Last data update: Oct 07, 2024. (Total: 47845 publications since 2009)
Records 1-21 (of 21 Records) |
Query Trace: Luncheon C[original query] |
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About 1.5 million community-dwelling US adults with active epilepsy reported uncontrolled seizures in the past 12 months, and seizure control varied by annual family income-National Health Interview Survey, United States 2021 and 2022
Kobau R , Luncheon C , Greenlund KJ . Epilepsy Behav 2024 157 109852 Uncontrolled seizures among people with epilepsy increase risk of adverse health and social outcomes including increased risk of death. Previous population-based studies have reported suboptimal seizure control and disparities in seizure control among U.S. adults with active epilepsy (self-reported doctor-diagnosed epilepsy and taking anti-seizure medicine or with ≥ 1 seizures in the past 12 months) by annual family income. This brief is based upon data from the 2021 and 2022 National Health Interview Survey (NHIS) to provide updated national estimates of the percentages of adults with active epilepsy with and without seizure control (0 seizures in past 12 months) vs. ≥ 1) by anti-seizure medication use and by annual family income. Annual family income was operationalized with NHIS poverty-income ratio (PIR) categories (i.e., total family income divided by the US Census Bureau poverty threshold given the family's size and number of children): PIR < 1.0, 1.0 ≤ PIR < 2.0; PIR ≥ 2.0. Among the 1.1 % of US adults with active epilepsy in 2021/2022 (estimated population about 2.9 million), 49.2 % (∼1.4 million) were taking antiseizure medication and reported no seizures (seizure control), 36.2 % (∼1.1 million) were taking antiseizure medication and reported ≥ 1 seizures (uncontrolled seizures), and 14.7 % (∼400,000) were not taking antiseizure medication and had ≥ 1 seizures (uncontrolled seizures). The prevalence of seizure control among those with active epilepsy varied substantially by annual family income, with a larger percentage of adults with PIR ≥ 2.0 reporting seizure control compared with those with PIR < 1.0. Opportunities for intervention include improving provider awareness of epilepsy treatment guidelines, enhancing access and referral to specialty care, providing epilepsy self-management supports, and addressing unmet social needs of people with epilepsy with uncontrolled seizures, especially those at lowest family income levels. |
Multipathogen outbreak of bacillus cereus and clostridium perfringens among hospital workers in Alaska, August 2021
Newell K , Helfrich K , Isernhagen H , Jones M , Stickel G , McKeel H , Castrodale L , McLaughlin J . Public Health Rep 2023 333549231170220 OBJECTIVE: Clostridium perfringens and Bacillus cereus are common causes of reported foodborne illness. On August 6, 2021, the Alaska Division of Public Health identified a multipathogen gastrointestinal outbreak among hospital staff in Homer, Alaska. The objectives of this study were to identify the outbreak source and prevent future illness. METHODS: We conducted a retrospective cohort study of hospital staff who participated in luncheon events during August 5-7, 2021, and used an online survey to identify hospital staff with gastrointestinal illness. We defined case patients as people who reported new-onset gastrointestinal illness (diarrhea or abdominal cramping) after food consumption during the luncheon events. We calculated adjusted odds ratios of gastrointestinal illness associated with reported food exposures. We tested available food samples for C perfringens and B cereus and tested case patient stool specimens for C perfringens. We conducted an environmental investigation at the implicated vendor site. RESULTS: Of 202 survey responses, 66 (32.7%) people reported acute gastrointestinal illness: 64 (97.0%) reported diarrhea, 62 (94.9%) reported abdominal cramps, and none were hospitalized. Of 79 people who consumed ham and pulled pork sandwiches, 64 (81.0%) met the case definition; this food item was significantly associated with increased odds of gastrointestinal illness (adjusted odds ratio = 296.4; 95% CI, 76.7-2019.1). C perfringens and B cereus were isolated at confirmatory levels from sandwich samples. C perfringens enterotoxin was detected in all 5 stool specimens tested. Environmental investigators observed other food items at the sandwich vendor that were refrigerated outside the required temperature range (>41 °F); no clear handling deficiencies for the implicated food were identified. CONCLUSION: Quick notification and effective collaboration can help detect an outbreak, identify the responsible food vehicle, and mitigate further risk. |
COVID-19 vaccination status and related process of care outcomes among U.S. adults with active epilepsy-National Health Interview Survey, United States, 2021
