Abstract 13360: The Association Between Food Insecurity and Cardiovascular Mortality in the United States From 2011 to 2017 - A Longitudinal Analysis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Stephen Y Wang ◽  
Atheendar S Venkataramani ◽  
Christina A Roberto ◽  
Lauren A Eberly ◽  
Peter W Groeneveld ◽  
...  
Keyword(s):  
Food Insecurity ◽  
Fixed Effects ◽  
The United States ◽  
Mortality Rates ◽  
County Level ◽  
Elderly Adults ◽  
Mortality Trends ◽  
Annual Percent Change ◽  
Cross Sectional ◽  
Longitudinal Changes

Introduction: Prior analyses suggest a link between food insecurity and cardiovascular (CV) health but are limited by cross-sectional designs. We investigated whether longitudinal changes in food insecurity are independently associated with CV mortality. Methods: Using National Center for Health Statistics data, we determined annual U.S. county-level age-adjusted CV mortality rates for non-elderly (20-64 years old) and elderly (65 years and older) adults. County-level food insecurity rates were obtained from the Map the Meal Gap project. We examined CV mortality trends by quartiles of average annual percent change (APC) in food insecurity. Using a Poisson fixed effects estimator, we assessed the association between longitudinal changes in food insecurity and CV mortality rates after accounting for time-varying demographic (proportion of residents who were male, black, Hispanic), economic (median household income, unemployment, poverty, education attainment, and housing vacancy rates), and healthcare access (insurance coverage, density of healthcare providers and hospital beds) variables. Results: Between 2011 and 2017, mean food insecurity rates decreased from 14.7% to 13.3%. In counties in the highest quartile of APC for absolute value change in food insecurity, non-elderly CV mortality increased from 82.2(SD=33.9) to 87.4(SD=37.3) per 100,000 individuals (p<0.001), while in counties in the lowest quartile of APC, mortality was stable [60.8(SD=22.2) to 60.0(SD=23.0) per 100,000 individuals, p=0.64]. Elderly CV mortality significantly declined in all quartiles [1643.3(SD=315.7) to 1542.7(SD=299.4) per 100,000 (p<0.001) in the highest quartile and 1408.3(SD=225.9) to 1338.6(SD=213.8) per 100,000 (p<0.001) in the lowest quartile). A 1 percentage point increase in food insecurity was independently associated with a 0.83% (95% CI 0.42 - 1.25, P<0.001) increase in CV mortality for non-elderly adults. This was not significant for elderly adults (-0.06%, 95% CI -0.39 - 0.28, P=0.74). Conclusion: From 2011 to 2017, an increase in food insecurity was independently associated with an increase in CV mortality rates for non-elderly adults in the U.S. Interventions targeting food insecurity may play a role in improving community CV health.

scholarly journals Time Trends in Pulmonary Embolism Mortality Rates in the United States, 1999 to 2018

2020 ◽  
Vol 9 (17) ◽  
Author(s):  
Karlyn A. Martin ◽  
Rebecca Molsberry ◽  
Michael J. Cuttica ◽  
Kush R. Desai ◽  
Daniel R. Schimmel ◽  
...  
Keyword(s):  
United States ◽  
Pulmonary Embolism ◽  
Inflection Point ◽  
The United States ◽  
Mortality Rates ◽  
Mortality Trends ◽  
Annual Percent Change ◽  
Younger Adults ◽  
Men And Women ◽  
Percent Change

Background Although historical trends before 1998 demonstrated improvements in mortality caused by pulmonary embolism (PE), contemporary estimates of mortality trends are unknown. Therefore, our objective is to describe trends in death rates caused by PE in the United States, overall and by sex‐race, regional, and age subgroups. Methods and Results We used nationwide death certificate data from Centers for Disease Control and Prevention Wide‐Ranging Online Data for Epidemiologic Research to calculate age‐adjusted mortality rates for PE as underlying cause of death from 1999 to 2018. We used the Joinpoint regression program to examine statistical trends and average annual percent change. Trends in PE mortality rates reversed after an inflection point in 2008, with an average annual percent change before 2008 of −4.4% (−5.7, −3.0, P <0.001), indicating reduction in age‐adjusted mortality rates of 4.4% per year between 1999 and 2008, versus average annual percent change after 2008 of +0.6% (0.2, 0.9, P <0.001). Black men and women had approximately 2‐fold higher age‐adjusted mortality rates compared with White men and women, respectively, before and after the inflection point. Similar trends were seen in geographical regions. Age‐adjusted mortality rates for younger adults (25–64 years) increased during the study period (average annual percent change 2.1% [1.6, 2.6]) and remained stable for older adults (>65 years). Conclusions Our study findings demonstrate that PE mortality has increased over the past decade and racial and geographic disparities persist. Identifying the underlying drivers of these changing mortality trends and persistently observed disparities is necessary to mitigate the burden of PE‐related mortality, particularly premature preventable PE deaths among younger adults (<65 years).

