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Unemployment and Depression Among Emerging Adults in 12 States, Behavioral Risk Factor Surveillance System, 2010

May 19, 2015 Comments off

Unemployment and Depression Among Emerging Adults in 12 States, Behavioral Risk Factor Surveillance System, 2010
Source: Preventing Chronic Disease (CDC)

Introduction
The high rate of unemployment among emerging adults (aged 18 to 25 years) is a public health concern. The risk of depression is higher among the unemployed than among the employed, but little is known about the relationship between unemployment and mental health among emerging adults. This secondary data analysis assessed the relationship between unemployment and depression among emerging adults.

Methods
Data from the 2010 Behavioral Risk Factor Surveillance System (BRFSS) were analyzed. Responses to the Patient Health Questionnaire-8 provided data about the prevalence of depression. Bivariate relationships were assessed using χ2 tests, and multivariable adjusted odds ratios were calculated with logistic regressions. Sociodemographic variables were sex, race/ethnicity, marital status, and education. In addition, logistic regression models adjusted for health insurance status, disability, smoking, and body mass index. The analyses were completed using SAS 9.3 survey procedures to account for the complex sampling design.

Results
Almost 12% of emerging adults were depressed (PHQ-8 ≥10) and about 23% were unemployed. Significantly more unemployed than employed emerging adults were classified with depression. In the final model, the odds of depression were about 3 times higher for unemployed than employed emerging adults.

Conclusion
The relationship between unemployment and depression is significant among emerging adults. With high rates of unemployment for this age group, this population may benefit from employment- and mental-health–focused interventions.

County-Level Variation in Prevalence of Multiple Chronic Conditions Among Medicare Beneficiaries, 2012

March 23, 2015 Comments off

County-Level Variation in Prevalence of Multiple Chronic Conditions Among Medicare Beneficiaries, 2012
Source: Preventing Chronic Disease (CDC)

In 2012, 15% of aged Medicare beneficiaries had 6 or more chronic conditions. Prevalence varied geographically by county; counties in the lowest quintile had prevalence estimates of 10.3% or lower, and those in the highest quintile had prevalence estimates of 17.3% or higher. Counties in the highest quintile had prevalence estimates that were 1.2 times higher than the national average of 15%. Eighty-seven counties had estimates at least 1.5 times higher than the national average; 3 counties had prevalence estimates at least twice the national average. Counties in the Northeast and Southeast generally had a higher prevalence of aged beneficiaries with 6 or more chronic conditions than the national average, whereas counties with prevalence estimates below the national average were predominantly in the western states of Oregon, Montana, and Wyoming.

Temporal Trends in Fast-Food Restaurant Energy, Sodium, Saturated Fat, and Trans Fat Content, United States, 1996–2013

March 23, 2015 Comments off

Temporal Trends in Fast-Food Restaurant Energy, Sodium, Saturated Fat, and Trans Fat Content, United States, 1996–2013
Source: Preventing Chronic Disease (CDC)

Introduction
Excess intakes of energy, sodium, saturated fat, and trans fat are associated with increased risk for cardiometabolic syndrome. Trends in fast-food restaurant portion sizes can inform policy decisions. We examined the variability of popular food items in 3 fast-food restaurants in the United States by portion size during the past 18 years.

Methods
Items from 3 national fast-food chains were selected: French fries, cheeseburgers, grilled chicken sandwich, and regular cola. Data on energy, sodium, saturated fat, and trans fat content were collated from 1996 through 2013 using an archival website. Time trends were assessed using simple linear regression models, using energy or a nutrient component as the dependent variable and the year as the independent variable.

Results
For most items, energy content per serving differed among chain restaurants for all menu items (P ≤ .04); energy content of 56% of items decreased (β range, −0.1 to −5.8 kcal) and the content of 44% increased (β range, 0.6–10.6 kcal). For sodium, the content of 18% of the items significantly decreased (β range, −4.1 to −24.0 mg) and the content for 33% increased (β range, 1.9–29.6 mg). Absolute differences were modest. The saturated and trans fat content, post-2009, was modest for French fries. In 2013, the energy content of a large-sized bundled meal (cheeseburger, French fries, and regular cola) represented 65% to 80% of a 2,000-calorie-per-day diet, and sodium content represented 63% to 91% of the 2,300-mg-per-day recommendation and 97% to 139% of the 1,500-mg-per-day recommendation.

