Local Health Department Assurance of Services and the Health of California’s Seniors.

Local Health Department Assurance of Services and the Health of California’s Seniors.

J Public Health Manag Pract. 2013 Jul 8;
Rodriguez HP, Herrera AP, Wang Y, Jacobson DM

To examine the extent to which local health department (LHD) assurance of select services known to promote and protect the health of older adults is associated with more favorable population health indicators among seniors.Data from the California Health Interview Survey (CHIS: 2003, 2005, and 2007) were linked with the 2005 wave of the National Association of County and City Health Officials profile survey and the Area Resource File to assess the association of LHD assurance and senior health indicators. Assurance was measured by an index of 5 services, either directly provided or contracted by LHDs: cancer screening, injury prevention, comprehensive primary care, home health care, and chronic disease prevention. Multilevel regression models estimated the association of LHD assurance of services and each of 6 older adult health indicators, controlling for individual, LHD, and county characteristics that included key social determinants of health, such as poverty.Fifty-seven California counties.33,154 older adults (age 65 and older).Colorectal cancer screening, mammography, healthy eating, physical activity, and multiple falls among older adults.Local health departments provided or contracted a median of 2 of the 5 services. In adjusted analyses, LHD assurance of services was generally unassociated with the seniors’ health behaviors, screening, and falls. Greater LHD expenditures per capita were associated with significantly better mammography screening rates (adjusted odds ratio [AOR] = 1.22, P < 0.01) compared to jurisdictions in the bottom one-third of per capita LHD spending. Greater county-level poverty (a social determinant of health) was associated with greater junk food consumption (AOR = 1.14, P < 0.01) and worse fruit and vegetable consumption (AOR = 0.97, P < 0.01). Highly impoverished counties were consistently in the bottom quartile of performance across all indicators.The LHD's assurance of select services known to promote and protect the health of older adults does not appear to translate into higher rates of colorectal cancer screening, mammography, healthy eating, physical activity, and fewer falls among seniors. County-level poverty is most strongly associated with older adult health, underscoring a key barrier to address in local senior health improvement efforts. HubMed – eating


Is it an eating disorder, gastrointestinal disorder, or both?

Curr Opin Pediatr. 2013 Jul 4;
Bern EM, O’Brien RF

The authors examine the differential diagnosis for gastrointestinal disorders that should be considered in individuals who present with nonspecific gastrointestinal and nutritional complaints suggestive of an eating disorder.This review first identifies diseases with which eating disorders are often confused and then explores features in the history, physical examination, and laboratory studies which can provide clues to the cause of the patient’s symptoms. In addition, it discusses the recommended evaluation and treatments for the gastrointestinal diseases that most commonly mimic the presentation of eating disorders, including Crohn disease (CrD), celiac disease, gastroesophageal reflux disease (GERD), and eosinophilic esophagitis (EoE).The ubiquitous nature of the gastrointestinal complaints requires the clinician to consider a broad differential diagnosis when evaluating a patient for an eating disorder. HubMed – eating


Risk Factors for Obesity in Children and Adults.

J Investig Med. 2013 Jul 8;
Siddarth D

The purpose of this study was to determine whether modifiable lifestyle factors such as eating habits, physical activity, and screen-viewing time, as well as ethnicity, sex, and family income level, were associated with obesity in children and adults and whether the associations differed across age groups.The data were drawn from the National Health and Nutrition Examination Survey 2009-2010.Multivariable logistic regression analyses were used, with obesity (defined as a body mass index of >30 kg/m for adults and ?95th percentile for children of the same age and sex) as the outcome variable. For children, screen-viewing (TV/computer) time was the only significant factor; in contrast, for adolescents, eating habits were the only significant predictor. For young and middle-aged adults, lack of physical exercise and time spent in sedentary activities were the determinants of obesity, whereas for older adults, both eating habits and physical activity measures were related to obesity.Distinct lifestyle factors have significant associations with obesity in different age groups, and this study underscores the need for age-specific intervention programs to address the obesity epidemic. HubMed – eating


Disordered eating behaviors in adolescents and adults living in the same household in metropolitan area of Rio de Janeiro, Brazil.

Psychiatry Res. 2013 Jul 7;
Ferreira JE, de Souza PR, da Costa RS, Sichieri R, da Veiga GV

To examine the prevalence of disordered eating behaviors among adolescents and adults living in the same household.We conducted a population-based cross-sectional study developed with a probabilistic sample of 511 adolescents and 1254 adults living in the metropolitan area of Rio de Janeiro, Brazil. The frequency of binge eating, purging, and strict dieting or fasting over the previous 6 months was ascertained using a self-report questionnaire.Binge eating (20.0% vs. 8.4%), strict dieting or fasting (18.9% vs. 2.4%), and purging (3.3% vs. 2.2%) were more frequent among adolescents than adults. There was a significant association between frequency of binge eating and strict dieting or fasting in adults and in adolescents living in the same household.The presence of disordered eating behaviors in adults may be a risk factor for the development of eating disorders in adolescents living in the same household. Thus, the development and implementation of eating disorder interventions should consider incorporating a family component. HubMed – eating