segregation: high (most segregated); medium (integrated) and low (less segregated or integrated). Segregation was measured at the census tract and assessed using the Getis-Ord local $G_i^{\rm{\ast}}$ statistic based on the proportion of heads of household in a neighbourhood earning a monthly income of 0-3 minimum wages. Binary logistic regression using generalized estimating equations were used to model the associations. SETTING: Belo Horizonte, Brazil. PARTICIPANTS: Adults (n 1301) residing in the geographical environment (178 census tracts) of ten units of the Brazilian primary-care service known as the Health Academy Program. RESULTS: Of the 1301 participants, 27·7 % lived in highly segregated neighbourhoods, where prevalence of regular consumption of fruit was lower compared with more affluent areas (34·6 v. 53·2 %, respectively). Likewise, regular consumption of vegetables (70·1 v. 87·6 %), fish (23·6 v. 42·3 %) and replacement of lunch or dinner with snacks (0·8 v. 4·7 %) were lower in comparison to more affluent areas. In contrast, regular consumption of beans was higher (91·0 v. 79·5 %). The associations of high-segregated neighbourhood with consumption of vegetables (OR = 0·62; 95 % CI 0·39, 0·98) and beans (OR = 1·85; 95 % CI 1·07, 3·19) remained significant after adjustments. CONCLUSIONS: Economic residential segregation was associated with healthy eating markers even after adjustments for individual-level factors and perceived food environment.

At the intersection of place, race, and health in Brazil: Residential segregation and cardio-metabolic risk factors in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

Residential segregation is the spatial manifestation of entrenched socioeconomic and racial inequities and is considered a fundamental cause of racial inequalities in health. Despite the well-documented racialized spatial inequalities that exist in urban areas throughout Brazil, few empirical investigations have examined the link between residential segregation and health and considered its implications for racial health inequalities in this setting. In the present study, we used data from the Brazilian Longitudinal Study of Adult Health (2008-2010) to examine the association between economic residential segregation and two major cardio-metabolic risk factors-hypertension and diabetes. We also examined whether associations were stronger for historically marginalized racial groups in Brazil. Residential segregation was calculated for study-defined neighborhoods using the Getis-Ord Local Gi* statistic and was based on household income data from the 2010 IBGE demographic census. Multivariable logistic regression models were used to examine associations. In our sample, Blacks and Browns were more likely to live in economically segregated neighborhoods. After taking into account income, education, and other demographic characteristics we found that individuals living in the most economically segregated neighborhoods were 26% more likely to have hypertension and 50% more likely to have diabetes than individuals living in more affluent areas. Although Blacks and Browns living in highly segregated neighborhoods had higher prevalence of hypertension and diabetes compared to Whites, we observed no statistically significant racial differences in the associations with residential segregation. Our findings suggest that residential segregation may be an important structural determinant of cardio-metabolic risk factors in Brazil. Moreover, the systematic and disproportionate exposure of Blacks and Browns to highly segregated neighborhoods may implicate these settings as potential drivers of racial inequalities in cardio-metabolic risk factors in urban settings in Brazil.

Metropolitan residential segregation and very preterm birth among African American and Mexican-origin women.

Residential segregation is associated with poor health-including poor birth outcomes-among African Americans in US cities and metropolitan areas. However, the few existing studies of this relationship among Mexican-origin women have produced mixed results. In this study, the relationship between segregation and very preterm birth was examined with National Center for Health Statistics (NCHS) data on singleton births to African American women (n = 400,718) in 238 metropolitan areas and to Mexican-origin women (n = 552,382) in 170 metropolitan areas. The study evaluated 1) whether residential segregation is positively associated with very preterm birth among both African American and Mexican-origin women and 2) if so, whether exposure to neighborhood poverty accounts for these associations. Results from multi-level analysis indicate that residential segregation is positively associated with very preterm birth among both groups of women. However, this association is robust across different measures of segregation only for African Americans. Conversely, differences across metropolitan areas in average levels of exposure to neighborhood poverty account for the positive association between segregation and very preterm birth among Mexican-origin women, but not among African American women.

