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Obesity is a serious public health problem in the United States. It is important to estimate obesity prevalence at the local level to target programmatic and policy interventions. It is challenging, however, to obtain local estimates of obesity prevalence because national health surveys such as the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS) are not designed to produce direct estimates at the local levels (e.g. census tracts) due to small population samples and the need to preserve individual confidentiality. In this study we address the problem of estimating local obesity prevalence rates by implementing a spatial microsimulation modeling technique to proportionally replicate the demographic characteristics of BRFSS respondents to census tract populations in metropolitan Detroit. Obesity prevalence rates are examined for high and low spatial clusters and studied in relation to the U.S. Department of Agriculture's (USDA) measures of low-income neighborhoods and local food deserts and CDC's measure of healthy and less healthy food environments currently used to target obesity reduction initiatives. This study found that obesity prevalence was largely clustered in the City of Detroit extending north into contiguous suburbs. The spatial patterns of highest obesity prevalence tracts were most similarly aligned with USDA-defined low-income tracts and CDC's less healthy food tracts. The locations of USDA's food desert tracts rarely overlapped with the highest obesity prevalence tracts. This study demonstrated a new methodology by which to assess local areas in need of future obesity interventions. 相似文献
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Objectives
We examined whether and to what extent the relationship between township disadvantages and obesity varied across geographical areas.Methods
A cross-sectional analysis of a population-based sample of Taiwanese adults (N = 25,985) from the 2005 Social Development Trend Survey on Health and Safety was performed. Multilevel models integrated with geographically weighted regressions were employed to analyze the spatially varying association between area disadvantages and obesity. The dependent variable was body mass index calculated from respondents’ self-reported weight and height. The key explanatory variable was a township disadvantage index made of poverty level, minority composition, and social disorder. Other individual socio-demographic characteristics were included to account for the compositional effect.Results
The association between township disadvantages and elevated obesity risk in Taiwan was found to be area-specific. In contrast to results from the commonly used global regression, geographically weighted regression model showed that township disadvantages elevated obesity level only in certain areas.Conclusions
We found heterogeneity of place-level determinants of obesity across geographical areas. Adoption of population approach to curb obesity would require area-specific strategies for most needed areas. 相似文献3.
Clare Herrick 《Geoforum》2007,38(1):90-102
The inclusion of obesity within public health rests on a proven and accepted biomedical link between body weight and health status. Drawing on the 2005 controversy over annual death rates attributable to obesity in the US, this paper contends that uncertainty as to the causal mechanisms linking body weight and health are undermining the development of effective obesity prevention policies. Consequently, this also weakens the justification of the inclusion of such policies within public health. This work draws on recent interest in ‘critical geographies of public health’ and the continued attention to the recursive relations between people and places in the context of health which may offer a useful theoretical viewpoint from which unpack such aetiological uncertainty. Without an agreed or universal risk from obesity, the paper argues that public health obesity prevention through social marketing should be geographical in outlook. The three examples of 5 a day, Jamie’s School Dinners and Sesame Street’s Cookie Monster are discussed to illustrate the effectiveness of communicating risk in a manner that allows intention to be effectively translated into risk-minimising behaviour within the dictates of locale. 相似文献
