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Los Angeles, CA, United States

Tarleton H.P.,Loyola Marymount University | Smith L.V.,Office of Health Assessment and Epidemiology | Smith L.V.,University of California at Los Angeles | Zhang Z.-F.,University of California at Los Angeles | Kuo T.,University of California at Los Angeles
Journal of Community Health

Body mass index (BMI) and waist circumference (WC) are two common anthropometric measures of obesity in clinical and public health practice. Consensus, however, remains elusive regarding their utility for predicting cardiovascular disease risk in multiethnic populations. We address this gap in the literature by analyzing cross-sectional data from the first round of the Los Angeles County Health and Nutrition Examination Survey, 2011. We characterized the relationships between BMI, WC, waist-to-hip ratios, waist-to-height ratios, and chronic disease extent, as confirmed by the presence of hypertension, diabetes, and/or two or more other chronic conditions as defined by a composite indicator 'comorbidity'. To account for race/ethnicity, age, gender, and cigarette smoking frequency, adjusted odds ratios (aOR) were generated and reported for each of the regression analyses. Whereas being overweight was associated with hypertension alone (aOR 2.10; 95 % CI 1.12-3.94), obesity was associated with hypertension (aOR 5.04; 95 % CI 2.80-9.06) as well as diabetes (aOR 5.28; 95 % CI 2.25-12.3) and comorbidity (aOR 3.69; 95 % CI 2.02-6.77). In whites and African-Americans, BMI and WC were positively related to diabetes, hypertension and comorbidity. In Hispanics, BMI and WC were also positively related to diabetes and comorbidity, but only the former measure was associated with hypertension (p < 0.050). In Asians, BMI was not a significant predictor of diabetes, hypertension and/or comorbidity. Collectively, the findings suggest that BMI is not universally informative and waist circumference and its derivatives may represent a viable, more racially/ethnically appropriate alternative for use with selected minority groups. © 2013 Springer Science+Business Media New York. Source

Baldwin S.B.,Office of Health Assessment and Epidemiology | Fehrenbacher A.E.,University of California at Los Angeles | Eisenman D.P.,University of California at Los Angeles
Qualitative Health Research

This study examined coercive conditions experienced by trafficked persons in the context of Bidermans theory of coercion. We conducted semi-structured interviews with 12 adult women trafficked into Los Angeles County, from 10 countries, for domestic work and/or sex work. Participants described health problems they experienced in relation to their trafficking experience and their perceptions of conditions that caused health problems. Utilizing a framework analysis approach, we analyzed themes using Bidermans framework. Participants reported experiencing the range of nonphysical coercive tactics outlined by Biderman, including isolation, monopolization of perception, induced debility or exhaustion, threats, occasional indulgences, demonstration of omnipotence, degradation, and enforcement of trivial demands. Our analysis demonstrates how these coercion tactics reinforced the submission of trafficked persons to their traffickers even in the absence of physical force or restraints. Such psychological abuse creates extreme stress that can lead to acute and chronic, physical and mental health problems. © The Author(s) 2014. Source

Cummings P.L.,Office of Senior Health | Sorvillo F.,Office of Health Assessment and Epidemiology | Sorvillo F.,University of California at Los Angeles | Kuo T.,Office of Senior Health | Kuo T.,University of California at Los Angeles
Journal of the American Geriatrics Society

