American journal of preventive medicine
-
Comparative Study
Measuring food availability and access in African-American communities: implications for intervention and policy.
Obesity is a major public health concern in the U. S. As compared to whites, minority populations are disproportionately at risk, with the highest prevalence rates of overweight and obesity occurring among African American women. ⋯ A major challenge has been the need for reliable and valid measures to assess aspects of the neighborhood food environment that encourage or inhibit healthful eating behaviors and weight management. Investigators have made considerable gains in the development of tools and approaches to measure neighborhood food environments overall, but few studies focus on the specific challenges and issues associated with characterizing neighborhood food environments in communities of color. This paper highlights important considerations for measuring food environments in African-American neighborhoods and their implications for developing programmatic and policy solutions to reduce racial disparities in overweight.
-
The rise in obesity levels in the U. S. in the past several decades has been dramatic, with serious implications for public health and the economy. Experiences in tobacco control and other public health initiatives have shown that public policy may be a powerful tool to effect structural change to alter population-level behavior. ⋯ Moving forward, timely evaluation of natural experiments is of especially high priority. A variety of policies intended to promote healthy weight in children and adults are being implemented in communities and at the state and national levels. Although some of these policies are supported by the findings of intervention research, additional research is needed to evaluate the implementation and quantify the impact of new policies designed to address obesity.
-
The capacity of public parks and recreation environments to promote physical activity for low-income communities of color is receiving increased attention from researchers and policymakers. As a result, several systems to measure park and recreation environments have been recently developed. Developing measures is important because they are critical to establishing key correlates and determinants that drive physical activity and inform intervention strategies. ⋯ One strategy for incorporating the perceptions is community-based participatory research. The rapid development of high-quality tools for measuring parks and recreation environments is encouraging. However, existing measures should be tested and refined in varying social-ecologic conditions, and new tools should be developed specifically for nuances associated with low-income minority communities.
-
The National Institute of Mental Health convened a meeting in October 2005 to review the literature on obesity, nutrition, and physical activity among those with mental disorders. The findings of this meeting and subsequent update of the literature review are summarized here. Levels of obesity are higher in those with schizophrenia and depression, as is mortality from obesity-related conditions such as coronary heart disease. ⋯ The minimal research on weight-management programs for those with mental disorders indicates that meaningful changes in dietary intake and physical activity are possible. Physical activity is an important component of any weight-management program, particularly for those with depression, for which a substantial body of research indicates both mental and physical health benefits. Obesity among those with mental disorders has not received adequate research attention, and empirically-based interventions to address the increasing prevalence of obesity and risk of cardiovascular and metabolic diseases in this population are lacking.
-
Environmental tobacco smoke (ETS) exposure during pregnancy contributes to adverse infant health outcomes. Limited previous research has focused on identifying correlates of ETS avoidance. This study sought to identify proximal and more distal correlates of ETS avoidance early in pregnancy among African-American women. ⋯ Social contextual factors were the strongest determinants of ETS avoidance during pregnancy. Results highlight the importance of prenatal screening to identify pregnant nonsmokers at risk, encouraging household smoking bans, gaining support from significant others, and fully understanding the interpersonal context of a woman's pregnancy before providing behavioral counseling and advice to prevent ETS exposure.