Neighborhood safety and physical inactivity in adults from Curitiba, Brazil

ABSTRACT: BACKGROUND: Neighborhood safety is one of the environmental aspects that can influence physical activity. We analyzed the association between perceived neighborhood safety and physical inactivity (PI) in adults and examined effect modification according to sociodemographic variables. METHODS: A cross-sectional study was conducted with 1,261 adults (62% women), age 18-69 years from Curitiba, Brazil. RESULTS: The perception of unsafe neighborhood was higher among women, older participants, those classified in the high socioeconomic (SES) group, overweighed and also among those reporting to have PA equipments and children. The association between perception safety of walking during the day and walking for leisure (women PR = 1.12 CI95% = 1.02-1.22; men PR = 0.82 CI95% = 0.64-1.05; interaction term PR = 1.38 CI95% = 1.03-1.83) and safe perception was associated with PI, just in the highest SES group (PR = 1.09; CI95% = 1.00-1.19; p trend = 0.032) when compared with their counterparts (low SES PR = 0.99; CI95% =0.90-1.04; p trend = 0.785; interaction term PR = 1.09; CI95% = 1.03-1.15; p trend = 0.007). CONCLUSION: The perception of safety in the neighborhood was moderately associated with PI in transport, but this association varies across subgroups of sociodemographic variables.     

Prevalence of regular physical activity among adults--United States, 2001 and 2005

Regular physical activity is associated with decreased risk for obesity, heart disease, hypertension, diabetes, certain cancers, and premature mortality. CDC and the American College of Sports Medicine recommend that adults engage in at least 30 minutes of moderate physical activity on most days and preferably on all days. Healthy People 2010 objectives include increasing the proportion of adults who engage regularly in moderate or vigorous activity to at least 50% (objective 22-2). In addition, reducing racial and ethnic health disparities, including disparities in physical activity, is an overarching national goal. To examine changes in the prevalence of regular, leisure-time, physical activity from 2001 to 2005, CDC analyzed data from the Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the results of that analysis, which indicated that, from 2001 to 2005, the prevalence of regular physical activity increased 8.6% among women overall (from 43.0% to 46.7%) and 3.5% among men (from 48.0% to 49.7%). In addition, the prevalence of regular physical activity increased 15.0% (from 31.4% to 36.1%) among non-Hispanic black women and 12.4% (from 40.3% to 45.3%) among non-Hispanic black men, slightly narrowing previous racial disparities when compared with increases of 7.8% (from 46.0% to 49.6%) for white women and 3.4% (from 50.6% to 52.3%) for white men, respectively. CDC, state and local public health agencies, and other public health partners should continue to implement evidence-based, culturally appropriate initiatives to further increase physical-activity levels among all adults, with special focus on eliminating racial/ethnic disparities.     

Correlates of sunburn experiences among U.S. adults: results of the 2000 National Health Interview Survey

OBJECTIVE: The purpose of this study was to determine the rate of sunburns in the U.S. adult population and the correlates of sunburns. METHODS: Data from the 2000 National Health Interview Survey Cancer Control Module were used to calculate the number of sunburns (0, 1, 2, or > or = 3) experienced during the past year by age, sex, race/ethnicity, and skin sensitivity to sun exposure. The relationship between no sunburns vs. one or more sunburns and additional demographic, health, and behavioral factors for adults who self-identify as white Hispanic or white non-Hispanic was assessed using general linear contrasts. Multivariate logistic regression modeling was conducted to determine the most important covariates associated with sunburns. All analyses were weighted for the complex sampling design. RESULTS: The study data suggest that overall, 18.5% (95% confidence interval [CI] 17.9, 19.1) of U.S. adults experience one sunburn a year, 9.7% (95% CI 9.3, 10.1) experience two, and 8.0% (95% CI 7.6, 8.4) experience > or = 3 sunburns. The data also indicate that adults who self-identify as white non-Hispanic experience sunburns more frequently than (in order of prevalence) those who identify as American Indian/Alaska Native, white Hispanic, Asian/Pacific Islander, or black. Sunburns were found to be more common among men than among women, more common among younger age groups than among older age groups, and more common among those with skin more prone to sunburn than among those with skin less prone to sunburn. Among individuals who self-identify as white Hispanic or white non-Hispanic, protective behaviors associated with lower rates of one or more sunburns in multivariate analyses are staying in the shade (odds ratio [OR] 0.73, 95% CI 0.66, 0.80) and wearing long-sleeved shirts (OR 0.86, 95% CI 0.75, 0.99). CONCLUSIONS: Many American adults have one or more sunburns per year. Methods to protect from sun exposure may not be used as needed to prevent sunburn.     