Strategic Planning in Emergency Management: Evaluating the Impacts on Local Program Quality

2020 ◽  
Vol 17 (3) ◽  
Author(s):  
Scott Robert Manning
Keyword(s):  
Strategic Planning ◽  
Emergency Management ◽  
Survey Design ◽  
Management Practice ◽  
The United States ◽  
Program Quality ◽  
County Level ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Local Program

AbstractThis study examined the strategic planning practices of county-level emergency management agencies (EMAs), with a specific focus on strategic planning adoption and its relationship to local program quality. The study utilized a descriptive, cross-sectional survey design to collect planning- and program-related data from more than 300 county-level EMAs across the United States. The study findings revealed that most of the county EMAs included in the final sample had previously engaged in strategic planning activities, with nearly all of them continuing to use strategic planning as part of their general management practice. The study findings further revealed that strategic planning had a direct and significant impact on the overall quality of local emergency management programs, and that the strategic planning EMAs had significantly higher mean quality scores across all program dimensions when compared to the non-strategic planning EMAs.

scholarly journals Association between food insecurity and access to a mental health professional: cross-sectional analysis of NHANES 2007–2014

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nina Camille Burruss ◽  
Marina Girgis ◽  
Karen Elizabeth Green ◽  
Lingyi Lu ◽  
Deepak Palakshappa
Keyword(s):  
Mental Health ◽  
Health Professional ◽  
Food Insecurity ◽  
Mental Health Professional ◽  
The United States ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
The Past ◽  
Cross Sectional Analysis ◽  
Sectional Analysis

Abstract Background To determine if individuals with food insecurity (FI) were less likely to have seen a mental health professional (MHP) within the past year than individuals without FI. Methods This is a cross-sectional analysis of data from the National Health and Nutrition Examination Survey (NHANES) conducted in the United States between 2007 and 2014. All participants 20 years of age or older were eligible for this study. We excluded participants who were pregnant, missing FI data, or missing data from the Patient Health Questionnaire (PHQ-9). The primary outcome was self-reported contact with a MHP in the past 12 months. We used multivariable logistic regression models to test the association between FI and contact with a MHP, controlling for all demographic and clinical covariates. Results Of the 19,789 participants, 13.9% were food insecure and 8.1% had major depressive disorder (MDD). In bivariate analysis, participants with FI were significantly more likely to have MDD (5.3% vs 2.8%, p < 0.0001) and to have been seen by a MHP in the preceding 12 months (14.0% vs 6.9%, p < 0.0001). In multivariable models, adults with FI had higher odds of having seen a MHP (OR = 1.32, CI: 1.07, 1.64). Conclusions This study demonstrates that individuals with FI were significantly more likely to have seen a MHP in the preceding 12 months compared to individuals without FI. Given the growing interest in addressing unmet social needs in healthcare settings, this data suggests that visits with MHPs may be a valuable opportunity to screen for and intervene on FI.

Examining the Relationship Between Food Insecurity and Academic Performance: Implications for Diversity and Equity in Higher Education

2021 ◽  
pp. 152102512110538
Author(s):  
Heather Mechler ◽  
Kathryn Coakley ◽  
Marygold Walsh-Dilley ◽  
Sarita Cargas
Keyword(s):  
Higher Education ◽  
United States ◽  
Food Insecurity ◽  
Educational Equity ◽  
The United States ◽  
Cross Sectional Study ◽  
Drop Out ◽  
Cross Sectional ◽  
Professional Students ◽  
The Relationship

In recent years, researchers have increasingly focused on the experience of food insecurity among students at higher education institutions. Most of the literature has focused on undergraduates in the eastern and midwestern regions of the United States. This cross-sectional study of undergraduate, graduate, and professional students at a Minority Institution in the southwestern United States is the first of its kind to explore food insecurity among diverse students that also includes data on gender identity and sexual orientation. When holding other factors constant, food-insecure students were far more likely to fail or withdraw from a course or to drop out entirely. We explore the role that higher education can play in ensuring students’ basic needs and implications for educational equity.

scholarly journals The Prevalence and Associated Characteristics of Food Insecurity Among U.S. Army Soldiers

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 195-195
Author(s):  
Carolyn Greene ◽  
Bethany Deschamps ◽  
Brenda Bustillos
Keyword(s):  
Food Insecurity ◽  
Short Form ◽  
Grey Literature ◽  
The United States ◽  
Study Data ◽  
Household Food Security ◽  
Cross Sectional ◽  
Army Soldiers ◽  
Main Effects ◽  
Female Soldiers

