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Abbas M, Nasar Z, Rosenthal D, Butts H, Fullilove R, Derose D, Moreau P, Nguyen H, Law M. Addressing Food Insecurity Through Community Empowerment in a Staten Island (Richmond County) Neighborhood in New York City. J Community Health 2024; 49:907-912. [PMID: 38466488 DOI: 10.1007/s10900-024-01329-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 03/13/2024]
Abstract
This study investigated community empowerment as a means of addressing food insecurity amongst underserved neighborhoods by increasing available and affordable food choices through Clementine Collective stands in Staten Island, New York (Richmond County), one of the 5 Boroughs of New York City. Given the growing complexity of food insecurity, inclusive and equitable action must be taken that incorporates the voices, perspectives and needs of those most impacted. Through methods of community engagement and empowerment, the Clementine Collective collaborates with local community residents to introduce sustainable solutions that address food insecurity. A survey (N = 132) was administered to customers of a Clementine Collective stand, located in Staten Island, that assessed customers' food habits and attitudes towards their food environment and solutions. The stand was placed in a local meat market grocery store. Descriptive statistics suggested that residents recognized gaps in their food environment and were empowered to advocate for solutions. Engaging residents from their food environment to advocate for local solutions, such as at community bodegas, or small grocery stores, may be an effective method of addressing food insecurity.
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Affiliation(s)
- Miral Abbas
- Columbia University Mailman School of Public Health, Columbia University, New York, USA
| | - Zainab Nasar
- Columbia University Mailman School of Public Health, Columbia University, New York, USA
| | - David Rosenthal
- Columbia University Mailman School of Public Health, Columbia University, New York, USA
| | - Heather Butts
- Columbia University Mailman School of Public Health, Columbia University, New York, USA.
| | - Robert Fullilove
- Columbia University Mailman School of Public Health, Columbia University, New York, USA
| | - Daphne Derose
- Columbia University Mailman School of Public Health, Columbia University, New York, USA
| | - Patrick Moreau
- Columbia University Mailman School of Public Health, Columbia University, New York, USA
- Community Health Worker, Staten Island University Hospital, Staten Island, USA
| | - Hedda Nguyen
- Columbia University Mailman School of Public Health, Columbia University, New York, USA
| | - Monica Law
- Columbia University Mailman School of Public Health, Columbia University, New York, USA
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2
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Ares G, Turra S, Bonilla L, Costa M, Verdier S, Brunet G, Alcaire F, Curutchet MR, Vidal L. WEIRD and non-consensual food deserts and swamps: A scoping review of operational definitions. Health Place 2024; 89:103315. [PMID: 39013213 DOI: 10.1016/j.healthplace.2024.103315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 07/02/2024] [Accepted: 07/05/2024] [Indexed: 07/18/2024]
Abstract
The aim of the present study was to critically analyze operational definitions of food deserts and food swamps included in empirical studies published in peer-reviewed journals. A scoping review was conducted following the recommendations of the Joanna Briggs Institute and PRISMA Extension for Scoping Reviews. A search of the scientific literature was performed on August 2023 to identify empirical studies including operational definitions of food deserts and/or food swamps in three databases: Scopus, PubMed, and Scielo. A total of 932 scientific articles were identified in the three databases, from which 157 articles, published between 2002 and 2023, were included in the review. The included studies were mainly conducted in WEIRD (Western, Educated, Industrilaized, Rich and Democractic) countries. They presented a total of 107 operational definitions of food deserts and 30 operational definitions of food swamps. Large heterogeneity in the operational definitions of food deserts and food swamps was found. Published studies differed in all the elements of the operational definitions analyzed in the present work. Results stress the need for standardization and the development of more objective and multivariate continuous measures of physical food accessibility that reflect the complexity of modern food environments globally. A series of recommendations to advance food environment research are derived.
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Affiliation(s)
- Gastón Ares
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n, CP 91000, Pando, Uruguay.
| | - Sergio Turra
- Escuela de Nutrición, Universidad de la República, Av. Ricaldoni S/N, CP 11600, Montevideo, Uruguay
| | - Luciana Bonilla
- Instituto Nacional de Alimentación, Ministerio de Desarrollo Social, Piedras 165, CP 11000, Montevideo, Uruguay
| | - María Costa
- Instituto Nacional de Alimentación, Ministerio de Desarrollo Social, Piedras 165, CP 11000, Montevideo, Uruguay
| | - Sofía Verdier
- Instituto Nacional de Alimentación, Ministerio de Desarrollo Social, Piedras 165, CP 11000, Montevideo, Uruguay
| | - Gerónimo Brunet
- Espacio Interdisciplinario, Universidad de la República, José Enrique Rodó 1843, CP 11200, Montevideo, Uruguay
| | - Florencia Alcaire
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n, CP 91000, Pando, Uruguay
| | - María Rosa Curutchet
- Instituto Nacional de Alimentación, Ministerio de Desarrollo Social, Piedras 165, CP 11000, Montevideo, Uruguay
| | - Leticia Vidal
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n, CP 91000, Pando, Uruguay
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Endo Y, Tsilimigras DI, Khalil M, Yang J, Woldesenbet S, Sasaki K, Limkemann A, Schenk A, Pawlik TM. The impact of county-level food access on the mortality and post-transplant survival among patients with steatotic liver disease. Surgery 2024; 176:196-204. [PMID: 38609786 DOI: 10.1016/j.surg.2024.02.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/13/2024] [Accepted: 02/26/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND The impact of county-level food access on mortality associated with steatotic liver disease, as well as post-liver transplant outcomes among individuals with steatotic liver disease, have not been characterized. METHODS Data on steatotic liver disease-related mortality and outcomes of liver transplant recipients with steatotic liver disease between 2010 and 2020 were obtained from the Centers for Disease Control Prevention mortality as well as the Scientific Registry of Transplant Recipients databases. These data were linked to the food desert score, defined as the proportion of the total population in each county characterized as having both low income and limited access to grocery stores. RESULTS Among 2,710 counties included in the analytic cohort, median steatotic liver disease-related mortality was 27.3 per 100,000 population (interquartile range 24.9-32.1). Of note, patients residing in counties with high steatotic liver disease death rates were more likely to have higher food desert scores (low: 5.0, interquartile range 3.1-7.8 vs moderate: 6.1, interquartile range, 3.8-9.3 vs high: 7.6, interquartile range 4.1-11.7). Among 28,710 patients who did undergo liver transplantation, 5,310 (18.4%) individuals lived in counties with a high food desert score. Liver transplant recipients who resided in counties with the worst food access were more likely to have a higher body mass index (>35 kg/m2: low food desert score, 17.3% vs highest food desert score, 20.1%). After transplantation, there was no difference in 2-year graft survival relative to county-level food access (food desert score: low: 88.4% vs high: 88.6%; P = .77). CONCLUSION Poor food access was associated with a higher incidence rate of steatotic liver disease-related death, as well as lower utilization of liver transplants. On the other hand, among patients who did receive a liver transplant, there was no difference in 2-year graft survival regardless of food access strata. Policy initiatives should target the expansion of transplantation services to vulnerable communities in which there is a high mortality of steatotic liver disease.
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Affiliation(s)
- Yutaka Endo
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH
| | - Diamantis I Tsilimigras
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH
| | - Mujtaba Khalil
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH
| | - Jason Yang
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH
| | - Selamawit Woldesenbet
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH
| | | | - Ashley Limkemann
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH
| | - Austin Schenk
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH
| | - Timothy M Pawlik
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH.
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Bao Y, Osborne M, Wang E, Jaenicke EC. BMI/Obesity and consumers' price sensitivity: Implications for food tax policies. PNAS NEXUS 2024; 3:pgae190. [PMID: 38864007 PMCID: PMC11165645 DOI: 10.1093/pnasnexus/pgae190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 04/24/2024] [Indexed: 06/13/2024]
Abstract
We examine the relationship between BMI and food purchase behavior using a unique dataset that links individual-level food purchases to health data. We find that individuals with higher BMI are significantly more sensitive to price changes in vice categories but do not show similar sensitivity in comparable nonvice categories. We rely on past literature that defines and identifies vice categories as those that are tempting and purchased impulsively. We explore the effectiveness of a 10% price increase on vice food categories, a hypothetical policy similar in spirit to a fat tax or sugar tax. We predict that such a tax would substantially reduce consumption of these foods, and would be particularly effective in reducing consumption by individuals with higher BMI.
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Affiliation(s)
- Ying Bao
- Gies College of Business, University of Illinois at Urbana and Champaign, 1206 S 6th Street, Champaign, IL 61822, USA
| | - Matthew Osborne
- Department of Management, University of Toronto Mississauga, 3359 Mississauga Road, Mississauga, ON L5L 1C6, Canada
| | - Emily Wang
- Department of Resource Economics, University of Massachusetts Amherst, 80 Campus Center Way, Amherst, MA 01003, USA
| | - Edward C Jaenicke
- Department of Agricultural Economics, Sociology, and Education, Penn State University, 208-B Armsby, University Park, PA 16802, USA
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Simandjuntak DP, Jaenicke EC, Wrenn DH. Pandemic-induced changes in household-level food diversity and diet quality in the U.S. PLoS One 2024; 19:e0300839. [PMID: 38820463 PMCID: PMC11142597 DOI: 10.1371/journal.pone.0300839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 03/05/2024] [Indexed: 06/02/2024] Open
Abstract
Using household-level U.S. food-purchase data, this study investigates pandemic-induced changes in two measures of diet quality, a Berry Index that measures food diversity and a USDAScore that measures adherence to dietary guidelines. Using NielsenIQ consumer panel data and a total of XXX households that neither moved location nor left the panel from 2018 through 2020, we estimate an event-study model where each household's diet quality measures before and during the pandemic period are compared against the same households' scores one year prior. In the two-to-three months following pandemic-based school closures, which spanned the March-June 2020 period, depending on the specific U.S. state, we find modest increases in food diversity (of up to 2.6 percent compared to the prior year) for the Berry Index and larger temporary increases (of up to 8.5 percent) in diet quality as measured by the USDAScore. We also find that households with different demographic characteristics generally follow the same patters; however, households with young children, low-income households, and households that do not own a vehicle exhibit smaller increases.
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Affiliation(s)
- Daniel P Simandjuntak
- Department of Agricultural Economics, Sociology, and Education, Penn State University, University Park, Pennsylvania, United States of America
| | - Edward C Jaenicke
- Department of Agricultural Economics, Sociology, and Education, Penn State University, University Park, Pennsylvania, United States of America
| | - Douglas H Wrenn
- Department of Agricultural Economics, Sociology, and Education, Penn State University, University Park, Pennsylvania, United States of America
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Wolińska IA, Kraik K, Poręba R, Gać P, Poręba M. Environmental factors of obesity before and after COVID-19 pandemic: a review. Front Public Health 2023; 11:1213033. [PMID: 38186688 PMCID: PMC10766782 DOI: 10.3389/fpubh.2023.1213033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 11/30/2023] [Indexed: 01/09/2024] Open
Abstract
In past decades the prevalence of overweight and obesity had grown rapidly. There are numerous factors contributing to this unfavorable change in people's health. This review article investigates the environmental factors which may play a role in the prevalence of overweight and obesity and additionally the novel factors which appeared after the beginning of the COVID-19 pandemic, which caused the increase in BMI during the lockdown period. Most of the studies reveal that the COVID-19 pandemic and lockdown contributed to the growth of BMI in numerous countries and, eventually the prevalence of overweight and obesity increased. Studies suggest that the physical activity was decreased while sleep time and screen time were increased and the amount of food consumed increased, additionally more processed food with long shelf life was consumed. The diverse environmental factors may have an impact on obesity and overweight development taking into account policy and local school policy issues, socioeconomic status, lifestyle including physical activity, diet habits, and amongst others, more trivial causes such as uninteresting neighborhoods, lack of sense of security outside the place of residence or a long distance from shops. Still, this is the object of debate if air pollution is an environmental risk factor influencing the unfavorable trends towards increasing body weight.
