Minority Health and Health Equity Archive
Permanent URI for this collectionhttp://hdl.handle.net/1903/21769
Welcome to the Minority Health and Health Equity Archive (MHHEA), an electronic archive for digital resource materials in the fields of minority health and health disparities research and policy. It is offered as a no-charge resource to the public, academic scholars and health science researchers interested in the elimination of racial and ethnic health disparities.
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Item Outpatient weight management in African-Americans: The Healthy Eating and Lifestyle Program (HELP) study(2005) Kumanyika, Shiriki K; Shults, Justine; Fassbender, Jennifer E; Whitt-Glover, Melicia C; Brake, Vivian; Kallan, Michael J; Iqbal, Nayyar; Bowman, Marjorie AItem Ethnic Comparison of Weight Loss in Trial of Nonpharmacologic Interventions in the Elderly(2001) Kumanyika, Shiriki K.; Espeland, Mark A.; Bahnson, Judy L.; Bottom, Juliene B.; Charleston, Jeanne B.; Folmar, Steve; Wilson, Alan C.; Whelton, Paul K.Item Translating the Diabetes Prevention Program Into an Urban Medically Underserved Community(2008) Seidel, Miriam; Powell, Robert; Zgibor, Janice; Siminerio, Linda; Piatt, GretchenItem Translating the Diabetes Prevention Program Into an Urban Medically Undeserved Community(2008) Seidel, Miriam; Powell, Robert; Zgibor, Janice; Siminerio, Linda; Piatt, GretchenItem Ethnic Comparison of Weight Loss in Trial of Nonpharmacologic Interventions in the Elderly(2001) Kumanyika, Shiriki K.; Espeland, Mark A.; Bahnson, Judy L.; Bottom, Juliene B.; Charleston, Jeanne B.; Folmar, Steve; Wilson, Alan C.; Whelton, Paul K.Item F as in Fat: How Obesity Threatens America’s Future 2012(Trust for America's Health/Robert Wood Johnson Foundation, 2012) Levi, Jeffrey; Segal, Laura M.; St. Laurent, Rebecca; Lang, Albert; Rayburn, JackItem Exercise Like a Hunter-Gatherer: A Prescription for Organic Physical Fitness(2011) O'Keefe, James H.; Vogel, Robert; Lavie, Carl J.; Cordain, LorenItem The Role of Local Food Availability in Explaining Obesity Rsik Among Young School-Aged Children(2012) Lee, HelenIn recent years, research and public policy attention has increasingly focused on understanding whether modifiable aspects of the local food environment – the types and composition of food outlets families have proximate access to – are drivers of and potential solutions to the problem of childhood obesity in the United States. Given that much of the earlier published research has documented greater concentrations of fast-food outlets alongside limited access to large grocery stores in neighborhoods with higher shares of racial/ethnic minority groups and residents living in poverty, differences in retail food contexts may indeed exacerbate notable child obesity disparities along socioeconomic and racial/ethnic lines. This paper examines whether the lack of access to more healthy food retailers and/or the greater availability of “unhealthy” food purveyors in residential neighborhoods explains children’s risk of excessive weight gain, and whether differential food availability explains obesity disparities. I do so by analyzing a national survey of U.S. children followed over elementary school (Early Childhood Longitudinal Study – Kindergarten Cohort) who are linked to detailed, longitudinal food availability measures from a comprehensive business establishment database (the National Establishment Time Series). I find that children who live in residentially poor and minority neighborhoods are indeed more likely to have greater access to fast-food outlets and convenience stores. However, these neighborhoods also have greater access to other food establishments that have not been linked to increased obesity risk, including large-scale grocery stores. When examined in a multi-level modeling framework, differential exposure to food outlets does not independently explain weight gain over time in this sample of elementary school-aged children. Variation in residential food outlet availability also does not explain socioeconomic and racial/ethnic differences. It may thus be important to reconsider whether food access is, in all settings, a salient factor in understanding obesity risk among young children.Item Lifestyle Change and Mobility in Obese Adults with Type 2 Diabetes(2012) Rejeski, W. Jack; Ip, Edward H.; Bertoni, Alain G.; Bray, George A.; Evans, Gina; Gregg, Edward W.; Zhang, QiangBackground Adults with type 2 diabetes mellitus often have limitations in mobility that increase with age. An intensive lifestyle intervention that produces weight loss and improves fitness could slow the loss of mobility in such patients. Methods We randomly assigned 5145 overweight or obese adults between the ages of 45 and 74 years with type 2 diabetes to either an intensive lifestyle intervention or a diabetes support-and-education program; 5016 participants contributed data. We used hidden Markov models to characterize disability states and mixed-effects ordinal logistic regression to estimate the probability of functional decline. The primary outcome was self-reported limitation in mobility, with annual assessments for 4 years. Results At year 4, among 2514 adults in the lifestyle-intervention group, 517 (20.6%) had severe disability and 969 (38.5%) had good mobility; the numbers among 2502 participants in the support group were 656 (26.2%) and 798 (31.9%), respectively. The lifestyle-intervention group had a relative reduction of 48% in the risk of loss of mobility, as compared with the support group (odds ratio, 0.52; 95% confidence interval, 0.44 to 0.63; P<0.001). Both weight loss and improved fitness (as assessed on treadmill testing) were significant mediators of this effect (P<0.001 for both variables). Adverse events that were related to the lifestyle intervention included a slightly higher frequency of musculoskeletal symptoms at year 1. Conclusions Weight loss and improved fitness slowed the decline in mobility in overweight adults with type 2 diabetes. (Funded by the Department of Health and Human Services and others; ClinicalTrials.gov number, NCT00017953.)Item Reestablishing Healthy Food Retail: Changing the Landscape of Food Deserts(2012) Karpyn, Allison; Young, Candace; Weiss, StephanieAbstract available at publisher's website.