Objectives To update and examine Alzheimer's disease-related mortality trends according to age, sex, race and ethnicity, geography, and other case characteristics for a 10-year period. Design Trend and comparative analyses of the U.S. multiple-cause-of-death records for 1999 to 2008. Setting United States. Participants Participants were decedents with Alzheimer's disease (AD) coded as underlying or associated cause of death; decedents with other forms of dementia or cognitive disorder were excluded. Measurements Case frequency, age-specific death rates, and crude and age-adjusted mortality rates were estimated for all AD decedents from the sampled period. Measures of AD mortality burden were compared with those of other leading causes of death (e.g., diabetes mellitus, stroke). Results From 1999 to 2008, 879,281 AD-related deaths were identified. The age-adjusted mortality rate for AD increased from 45.3 per 100,000 population (95% confidence interval (CI) = 45.0-45.7) in 1999 to 50.0 per 100,000 population (95% CI = 49.7-50.3) in 2008. The average age at death was 85.9. Differences in AD-related deaths varied according to sex, race and ethnicity, and geography. The number of AD-related deaths and age-specific mortality for persons aged 85 and older (n = 532,338, 1,096.6 per 100,000 population) were comparable with those from the same age group who died from diabetes mellitus (n = 488,593, 1,006.5 per 100,000 population). Conclusion The burden of AD-related mortality was substantial for the period 1999 to 2008. This burden is expected to grow rapidly as the baby boomer generation ages. Findings from this study may have important implications for present and future planning in medicine, social services, public policy, and public health. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society. Source

Shih M.,Office of Health Assessment and Epidemiology | Dumke K.A.,University of Southern California | Goran M.I.,University of Southern California
Pediatric Obesity

What is already known about this subject Neighbourhood social, economic and environmental factors are associated with childhood obesity. Childhood obesity disproportionately impacts those living in low-income neighbourhoods. What this study adds Childhood obesity prevalence is strongly associated with community-level social and economic conditions as measured using a composite Economic Hardship Index. Childhood obesity prevalence among communities in the highest hardship quartile was more than double the prevalence among communities in the lowest hardship quartile (26.9 vs. 12.5%). The relationship between economic hardship and obesity differs by race/ethnicity. Objective The association between community-level economic hardship and childhood obesity prevalence was examined in Los Angeles County, one of the largest and most racially and ethnically diverse regions in the United States. Methods Data from the 2008-2009 California Department of Education's Physical Fitness Testing Program were analyzed to assess obesity prevalence among 5th, 7th and 9th grade students attending public schools (n=298485). Community-level socioeconomic conditions were compared using a census-tract-based Economic Hardship (EH) index. Mixed-effects modelling was used to examine the association between obesity prevalence and gender, grade, race/ethnicity and EH. Results Higher community-level EH was associated with higher childhood obesity prevalence (P<0.001). The obesity prevalence among communities in the highest EH quartile (26.9%) was more than double the obesity prevalence among communities in the lowest EH quartile (12.5%). The slope of the association between EH and childhood obesity differed by racial/ethnic group. The slope was higher for non-Hispanic White students, Hispanics, and non-Hispanic Asians, and lower for non-Hispanic Black students. Racial/ethnic disparities were observed across the socioeconomic spectrum. Conclusions Findings suggest that efforts to improve community socioeconomic conditions could reduce childhood obesity prevalence. Prevention efforts should target communities with high economic hardship and also focus on providing culturally relevant interventions that address disparities in obesity prevalence across communities. © 2012 The Authors. Source

Cui Y.,Office of Health Assessment and Epidemiology | Baldwin S.B.,Office of Health Assessment and Epidemiology | Lightstone A.S.,Office of Health Assessment and Epidemiology | Shih M.,Office of Health Assessment and Epidemiology | Yu H.,University of California at Los Angeles
Journal of Urban Health

Los Angeles County has among the lowest smoking rates of large urban counties in the USA. Nevertheless, concerning disparities persist as high smoking prevalence is found among certain subgroups. We calculated adult smoking prevalence in the incorporated cities of Los Angeles County in order to identify cities with high smoking prevalence. The prevalence was estimated by a model-based small area estimation method with utilization of three data sources, including the 2007 Los Angeles County Health Survey, the 2000 Census, and the 2007 Los Angeles County Population Estimates and Projection System. Smoking prevalence varied considerably across cities, with a more than fourfold difference between the lowest (5.3%) and the highest prevalence (21.7%). Higher smoking prevalence was generally found in socioeconomically disadvantaged cities. The disparities identified here add another layer of data to our knowledge of the health inequities experienced by low-income urban communities and provide much sought data for local tobacco control. Our study also demonstrates the feasibility of providing credible local estimates of smoking prevalence using the model-based small area estimation method. © 2011 The New York Academy of Medicine. Source

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