Total, free, and percent free prostate-specific antigen levels among U.S. men, 2001-04

OBJECTIVE: Screening for prostate cancer using prostate-specific antigen (PSA) tests is common but remains controversial. Total PSA using thresholds of 4.0 and 2.5 ng/mL has been used for screening men. In addition, the percent free PSA (free PSA/total PSA x 100%) using thresholds of less than 25% and 15% have been proposed for use in screening for prostate cancer in conjunction with the total PSA. The distributions of total PSA, free PSA, and percent free PSA, which vary with age and race-ethnicity among American men, would help determine the burden of screening using different thresholds of PSA tests. METHODS: PSA tests were performed on serum samples from men age 40 years and older (n = 2,546) who participated in the 2001-04 National Health and Nutrition Examination Survey (NHANES). Total, free and percent free PSA were estimated for Mexican American, non-Hispanic white, and non-Hispanic black men. RESULTS: About 6.2%, (95% confidence interval, 95% CI: 5.2-7.2%), corresponding to an estimated 3.6 million (95% CI: 3.0-4.2 million) men 40 years of age and older, had a total PSA of greater than or equal to 4.0 ng/mL. Approximately 3.6% (95% CI: 1.8-6.2%) of Mexican American men, 6.2% (95% CI: 5.1-7.6%) of non-Hispanic white men, and 7.8% (95% CI: 5.2-11.1 ) of non-Hispanic black men had total PSA of 4.0 ng/mL or more. Approximately 13.1 (95% CI: 11.7-14.5%) of men 40 years of age and older had total PSA greater than or equal to 2.5 ng/mL. For men with total PSA less than 2.5 ng/mL, 23.1% (95% CI: 21.0-25.3%) had a percent free PSA between 15% and 25%, and 5.0% had free PSA (95% CI: 3.9-6.4%) less than or equal to 15%. CONCLUSIONS: The effect of lowering the total PSA thresholds increases the number of U.S. men who would be referred for screening for prostate cancer. Total and free PSA increased with age in Mexican American, non-Hispanic white, and non-Hispanic black men. Information about the distribution of total, free, and percent free PSA will help guide public health policy in screening for prostate cancer.     

Race/ethnicity and self-reported diabetes among adults in the National Health Interview Survey: 2000-2003

OBJECTIVE: We investigated the effect of race among Hispanic and non-Hispanic people on self-reported diabetes after adjusting for selected individual characteristics and known risk factors. METHODS: Using the National Health Interview Survey 2000-2003, these analyses were limited to Hispanic and non-Hispanic people who self-identified as white or black/African American for a final sample of 117,825 adults, including 17,327 Hispanic people (with 356 black and 16,971 white respondents). RESULTS: The overall prevalence of diabetes was 7.2%. After adjusting for selected covariates, Hispanic white and black respondents were 1.56 (95% confidence interval [CI] 1.32, 1.83) and 2.64 (95% CI 1.10, 6.35) times more likely to report having diabetes than non-Hispanic white respondents. The estimate for non-Hispanic black respondents was 1.45 (95% CI 1.29, 1.64). When compared to low-income non-Hispanic white respondents, low-income Hispanic white respondents (odds ratio [OR] 1.64; 95% CI 1.26, 2.19) and non-Hispanic black respondents (OR 1.71; 95% CI 1.38, 2.11) were more likely to report having diabetes. Hispanic black people born in the U.S. were 3.54 (95% CI 1.27, 9.82) times more likely to report having diabetes when compared to Hispanic white people born in the U.S. In comparison to non-Hispanic white respondents, the odds of reporting diabetes decreased for non-Hispanic black respondents, while the odds remained constant for Hispanic white respondents (p-value for interaction between survey year and race/ethnicity = 0.03). CONCLUSIONS: This study suggests that race may be a proxy for unmeasured exposures among non-Hispanic and Hispanic people. Thus, given the importance of race on health and the racial heterogeneity among Hispanic people, race among Hispanic people should be investigated whenever the data allow it.     