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Affiliation(s)
- Irena Anna Wolińska
- Divison of Pathophysiology, Department of Physiology and Pathophysiology, Wroclaw Medical University, Wrocław, Poland
| | - Krzysztof Kraik
- Students’ Scientific Association of Cardiovascular Diseases Prevention, Wroclaw Medical University, Wrocław, Poland
| | - Rafał Poręba
- Department of Internal Medicine, Occupational Diseases and Hypertension, Wroclaw Medical University, Wrocław, Poland
| | - Paweł Gać
- Division of Environmental Health and Occupational Medicine, Department of Population Health, Wroclaw Medical University, Wrocław, Poland
| | - Małgorzata Poręba
- Department of Paralympic Sport, Wroclaw University of Health and Sport Sciences, Wrocław, Poland
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Khalil M, Munir MM, Endo Y, Woldesenbet S, Resende V, Rawicz-Pruszyński K, Khan MMM, Waqar U, Katayama E, Dilhoff M, Cloyd J, Ejaz A, Pawlik TM. Association of County-Level Food Deserts and Food Swamps with Hepatopancreatobiliary Cancer Outcomes. J Gastrointest Surg 2023; 27:2771-2779. [PMID: 37940806 DOI: 10.1007/s11605-023-05879-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 10/28/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Malnutrition has been linked to the development of hepatopancreatobiliary (HPB) cancer. We sought to examine the association between food swamps and food deserts on surgical outcomes of patients with HPB cancer. METHODS Patients who underwent surgery for HPB cancer between 2014 and 2020 were identified from the Medicare Standard Analytic Files. Patient-level data were linked to the United States Department of Agriculture data on food swamps and deserts. Multivariable regression was performed to examine the association between the food environment and outcomes. RESULTS Among 53,426 patients, patients from the worse food environment were more likely to be Black, have a higher Charlson Comorbidity Index, and reside in areas with high social vulnerability. Following surgery, the overall incidence of textbook outcome (TO) was 41.6% (n = 22,220). Patients residing in the worse food environments less often achieved a TO versus individuals residing in the healthiest food environments (food swamp: 39.4% vs. 43.9%; food desert: 38.5% vs 42.2%; p < 0.05). On multivariable analysis, individuals residing in the poorest food environments were associated with lower odds of achieving TO compared with individuals living in healthiest food environments (food swamp: OR 0.83, 95%CI 0.75-0.92, food desert: OR 0.86, 95%CI 0.76-0.97; both p < 0.05). CONCLUSION The surrounding food environment of patients may serve as a modifiable socio-demographic risk factor that contributes to disparities in surgical outcomes of HPB cancer.
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Affiliation(s)
- Mujtaba Khalil
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Muhammad Musaab Munir
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Yutaka Endo
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Selamawit Woldesenbet
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Vivian Resende
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
- Federal University of Minas Gerais School of Medicine, Belo Horizonte, Brazil
| | - Karol Rawicz-Pruszyński
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
- Department of Surgical Oncology, Medical University of Lublin, Lublin, Poland
| | - Muhammad Muntazir Mehdi Khan
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Usama Waqar
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
- Medical College, Aga Khan University, Karachi, Pakistan
| | - Erryk Katayama
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Mary Dilhoff
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Jordan Cloyd
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Aslam Ejaz
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Timothy M Pawlik
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
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Raber M, Brozovich J, Le T, Brown A, Saenz T, Caracostis A, Basen-Engquist K. The Bite of HOPE Small Food Business Development Program: a clinic-based culinary medicine program targeting local business owners. Transl Behav Med 2023; 13:845-850. [PMID: 37210084 DOI: 10.1093/tbm/ibad030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2023] Open
Abstract
Culinary medicine is a popular approach to health promotion, but most programs focus on patient or provider-facing education. While laudable, these efforts do not represent the full potential for culinary medicine to impact community health. We describe a novel approach to culinary medicine at a federally qualified health center (FQHC), the HOPE Clinic: Bite of HOPE Small Food Business Development (SFBD) program. Describe the design and implementation of the Bite of HOPE SFBD program and examine initial response to the program through interviews and focus groups with past participants. The SFBD program aims to create healthy food outlets by supporting local small businesses with education, resources, and mentorship support. Former participants in the SFBD program were invited to participate in focus groups and interviews exploring their experience and perceived program impact. Three focus groups (n = 10) and nine in-depth interviews were conducted. Most participants were Black or Hispanic and all operated their businesses in the community surrounding HOPE Clinic. Five themes emerged from the data including perceived program purpose, program discovery, motivating factors to participation, perceived program impact, and suggestions for improvement. Participants expressed high satisfaction with the program and positive changes in both business development and personal eating habits. There is an opportunity to leverage the culinary medicine model to support local small food business and improve community health. The Bite of HOPE SFBD program offers an example of how clinic-based resources can expand into the surrounding environment.
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Affiliation(s)
- Margaret Raber
- Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030, USA
| | - Joseph Brozovich
- HOPE Clinic-Aldine Community Health Center, 3000 Aldine Mail Route Rd, Houston TX 77039, USA
| | - Thuan Le
- Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030, USA
| | - Asyjia Brown
- Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030, USA
| | - Tabbie Saenz
- HOPE Clinic-Aldine Community Health Center, 3000 Aldine Mail Route Rd, Houston TX 77039, USA
| | - Andrea Caracostis
- HOPE Clinic-Aldine Community Health Center, 3000 Aldine Mail Route Rd, Houston TX 77039, USA
| | - Karen Basen-Engquist
- Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030, USA
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Park SH, Lee YQ, Müller-Riemenschneider F, Dickens BSL, van Dam RM. Acculturation as a Determinant of Obesity and Related Lifestyle Behaviors in a Multi-Ethnic Asian Population. Nutrients 2023; 15:3619. [PMID: 37630809 PMCID: PMC10459113 DOI: 10.3390/nu15163619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/16/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
Limited attention has been given to the role of cultural orientation towards different ethnic groups in multi-ethnic settings without a dominant host culture. We evaluated whether acculturation levels, reflecting cultural orientation towards other ethnic groups, were associated with obesity and related lifestyle behaviors in a cosmopolitan Asian population. We conducted the current study based on data from the Singapore Multi-Ethnic Cohort (N = 10,622) consisting of ethnic Chinese, Malays, and Indians aged 21 to 75 years. Multivariable linear and logistic regression analyses were used to examine associations between the acculturation level (z-score), obesity, and related lifestyle behaviors, including dietary habits and physical activity. A higher acculturation level was directly associated with a higher prevalence of obesity among Chinese, whereas an inverse association was found for ethnic Indians, and no significant association in Malays. In ethnic Malays, greater acculturation was significantly associated with higher dietary quality and less sedentary time. Furthermore, a high acculturation level was significantly associated with higher sugar-sweetened beverage consumption and more leisure-time PA in all ethnic groups. Our findings suggest that greater cultural orientation towards other ethnic groups was associated with convergence in obesity levels. More research is required to understand how acculturation affects obesity-related lifestyle factors in multi-ethnic settings.
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Affiliation(s)
- Su Hyun Park
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (Y.Q.L.); (F.M.-R.); (B.S.L.D.); (R.M.v.D.)
| | - Yu Qi Lee
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (Y.Q.L.); (F.M.-R.); (B.S.L.D.); (R.M.v.D.)
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (Y.Q.L.); (F.M.-R.); (B.S.L.D.); (R.M.v.D.)
- Digital Health Center, Berlin Institute of Health, Charité-Universitäts Medizin Berlin, 10117 Berlin, Germany
| | - Borame Sue Lee Dickens
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (Y.Q.L.); (F.M.-R.); (B.S.L.D.); (R.M.v.D.)
| | - Rob M. van Dam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (Y.Q.L.); (F.M.-R.); (B.S.L.D.); (R.M.v.D.)
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA
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10
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Cheng ER, Cengiz AY, Miled ZB. Predicting body mass index in early childhood using data from the first 1000 days. Sci Rep 2023; 13:8781. [PMID: 37258628 PMCID: PMC10232444 DOI: 10.1038/s41598-023-35935-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 05/25/2023] [Indexed: 06/02/2023] Open
Abstract
Few existing efforts to predict childhood obesity have included risk factors across the prenatal and early infancy periods, despite evidence that the first 1000 days is critical for obesity prevention. In this study, we employed machine learning techniques to understand the influence of factors in the first 1000 days on body mass index (BMI) values during childhood. We used LASSO regression to identify 13 features in addition to historical weight, height, and BMI that were relevant to childhood obesity. We then developed prediction models based on support vector regression with fivefold cross validation, estimating BMI for three time periods: 30-36 (N = 4204), 36-42 (N = 4130), and 42-48 (N = 2880) months. Our models were developed using 80% of the patients from each period. When tested on the remaining 20% of the patients, the models predicted children's BMI with high accuracy (mean average error [standard deviation] = 0.96[0.02] at 30-36 months, 0.98 [0.03] at 36-42 months, and 1.00 [0.02] at 42-48 months) and can be used to support clinical and public health efforts focused on obesity prevention in early life.
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Affiliation(s)
- Erika R Cheng
- Division of Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine, 410 W. 10th Street, Indianapolis, IN, 46220, USA.
| | - Ahmet Yahya Cengiz
- Department of Computer Science, Purdue School of Science, IUPUI, Indianapolis, IN, USA
| | - Zina Ben Miled
- Department of Electrical and Computer Engineering, School of Engineering and Technology, Indiana University Purdue University at Indianapolis, Indianapolis, IN, USA
- Regenstrief Institute, Inc., Indianapolis, IN, USA
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11
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Wood EK, Stamos G, Mitchell AJ, Gonoud R, Horgan AM, Nomura O, Young A, Nigg JT, Gustafsson HC, Sullivan EL. The association between food desert severity, socioeconomic status, and metabolic state during pregnancy in a prospective longitudinal cohort. Sci Rep 2023; 13:7197. [PMID: 37137940 PMCID: PMC10156695 DOI: 10.1038/s41598-023-32783-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 04/02/2023] [Indexed: 05/05/2023] Open
Abstract
Poor metabolic health during pregnancy is associated with health concerns for pregnant individuals and their offspring. Lower socioeconomic status (SES) is one risk factor for poor metabolic health, and may be related to limited access to healthful and affordable foods (e.g., living in a food desert). This study evaluates the respective contributions of SES and food desert severity on metabolic health during pregnancy. The food desert severity of 302 pregnant individuals was determined using the United States Department of Agriculture Food Access Research Atlas. SES was measured using total household income adjusted for household size, years of education, and amount of reserve savings. Information about participants' glucose concentrations one hour following an oral glucose tolerance test during the second trimester was extracted from medical records and percent adiposity during the second trimester was assessed using air displacement plethysmography. Information about participants' nutritional intake during the second trimester was obtained by trained nutritionists via three unannounced 24-h dietary recalls. Structural equation models showed that lower SES predicted higher food desert severity (β = - 0.20, p = 0.008) and higher adiposity (β = - 0.27, p = 0.016) and consumption of a more pro-inflammatory diet (β = - 0.25, p = 0.003) during the second trimester of pregnancy. Higher food desert severity also predicted higher percent adiposity during the second trimester (β = 0.17, p = 0.013). Food desert severity significantly mediated the relationship between lower SES and higher percent adiposity during the second trimester (βindirect = - 0.03, 95% CI [- 0.079, - 0.004]). These findings indicate that access to healthful and affordable foods is a mechanism by which SES contributes to adiposity during pregnancy and may inform interventions intended to improve metabolic health during pregnancy.