Conclusion
Findings suggest that efforts to promote reductions in energy, sodium, saturated fat, and trans fat intakes need to be shifted from emphasizing portion-size labels to additional factors such as total calories, frequency of eating, number of items ordered, menu choices, and energy-containing beverages.

National and State Cost Savings Associated With Prohibiting Smoking in Subsidized and Public Housing in the United States

January 3, 2015 Comments off

National and State Cost Savings Associated With Prohibiting Smoking in Subsidized and Public Housing in the United States
Source: Preventing Chronic Disease (CDC)

Introduction
Despite progress in implementing smoke-free laws in indoor public places and workplaces, millions of Americans remain exposed to secondhand smoke at home. The nation’s 80 million multiunit housing residents, including the nearly 7 million who live in subsidized or public housing, are especially susceptible to secondhand smoke infiltration between units.

Methods
We calculated national and state costs that could have been averted in 2012 if smoking were prohibited in all US subsidized housing, including public housing: 1) secondhand smoke-related direct health care, 2) renovation of smoking-permitted units; and 3) smoking-attributable fires. Annual cost savings were calculated by using residency estimates from the Department of Housing and Urban Development and cost data reported elsewhere. Data were adjusted for inflation and variations in state costs. National and state estimates (excluding Alaska and the District of Columbia) were calculated by cost type.

Results
Prohibiting smoking in subsidized housing would yield annual cost savings of $496.82 million (range, $258.96–$843.50 million), including $310.48 million ($154.14–$552.34 million) in secondhand smoke-related health care, $133.77 million ($75.24–$209.01 million) in renovation expenses, and $52.57 million ($29.57–$82.15 million) in smoking-attributable fire losses. By state, cost savings ranged from $0.58 million ($0.31–$0.94 million) in Wyoming to $124.68 million ($63.45–$216.71 million) in New York. Prohibiting smoking in public housing alone would yield cost savings of $152.91 million ($79.81–$259.28 million); by state, total cost savings ranged from $0.13 million ($0.07–$0.22 million) in Wyoming to $57.77 million ($29.41–$100.36 million) in New York.

Conclusion
Prohibiting smoking in all US subsidized housing, including public housing, would protect health and could generate substantial societal cost savings.

Prevalence of Alcohol Dependence Among US Adult Drinkers, 2009–2011

November 21, 2014 Comments off

Prevalence of Alcohol Dependence Among US Adult Drinkers, 2009–2011
Source: Preventing Chronic Disease (CDC)

Introduction
Excessive alcohol consumption is responsible for 88,000 deaths annually and cost the United States $223.5 billion in 2006. It is often assumed that most excessive drinkers are alcohol dependent. However, few studies have examined the prevalence of alcohol dependence among excessive drinkers. The objective of this study was to update prior estimates of the prevalence of alcohol dependence among US adult drinkers.

Methods
Data were analyzed from the 138,100 adults who responded to the National Survey on Drug Use and Health in 2009, 2010, or 2011. Drinking patterns (ie, past-year drinking, excessive drinking, and binge drinking) were assessed by sociodemographic characteristics and alcohol dependence (assessed through self-reported survey responses and defined as meeting ≥3 of 7 criteria for dependence in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition).

Results
Excessive drinking, binge drinking, and alcohol dependence were most common among men and those aged 18 to 24. Binge drinking was most common among those with annual family incomes of $75,000 or more, whereas alcohol dependence was most common among those with annual family incomes of less than $25,000. The prevalence of alcohol dependence was 10.2% among excessive drinkers, 10.5% among binge drinkers, and 1.3% among non-binge drinkers. A positive relationship was found between alcohol dependence and binge drinking frequency.

Conclusion
Most excessive drinkers (90%) did not meet the criteria for alcohol dependence. A comprehensive approach to reducing excessive drinking that emphasizes evidence-based policy strategies and clinical preventive services could have an impact on reducing excessive drinking in addition to focusing on the implementation of addiction treatment services.

