Minority Health and Health Equity Archive
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Item “I Come from a Black-Eyed Pea Background”: The Incorporation of History into Women's Discussions of Diet and Health(2012) Smith, Katherine Clegg; Kromm, Elizabeth Edsall; Brown, Natasha Ann; Klassen, Ann CarrollAbstract available at publisher's website.Item A Qualitative Exploration of the Influence of Culture and Extended Family Networks on the Weight-related Behaviors of Urban African American Children(2011) Brown, Natasha A.Background: Childhood obesity is a public health problem with significant long-term implications and racial/ethnic disparities. African American extended family members play a significant role in child rearing and socialization, and research suggests that grandparents, in general, may influence children’s weight-related behaviors. There is, however, a lack of research exploring how urban African American children’s relationships with extended family members may influence children’s weight-related behaviors. Therefore, this study examines how extended family members’ roles and responsibilities may influence urban African American children’s weight-related behaviors, how extended family members socialize children to adopt weight-related behaviors, and how extended family members’ socialization practices may differ from those of primary caregivers. Methods: This study builds upon and extends the work of a previous, mixed-methods study of 31 primary caregiver-child dyads, which was designed to examine household and neighborhood factors related to childhood obesity. In Phase 2, individual semi-structured, in-depth interviews were conducted with 8 Baltimore City children; paired interviews were conducted with their primary caregivers and one adult member of each child’s extended family. Manuscript 1 combines qualitative data from both studies to present case studies of the 4 families that participated in both studies. Manuscripts 2 and 3 focus on data collected from Phase 2’s 8 family units, and present detailed analyses of familial influences on children’s physical activity and dietary behaviors, respectively. Findings: Manuscript 1 indicates that mothers and extended family members may differ in their influences on children’s weight-related behaviors, which may be related to differences in the adults’ roles and responsibilities with the children. Manuscript 2 suggests that extended family members may be more physically active with children; this may be influenced by perceived familial closeness and different relationship dynamics. Manuscript 3 indicates that children are consistently taught to value food-based family traditions; however, adults may be inconsistent in the socialization strategies used in day-to-day dietary routines. These findings suggest that future family-based obesity interventions for African American children should extend beyond the immediate family to include key extended family members and consider the extended family networks’ norms and values.Item Racial/Ethnic Disparities in Exercise and Dietary Behaviors of Middle-Aged and Older Adults(2011) August, Kristin J.; Sorkin, Dara H.Abstract available at publisher's web site.Item Health Promotion in Latinos(2010) Pekmezi, D.; Marquez, B.; Marcus-Blank, J.Abstract available at publisher's web site.Item Overweight and Depressive Symptoms among African-American Women(2000) Siegel, Judith M; Yancey, Antronette K; McCarthy, William JAbstract available at publisher's web site.Item Price, availability, and youth obesity: evidence from Bridging the Gap.(2009) Chaloupka, Frank J; Powell, Lisa MAfter a decade of analyzing environmental influences on substance use and its consequences among youth in the United States, the Robert Wood Johnson Foundation's Bridging the Gap program has begun studying the effect of environmental factors on youth physical activity, diet, and weight outcomes. Much of this research has focused on access to food, as reflected by availability and price. Program researchers have documented disparities in access to healthy foods and opportunities for physical activity; healthier food outlets and opportunities for physical activity are relatively less available in communities with lower income and larger proportions of racial/ethnic minority populations. They also have found that healthier environments are associated with more fruit and vegetable consumption, more physical activity, lower body mass index, and reduced likelihood of obesity among youth.Item Health Behaviors and Racial Disparity in Blood Pressure Control in the National Health and Nutrition Examination Survey(2011) Redmond, N.; Baer, H. J.; Hicks, L. S.Minorities have a higher prevalence of hypertension, a major risk factor for cardiovascular disease, which contributes to racial/ethnic disparities in morbidity and mortality in the United States. Many modifiable health behaviors have been associated with improved blood pressure control, but it is unclear how racial/ethnic differences in these behaviors are related to the observed disparities in blood pressure control. Cross-sectional analyses were conducted among 21 489 US adults aged >20 years participating in the National Health and Nutrition Examination Survey from 2001 to 2006. Secondary analyses were conducted among those with a self-reported diagnosis of hypertension. Blood pressure control was defined as systolic values <140 mm Hg and diastolic values <90 mm Hg (or <130 mm Hg and <80 mm Hg among diabetics, respectively). In primary analyses, non-Hispanic blacks had 90% higher odds of poorly controlled blood pressure compared with non-Hispanic whites after adjustment for sociodemographic and clinical characteristics (P<0.001). In secondary analyses among hypertensive subjects, non-Hispanic blacks and Mexican Americans had 40% higher odds of uncontrolled blood pressure compared with non-Hispanic