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Affiliation(s)
- Elizabeth K Wood
- Department of Psychiatry, Oregon Health & Science University, Portland, USA
| | - Gayle Stamos
- Department of Psychiatry, Oregon Health & Science University, Portland, USA
| | - A J Mitchell
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, USA
| | - Rose Gonoud
- Department of Psychiatry, Oregon Health & Science University, Portland, USA
| | - Angela M Horgan
- Clinical & Translational Research Center, Oregon Health & Science University, Portland, USA
| | - Olivia Nomura
- Department of Psychiatry, Oregon Health & Science University, Portland, USA
| | - Anna Young
- Department of Psychiatry, Oregon Health & Science University, Portland, USA
| | - Joel T Nigg
- Department of Psychiatry, Oregon Health & Science University, Portland, USA
| | - Hanna C Gustafsson
- Department of Psychiatry, Oregon Health & Science University, Portland, USA
| | - Elinor L Sullivan
- Department of Psychiatry, Oregon Health & Science University, Portland, USA.
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, USA.
- Division of Neuroscience, Oregon National Primate Research Center, Portland, USA.
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12
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Allen J. The indirect effects of food insecurity on obesogenic environments. Front Public Health 2023; 10:1052957. [PMID: 36685001 PMCID: PMC9853452 DOI: 10.3389/fpubh.2022.1052957] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 12/16/2022] [Indexed: 01/07/2023] Open
Abstract
Introduction The Centers for Disease Control and Prevention (CDC) estimates 39.8% of United States (US) residents have obesity. This study examined obesity-related factors at the county-level to determine the indirect effects on physical inactivity, insufficient sleep duration, income inequality, food insecurity, on obesity rates. Methodology Using the 2018 Robert Wood Johnson Foundation (RWJF) County Health Rankings data set, a multiple regression analysis was conducted to measure the percentage of the obesity rate explained by physical inactivity, insufficient sleep duration, food insecurity, and income inequality via geographically weighted county means. RWJF combines US federal and state datasets to produce a composite dataset comprised of information primarily from adults over the age of 18 from the 3,143 counties found within US borders. The aggregate county-level data serves as the unit of measure (N = 3,143). The indirect relationships (the product of two direct relationships) between obesity-related variables and obesity were measured and illustrated through a path analysis model. Results This study found the combination of independent variables explained 53% of the obesity rates in the US, R 2 = 0.53, p < 0.001, two-tailed. This study also found that food insecurity has both a direct and indirect effect on obesity, physical inactivity, and insufficient sleep duration. Physical inactivity has a direct effect on obesity and insufficient sleep duration, along with an indirect effect on obesity. Insufficient sleep duration has a direct effect on obesity. Conclusion This analysis found that food insecurity indirectly impacts an obesogenic environment and drives county-level BMI averages. The dataset used for analysis predates the COVID-19 pandemic but presents the effect of food insecurity during a normative year. The findings, though interesting, provide an opportunity for future research.
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Affiliation(s)
- Jeffrey Allen
- Department of Health Science and Public Health, St. Bonaventure University, Allegany, NY, United States
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13
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Adkins-Jackson PB, Burke NJ, Espinosa PR, Ison JM, Goold SD, Rosas LG, Doubeni CA, Brown AF. Inclusionary Trials: A Review of Lessons Not Learned. Epidemiol Rev 2022; 44:78-86. [PMID: 36124656 PMCID: PMC9494445 DOI: 10.1093/epirev/mxac007] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/22/2021] [Accepted: 09/07/2022] [Indexed: 12/29/2022] Open
Abstract
The COVID-19 pandemic revealed weaknesses in the public health infrastructure of the United States, including persistent barriers to engaging marginalized communities toward inclusion in clinical research, including trials. Inclusive participation in clinical trials is crucial for promoting vaccine confidence, public trust, and addressing disparate health outcomes. A long-standing body of literature describes the value of community-based participatory research in increasing marginalized community participation in research. Community-based participatory research emphasizes shared leadership with community members in all phases of the research process, including in the planning and implementation, interpretation, and dissemination. Shared leadership between academic and industry with marginalized communities can assist with inclusive participation in vaccine trials and increase public trust in the development of the vaccines and other therapies used during public emergencies. Nevertheless, epidemiologic and clinical research do not yet have a strong culture of community partnership in the scientific process, which takes time to build and therefore may be difficult to develop and rapidly scale to respond to the pandemic. We outline practices that contribute to a lack of inclusive participation and suggest steps that trialists and other researchers can take to increase marginalized communities' participation in research. Practices include planning for community engagement during the planning and recruitment phases, having regular dialogues with communities about their priorities, supporting them throughout a study, and navigating complex structural determinants of health. Additionally, we discuss how research institutions can support inclusive practices by reexamining their policies to increase participation in clinical trials and instilling institutional trustworthiness.
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Affiliation(s)
- Paris B Adkins-Jackson
- Correspondence to Dr. Paris Adkins-Jackson, Department of Epidemiology, Mailman School of Public Health, 722 W. 168th Street, New York, NY 10032 (e-mail: )
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14
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Pauuvale AF, Vickers MH, Pamaka S, Apelu D, Fehoko ‘A, ‘Ofanoa M, Bay JL. Exploring the Retail Food Environment Surrounding Two Secondary Schools with Predominantly Pacific Populations in Tonga and New Zealand to Enable the Development of Mapping Methods Appropriate for Testing in a Classroom. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15941. [PMID: 36498013 PMCID: PMC9739248 DOI: 10.3390/ijerph192315941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 11/14/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Rates of noncommunicable diseases (NCDs) are disproportionately high among people of Pacific ethnicity. Nutrition-related environmental exposures including food access and quality contribute to the matrix of factors impacting risk. Preventative interventions in adolescence and the opportunity to integrate health promotion into school-based learning are often overlooked. This study tested the potential of a low-cost method to map the retail food environment in a 1 km radius of two secondary schools in low socioeconomic communities with predominantly Pacific populations, in Tonga and New Zealand (NZ). Mapping utilized Google Earth, Google Maps, government maps, and observations. A rubric was developed to categorize food quality. Outlets within a 1 km radius of each school, (Tonga, n = 150; NZ, n = 52) stocked predominantly unhealthy foods. The NZ data compared favorably to previous studies, indicating the method was valid. The Tongan data is novel and indicates that alternative strategies can be used when access to GIS-type tools is limited. The method produced visual data that has the potential to be analyzed using strategies appropriate for secondary schools. The method should now be tested in classrooms to assess its potential to support school-age students to engage in mapping and critiquing the retail food environment.
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Affiliation(s)
- Alvina F. Pauuvale
- Liggins Institute, University of Auckland, Auckland 1142, New Zealand
- School of Population Health, University of Auckland, Auckland 1142, New Zealand
| | - Mark H. Vickers
- Liggins Institute, University of Auckland, Auckland 1142, New Zealand
| | | | | | | | - Malakai ‘Ofanoa
- School of Population Health, University of Auckland, Auckland 1142, New Zealand
| | - Jacquie L. Bay
- Liggins Institute, University of Auckland, Auckland 1142, New Zealand
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15
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Bhattacharya P, Klein MD, Beck AF, Xu Y, Kharofa RY. Associations Between Age of Onset of Pediatric Overweight/Obesity, a Child’s Sociodemographic Characteristics, and Characteristics of a Child’s Home Census Tract. Am J Health Promot 2022:8901171221138276. [DOI: 10.1177/08901171221138276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Purpose To identify associations between age of onset of overweight/obesity, a child’s sociodemographic characteristics, and characteristics of a child’s home census tract. Design Retrospective electronic health record review of children with overweight/obesity. Setting Three primary care centers associated with a free-standing, tertiary-care pediatric institution in Cincinnati. Subjects Patients born between August 1, 2013 and July 31, 2014, who had a body mass index (BMI) ≥85th percentile before 5 years of age (n = 794). Measures Primary outcome was the patient’s age at the first encounter when BMI was ≥85th percentile. Patient-level predictors were sex, age, race/ethnicity, health insurance, and number of moves captured in the health record. Census tract-level predictors were density of bus stops, presence of grocery stores, and a Socioeconomic Deprivation Index. Analysis Multivariable linear regression models assessed for independent associations between age of onset of overweight/obesity and predictors. Results Patients were 55.8% female, 73.6% black, and 79.1% publicly insured. Each additional move per year was associated with onset of overweight/obesity occurring 4.05 months earlier ( P < .0001). No significant associations between age of onset of overweight/obesity and census tract-level density of bus stops ( P = .82), presence of grocery stores ( P = .39), and socioeconomic deprivation ( P = .53) were demonstrated. Conclusion Public policy efforts toward improving access to grocery stores or public transportation may not be sufficient to prevent childhood obesity. Population-level interventions related to improving housing may also reduce obesity.
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Affiliation(s)
| | - Melissa D. Klein
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Andrew F. Beck
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Yingying Xu
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Roohi Y. Kharofa
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
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16
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Movement Is Life-Optimizing Patient Access to Total Joint Arthroplasty: Obesity Disparities. J Am Acad Orthop Surg 2022; 30:1028-1035. [PMID: 35171875 DOI: 10.5435/jaaos-d-21-00424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 12/24/2021] [Indexed: 02/01/2023] Open
Abstract
Thirty five percent of the American population is considered obese (body mass index [BMI] > 30). Obesity disproportionately affects African Americans, Hispanics, and women. Obesity is associated with postoperative complications, including wound complications, infections, and revision total joint arthroplasty (including total hip arthroplasty and total knee arthroplasty). Current BMI benchmarks (many institutions rely on a BMI of 40) selectively preclude patients from having surgery. Patients in these underserved populations can be optimized through the lens of shared decision making through the assessment of food security (eg, food deserts and food swamps), ability to afford healthy food, knowledge of social safety net and community resources to access healthy food, nutrition and weight loss referrals to programs that accept all forms of insurance, weight loss measurements as a percentage of body weight lost instead of BMI cutoffs, pharmacologic modalities, and bariatric surgery.
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17
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Eskandari F, Lake AA, Rose K, Butler M, O'Malley C. A mixed-method systematic review and meta-analysis of the influences of food environments and food insecurity on obesity in high-income countries. Food Sci Nutr 2022; 10:3689-3723. [PMID: 36348796 PMCID: PMC9632201 DOI: 10.1002/fsn3.2969] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 05/26/2022] [Accepted: 06/17/2022] [Indexed: 11/10/2022] Open
Abstract
Obesity remains a serious public health concern in rich countries and the current obesogenic food environments and food insecurity are predictors of this disease. The impact of these variables on rising obesity trends is, however, mixed and inconsistent, due to measurement issues and cross-sectional study designs. To further the work in this area, this review aimed to summarize quantitative and qualitative data on the relationship between these variables, among adults and children across high-income countries. A mixed-method systematic review was conducted using 13 electronic databases, up to August 2021. Two authors independently extracted data and evaluated quality of publications. Random-effects meta-analysis was used to estimate the odds ratio (OR) for the association between food insecurity and obesity. Where statistical pooling for extracted statistics related to food environments was not possible due to heterogeneity, a narrative synthesis was performed. Meta-analysis of 36,113 adults and children showed statistically significant associations between food insecurity and obesity (OR: 1.503, 95% confidence interval: 1.432-1.577, p < .05). Narrative synthesis showed association between different types of food environments and obesity. Findings from qualitative studies regarding a reliance on energy-dense, nutrient-poor foods owing to their affordability and accessibility aligned with findings from quantitative studies. Results from both qualitative and quantitative studies regarding the potential links between increased body weight and participation in food assistance programs such as food banks were supportive of weight gain. To address obesity among individuals experiencing food insecurity, wide-reaching approaches are required, especially among those surrounded by unhealthy food environments which could potentially influence food choice.