Los patrones espaciales de los comportamientos de riesgo en la ciudad de Córdoba (Argentina)-2001 / Spatial patterns of risk behaviors in Cordoba (Argentina)-2001 / /Padrões espaciais dos comportamentos de risco na cidade de Córdoba (Argentina)-2001

Partiendo de la premisa que los fenómenos sociales no se distribuyen en el espacio geográfico de manera homogénea, este trabajo tiene como objetivo explorar los patrones de localización espacial de los grupos sociales en la ciudad de Córdoba (Argentina) y relacionarlos con algunos comportamientos de riesgo de niños y jóvenes, en particular aquellos que se vinculan con la reproducción de desigualdades, de la pobreza y de la exclusión. Primero, se identifican las diferentes áreas socio-habitacionales que componen la ciudad, a partir del análisis de la distribución de los grupos sociales en el espacio urbano, con especial énfasis en sus características educativas y habitacionales. Segundo, se calculan los diferenciales de los comportamientos de riesgo de niños y jóvenes (insuficiencia educativa, inactividad juvenil y fecundidad adolescente tardía), según áreas de residencia anteriormente mencionadas. Tercero, se evalúa la incidencia del contexto socio-habitacional en dichos comportamientos. La información con la que se trabaja es la proveniente del Censo Nacional de Población, Hogares y Vivienda del año 2001, a nivel de radio censal.

Based on the premise that social phenomena are not evenly distributed in geographic space, this study aims to explore the spatial patterns of social groups in the city of Córdoba (Argentina), associating them with certain risk behaviors among children and adolescents, especially those related to the reproduction of inequality, poverty, and exclusion. First, we identify the different socio-residential areas comprising the city, from the analysis of the distribution of social groups in the urban space, with special emphasis on education and housing characteristics. Second, we calculate the differentials for risk behavior among children and adolescents (school dropout rates, youth inactivity, and late adolescence fertility) according to the aforementioned areas of residence. Third, we evaluate the impact of the socio-housing context in these behaviors. We use Data from the National Demographic and Household Census of 2001, at the census tract level.

Partindo da premissa de que os fenômenos sociais não são distribuídos de maneira homogênea no espaço geográfico, este estudo pretende explorar os padrões de localização espacial dos grupos sociais na cidade de Córdoba (Argentina), relacionando os mesmos com determinados comportamentos de risco de crianças e jovens, em especial aqueles vinculados à reprodução de desigualdades, da pobreza e da exclusão. Primeiro, são identificadas as diferentes áreas socio-habitacionais que compõem a cidade, a partir da análise da distribuição dos grupos sociais no espaço urbano, com especial ênfase nas suas características educacionais e habitacionais. Segundo, são calculados os diferenciais dos comportamentos de risco de crianças e jovens (evasão escolar, inatividade juvenil e fecundidade adolescente tardia), de acordo com as áreas de residência anteriormente mencionadas. Terceiro, é avaliada a incidência do contexto socio-habitacional nestes comportamentos. São utilizados os dados do Censo Demográfico e Domiciliar Nacional, de 2001, a nível do setor censitário.

Segregação socioespacial e inserção no mercado de trabalho na Região Metropolitana de Campinas / Socio-spatial segregation and insertion in the labor market in the Metropolitan Region of Campinas, Brazil / /Segregación socioespacial e inserción en el mercado de trabajo en la Región Metropolitana de Campinas

Partindo da premissa de que o "espaço importa", o presente estudo procura contribuir para os esforços analíticos voltados a investigar o impacto da segregação, aqui entendida como a concentração no espaço de estratos socioeconômicos semelhantes, sobre a capacidade de respostas das pessoas ou famílias aos vários problemas e riscos observados nas grandes aglomerações urbanas. Mais especificamente, este artigo pretende investigar, para o caso de uma região metropolitana emergente no Brasil (Campinas, no Estado de São Paulo), se há evidências do efeito da segregação sobre distintas características da inserção dos indivíduos no mercado de trabalho. A partir dos dados do Censo Demográfico de 2000, analisa-se de que forma o desemprego, a formalidade do trabalho e a proteção social da população economicamente ativa estariam influenciados tanto pelas características sociodemográficas, incluindo status migratório e condição de mobilidade intraurbana (pendularidade), quanto por sua localização no espaço regional. Como variável espacial relativa à segregação, propõe-se uma medida baseada no Índice de Moran Local, que busca identificar áreas homogêneas em termos da composição socioeconômica de seus habitantes. Os resultados obtidos, embora não conclusivos, sugerem a importância da localização sobre a forma de inserção dos indivíduos no mercado de trabalho, o que corrobora algumas proposições teóricas levadas em conta nesse estudo.