Personal and Parental Weight Misperception and Self-Reported Attempted Weight Loss in US Children and Adolescents, National Health and Nutrition Examination Survey, 2007–2008 and 2009–2010

September 30, 2014 Comments off

Personal and Parental Weight Misperception and Self-Reported Attempted Weight Loss in US Children and Adolescents, National Health and Nutrition Examination Survey, 2007–2008 and 2009–2010
Source: Preventing Chronic Disease (CDC)

Introduction
The objective of our study was to describe perceptions of child weight status among US children, adolescents, and their parents and to examine the extent to which accurate personal and parental perception of weight status is associated with self-reported attempted weight loss.

Methods
Our study sample comprised 2,613 participants aged 8 to 15 years in the National Health and Nutrition Examination Survey from the 2 most recent consecutive cycles (2007–2008 and 2009–2010). Categories of weight perception were developed by comparing measured to perceived weight status. Multivariable logistic regression analyses were used to examine the association between weight misperception and self-reported attempted weight loss.

Results
Among children and adolescents, 27.3% underestimated and 2.8% overestimated their weight status. Among parents, 25.2% underestimated and 1.1% overestimated their child’s weight status. Logistic regression analyses showed that the odds of self-reported attempted weight loss was 9.5 times as high (95% confidence interval [CI]: 3.8–23.6) among healthy-weight children and adolescents who overestimated their weight status as among those who perceived their weight status accurately; the odds of self-reported attempted weight loss were 3.9 (95% CI, 2.4–6.4) and 2.9 (95% CI, 1.8–4.6) times as high among overweight and obese children and adolescents, respectively, who accurately perceived their weight status than among those who underestimated their weight status. Parental misperception of weight was not significantly associated with self-reported attempted weight loss among children and adolescents who were overweight or obese.

Conclusion
Efforts to prevent childhood obesity should incorporate education for both children and parents regarding the proper identification and interpretation of actual weight status. Interventions for appropriate weight loss can target children directly because one of the major driving forces to lose weight comes from the child’s perception of his or her weight status.

The Contributions of Selected Diseases to Disparities in Death Rates and Years of Life Lost for Racial/Ethnic Minorities in the United States, 1999–2010

September 11, 2014 Comments off

The Contributions of Selected Diseases to Disparities in Death Rates and Years of Life Lost for Racial/Ethnic Minorities in the United States, 1999–2010
Source: Preventing Chronic Disease (CDC)

Introduction
Differences in risk for death from diseases and other causes among racial/ethnic groups likely contributed to the limited improvement in the state of health in the United States in the last few decades. The objective of this study was to identify causes of death that are the largest contributors to health disparities among racial/ethnic groups.

Methods
Using data from WONDER system, we measured the relative (age-adjusted mortality ratio [AAMR]) and absolute (difference in years of life lost [dYLL]) differences in mortality risk between the non-Hispanic white population and the black, Hispanic, American Indian/Alaska Native, and Asian/Pacific Islander populations for the 25 leading causes of death.

Results
Many causes contributed to disparities between non-Hispanic whites and blacks, led by assault (AAMR, 7.56; dYLL, 4.5 million). Malignant neoplasms were the second largest absolute contributor (dYLL, 3.8 million) to black–white disparities; we also found substantial relative and absolute differences for several cardiovascular diseases. Only assault, diabetes, and diseases of the liver contributed substantially to disparities between non-Hispanic whites and Hispanics (AAMR ≥ 1.65; dYLL ≥ 325,000). Many causes of death, led by assault (AAMR, 3.25; dYLL, 98,000), contributed to disparities between non-Hispanic whites and American Indians/Alaska Natives; Asian/Pacific Islanders did not have a higher risk than non-Hispanic whites for death from any disease.

Conclusion
Assault was a substantial contributor to disparities in mortality among non-Asian racial/ethnic minority populations. Research and intervention resources need to target diseases (such as diabetes and diseases of the liver) that affect certain racial/ethnic populations.

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