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Affiliation(s)
- Fatemeh Eskandari
- Centre for Public Health Research, School of Health and Life SciencesTeesside UniversityMiddlesbroughUK
- Fuse ‐ The Centre for Translational Research in Public HealthNewcastle upon TyneUK
| | - Amelia A. Lake
- Centre for Public Health Research, School of Health and Life SciencesTeesside UniversityMiddlesbroughUK
- Fuse ‐ The Centre for Translational Research in Public HealthNewcastle upon TyneUK
| | - Kelly Rose
- Centre for Public Health Research, School of Health and Life SciencesTeesside UniversityMiddlesbroughUK
- Fuse ‐ The Centre for Translational Research in Public HealthNewcastle upon TyneUK
| | - Mark Butler
- Centre for Public Health Research, School of Health and Life SciencesTeesside UniversityMiddlesbroughUK
| | - Claire O'Malley
- Centre for Public Health Research, School of Health and Life SciencesTeesside UniversityMiddlesbroughUK
- Fuse ‐ The Centre for Translational Research in Public HealthNewcastle upon TyneUK
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18
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Dasari SS, Archer M, Mohamed NE, Tewari AK, Figueiro MG, Kyprianou N. Circadian Rhythm Disruption as a Contributor to Racial Disparities in Prostate Cancer. Cancers (Basel) 2022; 14:cancers14205116. [PMID: 36291899 PMCID: PMC9600368 DOI: 10.3390/cancers14205116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/08/2022] [Accepted: 10/15/2022] [Indexed: 01/27/2023] Open
Abstract
In the United States, African American (AA) men have a 2.4 times higher mortality rate due to prostate cancer than White men. The multifactorial causes of the racial disparities in prostate cancer involve various social determinants of health, socioeconomic status, and access to healthcare. However, emerging evidence also suggests that circadian rhythm disruption (CRD) contributes to prostate cancer, and AA men may be more susceptible to developing CRDs. Circadian rhythms play a significant role in metabolism, hormone secretion, and sleep/wake cycles. Disruption in these circadian rhythms can be caused by airplane travel/jetlag, night shift work, exposure to light, and neighborhood noise levels, which can contribute to sleep disorders and chronic conditions such as obesity, diabetes, cardiovascular disease, and depression. The drivers of the racial disparities in CRD include night shift work, racial discrimination, elevated stress, and residing in poor neighborhoods characterized by high noise pollution. Given the increased vulnerability of AA men to CRDs, and the role that CRDs play in prostate cancer, elucidating the clock-related prostate cancer pathways and their behavior and environmental covariates may be critical to better understanding and reducing the racial disparities in prostate cancer.
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Affiliation(s)
- Sonali S. Dasari
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Maddison Archer
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Nihal E. Mohamed
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Tisch Cancer Institute, Mount Sinai Health, New York, NY 10029, USA
| | - Ashutosh K. Tewari
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Tisch Cancer Institute, Mount Sinai Health, New York, NY 10029, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Mariana G. Figueiro
- Tisch Cancer Institute, Mount Sinai Health, New York, NY 10029, USA
- Light and Health Research Center, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Correspondence: (M.G.F.); (N.K.)
| | - Natasha Kyprianou
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Tisch Cancer Institute, Mount Sinai Health, New York, NY 10029, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Correspondence: (M.G.F.); (N.K.)
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19
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Choi YJ, Crimmins EM, Ailshire JA. Food insecurity, food environments, and disparities in diet quality and obesity in a nationally representative sample of community-dwelling older Americans. Prev Med Rep 2022; 29:101912. [PMID: 35911578 PMCID: PMC9326331 DOI: 10.1016/j.pmedr.2022.101912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/07/2022] [Accepted: 07/18/2022] [Indexed: 11/29/2022] Open
Abstract
Food insecurity, reflecting a household's low ability to purchase healthy food, is a public health concern that is associated with poor diet and obesity. Poor food environments, characterized as a neighborhood with low access to healthy, affordable food, may amplify the negative impact of food insecurity on diet and obesity. This study aims to investigate whether food insecurity and food environments are jointly associated with an increased risk of poor diet quality and obesity. We used data from a nationally representative sample of community-dwelling older adults in the Health and Retirement Study Health Care and Nutrition Survey and the National Neighborhood Data Archive to investigate the role of household and neighborhood characteristics on diet and obesity. Weighted regression models were estimated to examine the relationship between food insecurity and food environments as well as their interaction with diet quality and obesity. Food insecure respondents had lower Healthy Eating Index scores and were more likely to be obese than food secure respondents. Living in a poor food environment was associated with lower Healthy Eating Index scores, but not with obesity. We did not find any interaction between food insecurity and food environment in determining either healthy eating or obesity. Reducing food insecurity and increasing access to healthy food environments may encourage healthier eating among older adults, while alleviating food-related hardship may also reduce their obesity risk.
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Affiliation(s)
- Yeon Jin Choi
- Leonard Davis School of Gerontology, University of Southern California, 3715 McClintock Avenue #218, Los Angeles, CA, USA
| | - Eileen M. Crimmins
- Leonard Davis School of Gerontology, University of Southern California, 3715 McClintock Avenue #218, Los Angeles, CA, USA
| | - Jennifer A. Ailshire
- Leonard Davis School of Gerontology, University of Southern California, 3715 McClintock Avenue #218, Los Angeles, CA, USA
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20
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Pysmenna O, Anderson KM. Income and Health Perceptions in an Economically Disadvantaged Community: A Qualitative Case Study from Central Florida. INTERNATIONAL JOURNAL OF COMMUNITY WELL-BEING 2022; 5:687-710. [PMID: 35996742 PMCID: PMC9387410 DOI: 10.1007/s42413-022-00177-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 07/20/2022] [Indexed: 11/03/2022]
Abstract
The link between income and adverse health outcomes continues to be problematic among racially and economically segregated urban communities. Although the consequences of living in areas of concentrated disadvantage have been delineated, there is a dearth of knowledge on how citizens from such areas perceive the effects of neighborhood characteristics on their individual and community health. This qualitative study explored how minority residents ( N = 23) viewed the intersectionality of income and health within their urban neighborhoods of economic distress. Focus groups were conducted using semi-structured interviews to better understand health concerns, needs, and barriers for individuals and their community. The main finding highlighted how residents desired to be healthy, but economic barriers prevented them from maintaining a healthy lifestyle and diet. While residing in a concentrated disadvantaged community, lack of income and power contributed to stress and fear that forced residents to prioritize survival over their wellbeing. Implications for improving individual and community health include operating within a systems framework to affect collective efficacy and empowerment among residents of low-income neighborhoods.
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21
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Greenwald HP, Tao E, Tilley G. Farmers' Market Incentives for Low-Income Families: Who Uses, How Much, and Why. Am J Prev Med 2022; 62:864-871. [PMID: 35597565 DOI: 10.1016/j.amepre.2021.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 10/22/2021] [Accepted: 11/30/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Focusing on participation and utilization, this research helps to assess the potential impact and contributions of farmers' market incentive programs, often seen as means for improving nutrition and preventing disease among low-income families. METHODS Evaluating the largest farmers' market incentive program in the U.S. (California Market Match), this study used (1) 3 administrative databases (n=1,469, 6,799, and 30,506), (2) a participant survey (n=2,723), and (3) longitudinal interviews (n=163) with active and former participants. Quantitative data were analyzed with contingency tables and multiple regression. Qualitative data were coded into analytically significant themes. Data were collected in 2015-2018 and analyzed in 2018-2021. RESULTS Participation was typically low and varied across localities (3.7%-19.8% of eligible families in a sample of ZIP codes). According to administrative records, market visits by participants in 2 California regions averaged 2.18 and 3.12 per season. However, 77.1% of participants in the shopper survey indicated that they were repeat customers, and 51.0% indicated that they were regular utilizers. Deterrents to utilization included perceptions of inconvenience and high prices but not availability of produce in the community or travel time to markets. Utilization was most frequent among Asian shoppers and residents of Southern California outside Los Angeles County. CONCLUSIONS Farmers' market incentive programs such as Market Match appear likely to benefit population health through a core of committed shoppers. Improvement in participation and utilization may be attained through a better understanding of the communities that the markets are intended to serve.
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Affiliation(s)
- Howard P Greenwald
- Sol Price School of Public Policy, University of Southern California, Los Angeles, California.
| | - Ernie Tao
- Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
| | - Gabrielle Tilley
- The Los Angeles Trust for Children's Health, Los Angeles, California
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22
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Browne NT, Hodges EA, Small L, Snethen JA, Frenn M, Irving SY, Gance-Cleveland B, Greenberg CS. Childhood obesity within the lens of racism. Pediatr Obes 2022; 17:e12878. [PMID: 34927392 DOI: 10.1111/ijpo.12878] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 11/28/2021] [Accepted: 12/03/2021] [Indexed: 11/30/2022]
Abstract
Despite decades of research and a multitude of prevention and treatment efforts, childhood obesity in the United States continues to affect nearly 1 in 5 (19.3%) children, with significantly higher rates among Black, Indigenous, and People of Colour communities. This narrative review presents social foundations of structural racism that exacerbate inequity and disparity in the context of childhood obesity. The National Institute of Minority Health and Health Disparities' Research Framework guides the explication of structurally racist mechanisms that influence health disparities and contribute to childhood obesity: biologic and genetic, health behaviours, chronic toxic stress, the built environment, race and cultural identity, and the health care system. Strategies and interventions to combat structural racism and its effects on children and their families are reviewed along with strategies for research and implications for policy change. From our critical review and reflection, the subtle and overt effects of societal structures sustained from years of racism and the impact on the development and resistant nature of childhood obesity compel concerted action.
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Affiliation(s)
| | - Eric A Hodges
- UNC-Chapel Hill School of Nursing, Chapel Hill, North Carolina, USA
| | - Leigh Small
- Michigan State University College of Nursing, East Lansing, Michigan, USA
| | - Julia A Snethen
- University of Wisconsin-Milwaukee, College of Nursing, Milwaukee, Wisconsin, USA
| | - Marilyn Frenn
- Marquette University College of Nursing, Milwaukee, Wisconsin, USA
| | - Sharon Y Irving
- Pediatric Nursing, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA.,Pediatric Critical Care, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | | | - Cindy Smith Greenberg
- College of Health and Human Development, California State University, Fullerton, California, USA
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23
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Social Determinants of Kidney Stone Disease: The Impact of Race, Income and Access on Urolithiasis Treatment and Outcomes. Urology 2022; 163:190-195. [PMID: 34506806 DOI: 10.1016/j.urology.2021.08.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/23/2021] [Accepted: 08/27/2021] [Indexed: 01/11/2023]
Abstract
The medical and surgical management of kidney stones is one of the most common functions of the urologist. Management choices are often nuanced, involving the decision to embark on one surgical plan among several options. As the wider medical community critically evaluates the care we provide to an increasingly diverse population, it will be important to examine patient outcomes with a particular focus on ensuring equitable care. This review examines the influence of social parameters on the care of kidney stone patients. The dearth of literature in this area warrants rigorous studies on the relationship between race as well as socioeconomic status and the management of kidney stone disease.
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24
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Fraser T, Aldrich DP, Panagopoulos C, Hummel D, Kim D. The harmful effects of partisan polarization on health. PNAS NEXUS 2022; 1:pgac011. [PMID: 36712795 PMCID: PMC9802430 DOI: 10.1093/pnasnexus/pgac011] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 09/26/2021] [Accepted: 02/11/2022] [Indexed: 02/01/2023]
Abstract
Partisan polarization significantly drives stress and anxiety among Americans, and recent aggregate-level studies suggest polarization may be shaping their health. This individual-level study uses a new representative dataset of 2,752 US residents surveyed between December 2019 and January 2020, some US residents report more days of poor physical and mental health per month than others. Using negative binomial models, zero inflated models, and visualizations, we find evidence that polarization is linked to declines in physical health: the more distant an individual feels politically from the average voter in their state, the worse health outcomes he or she reports. By uncovering the individual-level political correlates of health, this study aims to encourage further study and attention to the broader consequences of political polarization on American communities.