whites after adjustment for sociodemographic and clinical characteristics (P<0.001). For both analyses, the racial/ethnic differences in blood pressure control persisted even after further adjustment for modifiable health behaviors, which included medication adherence in secondary analyses (P<0.001 for both analyses). Although population-level adoption of healthy behaviors may contribute to reduction of the societal burden of cardiovascular disease in general, these findings suggest that racial/ethnic differences in some health behaviors do not explain the disparities in hypertension prevalence and control. (Item Physical Activity and Food Environments: Solutions to the Obesity Epidemic(2009) SALLIS, JAMES F.; GLANZ, KARENCONTEXT: Environmental, policy, and societal changes are important contributors to the rapid rise in obesity over the past few decades, and there has been substantial progress toward identifying environmental and policy factors related to eating and physical activity that can point toward solutions. This article is a status report on research on physical activity and food environments, and it suggests how these findings can be used to improve diet and physical activity and to control or reduce obesity. METHODS: This article summarizes and synthesizes recent reviews and provides examples of representative studies. It also describes ongoing innovative interventions and policy change efforts that were identified through conference presentations, media coverage, and websites. FINDINGS: Numerous cross-sectional studies have consistently demonstrated that some attributes of built and food environments are associated with physical activity, healthful eating, and obesity. Residents of walkable neighborhoods who have good access to recreation facilities are more likely to be physically active and less likely to be overweight or obese. Residents of communities with ready access to healthy foods also tend to have more healthful diets. Disparities in environments and policies that disadvantage low-income communities and racial minorities have been documented as well. Evidence from multilevel studies, prospective research, and quasi-experimental evaluations of environmental changes are just beginning to emerge. CONCLUSIONS: Environment, policy, and multilevel strategies for improving diet, physical activity, and obesity control are recommended based on a rapidly growing body of research and the collective wisdom of leading expert organizations. A public health imperative to identify and implement solutions to the obesity epidemic warrants the use of the most promising strategies while continuing to build the evidence base.Item YOUR GUIDE TO Lowering Your Cholesterol With TLC(2005) UNSPECIFIEDHigh blood cholesterol can affect anyone. It’s a serious condition that increases the risk for heart disease, the number one killer of Americans—women and men. The higher your blood cholesterol level, the greater your risk. Fortunately, if you have high blood cholesterol, there are steps you can take to lower it and protect your health. This booklet will show you how to take action by following the “TLC Program” for reducing high blood cholesterol. TLC stands for Therapeutic Lifestyle Changes, a three-part program that uses diet, physical activity, and weight management. Sometimes, drug treatment also is needed to lower blood cholesterol enough. But even then, the TLC Program should be followed. The booklet has four main sections: It explains why cholesterol matters and helps you find your heart disease risk; describes the TLC Program; talks about a condition called the metabolic syndrome that can also be treated with TLC; and offers advice on how to make heart healthy lifestyle changes. Within the sections you’ll find tips on such topics as how to: communicate better with your doctor and other health care professionals, read food labels, make and stick with lifestyle changes, plan heart healthy menus for the whole family, and make heart healthy choices when you eat out. Anyone can develop high blood cholesterol—everyone can take steps to lower it.Item Neighborhood Characteristics Associated with the Location of Food Stores and Food Service Places(2002) Morland, Kimberly; Wing, Steve; Diez Roux, Ana; Poole, CharlesBackground: Although the relationship between diet and disease is well established, sustainable dietary changes that would affect risk for disease have been difficult to achieve. Whereas individual factors are traditional explanations for the inability of some people to change dietary habits, little research has investigated how the physical availability of healthy foods affects individuals’ diets. This study examines the distribution of food stores and food service places by neighborhood wealth and racial segregation. Methods: Names and addresses of places to buy food in Mississippi, North Carolina, Maryland, and Minnesota were obtained from respective departments of health and agriculture. Addresses were geocoded to census tracts. Median house values were used to estimate neighborhood wealth, while the proportion of black residents was used to measure neighborhood racial segregation. Results: Compared to the poorest neighborhoods, large numbers of supermarkets and gas stations with convenience stores are located in wealthier neighborhoods. There are 3 times fewer places to consume alcoholic beverages in the wealthiest compared to the poorest neighborhoods (prevalence ratio [PR]0.3, 95% confidence interval [CI]0.1– 0.6). Regarding neighborhood segregation, there are 4 times more supermarkets located in white neighborhoods compared to black neighborhoods (PR4.3, 95% CI1.5–12.5). Conclusions: Without access to supermarkets, which offer a wide variety of foods at lower prices, poor and minority communities may not have equal access to the variety of healthy food choices available to nonminority and wealthy communities.