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Based on the data from the Behavioral Risk Factor Surveillance System (BRFSS) in 2007, 2009 and 2011 in Utah, this research uses multilevel modeling (MLM) to examine the associations between neighborhood built environments and individual odds of overweight and obesity after controlling for individual risk factors. The BRFSS data include information on 21,961 individuals geocoded to zip code areas. Individual variables include BMI (body mass index) and socio-demographic attributes such as age, gender, race, marital status, education attainment, employment status, and whether an individual smokes. Neighborhood built environment factors measured at both zip code and county levels include street connectivity, walk score, distance to parks, and food environment. Two additional neighborhood variables, namely the poverty rate and urbanicity, are also included as control variables. MLM results show that at the zip code level, poverty rate and distance to parks are significant and negative covariates of the odds of overweight and obesity; and at the county level, food environment is the sole significant factor with stronger fast food presence linked to higher odds of overweight and obesity. These findings suggest that obesity risk factors lie in multiple neighborhood levels and built environment features need to be defined at a neighborhood size relevant to residents' activity space. 相似文献
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Street connectivity, defined as the number of (3-way or more) intersections per area unit, is an important index of built environments as a proxy for walkability in a neighborhood. This paper examines its geographic variations across the rural-urban continuum (urbanicity), major racial-ethnic groups and various poverty levels. The population-adjusted street connectivity index is proposed as a better measure than the regular index for a large area such as county due to likely concentration of population in limited space within the large area. Based on the data from the Behavioral Risk Factor Surveillance System (BRFSS), this paper uses multilevel modeling to analyze its association with physical activity and obesity while controlling for various individual- and county-level variables. Analysis of data subsets indicates that the influences of individual and county-level variables on obesity risk vary across areas of different urbanization levels. The positive influence of street connectivity on obesity control is limited to the more but not the mostly urbanized areas. This demonstrates the value of obesogenic environment research in different geographic settings, helps us reconcile and synthesize some seemingly contradictory results reported in different studies, and also promotes that effective policies need to be highly sensitive to the diversity of demographic groups and geographically adaptable. 相似文献
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目的 探讨肥胖患者上气道结构的多层螺旋CT（MSCT）形态学改变,以揭示肥胖患者上气道结构异常及其与阻塞性睡眠呼吸暂停综合征（OSAHS）病情严重程度的关系。方法 选择经多导睡眠监测（PSG）确诊的非OSAHS和OSAHS肥胖患者各25例,对所有入组患者进行额窦层面至第7颈椎水平多层螺旋CT扫描及三维重建,测量鼻咽、腭咽、口咽和喉咽的最小截面积及其周围组织并进行比较。并且分析4个平面测量指标与体重指数（BMI）、颈围、睡眠呼吸暂停低通气指数（AHI）等指标的相关性。结果 与非OSAHS组患者比较,OSAHS组肥胖患者软腭的面积明显增大（P<0.05）,其体积增大更加明显（P<0.01）;口咽部气道的截面积、前后径、体积,均比非OSAHS组患者明显减小（P均<0.05）,并且软腭的体积均与BMI、AHI呈正相关（P均<0.01）。结论 MSCT能从二维及三维结构评估肥胖患者上气道阻塞及周围软组织情况,并且提示软腭体积增大可能与OSAHS严重程度相关。 相似文献
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《Geoforum》2017
This article interrogates how social media can provide a platform for contesting dominant discourses. It does so through the lens of competitive eating, demonstrating that amateur competitive eaters use social media sites to challenge and subvert mass media representations of their sport while concomitantly upholding normative notions of healthy eating and bodies. Competitors consider themselves to be skilful athletes that discipline and train their bodies to eat. They regard their eating practices, which are often depicted in the mass media as uncontrolled and gluttonous, as controlled ingestion, and present an alternative perspective of their ‘sport’ – a perspective that stresses health, physical expertise and a fit, trained body over voracity and insatiability. Social media acts as a ‘precipitating agency’ for the creation of these alternative definitions of disciplined eating, as well as the construction of new digital eating identities. Instead of focusing on the food being ingested and the ‘Carnivalesque’ practice of competitive eating, we draw attention to the performers’ voices and the ways they attend to the mechanics of gurgitation, including methods of chewing, swallowing and stomach stretching, and their ability to manage, regulate and operate ingestivity. As hegemonic discourses align the notion of ‘good eating’ to discipline, order and restraint, competitive eating is thus revealed to be a practice that mirrors and appropriates, yet also ultimately reproduces, conventional narratives. Social media is, in turn, shown to be a political tool for counter-discursive practices that are produced in dialogue with, and concomitantly uphold and contest, normative discourses of mass media. 相似文献
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