Do women with tuberculosis have a lower likelihood of getting diagnosed? Prevalence and case detection of sputum smear positive pulmonary TB, a population-based study from Vietnam

OBJECTIVE: The aim was to estimate the gender-specific prevalence of tuberculosis (TB) through screening. A further aim was to calculate case detection within the Vietnamese National TB program. STUDY DESIGN AND SETTING: A population-based survey of 35,832 adults was performed within an existing sociodemographic longitudinal study in Bavi district, northern Vietnam. Cases were identified by a screening question about prolonged cough and further diagnosed with sputum examination and a chest X-ray. RESULTS: The estimated prevalence of pulmonary TB among men was 90/100,000 (95% CI 45-135/100,000) and among women 110/100,000 (95% CI 63-157/100,000). Case detection in the district was estimated to 39% (95% CI 20-76%) among men and 12% (95% CI 6-26%) among women. CONCLUSION: TB prevalence was similar among men and women. Case detection among men and women was significantly lower than the reported national case detection of 80%, and there was a significant underdetection of female cases. These findings warrant actions, and emphasize the need to perform similar studies in different contexts.     

Physical activity levels in adults living in Bogotá (Colombia): prevalence and associated factors

OBJECTIVE: To determine the prevalence of physical activity levels in adults aged 18 to 65 years in Bogotá city and identify the factors associated with regular physical activity. METHODS: We conducted a population-based, cross-sectional survey in 3,000 adult residents of Bogotá in 2003 who were selected through a multistage probabilistic sample. Physical activity levels were determined using the short version of the International Physical Activity Questionnaire. Factors associated with regular physical activity were identified by logistic regression models. RESULTS: The adjusted prevalence of persons undertaking regular physical activity was 36.8%. After adjustment for potential confounders, regular physical activity was more likely in men (odds ratio [OR] = 1.62; 95% CI, 1.31-2.01) and in those whose self-perceived health status was good or very good (OR = 1.87; 95% CI, 1.41-2.49) and was less likely in those aged 30-49 years or 50-65 years (OR = 0.78; 95% CI, 0.63-0.96, and OR = 0.60; 95% CI, 0.43-0.82, respectively) and in those whose main activity in the previous 30 days was searching for a job (OR = 0.71; 95% CI, 0.51-0.97) or carrying out household tasks (OR = 0.72; 95% CI, 0.54-0.96). In women, unlike men, age groups showed no association with regular physical activity. CONCLUSION: This study shows gender differences in the prevalence of physical activity levels and associated factors. Future studies should establish, in the context of Latin American cities, whether it is appropriate to determine specific measures in each domain, in addition to overall physical activity levels.     

Elevated blood pressure among U.S. adults with diabetes, 1988-1994.

BACKGROUND: Recent guidelines and clinical trial results emphasize the importance of controlling blood pressure among people with diabetes. We estimated the prevalence of elevated blood pressure among U.S. adults with diagnosed diabetes, and examined the extent to which elevated blood pressure is being treated and controlled. METHODS: The Third National Health and Nutrition Examination Survey (1988-1994), a probability survey of the civilian, non-institutionalized population of the United States, consisted of an interview and physical examination, which included blood pressure measurement. Survey participants included 1507 adults (aged > or = 18 years) with self-reported diabetes. Among people with self-reported diabetes, we estimated elevated blood pressure (mean blood pressure of > or = 130/85 mm Hg or use of antihypertensive medication); awareness (prior diagnosis of hypertension); treatment (antihypertensive medication use); and control (mean blood pressure of <130/85 or <140/90). RESULTS: In the 1988-1994 period, 71% (95% confidence interval [CI]=+/-4.4%) of all U.S. adults with diabetes had elevated blood pressure. The prevalence of elevated blood pressure increased with age and was high among both men and women and among Mexican Americans, non-Hispanic blacks, and non-Hispanic whites. Among those with elevated blood pressure, 71% (95% CI=+/-4.1%) were aware and 57% (95% CI=+/-4.2%) were treated, but only 12% (95% CI=+/-3.2%) had mean blood pressure <130/85 and 45% (95% CI=+/-4.9%) had mean blood pressure <140/90. Control of blood pressure was least common among older people. CONCLUSIONS: All people with diabetes-regardless of age, gender, and race and ethnicity-may benefit from efforts to prevent hypertension. The control of elevated blood pressure is inadequate and broad-based efforts are needed to improve blood pressure control.     