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Affiliation(s)
- Timothy Fraser
- To whom correspondence should be addressed: 960A Renaissance Park, 360 Huntington Ave, Boston, MA 02115.
| | - Daniel P Aldrich
- Political Science Department, Northeastern University, Boston, MA 02115, USA
| | - Costas Panagopoulos
- Political Science Department, Northeastern University, Boston, MA 02115, USA
| | - David Hummel
- Economics Department, Northeastern University, Boston, MA 02115, USA
| | - Daniel Kim
- Bouve College of Health Sciences, Northeastern University, Boston, MA 02115, USA
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Fuligni GL, Gonzalez CJ, Figueroa R. Adolescents' proxy reports on obesity-related parenting practices: factorial validity and reliability across four behavioral domains. BMC Public Health 2022; 22:329. [PMID: 35172801 PMCID: PMC8848982 DOI: 10.1186/s12889-022-12745-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 02/09/2022] [Indexed: 11/18/2022] Open
Abstract
Background Adolescents’ energy balance behaviors are precursors to obesity shaped by the practices or strategies that many parents implement. Although key stakeholders to their families, adolescents are rarely considered to report on these obesity-related parenting practices. The aim of this study is to assess the factorial and predictive validity of adolescents’ proxy-report of parents’ obesity-related parenting across four behavioral domains. Methods This study used data from the Family Life, Activity, Sun, Health, and Eating (FLASHE) study. This study tests whether adolescents’ proxy reports about their parents’ obesity-related parenting are significantly associated with parents’ responses on their own obesity-related parenting, as well as whether these reports are significantly associated to parent-adolescent energy balance behaviors. Factorial validity was assessed using linear regression and Confirmatory Factor Analysis (CFA), whereas predictive validity was assessed using Actor-Partner Interdependence Modeling (APIM). Results Regression results indicated that adolescents’ proxy report is significantly associated with parents’ report of their own parenting in all four domains (β = .59—.71; p < 0.05). CFA results indicated a final factor structure that loaded significantly onto hypothesized obesity-related parenting domains (β > .30) in both adolescents and parents. APIM results indicated that both parent- (β = .32; p < 0.05) and adolescent-(β = .21; p < 0.05) reported obesity parenting for fruit and vegetable consumption were associated with their own fruit and vegetable intake. In addition, adolescent-reported physical activity parenting was significantly associated with adolescent physical activity (β = 0.23; p < 0.05). Regarding partner effects, only parent-reported parenting for fruit and vegetable consumption were significantly associated with adolescent intake of fruit and vegetables (β = 0.15, p < 0.05) and adolescent-reported physical activity parenting was significantly associated with parental physical activity (β = 0.16, p < 0.05). Neither adolescent nor parent reported parenting were significantly associated with screen time or junk food intake outcomes. Each final obesity-related parenting scale had good internal consistency (a = .74-.85). Conclusions We found that adolescent- and parent-reported obesity-related parenting were significantly associated, while adolescent-reported parenting were more explanatory of fruit and vegetable intake and physical activity than parent-reported parenting. These findings suggest that adolescent proxy reports may be a valid source of information on obesity-related parenting.
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Affiliation(s)
- Gabriel L Fuligni
- College of Human Ecology, Division of Nutritional Sciences, Cornell University, 244 Garden Avenue, Ithaca, NY, 14853, USA
| | - Christopher J Gonzalez
- Division of General Internal Medicine, Weill Cornell Medicine, 338 E 66th Street, New York, NY, USA.,Division of General Internal Medicine, 338 E 66th Street, New York, NY, 10065, USA
| | - Roger Figueroa
- College of Human Ecology, Division of Nutritional Sciences, Cornell University, 244 Garden Avenue, Ithaca, NY, 14853, USA.
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Bayne D, Srirangapatanam S, Hicks CR, Armas-Phan M, Showen A, Suskind A, Seligman H, Bibbins-Domingo K, Stoller M, Chi TL. Community Income, Healthy Food Access, and Repeat Surgery for Kidney Stones. Urology 2022; 160:51-59. [PMID: 34813836 PMCID: PMC9851910 DOI: 10.1016/j.urology.2021.11.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To determine if limited food access census tracts and food swamp census tracts are associated with increased risk for repeat kidney stone surgery. And to elucidate the relationship between community-level food retail environment relative to community-level income on repeat stone surgery over time. METHODS Data were abstracted from the University of California, San Francisco Information Commons. Adult patients were included if they underwent at least one urologic stone procedure. Census tracts from available geographical data were mapped using Food Access Research Atlas data from the United States Department of Agriculture Economic Research Service. Kaplan-Meier curves were employed to illustrate time to a second surgical procedure over 5 years, and log-rank tests were used to test for statistically significant differences. A multivariate Cox regression model was used to generate hazard ratios for undergoing second surgery by group. RESULTS A total of 1496 patients were included in this analysis. Repeat stone surgery occurred in 324 patients. Kaplan-Meier curves demonstrated a statistically significant difference in curves depicting patients living in low income census tracts (LICTs) vs those not living in LICTs (P <.001). On Cox regression models, patients in LICTs had significantly higher risk of undergoing repeat surgery (P = .011). Patients from limited food access census tracts and food swamp census tracts did not have a significantly higher adjusted risk of undergoing second surgery (P = .11 and P = .88, respectively). CONCLUSION Income more so than food access associates with increased risk of repeat kidney stone surgery. Further research is needed to explore the interaction between low socioeconomic status and kidney stone outcomes.
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Affiliation(s)
- David Bayne
- Urology, University of California San Francisco, San Francisco, CA.
| | | | - Cameron R Hicks
- Urology, University of California San Francisco, San Francisco, CA
| | | | - Amy Showen
- Urology, University of California San Francisco, San Francisco, CA
| | - Anne Suskind
- Urology, University of California San Francisco, San Francisco, CA
| | - Hilary Seligman
- Urology, University of California San Francisco, San Francisco, CA
| | | | - Marshall Stoller
- Urology, University of California San Francisco, San Francisco, CA
| | - Thomas L Chi
- Urology, University of California San Francisco, San Francisco, CA
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Obesity, Body Image Dissatisfaction, and Sexual Dysfunction: A Narrative Review. SEXES 2022. [DOI: 10.3390/sexes3010002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
With approximately two-thirds of the United States adult population classified as overweight or obese, obesity remains a critical public health concern. Obesity not only contributes to several health complications including type 2 diabetes mellitus and cardiovascular disease, but the condition is also associated with sexual dysfunction in both women and men. Despite evidence linking obesity and its concomitant pathophysiology to sexual problems, the potential roles of psychosocial factors such as body image are understudied. This narrative review evaluates the research linkages between obesity and sexual dysfunction, with particular attention to the potential effects of body image dissatisfaction. A literature search of biomedical and psychological databases was used to identify research pertaining to obesity, sexual function, and/or body image constructs. The pathophysiological effects of obesity on sexual function are well-documented in mechanistic studies and animal trials, often with corroboration in human clinical samples. However, very few studies examine obesity, body image, and sexual function in tandem. Body image dissatisfaction appears to independently impinge upon the sexual response cycle and mental health outcomes, irrespective of body weight. While obesity is often associated with negative body image appraisal, it is unclear whether these constructs exert additive, synergistic, or antagonistic effects on sexual responsivity. Additionally, overweight/obese individuals who exhibit higher levels of body image satisfaction or self-confidence appear to be protected from the deleterious effects of obesity on sexual satisfaction, at least to some extent. Greater reliance upon conceptual/theoretical models from the body image literature may better clarify the relationships between these constructs.
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Ghazaryan A, Carlson A, Rhone AY, Roy K. Association between the Nutritional Quality of Household At-Home Food Purchases and Chronic Diseases and Risk Factors in the United States, 2015. Nutrients 2021; 13:nu13093260. [PMID: 34579136 PMCID: PMC8468462 DOI: 10.3390/nu13093260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/11/2021] [Accepted: 09/16/2021] [Indexed: 11/23/2022] Open
Abstract
Lower diet quality is a leading preventable risk factor for obesity and chronic diseases. This study assesses differences in the nutritional quality of at-home food purchases, using the Healthy Eating Index (HEI)-2015 and its components, among households with and without a member reporting type 2 diabetes (T2D), cardiovascular disease (CVD), obesity, and/or smoking. We use the 2015 IRI Consumer Network nationally representative household food purchase scanner data, combined with the IRI MedProfiler and the USDA’s Purchase-to-Plate Crosswalk datasets. For each/multiple condition(s), the difference in mean HEI score adjusted for covariates is tested for equivalence with the respective score against households without any member with the condition(s). The HEI score is higher for households without a member with reported T2D (2.4% higher), CVD (3.2%), obesity (3.3%), none of the three conditions (6.1%, vs. all three conditions), and smoking (10.5%) than for those with a member with the respective condition. Households with a member with T2D score better on the added sugar component than those with no member reporting T2D. We found that the average food purchase quality is lower than the recommended levels, especially for households with at least one member reporting a chronic condition(s).
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Affiliation(s)
- Armen Ghazaryan
- Office of the Director (OD), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), Atlanta, GA 30341, USA
| | - Andrea Carlson
- Economic Research Service (ERS), United States Department of Agriculture (USDA), Washington, DC 20024, USA
| | - Alana Y Rhone
- Economic Research Service (ERS), United States Department of Agriculture (USDA), Washington, DC 20024, USA
| | - Kakoli Roy
- Office of the Director (OD), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), Atlanta, GA 30341, USA
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High BMI Predicts Attention to Less Healthy Product Sets: Can a Prompt Lead to Consideration of Healthier Sets of Products? Nutrients 2021; 13:nu13082620. [PMID: 34444780 PMCID: PMC8400244 DOI: 10.3390/nu13082620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/19/2021] [Accepted: 07/27/2021] [Indexed: 01/08/2023] Open
Abstract
While the food environment has been implicated in diet-related health disparities, individuals’ ability to shape the food environment by limiting attention to a subset of products has not been studied. We examine the relationship between BMI category and consideration set—the products the individual considers before making a final choice—in an online hypothetical shopping experiment. Specifically, we focus on the healthiness of the consideration set the individual selected. Secondly, we examined the interaction of a health prompt (versus a no-prompt control) with BMI category on the healthiness of the consideration set. We used linear probability models to document the relationship between weight status and consideration set, between prompt and consideration set, and the effect of the interaction between prompt and weight status on consideration set. We found that (1) obese individuals are 10% less likely to shop from a consideration set that includes the healthy options, (2) viewing the prompt increased the probability of choosing a healthy consideration set by 9%, and (3) exposure to the prompt affected individuals in different BMI categories equally. While obese individuals are more likely to ignore healthier product options, a health-focused prompt increases consideration of healthy options across all BMI categories.
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Fan L, Canales E, Fountain B, Buys D. An Assessment of the Food Retail Environment in Counties with High Obesity Rates in Mississippi. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2021. [DOI: 10.1080/19320248.2020.1852147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Linlin Fan
- Department of Agricultural Economics, Sociology and Education, Pennsylvania State University, State College, Pennsylvania, USA
| | - Elizabeth Canales
- Department of Agricultural Economics, Mississippi State University, Starkville, Mississippi, USA
| | - Brent Fountain
- Department of Food Science, Nutrition and Health Promotion, Mississippi State University, Starkville, Mississippi, USA
| | - David Buys
- Department of Food Science, Nutrition and Health Promotion, Mississippi State University, Starkville, Mississippi, USA
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Gray HL, Berumen JH, Lovett SM, Himmelgreen D, Biswas D, Bohn J, Peacock C, Buro AW. A Mixed-methods Study to Understand Food Environments and Grocery Shopping Patterns of Community Residents in Underserved Neighborhoods in Tampa, Florida. Ecol Food Nutr 2021; 60:435-453. [PMID: 33356564 DOI: 10.1080/03670244.2020.1862098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
A mixed methods study was conducted to better understand food access, food retail store environment, and perspectives of community residents on their grocery store shopping patterns and access to healthy foods in underserved, predominantly African American neighborhoods. GIS mapping, grocery store observations (n = 4), a food access and grocery store environment survey (n = 126), and focus groups (n = 48) were used. The results indicate that these neighborhoods have a low density of grocery stores, and only two out of four grocery stores meet the standard for a healthy retail store. Barriers to getting healthy foods and solutions to improve food access are discussed.
