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Shih M.,Office of Health Assessment and Epidemiology | Du Y.,Office of Health Assessment and Epidemiology | Lightstone A.S.,Office of Health Assessment and Epidemiology | Simon P.A.,530 Wilshire Blvd | And 2 more authors.
Preventive Medicine | Year: 2014

Objective: The primary objective of this analysis was to examine the burden of diabetes among Asians and Asian subgroups in Los Angeles County, which has the largest county population of Asians in the U.S. Method: Data were analyzed from 6. cycles of the Los Angeles County Health Survey, 1997-2011 (n = 47,282). Asian adults (n = 4672) were categorized into the following ethnic subgroups: Chinese, Filipino, Korean, Japanese, Vietnamese, South Asian, and Other Asian. Descriptive and multivariable logistic regression analyses were conducted to examine trends in prevalence, prevalence among Asian subgroups, and factors associated with diabetes. Results: In 2005, we observed a rapid increase in diabetes prevalence among Asians compared to whites despite consistently lower BMI relative to other racial/ethnic groups. Diabetes prevalence was significantly higher among Filipinos and South Asians (>. 10%) compared to East Asians and Vietnamese (<. 7%). After adjusting for all covariates, Asians who were older, non-drinkers, insured, and overweight or obese were found to have increased odds of diabetes. Conclusion: Diabetes prevalence is increasing more rapidly among Asians compared to whites despite overall lower BMI. The significant heterogeneity among Asian subgroups highlights the need for disaggregated data and additional research to develop culturally appropriate interventions for diabetes prevention and control. © 2014 Elsevier Inc. Source


Simon P.A.,530 Wilshire Blvd
Preventing Chronic Disease | Year: 2014

We assessed public opinion on nutrition-related policies to address child obesity: a soda tax, restrictions on advertising unhealthy foods and beverages to children, and restrictions on siting fast food restaurants and convenience stores near schools. We analyzed data from 998 adults (aged ≥18 years) in the 2011 Los Angeles County Health Survey. Support was highest for advertising restrictions (74%), intermediate for a soda tax (60%), and lowest for siting restrictions on fast food restaurants and convenience stores (44% and 37%, respectively). Support for food and beverage advertising restrictions and soda taxation is promising for future policy efforts to address child obesity. Source


Simon P.A.,530 Wilshire Blvd
Preventing Chronic Disease | Year: 2013

This study assessed changes in consumption of sugar-sweetened beverages (SSBs) among children (aged <17 years) in Los Angeles County. We analyzed children's data from the 2007 (n = 5,595) and 2011 (n = 5,934) Los Angeles County Health Survey. The percentage of children who consumed 1 or more SSB per day decreased from 43.3% in 2007 to 38.3% in 2011 (P < .OOl); this decrease was seen across most sociodemographic subgroups. Despite measurable progress in reducing SSB consumption among children in Los Angeles County, consumption remains high, highlighting the need for additional policy and programmatic interventions. Objective Given recent evidence of the link between consumption of sugar-sweetened beverages (SSBs) and obesity (l), reducing SSB consumption has become a focus of childhood obesity prevention efforts. For example, California legislation prohibiting the sale of most SSBs on school campuses became effective in 2007 (2). In Los Angeles County, this policy was accompanied by intensive education on SSBs in schools, preschools, childcare sites, and other community settings, and in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), which serves more than 50% of children younger than 5 years in the county (Shannon Whaley, PhD, Director of Research and Evaluation, PHFE WIC, Los Angeles County, March 20, 2013). To assess the collective effect of these and other efforts, we examined data on SSB consumption among children in the county from the 2007 and 2011 Los Angeles County Health Survey (LACHS). Methods The LACHS is a periodically administered, random-digit-dial telephone survey of the noninstitutionalized county population and includes both adult and child (aged <17 years) components (3). We analyzed data from the child components of the 2 most recent surveys, conducted in 2007 and 2011 with 2 independent samples (n = 5,595 in 2007 and 5,934 in 2011). The study was approved by the Los Angeles County Department of Public Health's institutional review board. For each survey, 1 child was randomly selected from each sampled household, and data were reported by the parent or other adult in the household who was most knowledgeable about the child's health and well-being (henceforth referred to as "primary caretaker"). The surveys included identically worded questions on sociodemographic characteristics and SSB consumption ("On an average day, about how many sodas or other sweetened drinks such as Gatorade, Red Bull, or Sunny Delight does [child] drink? Do not include diet sodas or sugar-free drinks. Please count a 12-ounce can, bottle, or glass as 1 drink."). The SSB consumption question was adapted from a question used in the 2005 New York City Community Health Survey. Interviews were conducted in English, Spanish, Cantonese, Mandarin, Vietnamese, and Korean. Among all eligible households contacted, interviews were completed for 40% in 2007 and 64% in 2011.There were 2 methodologic differences between the 2 surveys. First, only the 2011 survey included cellular telephones, which accounted for 4% of the interviews. Second, a more sophisticated raking procedure was adopted in weighting the survey in 2011 (4). These changes were made to maintain survey representativeness and validity and are similar to those made to the Behavioral Risk Factor Surveillance System in 2011 (5). Further details regarding the survey design and changes in weighting methods are reported elsewhere (3,4). The percentage of children who consumed 1 or more SSB per day was calculated for the total study group in each survey and by sex, age group, child's race/ethnicity, annual household income relative to the federal poverty level (FPL), and primary caretaker's level of education. Among Latinos, results were further stratified by the language of interview (English or Spanish). Differences in percentages were assessed for significance by using the X2 test, and 95% confidence intervals were calculated for each point estimate. All analyses were conducted using SAS (version 9.2, SAS Institute Inc, Cary, North Carolina) using child sample weights; significance was set using an a of .05. Results In both 2007 and 2011, the percentage of children who consumed 1 or more SSB per day was highest among children aged 12 to 17 years and lowest among those aged 5 years or younger (Table). The percentage of children who consumed 1 or more SSB per day was inversely related to household income and primary caretaker's education level. The percentage was higher among Latino and African American children than among white and Asian/Pacific Islander children. Among all children, the percentage who consumed 1 or more SSB per day decreased from 43.3% in 2007 to 38.3% in 2011 (P < .001). Similar declines were seen across sex and age groups and among Latino children in households interviewed in Spanish (Table). Declines were also seen among children whose primary caretaker had less than a high school education or a college or postgraduate degree. A decrease was also observed among children from households whose incomes were below 300% of the FPL (P < .001) but not among those from households whose incomes were at or above 300% of the FPL (P = ·61). Source