Environmental perceptions and walking in English adults

STUDY OBJECTIVE: To examine the relation between adults' perceptions of the social and physical environment and their self reported walking behaviour. DESIGN: Cross sectional survey. SETTING: England. PARTICIPANTS: A national sample of 4265 adults aged 16-74 years. MAIN OUTCOME MEASURES: Self reported walking behaviour was categorised into two dichotomous variables: (a) any reported walking in past four weeks, (b) reported walking > or =150 minutes per week in the past four weeks. Perceptions of the social environment covered safety of walking alone and social support for walking. Perceptions of the physical environment covered attractiveness of local area for walking, access to shops, leisure centres, parks, cycle paths, and traffic density. MAIN RESULTS: In women, perceived safety of walking during the day (OR = 0.53; 95% CI: 0.31 to 0.88), and no shop within walking distance (OR = 0.72; 95% CI: 0.52 to 0.99) were associated with any reported walking occasions. Perceptions of the environment were not related to women walking > or =150 min/week. In men, having a park within walking distance was associated with walking > or =150 min/week (OR = 2.22; 95% CI: 1.18 to 4.35). No other significant associations were found. CONCLUSIONS: Women seem to be more concerned about walking for utility and in safety. Men are more likely to walk > or =150 min/week if they have access to a local park but their walking is not influenced by concerns about safety. Future research should focus on the relation between objective measures rather than perceptions of the environment and physical activity.     

Metabolic syndrome among Caribbean-born persons living in the U.S. Virgin Islands.

OBJECTIVES: To determine the frequency of the metabolic syndrome (MS) among four subpopulations in the United States Virgin Islands and to estimate the risk for the MS that is associated with waist circumference cutpoints among overweight and obese individuals. METHODS: In a study undertaken from 1995 to 1999, data on demographic characteristics, anthropometric measurements, blood pressure measurements, and a blood sample were obtained from a population-based cohort of 893 Caribbean-born persons from four population subgroups who were living on Saint Croix (the largest island of the U.S. Virgin Islands) and who did not have a history of diagnosed diabetes. The four subpopulations were: (1) Hispanic white, (2) Hispanic black, (3) non-Hispanic black born in the U.S. Virgin Islands, and (4) non-Hispanic black born elsewhere in the Caribbean. Fasting blood samples were analyzed for glucose, insulin, triglycerides, and high-density lipoprotein cholesterol (HDL-C). National Cholesterol Education Program Adult Treatment Panel III guidelines were used to identify the MS. Insulin resistance was estimated by the homeostasis model assessment (HOMA-IR) method. RESULTS: The overall prevalence of the MS in the sample was 20.5% (95% confidence interval (CI) = 15.3%-25.7%). Persons who had classified themselves as both Hispanic and black had the highest frequency (27.8% (95% CI = 16.3%-39.3%)) of the MS and the highest HOMA-IR scores. After controlling for lifestyle factors and HOMA-IR, Hispanic ethnicity was independently associated with an increased risk of having the MS (odds ratio (OR) = 1.82, (95% CI = 1.07-3.07)), high triglycerides (OR = 3.66 (95% CI = 2.18-6.15)), and low HDL-C (OR = 1.60 (95% CI = 1.04-2.45)). A waist circumference of > 88 cm was associated with an increased risk of metabolic abnormalities among overweight and obese women. CONCLUSIONS: The frequency of the MS among Caribbean-born persons in the U. S. Virgin Islands is comparable to the frequency of the MS among the general population on the mainland of the United States. Among Caribbean-born persons living in the U.S. Virgin Islands, those who are Hispanic blacks may have a greater risk of cardiovascular disease than do other groups.     