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Affiliation(s)
- Heewon L Gray
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Jessica H Berumen
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Sharonda M Lovett
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - David Himmelgreen
- Department of Anthropology and the Center for the Advancement of Food Security & Healthy Communities, College of Arts and Sciences, University of South Florida, Tampa, Florida, USA
| | - Dipayan Biswas
- School of Marketing and Innovation, Muma College of Business, University of South Florida, Tampa, Florida, USA
| | - Joe Bohn
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | | | - Acadia W Buro
- College of Public Health, University of South Florida, Tampa, Florida, USA
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32
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Chiu BC, Olson ME, Fahey JW. Exploring the use of
Moringa oleifera
as a vegetable in Agua Caliente Nueva, Jalisco, Mexico: A qualitative study. FOOD FRONTIERS 2021. [DOI: 10.1002/fft2.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Belinda C. Chiu
- Johns Hopkins University Bloomberg School of Public Health Department of International Health Baltimore Maryland USA
| | - Mark E. Olson
- Instituto de Biología Universidad Nacional Autónoma de México Tercer Circuito s/n de Ciudad Universitaria Ciudad de México 04510 Mexico
| | - Jed W. Fahey
- Johns Hopkins University School of Medicine Department of Medicine Division of Clinical Pharmacology Department of Pharmacology and Molecular Sciences Lewis B. & Dorothy Cullman Chemoprotection Center, Bloomberg School of Public Health Department of International Health Center for Human Nutrition Baltimore Maryland USA
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Moughames E, Woo H, Galiatsatos P, Romero-Rivero K, Raju S, Tejwani V, Hoffman EA, Comellas AP, Ortega VE, Parekh T, Krishnan JA, Drummond MB, Couper D, Buhr RG, Paine R, Kaufman JD, Paulin LM, Putcha N, Hansel NN. Disparities in access to food and chronic obstructive pulmonary disease (COPD)-related outcomes: a cross-sectional analysis. BMC Pulm Med 2021; 21:139. [PMID: 33906617 PMCID: PMC8077917 DOI: 10.1186/s12890-021-01485-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/22/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Millions of Americans are living in food deserts in the United States, however the role of the local food environment on COPD has not been studied. The aim of this study is to determine the association between food deserts and COPD-related outcomes. METHOD In this cross-sectional analysis we linked data collected from SPIROMICS (SubPopulations and InteRmediate Outcome Measures in COPD Study) between 2010 and 2015 and food desert data, defined as an underserved area that lacks access to affordable healthy foods, from the Food Access Research Atlas. COPD outcomes include percentage of predicted forced expiratory volume in one second (FEV1%), St. George's Respiratory Questionnaire (SGRQ), COPD Assessment Test (CAT), 6-min walk distance test (6MWD), exacerbations, and air trapping. We used generalized linear mixed models to evaluate the association between living in food deserts and respiratory outcomes, adjusting for age, gender, race, education, income, marital status, BMI, smoking status, pack years, and urban status RESULTS: Among 2713 participants, 22% lived in food deserts. Participants living in food deserts were less likely to be white and more likely to have a lower income than those who did not live in food deserts. In the adjusted model controlling for demographics and individual income, living in food deserts was associated lower FEV1% (β = - 2.51, P = 0.046), higher air trapping (β = 2.47, P = 0.008), worse SGRQ (β = 3.48, P = 0.001) and CAT (β = 1.20, P = 0.003) scores, and 56% greater odds of severe exacerbations (P = 0.004). Results were consistent when looking at food access alone, regardless of whether participants lived in low income areas. CONCLUSIONS Findings suggest an independent association between food desert and food access alone with COPD outcomes. Health program planning may benefit from addressing disparities in access to food.
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Affiliation(s)
- Eric Moughames
- Department of Medicine, Johns Hopkins University, 4940 Eastern Avenue, Baltimore, MD, 21224, USA.
| | - Han Woo
- Division of Pulmonary and Critical Care, Johns Hopkins University, 4940 Eastern Avenue, Baltimore, MD, 21224, USA
| | - Panagis Galiatsatos
- Division of Pulmonary and Critical Care, Johns Hopkins University, 4940 Eastern Avenue, Baltimore, MD, 21224, USA
| | - Karina Romero-Rivero
- Division of Pulmonary and Critical Care, Johns Hopkins University, 4940 Eastern Avenue, Baltimore, MD, 21224, USA
| | - Sarath Raju
- Division of Pulmonary and Critical Care, Johns Hopkins University, 4940 Eastern Avenue, Baltimore, MD, 21224, USA
| | - Vickram Tejwani
- Division of Pulmonary and Critical Care, Johns Hopkins University, 4940 Eastern Avenue, Baltimore, MD, 21224, USA
| | - Eric A Hoffman
- Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
| | | | - Victor E Ortega
- Department of Medicine, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Trisha Parekh
- Department of Medicine, University of Alabama, Birmingham, AL, USA
| | - Jerry A Krishnan
- Department of Medicine, University of Illinois, Chicago, IL, USA
| | - Michael B Drummond
- Department of Medicine, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
| | - David Couper
- Department of Biostatistics, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
| | - Russell G Buhr
- Department of Medicine, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA, USA
| | - Robert Paine
- Department of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Joel D Kaufman
- Department of Medicine and Epidemiology, University of Washington, Seattle, WA, USA
| | - Laura M Paulin
- Department of Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
| | - Nirupama Putcha
- Division of Pulmonary and Critical Care, Johns Hopkins University, 4940 Eastern Avenue, Baltimore, MD, 21224, USA
| | - Nadia N Hansel
- Division of Pulmonary and Critical Care, Johns Hopkins University, 4940 Eastern Avenue, Baltimore, MD, 21224, USA
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Dhakal CK, Khadka S. Heterogeneities in Consumer Diet Quality and Health Outcomes of Consumers by Store Choice and Income. Nutrients 2021; 13:1046. [PMID: 33804858 PMCID: PMC8063805 DOI: 10.3390/nu13041046] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/08/2021] [Accepted: 03/23/2021] [Indexed: 12/02/2022] Open
Abstract
Obesity and other diet-related health conditions have received much attention in the public health literature over the past two decades. This study investigates the relationship between household food budget shares at different food outlets with diet quality and weight-related health outcomes in the United States. Our analysis used event-level food purchase data from the national household food acquisition and purchases survey (FoodAPS). We find that, after controlling for observables, food purchase location is significantly associated with diet quality and body mass index (BMI). Our findings indicate that larger food budget shares at convenience stores and restaurants are linked with poor diet quality based on the healthy eating index-2015 (HEI-2015) scores and higher BMI. We further explored potential heterogeneity on outcomes of interest across income groups. Results suggest heterogeneous effects may exist across income groups: low-income households, who spent a larger share of their food budget at convenience stores and fast-food restaurants are related to poor diet quality and more likely to be obese. Our findings will help improve understanding of the causes of diet-related health problems and may illuminate potential avenues of intervention to address obesity.
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Affiliation(s)
- Chandra K. Dhakal
- Department of Agricultural and Applied Economics, University of Georgia, Athens, GA 30602, USA;
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Abstract
Physical access to services and employment opportunities shapes the lives of people everywhere. For 3.4 billion people living in rural locations, the size of nearby urban centers and the associated travel time affect the breadth of services and opportunities available and their accessibility. We identify catchment areas of urban centers of different sizes and how many people gravitate toward each city or town, providing a full spatial representation of the connection between rural areas and urban centers and fresh insights on the diversity of urban–rural systems. The global dataset opens the door to applied research in various disciplines—such as poverty reduction, food systems, health, and education—where a person’s place of residence is an important factor. Using travel time to cities of different sizes, we map populations across an urban–rural continuum to improve on the standard dichotomous representations of urban–rural interactions. We extend existing approaches by 1) building on central place theory to capture the urban hierarchy in access to services and employment opportunities provided by urban centers of different sizes, 2) defining urban–rural catchment areas (URCAs) expressing the interconnection between urban centers and their surrounding rural areas, and 3) adopting a global gridded approach comparable across countries. We find that one-fourth of the global population lives in periurban areas of intermediate and smaller cities and towns, which challenges the centrality of large cities in development. In low-income countries, 64% of the population lives either in small cities and towns or within their catchment areas, which has major implications for access to services and employment opportunities. Intermediate and small cities appear to provide catchment areas for proportionately more people gravitating around them than larger cities. This could indicate that, for countries transitioning to middle income, policies and investments strengthening economic linkages between urban centers and their surrounding rural areas may be as important as investing in urbanization or the rural hinterlands. The dataset provided can support national economic planning and territorial development strategies by enabling policy makers to focus more in depth on urban–rural interactions.
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Horning ML, Hill T, Martin CL, Hassan A, Petrovskis A, Bohen L. The East Side Table Make-at-Home Meal-Kit Program is feasible and acceptable: A pilot study. Appetite 2020; 160:105087. [PMID: 33359465 DOI: 10.1016/j.appet.2020.105087] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 12/18/2020] [Accepted: 12/21/2020] [Indexed: 11/15/2022]
Abstract
Drawing from marketing literature, shopper solutions and food bundles (that group items to be used together) can promote purchase intention, efficacy, and related outcomes. Similarly, meal kits boxes (food bundles with step-by-step instructions to prepare home-cooked meals) have potential to be an accessible intervention to facilitate healthy, at-home food preparation and intake. This manuscript describes the feasibility, acceptability, and preliminary outcomes of a community-designed and -led program promoting healthy food skills, accessibility, and intake through meal kits. This pilot study was designed using community-based participatory research principles and 60 participants enrolled in the study. Participating families received a free meal kit weekly during the 10-week program. Meal-kit boxes also included language-appropriate recipe cards, step-by-step instructions, and supplemental educational material including links to videos with related food preparation tips and fact sheets about the meal. Data were collected at baseline, post-program, and follow-up (3 months post-program). Specifically, validated measures were used to assess food insecurity, food availability, cooking preparation techniques, self-efficacy, and fruit/vegetable intake. Process data were also collected. Descriptive statistics, paired t-tests, and Wilcoxon sign-ranked tests were used to describe data and evaluate outcomes. Content analysis was used to code open-ended survey responses into categories. Study findings indicated retention rates were high (≥90%); 83% made eight or more meal kits. At post-program, significant increases were observed in cooking/meal preparation self-efficacy, cooking techniques, and healthy food availability. At follow-up, only healthy food availability remained significantly higher. Findings suggest that meal-kit programs are feasible and acceptable, and there is a potential for these programs to influence factors important to increasing healthy home-cooked meals and dietary intake. Future research should use more rigorous designs and explore meal-kit dosage.
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Affiliation(s)
- Melissa L Horning
- School of Nursing, University of Minnesota, 5-140 Weaver Densford Hall, Minneapolis, MN, 55414, USA.
| | - Terese Hill
- East Side Table, M Health Fairview, 1690 University Avenue West, Suite 250, Saint Paul, MN, 55104, USA.
| | - Christie L Martin
- School of Nursing, University of Minnesota, 5-140 Weaver Densford Hall, Minneapolis, MN, 55414, USA.
| | - Abdirahman Hassan
- School of Nursing, University of Minnesota, 5-140 Weaver Densford Hall, Minneapolis, MN, 55414, USA.
| | - Anna Petrovskis
- School of Nursing, Box 357260, University of Washington, Seattle, WA, 98195, USA.
| | - Laura Bohen
- Health & Nutrition Programs, University of Minnesota Extension, Coffey Hall 1420 Eckles Ave, St Paul, MN, 55108, USA.
