Preventing Chronic Disease最新文献

Introduction: Mobility is a critical determinant of healthy aging. Agility, gait, balance, and fall risk, when left unassessed and unaddressed, may diminish older adults' ability to age in place, often leading to more restrictive, supervised care environments. This study examined racial and ethnic disparities in a composite mobility/functional measure in Hawai'i and the associations of selected social determinants of health (SDOH) with limitation status.

Methods: We analyzed data from the Hawai'i Behavioral Risk Factor Surveillance System collected from 2019 through 2021. The study population included community-dwelling adults aged 55 years or older from the 4 largest racial and ethnic groups in Hawai'i: White, Filipino, Japanese, and Native Hawaiian (unweighted n = 10,039; weighted population estimate = 350,922). We used weighted logistic regression to assess associations between mobility limitations and SDOH.

Results: Mobility limitations were reported by 28% of Native Hawaiian people aged 55 years or older, compared with 17% to 19% among other groups. Native Hawaiian adults aged 55 to 64 years also had substantially higher prevalence of mobility limitations than adults of the same age in other racial and ethnic groups. Higher income was protective against mobility limitations for both Native Hawaiian and White adults. In contrast, the associations of education and health insurance with mobility limitations varied across groups, with weaker protective associations of education among Native Hawaiian adults.

Conclusion: Findings suggest the importance of considering mobility-focused prevention and assessment for Native Hawaiian adults before the Medicare eligibility age of 65 years. To be effective, these interventions must be culturally grounded and tailored to the unique needs and lived experiences of Native Hawaiian communities.

Introduction: The prevalence of diabetes continues to increase - more than 38 million people in the US now have diabetes and 84 million have prediabetes. Because many new cases of incident diabetes may be attributed to suboptimal dietary quality, novel programs and policies to encourage healthy eating choices represent promising population-level approaches to reduce the number of new cases of diabetes.

Methods: To help estimate the potential impact of such programs and policies, we created the Microsimulation of Nutrition, Diabetes, and Cardiovascular Disease (MONDAC), a model to estimate the impact of simulated population-level dietary changes on downstream outcomes: body mass index, diabetes incidence, cardiovascular disease (CVD) incidence, all-cause mortality, quality-adjusted life years, direct medical costs, and cost-effectiveness.

Results: We used 24-hour recall data from the National Health and Nutrition Examination Survey to categorize food and beverage consumption into 51 mutually exclusive categories to understand the effects of dietary changes. We simulated the energy intake and dietary quality effects that result from increasing, decreasing, or reallocating intake of these 51 food categories. Reductions in calories induce weight loss via an energy balance model. Weight loss and improvements in dietary quality drive annual reductions in diabetes and CVD risk. Mortality was modeled using a lifetable approach, and direct medical care costs were applied using estimates from the literature. We cross-validated MONDAC with existing models to assess reliability of estimates. We provide an example simulation for MONDAC, modeling a reduction in sugar-sweetened beverage consumption at the national level in the US.

Conclusion: MONDAC provides a flexible approach to policy analysis to allow the user to simulate various food-related policies.

Introduction: Geographic disparities in childhood obesity have been demonstrated, but research examining differences in obesogenic behaviors by rurality is limited. This study examined children's rates of overweight and obesity, food security, and obesogenic behaviors (ie, physical activity, sleep time, and screen time) by rurality and the association between rurality and these 5 outcomes.

Methods: We analyzed cross-sectional data on children and adolescents aged 10 to 17 years (N = 35,963) from the 2021-2022 National Survey of Children's Health, a nationally representative sample of children and adolescents. Frequencies, proportions, and unadjusted results were calculated by using descriptive statistics and bivariate analyses. Multivariable logistic regression models were used to study the relationship between rurality and the 5 outcomes.

Results: Compared with urban children, rural children had higher odds of being overweight or obese (adjusted odds ratio [AOR] = 1.36; 95% CI, 1.19-1.56), being food insecure (AOR = 1.27; 95% CI, 1.11-1.44), and not meeting the recommended hours of sleep (AOR = 1.23; 95% CI, 1.07-1.40); and they had lower odds of being physically inactive (AOR = 0.79; 95% CI, 0.70-0.90) and having more than 2 hours of screen time on an average day (AOR = 0.85; 95% CI, 0.75-0.96).

Conclusion: The findings from this study are instructive for community partners and program developers in creating policies and programs that allow for multitiered interventions to promote positive health behaviors to reduce overweight and obesity among all children and adolescents.

Introduction: Women with multiple chronic conditions are more likely than women without them to report lower urinary tract symptoms (LUTS); understanding the association of common and coexisting chronic conditions with bladder health across adulthood may inform prevention efforts.

Methods: Data were collected from May 2022 through December 2023 from a regionally representative cohort of community-dwelling adult women in the US. Chronic conditions were assessed by self-report and bladder health, and LUTS were measured using validated questionnaires. Analyses were limited to women aged 40 years or older and included multivariable linear and logistic regression models, adjusted for age, body mass index, physical function, and educational attainment.