Can lay-led walking programmes increase physical activity in middle aged adults? A randomised controlled trial

STUDY OBJECTIVE: To compare health walks, a community based lay-led walking scheme versus advice only on physical activity and cardiovascular health status in middle aged adults. DESIGN: Randomised controlled trial with one year follow up. Physical activity was measured by questionnaire. Other measures included attitudes to exercise, body mass index, cholesterol, aerobic capacity, and blood pressure. SETTING: Primary care and community. PARTICIPANTS: 260 men and women aged 40-70 years, taking less than 120 minutes of moderate intensity activity per week. MAIN RESULTS: Seventy three per cent of people completed the trial. Of these, the proportion increasing their activity above 120 minutes of moderate intensity activity per week was 22.6% in the advice only and 35.7% in the health walks group at 12 months (between group difference =13% (95% CI 0.003% to 25.9%) p=0.05). Intention to treat analysis, using the last known value for missing cases, demonstrated smaller differences between the groups (between group difference =6% (95% CI -5% to 16.4%)) with the trend in favour of health walks. There were improvements in the total time spent and number of occasions of moderate intensity activity, and aerobic capacity, but no statistically significant differences between the groups. Other cardiovascular risk factors remained unchanged. CONCLUSIONS: There were no significant between group differences in self reported physical activity at 12 month follow up when the analysis was by intention to treat. In people who completed the trial, health walks was more effective than giving advice only in increasing moderate intensity activity above 120 minutes per week.     

Factores asociados a mala calidad de sueño en población brasilera a partir de los 40 años de edad: estudio VIGICARDIO

ObjectiveThe prevalence of poor sleep quality in men and women ≥ 40 years old from the VIGICARDIO Study was determined, and sociodemographic, health, lifestyle and social capital factors associated with poor sleep quality were identified.MethodsA population-based study conducted in 2011 among 1,058 non-institutionalised individuals randomly selected from Cambé, Paraná State, Brazil. Logistic regression was used to evaluate the association between sleep quality and sociodemographic, health, lifestyle and social capital factors in men and women.ResultsThe prevalence of poor sleep quality was 34% in men and 44% in women. Having bad/regular self-rated health status was a factor associated with poor sleep quality in men (OR: 1.79; 95% CI: 1.17-2.72) and women (OR: 2.43; 95% CI: 1.68-3.53). Being obese (OR: 1.67; 95% CI: 1.13-2.46), having depression (OR: 2.09; 95% CI: 1.41-3.13) and presenting temporal orientation difficulties (OR: 1.95; 95% CI: 1.08-3.52) were associated factors in women. Difficulty to understand what is explained (OR: 2.18; 95% CI: 1.16-4.09) and alcohol abuse (OR: 1.85; 95% CI: 1.21-2.83) were associated factors in men.ConclusionFactors affecting sleep quality are different for men and for women. These factors should be taken into consideration when devising activities that promote good sleep quality, with a view to improving their effectiveness.     

Features of the neighborhood environment and walking by U.S. adults

BACKGROUND: Manipulating the physical environment may be an efficacious way to promote physical activity. This study examined the relationships between features of the neighborhood environment and walking in the neighborhood by U.S. adults. METHODS: A random sample of women (n =266) and men (n =208) aged >18 years participated. Door-to-door interviews were conducted in 2003 to collect information about demographics, walking behavior, and features of the neighborhood environment. RESULTS: The analyses conducted in 2004 revealed that women were more likely to walk for exercise (odds ratio [OR]=4.6, 95% confidence interval [CI]=1.01-20.72) or walk a dog (OR=3.3, 95% CI=1.01-11.08) in the neighborhood if neighborhood safety was average as opposed to below average (p <0.05). Women with an average number of neighborhood destinations were more likely to walk for transportation in the neighborhood (OR=5.7, 95% CI=1.63-19.73) than women with a below average number of neighborhood destinations (p <0.01). In men, none of the neighborhood features were significantly associated with walking for exercise or walking a dog. Men were less likely to walk for transportation in the neighborhood if the functional (OR=0.22, 95% CI=0.06-0.89) or aesthetic (OR=0.17, 95% CI=0.03-0.89) features of the neighborhood were average versus below average. CONCLUSIONS: Prospective studies are needed to determine if changes in neighborhood safety and awareness of neighborhood destinations promote increases in walking by women. Evaluations of the relationships between other environmental features and walking behavior in men are warranted.     