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Weiss L, Quint E, Leto C, Vaughn I, Redrovan A, Fernandes M, Lamourt K, Edgar C, Reso A. Evaluation of an Integrated Health Promotion Program for a low-income urban population: Findings and lessons learned. Public Health Nurs 2020; 38:571-578. [PMID: 33216393 PMCID: PMC8359448 DOI: 10.1111/phn.12839] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 10/01/2020] [Accepted: 10/27/2020] [Indexed: 12/21/2022]
Abstract
Objectives To evaluate a multicomponent pilot program for low‐income individuals with, or at risk for, hypertension, diabetes, and/or overweight. Design Pre‐post evaluation including baseline and follow‐up assessments, satisfaction surveys, program utilization data, and focus groups. Sample The evaluation included 138 participants. The majority were Latinx (88%), female (82%), born outside the United States (80%), and had not graduated from high school (52%). The most common health conditions were hypertension (59%), overweight or obesity (55%), high cholesterol (53%), and diabetes (34%). Measurements Engagement in program activities, health indicators (e.g., blood pressure), and behavior change. Qualitative data focused on perceptions of the program and its impacts. Intervention The program offered a number of health promotion services, including consultation with a nurse and a community health worker (CHW), health and nutrition talks, subsidized farm shares, cooking classes, exercise classes, and home visits. Results There were improvements in general health, blood pressure, and knowledge and behavior related to disease management and healthy eating. Conclusions Program success was attributed to the wide range of complementary program components. The staffing model was also a strength: the CHW/nurse collaboration combined clinical expertise with cultural, language, and community knowledge to create a program that was accessible and empowering.
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Affiliation(s)
- Linda Weiss
- Center for Evaluation and Applied Research, The New York Academy of Medicine, New York, NY, USA
| | | | | | - Ivana Vaughn
- Center for Evaluation and Applied Research, The New York Academy of Medicine, New York, NY, USA
| | | | | | | | - Colin Edgar
- RiseBoro Community Partnership, Brooklyn, NY, USA
| | - Ada Reso
- Center for Evaluation and Applied Research, The New York Academy of Medicine, New York, NY, USA
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Racial Differences in Perceived Food Swamp and Food Desert Exposure and Disparities in Self-Reported Dietary Habits. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197143. [PMID: 33003573 PMCID: PMC7579470 DOI: 10.3390/ijerph17197143] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/18/2020] [Accepted: 09/18/2020] [Indexed: 01/24/2023]
Abstract
Both food swamps and food deserts have been associated with racial, ethnic, and socioeconomic disparities in obesity rates. Little is known about how the distribution of food deserts and food swamps relate to disparities in self-reported dietary habits, and health status, particularly for historically marginalized groups. In a national U.S. sample of 4305 online survey participants (age 18+), multinomial logistic regression analyses were used to assess by race and ethnicity the likelihood of living in a food swamp or food desert area. Predicted probabilities of self-reported dietary habits, health status, and weight status were calculated using the fitted values from ordinal or multinomial logistic regression models adjusted for relevant covariates. Results showed that non-Hispanic, Black participants (N = 954) were most likely to report living in a food swamp. In the full and White subsamples (N = 2912), the perception of residing in a food swamp/desert was associated with less-healthful self-reported dietary habits overall. For non-Hispanic Blacks, regression results also showed that residents of perceived food swamp areas (OR = 0.66, p < 0.01, 95% CI (0.51, 0.86)) had a lower diet quality than those not living in a food swamp/food desert area. Black communities in particular may be at risk for environment-linked diet-related health inequities. These findings suggest that an individual's perceptions of food swamp and food desert exposure may be related to diet habits among adults.
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Kariburyo MS, Andress L, Collins A, Kinder P. Place Effects and Chronic Disease Rates in a Rural State: Evidence from a Triangulation of Methods. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186676. [PMID: 32937778 PMCID: PMC7559142 DOI: 10.3390/ijerph17186676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/31/2020] [Accepted: 09/02/2020] [Indexed: 11/16/2022]
Abstract
High rates of chronic diseases and increasing nutritional polarization between different income groups in the United States are issues of concern to policymakers and public health officials. Spatial differences in access to food are mainly blamed as the cause for these nutritional inequalities. This study first detected hot and cold spots of food providers in West Virginia and then used those places in a quasi-experimental method (entropy balancing) to study the effects of those places on diabetes and obesity rates. We found that although hot spots have lower rates of chronic diseases than non-hot spots and cold spots have higher rates of chronic diseases than non-cold spots-the situation is complicated. With the findings of income induced chronic disease rates in urban areas, where most hot spots are located, there is evidence of another case for "food swamps." However, in cold spots which are located mainly in rural areas, higher rates of chronic diseases are attributed to a combination of access to food providers along with lacking the means (i.e., income for low-income households) to form healthier habits.
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Affiliation(s)
- Mohamed Shabani Kariburyo
- Division of Resource Economics and Management West Virginia University, Morgantown, WV 26506-6108, USA
| | - Lauri Andress
- Health Policy, Management, and Leadership, School of Public Health West Virginia University, Morgantown, WV 26506-9190, USA
| | - Alan Collins
- Division of Resource Economics and Management West Virginia University, Morgantown, WV 26506-6108, USA
| | - Paul Kinder
- Division of Resource Economics and Management West Virginia University, Morgantown, WV 26506-6108, USA
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Han J, Schwartz AE, Elbel B. Does Proximity to Fast Food Cause Childhood Obesity? Evidence from Public Housing. REGIONAL SCIENCE AND URBAN ECONOMICS 2020; 84:103565. [PMID: 32699458 PMCID: PMC7375416 DOI: 10.1016/j.regsciurbeco.2020.103565] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
We examine the causal link between proximity to fast food and the incidence of childhood obesity among low-income households in New York City. Using individual-level longitudinal data on students living in public housing linked to restaurant location data, we exploit the naturally occurring within-development variation in distance to fast food restaurants to estimate the impact of proximity on obesity. Since the assignment of households to specific buildings is based upon availability at the time of assignment to public housing, the distance between student residence and retail outlets-including fast food restaurants, wait-service restaurants, supermarkets, and corner stores-is plausibly random. Our credibly causal estimates suggest that childhood obesity increases with proximity to fast food, with larger effects for younger children who attend neighborhood schools.
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Affiliation(s)
- Jeehee Han
- Corresponding author at: Center for Policy Research, Eggers Hall, Maxwell School, Syracuse University, Syracuse NY 13244, United States.
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Mann G, Cafer A, Kaiser K, Gordon K. Community resilience in a rural food system: documenting pathways to nutrition solutions. Public Health 2020; 186:157-163. [PMID: 32836005 DOI: 10.1016/j.puhe.2020.06.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 04/09/2020] [Accepted: 06/19/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To describe and determine the barriers and facilitators to food-related health behaviors of residents in a rural Mississippi Delta community. STUDY DESIGN Descriptive study of qualitative interviews. METHODS A non-random sample of 34 low-income, food-insecure adults residing in a rural Mississippi Delta community were interviewed using fuzzy cognitive mapping, a mixed methods approach. RESULTS Participants strongly emphasized the time restraints they faced in both procuring and preparing foods, due to substantial travel time required to procure groceries. Participants also identified key facilitators to healthy eating behaviors, including seasonal produce stands, foraging, fishing, home provisioning, and access to the local food pantry. These barriers and facilitators are highly interconnected with other influential factors including poverty, lack of health care, unemployment, and faith-based support systems. CONCLUSIONS While the connection between low food access and poor eating habits is well researched, this novel mixed-method approach details two important elements missing from the literature: (1) other factors often overlooked that mitigate or exacerbate this relationship and (2) the dynamic nature of the relationships between these factors, poor eating habits, and health. Additionally, this research examines these relationships in an underrepresented rural minority population where resources needed to mitigate poor health are often much more limited. Findings from this study are critical to health and food policy in Mississippi and more generally, rural communities.
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Affiliation(s)
- G Mann
- Department of Nutrition and Hospitality Management, University of Mississippi, University, 220 Lenoir Hall, Sorority Row, P.O. Box 1848, MS, 38677, USA.
| | - A Cafer
- Department of Sociology & Anthropology, University of Mississippi, University, 543 Lamar Hall, P.O. Box 1848, MS, 38677, USA.
| | - K Kaiser
- Department of Criminal Justice and Legal Studies, University of Mississippi, University, M302 Mayes Hall, P.O. Box 1848, MS, 38677, USA.
| | - K Gordon
- Department of Nutrition and Hospitality Management, University of Mississippi, University, 108 Lenoir Hall, Sorority Row, P.O. Box 1848, MS, 38677, USA.
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Hirsch KE, Blomquist KK. Community-Based Prevention Programs for Disordered Eating and Obesity: Updates and Current Limitations. Curr Obes Rep 2020; 9:81-97. [PMID: 32445131 DOI: 10.1007/s13679-020-00373-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW To review the status of community-based disordered eating and obesity prevention programs from 2014 to 2019. RECENT FINDINGS In the last 5 years, prevention programs have found success in intervening with children and parental figures in wellness centers, physical activity centers, childcare centers, workplaces, online, and over-the-phone through directly reducing disordered eating and obesity or by targeting risk factors of disordered eating and obesity. Community-based prevention programs for disordered eating and programs targeting both disordered eating and obesity were scarce, highlighting the critical need for the development of these programs. Qualities of the most effective programs were those in which parents and children were educated on physical activity and nutrition via multiple group-based sessions. Limitations of current prevention programs include few programs targeting high-risk populations, a dearth of trained community members serving as facilitators, inconsistent reporting of adherence rates, and few direct measurements of disordered eating and obesity, as well as few long-term follow-ups, precluding the evaluation of sustained effectiveness.
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Affiliation(s)
- Katherine E Hirsch
- Department of Kinesiology, University of Windsor, 401 Sunset Avenue, Windsor, Ontario, N9B 3P4, Canada
| | - Kerstin K Blomquist
- Department of Psychology, Furman University, 3300 Poinsett Highway, Greenville, SC, 29613, USA.
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Knowledge Visualizations to Inform Decision Making for Improving Food Accessibility and Reducing Obesity Rates in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041263. [PMID: 32079089 PMCID: PMC7068274 DOI: 10.3390/ijerph17041263] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 01/26/2020] [Accepted: 02/07/2020] [Indexed: 12/15/2022]
Abstract
The aim of this article is to promote the use of knowledge visualization frameworks in the creation and transfer of complex public health knowledge. The accessibility to healthy food items is an example of complex public health knowledge. The United States Department of Agriculture Food Access Research Atlas (FARA) dataset contains 147 variables for 72,864 census tracts and includes 16 food accessibility variables with binary values (0 or 1). Using four-digit and 16-digit binary patterns, we have developed data analytical procedures to group the 72,684 U.S. census tracts into eight and forty groups respectively. This value-added FARA dataset facilitated the design and production of interactive knowledge visualizations that have a collective purpose of knowledge transfer and specific functions including new insights on food accessibility and obesity rates in the United States. The knowledge visualizations of the binary patterns could serve as an integrated explanation and prediction system to help answer why and what-if questions on food accessibility, nutritional inequality and nutrition therapy for diabetic care at varying geographic units. In conclusion, the approach of knowledge visualizations could inform coordinated multi-level decision making for improving food accessibility and reducing chronic diseases in locations defined by patterns of food access measures.
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Butkus R, Rapp K, Cooney TG, Engel LS. Envisioning a Better U.S. Health Care System for All: Reducing Barriers to Care and Addressing Social Determinants of Health. Ann Intern Med 2020; 172:S50-S59. [PMID: 31958803 DOI: 10.7326/m19-2410] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The American College of Physicians (ACP) has long advocated for universal access to high-quality health care in the United States. Yet, it is essential that the U.S. health system goes beyond ensuring coverage, efficient delivery systems, and affordability. Reductions in nonfinancial barriers to care and improvements in social determinants of health are also necessary. This ACP position paper calls for ending discrimination based on personal characteristics; correcting workforce shortages, including the undersupply of primary care physicians; and understanding and ameliorating social determinants of health. The ACP calls for increased efforts to address urgent public health threats, including injuries and deaths from firearms; environmental hazards; climate change; maternal mortality; substance use disorders; and the health risks associated with nicotine, tobacco use, and electronic nicotine delivery systems in order to achieve ACP's vision for a better U.S. health care system.
