CDC Health Disparities and Inequalities Report — United States, 2011
Morbidity and Mortality Weekly Supplement
Since 1946, CDC has monitored and responded to challenges in the nation’s health, with particular focus on reducing gaps between the least and most vulnerable U.S. residents in illness, injury, risk behaviors, use of preventive health services, exposure to environmental hazards, and premature death. We continue that commitment to socioeconomic justice and shared responsibility with the release of CDC Health Disparities and Inequalities in the United States — 2011, the first in a periodic series of reports examining disparities in selected social and health indicators.
Health disparities are differences in health outcomes between groups that reflect social inequalities. Since the 1980s, our nation has made substantial progress in improving residents’ health and reducing health disparities, but ongoing racial/ethnic, economic, and other social disparities in health are both unacceptable and correctable.
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Out of Sync? Demographic and other social science research on health conditions in developing countries
By: Jere Behrman, Julia Behrman, and Nykia M. Perez
Source: Demographic Research
In this paper, we present a framework for considering whether the marginal social benefits of demographic and social science research on various health conditions in developing countries are likely to be relatively high. Based on this framework, we argue that the relative current and future predicted prevalence of burdens of different health/disease conditions, as measured by disability-adjusted life years (DALYs), provide a fairly accurate reflection of some important factors related to the relative marginal social benefits of demographic and social science research on different health conditions. World Health Organization (WHO) DALYs projections for 2005-30 are compared with (a) demographic and other social science studies on health in developing countries during 1990-2005, and (b) presentations made at the Population Association of America annual meetings during the same time period. These comparisons suggest that recent demographic and social science research on health in developing countries has focused too much on HIV/AIDS, and too little on non-communicable diseases.
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Children and AIDS: Fifth Stocktaking Report, 2010
From press release:
Achieving an AIDS-free generation is possible if the international community steps up efforts to provide universal access to HIV prevention, treatment, and social protection, according to “Children and AIDS: Fifth Stocktaking Report 2010,” which was released today in New York. Attaining this goal, however, depends on reaching the most marginalized members of society.
While children in general have benefited enormously from the substantial progress made in the AIDS responses, there are millions of women and children who have fallen through the cracks due to inequities rooted in gender, economic status, geographical location, education level and social status. Lifting these barriers is crucial to universal access to knowledge, care, protection, and the prevention of mother-to-child transmission (PMTCT) for all women and children.
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Adolescent Obesity in the United States: Facts for Policymakers
Susan Wile Schwarz and Jason Peterson
Source: National Center for Children in Poverty, Mailman School of Public Health, Columbia University
Adolescent obesity in the United States has many important implications for both the health and well-being of the individual and society. Specific negative impacts of obesity on health include increased susceptibility to a host of diseases, chronic health disorders, psychological disorders, and premature death, which in turn add billions of dollars in health care costs each year. Excess medical costs due to overweight adolescents are estimated at more than $14 billion per year.3 Furthermore, adolescent obesity affects our nation’s ability to protect itself; more than a quarter of 17- to 24-year-olds are not fit to enroll in the military due to their weight.
Adolescence is a crucial period for establishing healthy behaviors. Many of the habits formed during this developmental stage will last well into adulthood.5 Although obesity is a complex problem not yet fully understood by researchers, by addressing the known factors that contribute to obesity in adolescence, policymakers can help ensure a healthy and productive adulthood for our nation’s youth.
Obesity and poor nutrition – combined with mental health disorders and emotional problems, violence and unintentional injury, substance use, and reproductive health problems – form part of a complex web of potential challenges to adolescents’ healthy emotional and physical development.
The world health report – Health systems financing: the path to universal coverage
“Good health is essential to human welfare and to sustained economic and social development. WHO’s Member States have set themselves the target of developing their health financing systems to ensure that all people can use health services, while being protected against financial hardship associated with paying for them.
In this report, the World Health Organization maps out what countries can do to modify their financing systems so they can move more quickly towards this goal – universal coverage – and sustain the gains that have been achieved The report builds on new research and lessons learnt from country experience. It provides an action agenda for countries at all stages of development and proposes ways that the international community can better support efforts in low income countries to achieve universal coverage and improve health outcomes.” (From website announcement)
Factors Influencing Rural Residents’ Utilization of Urban Hospitals
By: Margaret Jean Hall, Jill Marsteller, and Maria Owings
Source: National Center for Health Statistics
Objective—To examine, using nationally representative data, which patient, hospital, and county characteristics influence rural residents’ urban hospitalization.
Methods—Rural residents hospitalized in urban hospitals (crossovers) are compared with those hospitalized in rural hospitals (noncrossovers). National Hospital Discharge Survey data were merged with Area Resource File and Centers for Medicare & Medicaid Services data to study rural inpatients’ characteristics; hospital descriptors; and county or state socioeconomic and health service variables. Multivariate logistic regression analysis identified covariates of the likelihood of being a crossover.