Determinants of cigarette smoking in the black township population of Cape Town.

There is concern about the increasing tobacco consumption in developing countries, especially in urban communities. Little information is available on the prevalence and determinants of smoking in black townships in South Africa. We therefore conducted a survey of the smoking practices in three such townships in Cape Town, in which 673 higher primary schoolchildren and 1320 adults were interviewed using a WHO questionnaire translated into Xhosa. Results were analysed using a multiple logistic regression model. In higher primary schoolpupils, boys smoked much more than girls [adjusted odds ratio (ORa) = 17.8; 95% confidence interval (CI): 5.2-60.9]; and smoking prevalence increased with age (ORa = 1.6; 95% CI: 1.3-1.9), peer pressure (ORa = 4.4; 95% CI: 1.9-6.9), and poor health knowledge (ORa = 3.1; 95% CI: 1.6-5.8). In adults, smoking prevalence was 53% in men compared to 6% in women. In men, an urban experience of 6 or more years was significantly associated with smoking (ORa = 1.9; 95% CI: 1.2-3.0) after adjustment for age, health knowledge and occupation. No association was found between level of education and smoking prevalence. Men in higher paid occupations smoked more than those in low paid occupations (ORa = 1.7; 95% CI: 1.0-2.8). Unemployment, however, was not associated with smoking prevalence. The findings emphasise the need for primary prevention of smoking in women and boys. Urbanisation and increased earning power appear to boost tobacco consumption in the absence of active anti-smoking efforts.     

Promoting walking with pedometers in the community: the step-by-step trial

BACKGROUND: Pedometers have been identified as a potential motivational aid for increasing physical activity, but their efficacy has not been demonstrated in a community-based, nonclinical sample. DESIGN: A randomized controlled trial was conducted from August to December 2005. Analysis was completed in June 2006. SETTING/PARTICIPANTS: Inactive adults aged 30-65 years (n=369) recruited from the community. INTERVENTION: Comparison of a theoretically based self-help walking program (WP) and weekly diaries (sent by mail); the same walking program with a pedometer (WPP) (also by mail); and a no-treatment control group (C). MEASURES: Change in self-reported leisure time in any sports/recreation in the last 3 months, and all-purpose walking (APW) for exercise, recreation, and travel, and other moderate, vigorous physical activity in the last week. Proportions meeting physical activity recommendations (equal to or greater than 150 minutes and equal to or greater than five sessions/week(-1)) were determined. RESULTS: A 3-month follow-up interview was conducted with 314 (85%) participants. Intention-to-treat analyses indicated significance within-group increases of APW and leisure-time walking (LTW), but mean and median sessions and minutes changes were greatest in the WPP group. There were no significant between-group differences in regular LTW (walked equal to or greater than 5 sessions/week(-1) for at least 30 minutes/session), but the WPP group increased significantly participation in other sports/recreations and was more likely than the control group to meet physical activity recommendations by all leisure-time physical activity (adjusted odds ratio=2.40, 95% CI=1.17-4.93), by APW (adjusted odds ratio=1.75 95% CI=0.92-3.34) and all physical activity (adjusted odds ratio=1.59 95% CI=0.92-2.79) in the last week. CONCLUSIONS: Pedometers enhanced the effects of the self-help walking program. This low-cost intervention should be tested for sustainability.     