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Affiliation(s)
- Renee Butkus
- American College of Physicians, Washington, DC (R.B., K.R.)
| | - Katherine Rapp
- American College of Physicians, Washington, DC (R.B., K.R.)
| | - Thomas G Cooney
- Oregon Health & Science University and Portland Veterans Affairs Medical Center, Portland, Oregon (T.G.C.)
| | - Lee S Engel
- Louisiana State University Health Sciences Center, New Orleans, Louisiana (L.S.E.)
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Rummo PE, Feldman JM, Lopez P, Lee D, Thorpe LE, Elbel B. Impact of Changes in the Food, Built, and Socioeconomic Environment on BMI in US Counties, BRFSS 2003-2012. Obesity (Silver Spring) 2020; 28:31-39. [PMID: 31858733 DOI: 10.1002/oby.22603] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 07/02/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Researchers have linked geographic disparities in obesity to community-level characteristics, yet many prior observational studies have ignored temporality and potential for bias. METHODS Repeated cross-sectional data were used from the Behavioral Risk Factor Surveillance System (BRFSS) (2003-2012) to examine the influence of county-level characteristics (active commuting, unemployment, percentage of limited-service restaurants and convenience stores) on BMI. Each exposure was calculated using mean values over the 5-year period prior to BMI measurement; values were standardized; and then variables were decomposed into (1) county means from 2003 to 2012 and (2) county-mean-centered values for each year. Cross-sectional (between-county) and longitudinal (within-county) associations were estimated using a random-effects within-between model, adjusting for individual characteristics, survey method, and year, with nested random intercepts for county-years within counties within states. RESULTS A negative between-county association for active commuting (β = -0.19; 95% CI: -0.23 to -0.16) and positive associations for unemployment (β = 0.17; 95% CI: 0.14 to 0.19) and limited-service restaurants (β = 0.13; 95% CI: 0.11 to 0.14) were observed. An SD increase in active commuting within counties was associated with a 0.51-kg/m2 (95% CI: -0.72 to -0.31) decrease in BMI over time. CONCLUSIONS These results suggest that community-level characteristics play an important role in shaping geographic disparities in BMI between and within communities over time.
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Affiliation(s)
- Pasquale E Rummo
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Justin M Feldman
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Priscilla Lopez
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - David Lee
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Lorna E Thorpe
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Brian Elbel
- Department of Population Health, New York University School of Medicine, New York, New York, USA
- Wagner Graduate School of Public Service, New York University, New York, New York, USA
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Mazzola JJ, Jackson AT, Thiele A. Obesity in the Workplace: a Systematic Review of Barriers and Facilitators to Healthy Lifestyles. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/s41542-019-00046-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Stojek MM, Maples-Keller JL, Dixon HD, Umpierrez GE, Gillespie CF, Michopoulos V. Associations of childhood trauma with food addiction and insulin resistance in African-American women with diabetes mellitus. Appetite 2019; 141:104317. [PMID: 31185252 DOI: 10.1016/j.appet.2019.104317] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 06/05/2019] [Accepted: 06/07/2019] [Indexed: 02/07/2023]
Abstract
Food addiction (FA) describes a group of disordered eating behaviors. Childhood trauma has been associated with adult FA and trauma has known effects on the endocrine system, but it is unclear whether FA is associated with insulin resistance. We hypothesized that severity of childhood trauma will be associated with FA and higher insulin resistance (HOMA-IR) in a sample of obese women with type 2 diabetes mellitus (T2DM), and that FA will mediate the association between childhood trauma and HOMA-IR. Women with a diagnosis of T2DM (N = 73; MBMI = 35.86, SDBMI = 7.72; Mage = 50.59, SDage = 9.72) were recruited from a diabetes clinic at a county hospital. Participants completed the Childhood Trauma Questionnaire and the Yale Food Addiction Scale. Fasting blood samples were obtained from 64 participants to assess plasma hemoglobin A1c (HbA1c), insulin and glucose (used to calculate HOMA-IR); Oral Glucose Tolerance Test (OGTT) was performed to measure change in glucose and insulin secretion. 48% of the sample met diagnostic criteria for FA. Women with FA reported significantly higher HOMA-IR (F = 25.692, p < 0.001, df = 1,62), HbA1c (F = 4.358, p = 0.041, df = 1,62), and OGGT glucose (F = 5.539, p = 0.022, df = 1,62) as well as severity of childhood trauma (F = 10.453, p = 0.002, df = 1,71). In a hierarchical linear regression controlling for BMI, income level, and T2DM treatment, the severity of childhood trauma did not contribute to the prediction of HOMA-IR (β = -0.011, p = 0.942) whereas FA did (β = 0.422, p = 0.007). In a bootstrapped mediation analysis, the association between childhood trauma and HOMA-IR was mediated by FA severity (b = 0.596, p = 0.020). Understanding the psychological factors that contribute to HOMA-IR in an underserved population of African American women may lead to more effective diabetes management and prevention strategies.
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Affiliation(s)
- Monika M Stojek
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA; Emory Healthcare Veterans Program, USA
| | - Jessica L Maples-Keller
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA; Emory Healthcare Veterans Program, USA
| | - Hayley Drew Dixon
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Guillermo E Umpierrez
- Department of Medicine, Division of Endocrinology, Emory University School of Medicine, USA
| | - Charles F Gillespie
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Vasiliki Michopoulos
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA; Yerkes National Primate Research Center, Atlanta, GA, USA.
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Briggs AC, Black AW, Lucas FL, Siewers AE, Fairfield KM. Association between the food and physical activity environment, obesity, and cardiovascular health across Maine counties. BMC Public Health 2019; 19:374. [PMID: 30943942 PMCID: PMC6448221 DOI: 10.1186/s12889-019-6684-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 03/20/2019] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Accounting for nearly one-third of all deaths, cardiovascular disease is the leading cause of mortality and morbidity in the United States. Adverse health behaviors are major determinants of this high incidence of disease. Examining local food and physical activity environments and population characteristics in a poor, rural state may highlight underlying drivers of these behaviors. We aimed to identify demographic and environmental factors associated with both obesity and overall poor cardiovascular health (CVH) behaviors in Maine counties. METHODS Our cross-sectional study analyzed 40,398 Behavioral Risk Factor Surveillance System (BRFSS) 2011-2014 respondents alongside county-level United States Department of Agriculture (USDA) Food Environment Atlas 2010-2012 measures of the built environment (i.e., density of restaurants, convenience stores, grocery stores, and fitness facilities; food store access; and county income). Poor CVH score was defined as exhibiting greater than 5 out of the 7 risk factors defined by the American Heart Association (current smoking, physical inactivity, obesity, poor diet, hypertension, diabetes, and high cholesterol). Multivariable logistic regression models described the contributions of built environment variables to obesity and overall poor CVH score after adjustment for demographic controls. RESULTS Both demographic and environmental factors were associated with obesity and overall poor CVH. After adjustment for demographics (age, sex, personal income, and education), environmental characteristics most strongly associated with obesity included low full-service restaurant density (OR 1.34; 95% CI 1.24-1.45), low county median household income (OR 1.31; 95% CI 1.21-1.42) and high convenience store density (OR 1.21; 95% CI 1.12-1.32). The strongest predictors of overall poor CVH behaviors were low county median household income (OR 1.30; 95% CI 1.13-1.51), low full-service restaurant density (OR 1.38; 95% CI 1.19-1.59), and low fitness facility density (OR 1.27; 95% CI 1.11-1.46). CONCLUSIONS In a rural state, both demographic and environmental factors predict overall poor CVH. These findings may help inform communities and policymakers of the impact of both social determinants of health and local environments on health outcomes.
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Affiliation(s)
| | - Adam W. Black
- Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, 509 Forest Avenue, Suite 200, Portland, ME 04101 USA
| | - F. Lee Lucas
- Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, 509 Forest Avenue, Suite 200, Portland, ME 04101 USA
| | - Andrea E. Siewers
- Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, 509 Forest Avenue, Suite 200, Portland, ME 04101 USA
| | - Kathleen M. Fairfield
- Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, 509 Forest Avenue, Suite 200, Portland, ME 04101 USA
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Castillo EG, Chung B, Bromley E, Kataoka SH, Braslow JT, Essock SM, Young AS, Greenberg JM, Miranda J, Dixon LB, Wells KB. Community, Public Policy, and Recovery from Mental Illness: Emerging Research and Initiatives. Harv Rev Psychiatry 2019; 26:70-81. [PMID: 29381527 PMCID: PMC5843494 DOI: 10.1097/hrp.0000000000000178] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This commentary examines the roles that communities and public policies play in the definition and processes of recovery for adults with mental illness. Policy, clinical, and consumer definitions of recovery are reviewed, which highlight the importance of communities and policies for recovery. This commentary then presents a framework for the relationships between community-level factors, policies, and downstream mental health outcomes, focusing on macroeconomic, housing, and health care policies; adverse exposures such as crime victimization; and neighborhood characteristics such as social capital. Initiatives that address community contexts to improve mental health outcomes are currently under way. Common characteristics of such initiatives and select examples are discussed. This commentary concludes with a discussion of providers', consumers', and other stakeholders' roles in shaping policy reform and community change to facilitate recovery.
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Affiliation(s)
- Enrico G Castillo
- From the Center for Health Services and Society (Drs. Chung, Bromley, Kataoka, Young, Miranda, and Wells), Center for Social Medicine and Humanities (Drs. Braslow and Castillo), Division of Child and Adolescent Psychiatry (Dr. Kataoka), Department of Psychiatry and Biobehavioral Sciences (Dr. Greenberg), David Geffen School of Medicine, and School of Public Health (Drs. Miranda and Wells), University of California, Los Angeles; Los Angeles County Department of Mental Health (Dr. Castillo); RAND Corporation (Drs. Chung and Wells); Los Angeles Biomedical Research Institute (Dr. Chung); Healthy African American Families II (Dr. Chung); Health Services Research & Development Center of Innovation (Dr. Young), Desert Pacific MIRECC Health Services Unit (Drs. Bromley and Greenberg), VA Greater Los Angeles Healthcare System; Division of Behavioral Health Services and Policy Research, Department of Psychiatry, Columbia University College of Physicians and Surgeons (Drs. Essock and Dixon); New York State Psychiatric Institute (Drs. Essock and Dixon)
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Ramondt S, Ramírez AS. Assessing the impact of the public nutrition information environment: Adapting the cancer information overload scale to measure diet information overload. PATIENT EDUCATION AND COUNSELING 2019; 102:37-42. [PMID: 30097378 PMCID: PMC6289837 DOI: 10.1016/j.pec.2018.07.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Revised: 06/30/2018] [Accepted: 07/25/2018] [Indexed: 05/25/2023]
Abstract
OBJECTIVE A growing body of research suggests that exposure to too much information - particularly contradictory information that characterizes much health-related information - can lead to feeling overwhelmed. This construct has been conflated with fatalistic beliefs that are negatively associated with preventive behaviors. The objective of this study was to adapt the 8-item Cancer Information Overload (CIO) scale to assess overload of healthy diet information. METHODS Confirmatory factor analyses with a community sample of rural California adults (n = 290; 75% female; 58% Latino; 46% ≤ H.S./G.E.D.). RESULTS Items assessing Diet Information Overload loaded significantly on their relevant factor; factor loadings were acceptable (β >.40). The adapted original scale (CFI = 1.000, RSMEA = .000, SMSR = .022) and a shorter 5-item scale (CFI = .984, RMSEA = .051, SMSR = .026) fit well. CONCLUSION The Cancer Information Overload scale was successfully adapted and shortened to measure perceptions - previously mischaracterized as fatalistic - pertaining to diet information. Improved measures distinguishing between fatalistic beliefs and outcomes of the information environment are critical. PRACTICE IMPLICATIONS Understanding information overload is important for shaping prevention messages distinct from those needed to address fatalistic beliefs. Nutrition education efforts should consider the broader - cluttered - information environment in which nutrition education and communication occurs, and public health messages may drown.
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Affiliation(s)
- Steven Ramondt
- Psychological Sciences, University of California, Merced, CA, USA.
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