Abstract Objectives Food insecurity affects 11% of the United States (U.S.) population and leads to decrements in health and quality of life. Aside from grey literature, little is known about food insecurity among military personnel. The purpose of this study was to identify prevalence, gender discrepancies, and characteristics associated with food insecurity among U.S. Army soldiers. Investigators hypothesized that female soldiers who experience food insecurity will have higher body mass indices (BMI) than male soldiers, and that earning less income, being un-partnered, and having dependents while unmarried would be associated with food insecurity, irrespective of gender. Methods In this cross-sectional study, data were collected from 218 soldiers using the U.S. Household Food Security Survey Module: Six Item Short Form and a demographics questionnaire. Independent samples T-test and Chi square determined differences between samples. Two-way analysis of variance assessed interaction and main effects of food insecurity and gender on BMI. Logistic regressions determined likelihood of food insecurity based on paygrade, gender, marital status, number of dependents, and barracks residence. Results Over 22% of the sampled population was food insecure. When compared to food secure individuals, food insecure soldiers were younger (23.6 vs. 26.6 years) and had fewer dependents (0.70 vs. 1.16). Food insecure women had higher BMIs (25.3 vs. 23.5 kg/m2). Barracks residency was associated with food insecurity (χ2 = 7.290, P = 0.007). Main effects were significant for gender on BMI (P = 0.001), but interaction effects for food insecurity on BMI were not (P = 0.16). Soldiers with the rank of Private (OR = 5.510, P = 0.029) and Specialist (OR = 5.750, P = 0.032) had increased likelihood of food insecurity compared to officers. Conclusions Female soldiers and barracks residents may be most affected by food insecurity, which may have health implications that could affect career advancement and retention. The potential impact of food insecurity on military readiness and resiliency indicates the phenomenon may pose a risk to national security. Funding Sources No funding was received to complete this study.

scholarly journals Using Satellite Images and Deep Learning to Identify Associations Between County-Level Mortality and Residential Neighborhood Features Proximal to Schools: A Cross-Sectional Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Joshua J. Levy ◽  
Rebecca M. Lebeaux ◽  
Anne G. Hoen ◽  
Brock C. Christensen ◽  
Louis J. Vaickus ◽  
...  
Keyword(s):  
United States ◽  
Deep Learning ◽  
Mortality Rate ◽  
Satellite Images ◽  
The United States ◽  
Mortality Rates ◽  
Image Features ◽  
County Level ◽  
Crude Mortality Rate ◽  
Crude Mortality

What is the relationship between mortality and satellite images as elucidated through the use of Convolutional Neural Networks?Background: Following a century of increase, life expectancy in the United States has stagnated and begun to decline in recent decades. Using satellite images and street view images, prior work has demonstrated associations of the built environment with income, education, access to care, and health factors such as obesity. However, assessment of learned image feature relationships with variation in crude mortality rate across the United States has been lacking.Objective: We sought to investigate if county-level mortality rates in the U.S. could be predicted from satellite images.Methods: Satellite images of neighborhoods surrounding schools were extracted with the Google Static Maps application programming interface for 430 counties representing ~68.9% of the US population. A convolutional neural network was trained using crude mortality rates for each county in 2015 to predict mortality. Learned image features were interpreted using Shapley Additive Feature Explanations, clustered, and compared to mortality and its associated covariate predictors.Results: Predicted mortality from satellite images in a held-out test set of counties was strongly correlated to the true crude mortality rate (Pearson r = 0.72). Direct prediction of mortality using a deep learning model across a cross-section of 430 U.S. counties identified key features in the environment (e.g., sidewalks, driveways, and hiking trails) associated with lower mortality. Learned image features were clustered, and we identified 10 clusters that were associated with education, income, geographical region, race, and age.Conclusions: The application of deep learning techniques to remotely-sensed features of the built environment can serve as a useful predictor of mortality in the United States. Although we identified features that were largely associated with demographic information, future modeling approaches that directly identify image features associated with health-related outcomes have the potential to inform targeted public health interventions.

scholarly journals Mediators of Food Insecurity and Obesity in Female Heads-of-Household with Children

2017 ◽  
Vol 1 (3) ◽  
pp. 1-10
Author(s):  
Emily Havrilla
Keyword(s):  
Food Insecurity ◽  
Perceived Stress ◽  
Vulnerable Populations ◽  
Self Efficacy ◽  
The United States ◽  
Mediation Model ◽  
Cross Sectional ◽  
Heads Of Household ◽  
The Relationship ◽  
General Self Efficacy