Garcia A.,530 Wilshire Blvd | Baethke L.,Mayo Medical School | Kaur J.S.,Mayo Medical School
Journal of Cancer Education | Year: 2016

Cancer is now the second leading cause of death among American Indians and Alaska Natives (AIAN), and trends in cancer-related mortality over the past 2 decades show inferior control in AIAN compared to non-Hispanic Whites. The American Indian/Alaska Native Cancer Information Resource Center and Learning Exchange (Native C.I.R.C.L.E.) was developed in the year 2000 as part of a comprehensive network of partnerships to develop, maintain, and disseminate culturally appropriate cancer and other health information materials for AIAN educators and providers. Now, in its 15th year of existence, enough data has been accumulated by Native C.I.R.C.L.E. to analyze trends in the distribution of culturally relevant cancer information materials and compare access to both printed (hard copy) and online materials. The amount of culturally appropriate materials available since its creation has increased more than 10-fold. Print materials are now distributed throughout the world, and the number of materials requested from print and downloads combined are in the thousands on a monthly basis. Native C.I.R.C.L.E. is in the process of expanding its access and capabilities to target more of the lay AIAN public in order to address the digital divide. © 2016 American Association for Cancer Education Source


Robles B.,530 Wilshire Blvd | Frost S.,ICF International | Moore L.,West Virginia University | Harris C.V.,ICF International | And 3 more authors.
Preventive Medicine | Year: 2014

We described the prevalence of overweight and obesity among low-income women in rural West Virginia (WV) and urban Los Angeles County (LA County). Both communities participated in the national Communities Putting Prevention to Work program during 2010-2012. In each community, we completed health assessments on adult women recruited from public-sector clinics serving low-income populations. All participants answered survey questions regarding socio-demographics and diets. In both jurisdictions, we assessed obesity using objectively measured height and weight (calculated BMI). As part of each community case study, we performed multivariable regression analyses to describe the relationships between overweight and obesity and selected covariates (e.g., dietary behaviors). Overweight and obesity were prevalent among low-income women from WV (73%, combined) and LA County (67%, combined). In both communities, race and ethnicity appeared to predict the two conditions; however, the associations were not robust. In LA County, for example, African American and Hispanic women were 1.4 times (95% CI. =. 1.12, 1.81) more likely than white women to be overweight and obese. Collectively, these subpopulation health data served as an important guide for further planning of obesity prevention efforts in both communities. These efforts became a part of the subsequent Community Transformation Grants portfolio. © 2014 Elsevier Inc. Source

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