Rethinking race/ethnicity, income, and childhood asthma: racial/ethnic disparities concentrated among the very poor

OBJECTIVE: Past studies of the prevalence of childhood asthma have yielded conflicting findings as to whether racial/ethnic disparities remain after other factors, such as income, are taken into account. The objective of this study was to examine the association of race/ethnicity and family income with the prevalence of childhood asthma and to assess whether racial/ethnic disparities vary by income strata. METHODS: Cross-sectional data on 14,244 children aged <18 years old in the 1997 National Health Interview Survey were examined. The authors used logistic regression to analyze the independent and joint effects of race/ethnicity and income-to-federal poverty level (FPL) ratio, adjusting for demographic covariates. The main outcome measure was parental report of the child having ever been diagnosed with asthma. RESULTS: Bivariate analyses, based on weighted percentages, revealed that asthma was more prevalent among non-Hispanic black children (13.6%) than among non-Hispanic white children (11.2%; p<0.01), but the prevalence of asthma did not differ significantly between Hispanic children (10.1%) and non-Hispanic white children (11.2%; p=0.13). Overall, non-Hispanic black children were at higher risk for asthma than non-Hispanic white children (adjusted odds ratio [OR]=1.20; 95% confidence interval [CI] 1.03, 1.40), after adjustment for sociodemographic variables, including the ratio of annual family income to the FPL. Asthma prevalence did not differ between Hispanic children and non-Hispanic white children in adjusted analyses (adjusted OR=0.85; 95% CI 0.71, 1.02). Analyses stratified by income revealed that only among children from families with incomes less than half the FPL did non-Hispanic black children have a higher risk of asthma than non-Hispanic white children (adjusted OR=1.99; 95% CI 1.09, 3.64). No black vs. white differences existed at other income levels. Subsequent analyses of these very poor children that took into account additional potentially explanatory variables did not attenuate the higher asthma risk for very poor non-Hispanic black children relative to very poor non-Hispanic white children. CONCLUSIONS: Non-Hispanic black children were at substantially higher risk of asthma than non-Hispanic white children only among the very poor. The concentration of racial/ethnic differences only among the very poor suggests that patterns of social and environmental exposures must overshadow any hypothetical genetic risk.     

Incidence of hypertension and educational attainment: the NHANES I epidemiologic followup study. First National Health and Nutrition Examination Survey

Previous research has demonstrated the association between cardiovascular disease and education. However, few studies have described the incidence of hypertension, a risk factor for cardiovascular disease, by education or other socioeconomic status indicators. To examine the association between hypertension incidence and education, the authors analyzed data from the First National Health and Nutrition Examination Survey (NHANES I) Epidemiologic Followup Study (NHEFS) (1971-1984). The relative risk of hypertension incidence (blood pressure > or =160/95 and/or using antihypertensive medication) by education was calculated for non-Hispanic Whites (aged 25-64 years) and non-Hispanic Blacks (aged 25-44 years) normotensive at baseline using Cox proportional hazards models. The age-adjusted relative risk of hypertension incidence among persons with less than 12 years of education compared with those with more than 12 years was significant among non-Hispanic Whites aged 25-44 years (men: relative risk (RR) = 2.14, 95% confidence interval (CI): 1.29, 3.54; women: RR = 2.06, 95% CI: 1.39, 3.05) but not among non-Hispanic Blacks (RR = 1.16, 95% CI: 0.63, 2.14). Relative risks for non-Hispanic White men remained stable after adjusting for age, systolic blood pressure, body mass index, and region of residence; relative risks for non-Hispanic White women were reduced but remained significant. Non-Hispanic White men and women aged 45-64 years with less than 12 years of education were not at higher risk of developing hypertension compared with their more educated counterparts. These results demonstrate a significant interaction between age and education with an independent association between education and hypertension incidence among younger but not older non-Hispanic White men and women.     

Prevalence of fruit and vegetable consumption and physical activity by race/ethnicity--United States, 2005

Diets high in fruits and vegetables and participation in regular physical activity are associated with a lower risk for several chronic diseases and conditions. The National Cholesterol Education Program and the American Cancer Society both emphasize lifestyle modifications that include diet and physical activity to reduce disease risk. These are also two of the strategies implemented by states participating in CDC's Nutrition and Physical Activity Program to Prevent Obesity and Other Chronic Diseases. To examine the combined prevalence of 1) consumption of fruits and vegetables five or more times per day and 2) regular physical activity among U.S. adults by race/ethnicity, CDC analyzed self-reported data from the 2005 Behavioral Risk Factor Surveillance System (BRFSS). This report describes the results of that analysis, which indicated that the combined prevalence of these two behavioral strategies was higher among men of multiple/other races (16.5%) compared with non-Hispanic white men (12.6%). In addition, only 12.6% of non-Hispanic black women and 14.8% of Hispanic women, compared with 17.4% of non-Hispanic white women, engaged in these two behavioral strategies. These results underscore the need to promote diets high in fruits and vegetables and regular physical activity among all populations in the United States and among racial and ethnic minority communities in particular.     