Based on the premise that "space matters," the present study is intended as a contribution to the analytic efforts focused on investigating the impact of segregation, understood here as how the concentration in space of similar socioeconomic strata affects the ability of individuals and families to respond to the numerous problems and risks involved in large urban areas. More specifically, the article consists of an investigation into whether, for the case of an emerging metropolitan region in Brazil (Campinas, in the State of São Paulo), there are indications of the effect of segregation on the various characteristics of the inclusion of individuals in the labor market. Data from the Federal Demographic Census of 2000 show how unemployment, formality of labor, and the social protection of the economically active population are influenced both by the sociodemographic characteristics, including migratory status and condition of intraurban mobility (pendularity), and by the population's physical location in the region. As a spatial variable related to segregation, a measure is proposed on Moran's Local rate, which seeks to identify homogeneous areas in terms of the socioeconomic composition of their inhabitants. Although the results obtained are not conclusive, they do suggest the importance of location on way individuals are absorbed by the labor market. This finding corroborates several of the theoretical propositions taken into account in this study.

Partiendo de la premisa de que el "espacio es importante", el presente estudio procura aportar a los esfuerzos analíticos destinados a investigar el impacto de la segregación, que aquí se la entiende como la concentración en el espacio de estratos socioeconómicos semejantes, sobre la capacidad de respuestas de las personas o familias a los diversos problemas y riesgos observados en las grandes aglomeraciones urbanas. Más específicamente, este artículo pretende investigar, para el caso de una región metropolitana emergente en Brasil (Campinas, en el Estado de San Pablo), si hay evidencias del efecto de la segregación sobre distintas características de la inserción de los individuos en el mercado de trabajo. A partir de los datos del Censo Demográfico de 2000, se analiza de qué forma el desempleo, la formalidad del trabajo y la protección social de la población económicamente activa estarían influenciados tanto por las características sociodemográficas, incluyendo el estatus migratorio y la condición de movilidad intraurbana (pendularidad), como por su localización en el espacio regional. Como variable espacial relacionada con la segregación, se propone una medida basada en el Índice de Moran Local, que procura identificar áreas homogéneas en términos de la composición socioeconómica de sus habitantes. Los resultados obtenidos, aunque no concluyentes, sugieren la importancia de la localización sobre la forma de inserción de los individuos en el mercado de trabajo, lo cual corrobora algunas proposiciones teoréticas que se han tenido en cuenta en ese estudio.

Escolhas familiares, estratificação educacional e desempenho escolar: quais as relações / Family choices, educational stratification, and children's scholastic performance: what are the interrelations / Choix familiaux, stratification éducationnelle et performances scolaires: quels rapports y a-t-il entre eux

This article focuses on the impact of families' school choices on learning by children from different socioeconomic backgrounds in early primary school in the city of Rio de Janeiro, Brazil. The study analyzes data from a longitudinal research project on students that began second grade in 2005. The variables related to different family choices had significant effects on children's reading skills, even after adjusting for household assets and previous knowledge. The family's choice of a better school despite the distance from home had a particularly relevant impact.

Dans cet article, on recherche les effets des choix familiaux d'établissements d'enseignement sur l'apprentissage d'élèves d'origines sociales diverses fréquentant les premières années de l'enseignement primaire dans la ville de Rio de Janeiro. On part de données d'un projet longitudinal sur des enfants qui débutent en deuxième année de cet enseignement en 2005. Selon leurs résultats, les variables concernant les différents choix familiaux indiquent des effets significatifs sur l'apprentissage des élèves en lecture, indépendamment de leurs conditions économiques ou de leur apprentissage préalable. L'effet du choix familial de rechercher une école de qualité malgré sa distance du domicile de l'élève, est assez important.