Results: Of 3,423 eligible participants, 2,016 were aged 40 years or older and responded to questions on multiple chronic conditions. Of these, 449 had no chronic conditions, 405 reported 1 chronic condition, 652 had 2 or 3 chronic conditions, and 510 had 4 or more chronic conditions. Hypertension (41.4%) and osteoarthritis (13.6%) were the most frequently reported coexisting conditions (9.7% had both). Across the 10-item Bladder Health Scales and 6-item Bladder Function Indices, women with 0 or 1 chronic condition reported better bladder health than women with multiple chronic conditions. In this cohort, frequent LUTS did not vary by the number of chronic conditions.

Conclusion: The opportunity to promote bladder health among adult women with chronic conditions may precede the development of frequent LUTS. Additional research is needed to determine whether prevention strategies may differ according to common chronic conditions.

Social determinants of health (SDOH) contribute to asthma prevalence and disparities in health outcomes. We used data from 3,994 respondents to the Social Determinants and Health Equity (SD/HE) module of the 2022 Mississippi Behavioral Risk Factor Surveillance System survey to examine the association between a summary measure of SDOH and the prevalence of self-reported asthma among adults in Mississippi. Adults experiencing 1 (adjusted odds ratio [AOR], 1.67), 2 (AOR, 1.69) or 4 or more (AOR, 2.33) SD/HE risk factors had higher odds of asthma compared with those experiencing no SD/HE risk factors. Our findings suggest a need to develop interventions for adults in Mississippi with multiple SDOH/HE risk factors.

Introduction: Dental cavities are a common chronic disease among US children. Sugar-sweetened beverages (SSBs) are the leading contributor of added sugars in children's diets. We assessed the prevalence and adjusted odds of a caregiver-reported cavity in the past 12 months by SSB consumption among children aged 1 to 5 years.

Methods: We used data from the 2021-2022 National Survey of Children's Health. Our sample comprised children aged 1 to 5 years who had seen an oral health provider in the past 12 months. An adult caregiver reported whether the child had a cavity in the past 12 months and how frequently they consumed SSBs in the past 7 days. Models were adjusted for age, sex, race and ethnicity, highest level of education among adults in the household, and household federal poverty level. We used multivariable logistic regression to examine the relationship between cavities and SSB consumption.

Results: Among 23,023 US children in our sample, 11.6% had a caregiver-reported cavity in the past 12 months. Approximately 37.3% of children were reported to drink no SSBs, 39.5% drank SSBs 1 to 3 times in the past week, and 23.3% drank SSBs 4 or more times in the past week. Compared with children who drank no SSBs, those who drank SSBs 1 to 3 times in the past week or 4 or more times in the past week had 1.7 (95% CI, 1.4-2.2) times and 2.8 (95% CI, 2.1-3.6) times higher adjusted odds, respectively, to have a caregiver-reported cavity.

Conclusion: Frequent SSB consumption is common among children aged 1 to 5 years and is associated with higher odds of having a cavity. These findings highlight the need for public health and dental professionals to promote the reduction of SSB intake and encourage healthier choices among very young children and their caregivers to help mitigate oral health issues.

Introduction: Subjective cognitive decline (SCD) may be associated with poor oral health because of difficulty with self-care or comorbid conditions. Our study aimed to examine oral health status, use of dental services, and the prevalence of SCD among US middle-aged (45-64 y) and older (≥65 y) adults.

Methods: We conducted a cross-sectional analysis of 2022 Behavioral Risk Factor Surveillance System (BRFSS) data. Our sample consisted of 83,479 adults aged 45 years or older who completed the cognitive decline module. The associations between SCD and oral health, use of dental services, sociodemographic characteristics, chronic disease conditions, and dementia risk factors were examined by using multivariate regression with a generalized linear model, survey-weighted to account for BRFSS's complex sampling design. All models were stratified by age group (45-64 y vs ≥65 y).

Results: Middle-aged and older adults with poor oral health had a higher weighted prevalence of SCD (13.6%) compared with those with good oral health (7.7%). After controlling for covariates, SCD prevalence was increased among adults aged 45 to 64 years with more tooth loss and was lower for those in the same age group who had visited a dentist in the past year (PR = 0.77; 0.65-0.90). Among people aged 65 years or older, SCD prevalence was significantly higher for people with tooth loss compared with no tooth loss, though this pattern was not linear.

Conclusion: A significant association was found between the number of teeth lost, dental service use, and SCD, particularly among adults aged 45 to 64 years. Maintaining good oral health and having regular dental visits may be a strategy to reduce the risk of SCD in middle age. People should be encouraged to seek regular dental care.

We used data from the National Survey of Children's Health in 2021, 2022, and 2023 to examine trends in sugar-sweetened beverage (SSB) intake among children aged 1 to 5 years in the US. We performed trend analyses nationally, by age group, and by state and jurisdiction (District of Columbia) for 2 frequencies of intake: 1 to 3 times per week and 4 or more times per week, with "none" as the referent group. We found no significant linear trends at the national level. Two states had significant linear trends for SSB intake 1 to 3 times per week, and 6 states and the District of Columbia had significant linear trends for SSB intake ≥4 times per week. State public health professionals can use these data to understand recent SSB intake among children.