Involvement of young Australian adults in meal preparation: cross-sectional associations with abdominal obesity and body mass index

Previous research has shown that involvement in meal preparation is positively associated with better diet quality. However, it is unclear whether there is an association between involvement in meal preparation and being overweight or obese. This study investigated whether the level of involvement in meal preparation was associated with objectively measured weight status in young adults. During 2004-2006, a national sample of 1,996 Australian adults aged 26 to 36 years completed a self-administered questionnaire including questions on sociodemographic characteristics, diet, and physical activity. Participants were asked to report who usually prepared the main meal on working days and responses were categorized as “myself,” “shared,” or “someone else.” Waist circumference, weight, and height were measured by trained staff. Moderate abdominal obesity was defined as waist circumference ≥94 cm for men and ≥80 cm for women. Overweight was defined as body mass index (calculated as kg/m²) ≥25. Prevalence ratios were calculated using log binomial regression. After adjusting for age, education, and leisure time physical activity, men who shared the meal preparation had a slightly lower prevalence of moderate abdominal obesity (prevalence ratio=0.92; 95% confidence interval [CI]: 0.86 to 0.99) than those whose meals were usually prepared by someone else. There was no association with having sole responsibility (prevalence ratio=0.99; 95% CI: 0.92 to 1.06). There were no associations between level of involvement in meal preparation and being overweight (shared responsibility prevalence ratio=0.99; 95% CI: 0.92 to 1.07; sole responsibility prevalence ratio=0.98; 95% CI: 0.91 to 1.05). For women, level of involvement was not associated with moderate abdominal obesity (shared responsibility prevalence ratio=0.93; 95% CI: 0.84 to 1.03; sole responsibility prevalence ratio=0.94; 95% CI: 0.86 to 1.03) or being overweight (shared responsibility prevalence ratio=0.93; 95% CI: 0.84 to 1.02; sole responsibility prevalence ratio=0.93; 95% CI: 0.85 to 1.02). In this sample of young adults, level of involvement in meal preparation was not strongly related to weight status.     

Leisure-Time Physical Activity Patterns and Correlates Among Pregnant Women in Ontario, Canada

Physical activity significantly impacts public health as it reduces the risk of chronic diseases and provides numerous protective factors during pregnancy. Although Canadian guidelines recommend regular physical activity for healthy pregnant women, little is known about their leisure-time physical activity patterns. This study compared the physical activity levels of pregnant and non-pregnant women and examined socio-demographic and health correlates of physical activity during pregnancy. Canadian Community Health Survey data (2005–2008) from 623 pregnant women and 20,392 non-pregnant women aged 15–49 years in Ontario, Canada were examined. The prevalence of regular physical activity (15 or more minutes on at least 3 days of the week) was 58.3 % [95 % CI 52.9, 63.4], among pregnant women and 66.9 % [95 % CI 65.8, 68.0] among non-pregnant women. However, the prevalence of meeting Canadian guidelines for physical activity during pregnancy (30 or more minutes on at least 4 days of the week) was only 23.3 %, [95 % CI 19.4, 27.7] among pregnant women and 33.6 % [95 % CI 32.7, 34.6] among non-pregnant women. Pregnant women were less likely to be meeting guidelines if they were single, divorced, separated or widowed, a visible minority, had a household income between $20,000 and $79,999, and reported being in good or fair/poor health; when it came to education, women who had completed high school were more likely to be meeting guidelines. Few pregnant women in Ontario are meeting guidelines for physical activity during pregnancy. Results indicate that promoting physical activity during pregnancy should remain a public health priority.