Findings—About one-third of the rural resident hospitalizations in 2003 were in urban hospitals. Other factors constant, those requiring greater resources had higher odds of crossing over, as did younger inpatients, those transferred from other hospitals, receiving surgery, and with mental diagnoses or congenital anomalies. Males, emergency admissions, and intervertebral disk disorder inpatients had lower odds of crossing over compared with those who were not in these categories. Crossover patients’ hospitals had higher Medicare case mix indices than hospitals used by noncrossovers. Rural inpatients in government hospitals, rather than proprietary or non-profit hospitals, had greater odds of crossing over, as did rural patients from counties with lower population density, fewer hospital beds, more hospitals, more commuters, and lower per capita income compared with those in other categories.
Conclusions—Rural hospitals continue to be an important source of inpatient care, but rural residents travel to urban hospitals in some specific instances.
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Sharing of Data Leads to Progress on Alzheimer’s
Gina Kolata | New York Times
August 12, 2010
The key to a collaborative Alzheimer’s project was an ambitious agreement to share all the data, making every single finding public immediately.
Vital Signs: State-Specific Obesity Prevalence Among Adults — United States, 2009
Source: Morbidity and Mortality Weekly Early Release
Background: Obesity is a costly condition that can reduce quality of life and increases the risk for many serious chronic diseases and premature death. The U.S. Surgeon General issued the Call to Action to Prevent and Decrease Overweight and Obesity in 2001, and in 2007, no state had met the Healthy People 2010 objective to reduce obesity prevalence among adults to 15%.
Methods: CDC used 2009 Behavioral Risk Factor Surveillance System survey data to update estimates of national and state-specific obesity prevalence. Obesity was calculated based on self-reported weight and height and defined as body mass index (weight [kg] / height [m]2) ≥30.
Results: Overall self-reported obesity prevalence in the United States was 26.7%. Non-Hispanic blacks (36.8%), Hispanics (30.7%), those who did not graduate from high school (32.9%), and persons aged 50–59 years (31.1%) and 60–69 years (30.9%) were disproportionally affected. By state, obesity prevalence ranged from 18.6% in Colorado to 34.4% in Mississippi; only Colorado and the District of Columbia (19.7%) had prevalences of <20%; nine states had prevalences of ≥30%.
Conclusions: In 2009, no state met the Healthy People 2010 obesity target of 15%, and the self-reported overall prevalence of obesity among U.S. adults had increased 1.1 percentage points from 2007.
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Overcoming Rural Health Care Barriers through Innovative Wireless Health Technologies
Darrell M. West testimony in front of the Health Subcommittee of the U.S. House of Representatives Committee on Veterans Affairs
June 24, 2010 —
In testimony before the Health Subcommittee of the U.S. House of Representatives Committee on Veterans Affairs, Darrell West argues that wireless health technologies can provide quality and accessible care to rural veterans.
Genetic Markers of Adult Obesity Risk Are Associated with Greater Early Infancy Weight Gain and Growth
By: Cathy E. Elks, et al.
Source: PLoS Medicine
Genome-wide studies have identified several common genetic variants that are robustly associated with adult obesity risk. Exploration of these genotype associations in children may provide insights into the timing of weight changes leading to adult obesity.
Methods and Findings
Children from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort were genotyped for ten genetic variants previously associated with adult BMI. Eight variants that showed individual associations with childhood BMI (in/near: FTO, MC4R, TMEM18, GNPDA2, KCTD15, NEGR1, BDNF, and ETV5) were used to derive an “obesity-risk-allele score” comprising the total number of risk alleles (range: 2–15 alleles) in each child with complete genotype data (n = 7,146). Repeated measurements of weight, length/height, and body mass index from birth to age 11 years were expressed as standard deviation scores (SDS). Early infancy was defined as birth to age 6 weeks, and early infancy failure to thrive was defined as weight gain between below the 5th centile, adjusted for birth weight. The obesity-risk-allele score showed little association with birth weight (regression coefficient: 0.01 SDS per allele; 95% CI 0.00–0.02), but had an apparently much larger positive effect on early infancy weight gain (0.119 SDS/allele/year; 0.023–0.216) than on subsequent childhood weight gain (0.004 SDS/allele/year; 0.004–0.005). The obesity-risk-allele score was also positively associated with early infancy length gain (0.158 SDS/allele/year; 0.032–0.284) and with reduced risk of early infancy failure to thrive (odds ratio = 0.92 per allele; 0.86–0.98; p = 0.009).
The use of robust genetic markers identified greater early infancy gains in weight and length as being on the pathway to adult obesity risk in a contemporary birth cohort.