Background: The prevalence of obesity is a significant issue in the United States. Among vulnerable populations, obesity exists in the presence of household food insecurity; however the mechanisms of the relationship are not well understood. General perceived stress and general self-efficacy were evaluated as mediators of the relationship between food insecurity and obesity in female heads-of-household with children. Methods: A cross-sectional correlational design with mediation model testing was used. Subjects (N = 86) were recruited through convenience sampling. Data were collected using a demographic questionnaire, the Core Food Security Module (CFSM), the General Perceived Stress Questionnaire (PSQ), and the General Self-Efficacy Scale (SES). Body mass index and waist –to-hip circumference were calculated from measured data. Results: Significant relationships were found between food insecurity and general perceived stress, general perceived stress and obesity, and general self-efficacy and obesity. Mediation models’ testing was not completed due the lack of a significant correlation between food insecurity and obesity. Post hoc analysis was completed using bootstrapping and a revised mediation model process. Conclusion: General perceived stress and general self-efficacy are associated with obesity in female heads-of-household with children who are food insecure. Keywords: Food insecurity, Obesity, Stress, Self-efficacy, Vulnerable populations, Quantitative research, Socioeconomic factors

Abstract 10: Widening Rural Disadvantage in United States Premature Heart Disease Mortality: Trends by Region and Race/Ethnicity, 2000 - 2013

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Elizabeth B Pathak ◽  
Colin J Forsyth
Keyword(s):  
United States ◽  
Heart Disease ◽  
American Indians ◽  
Rural Areas ◽  
The United States ◽  
Vital Statistics ◽  
The South ◽  
Mortality Trends ◽  
Annual Percent Change ◽  
Death Rates

Objectives: The purpose of this study was to quantify rural and metropolitan trends in premature heart disease (HD) mortality using the most up-to-date data available (through 2013). To our knowledge this is the first study to analyze these geographic disparities for Hispanics (HSP), Asians/Pacific Islanders (API), and American Indians/Alaska Natives (AI/AN). Methods: Annual age-adjusted HD death rates for adults aged 25-64 years were analyzed for 2000-2013. Rates were calculated for 5 racial/ethnic groups (Non-Hispanic Whites (WNH), Non-Hispanic Blacks (BNH), HSP of any race, Non-Hispanic API, and Non-Hispanic AI/AN). County-level data were aggregated by urbanicity: large central metro (LCM), large fringe metro (LFM), medium/small metro (MSM), and micropolitan/rural (RURAL). Region was defined as South (16 states) and Non-South. All data were obtained from the National Vital Statistics System on CDC WONDER. Average annual percent change (AAPC) was calculated by linear regression of the log-transformed death rates using SAS 9.4. Results: In 2013, the national population-at-risk predominantly resided in metro areas. However, there were more than 10 million RURAL adults aged 25-64 years in the South (16.2% of the region) and more than 13.4 million in the non-South (12.9% of the region). Nationwide, HD death rates were lowest in the LFM counties. In the South, the rate ratio (RR) for RURAL vs. LFM areas in 2011-2013 was 1.76 (95% CI 1.73 to 1.79) for WNH, 2.00 (95% CI 1.85 to 2.16) for HSP, 1.78 (95%CI 1.71 to 1.82) for BNH, 1.57 (95% CI 1.22 to 2.03) for API, and 3.13 (95% CI 2.47 to 3.96) for NNH. In the non-South, RURAL vs. LFM RRs were smaller, with the exception of API (RR 2.37, 95% CI 2.07 to 2.71). Temporal trend analyses revealed significantly smaller AAPC in RURAL areas (see Table). Conclusions: Higher death rates coupled with slower declines have resulted in a widening rural disadvantage in premature HD mortality in the United States from 2000 to 2013, particularly for WNH, HSP, BNH, and AI/AN in the South, and WNH in the non-South.

scholarly journals The evolution of infant mortality inequality in the United States, 1960–2016

2020 ◽  
Vol 6 (29) ◽  
pp. eaba5908
Author(s):  
Nick Turner ◽  
Kaveh Danesh ◽  
Kelsey Moran
Keyword(s):  
United States ◽  
Infant Mortality ◽  
The United States ◽  
Mortality Rates ◽  
County Level ◽  
Level Data ◽  
Antipoverty Programs ◽  
The Relationship ◽  
Over Time ◽  
Mortality Inequality

What is the relationship between infant mortality and poverty in the United States and how has it changed over time? We address this question by analyzing county-level data between 1960 and 2016. Our estimates suggest that level differences in mortality rates between the poorest and least poor counties decreased meaningfully between 1960 and 2000. Nearly three-quarters of the decrease occurred between 1960 and 1980, coincident with the introduction of antipoverty programs and improvements in medical care for infants. We estimate that declining inequality accounts for 18% of the national reduction in infant mortality between 1960 and 2000. However, we also find that level differences between the poorest and least poor counties remained constant between 2000 and 2016, suggesting an important role for policies that improve the health of infants in poor areas.

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