Kobau R , Luncheon C , Pastula DM , Greenlund KJ . Epilepsy Behav 2023 143 109223 Growing research has examined the effects of the COVID-19 pandemic on people with epilepsy. There are no published national estimates of COVID-19 vaccination status among U.S. adults with active epilepsy. The purpose of this study is to use 2021 National Health Interview Survey (NHIS) data to examine select COVID-19-related outcomes by epilepsy status in a nationally representative sample of US adults. The study sample met the criteria for operationalization of epilepsy status (i.e., active epilepsy vs. no epilepsy history) and select questions related to COVID-19 testing, vaccination, delays in care, or experience with virtual care during the COVID-19 pandemic. All analyses accounted for the NHIS complex sample design and response sampling weights. Our study found that in 2021 receipt of one COVID-19 vaccination among U.S. adults with active epilepsy was generally similar to that among adults without a history of epilepsy. By age, adults aged 18-44 years with active epilepsy (27.0%) were significantly less likely to have reported receiving two COVID-19 vaccinations compared with their peers with no epilepsy history (39.1%). Compared to adults with no epilepsy history, adults with active epilepsy reported similar experiences and outcomes regarding COVID-19 testing and obtaining health care during the COVID-19 pandemic. This study provides baseline estimates of select COVID-19 outcomes among US adults with active epilepsy to guide interventions and additional studies. |
Active epilepsy prevalence among U.S. adults is 1.1% and differs by educational level-National Health Interview Survey, United States, 2021
Kobau R , Luncheon C , Greenlund K . Epilepsy Behav 2023 142 109180 This study used the most recent national data from the 2021 National Health Interview Survey (NHIS) to provide updated estimates of the prevalence of active epilepsy (self-reported doctor-diagnosed epilepsy, currently under treatment with antiseizure medicines or had at least 1 seizure in the past 12 months, or both) and inactive epilepsy (self-reported doctor-diagnosed history of epilepsy, not under treatment with antiseizure medicines and with no seizures in the past 12 months) overall and by sex, age groups, race/ethnicity, education level, and health insurance status. In 2021, 1.1% of U.S. adults, (approximately 2,865,000 adults) reported active epilepsy; 0.6% (approximately 1,637,000 adults) reported inactive epilepsy. The prevalence of active epilepsy and inactive epilepsy did not differ by age or sex. Active and inactive epilepsy prevalence differed by educational level. Weighted population estimates are reported for each subgroup (e.g., women; non-Hispanic Blacks) for program or policy development. Although active epilepsy prevalence has remained relatively stable over the past decade, this study shows that more than half of U.S. adults with active epilepsy have ≤high school diploma/GED, which can inform the development and implementation of interventions. Additional monitoring is necessary to examine population trends in active prevalence overall and in subgroups. |
Heterogeneity in obesity prevalence among Asian American adults
Shah NS , Luncheon C , Kandula NR , Khan SS , Pan L , Gillespie C , Loustalot F , Fang J . Ann Intern Med 2022 175 (11) 1493-1500 BACKGROUND: Obesity increases the risk for metabolic and cardiovascular disease, and this risk occurs at lower body mass index (BMI) thresholds in Asian adults than in White adults. The degree to which obesity prevalence varies across heterogeneous Asian American subgroups is unclear because most obesity estimates combine all Asian Americans into a single group. OBJECTIVE: To quantify obesity prevalence in Asian American subgroups among U.S. adults using both standard BMI categorizations and categorizations tailored to Asian populations. DESIGN: Cross-sectional. SETTING: United States, 2013 to 2020. PARTICIPANTS: The analytic sample included 2 882 158 adults aged 18 years or older in the U.S. Behavioral Risk Factor Surveillance System surveys (2013 to 2020). Participants self-identified as non-Hispanic White ([NHW] n = 2 547 965); non-Hispanic Black ([NHB] n = 263 136); or non-Hispanic Asian ([NHA] n = 71 057), comprising Asian Indian (n = 13 916), Chinese (n = 11 686), Filipino (n = 11 815), Japanese (n = 12 473), Korean (n = 3634), and Vietnamese (n = 2618) Americans. MEASUREMENTS: Obesity prevalence adjusted for age and sex calculated using both standard BMI thresholds (≥30 kg/m(2)) and BMI thresholds modified for Asian adults (≥27.5 kg/m(2)), based on self-reported height and weight. RESULTS: Adjusted obesity prevalence (by standard categorization) was 11.7% (95% CI, 11.2% to 12.2%) in NHA, 39.7% (CI, 39.4% to 40.1%) in NHB, and 29.4% (CI, 29.3% to 29.5%) in NHW participants; the prevalence was 16.8% (CI, 15.2% to 18.5%) in Filipino, 15.3% (CI, 13.2% to 17.5%) in Japanese, 11.2% (CI, 10.2% to 12.2%) in Asian Indian, 8.5% (CI, 6.8% to 10.5%) in Korean, 6.5% (CI, 5.5% to 7.5%) in Chinese, and 6.3% (CI, 5.1% to 7.8%) in Vietnamese Americans. The prevalence using modified criteria (BMI ≥27.5 kg/m(2)) was 22.4% (CI, 21.8% to 23.1%) in NHA participants overall and 28.7% (CI, 26.8% to 30.7%) in Filipino, 26.7% (CI, 24.1% to 29.5%) in Japanese, 22.4% (CI, 21.1% to 23.7%) in Asian Indian, 17.4% (CI, 15.2% to 19.8%) in Korean, 13.6% (CI, 11.7% to 15.9%) in Vietnamese, and 13.2% (CI, 12.0% to 14.5%) in Chinese Americans. LIMITATION: Body mass index estimates rely on self-reported data. CONCLUSION: Substantial heterogeneity in obesity prevalence exists among Asian American subgroups in the United States. Future studies and public health efforts should consider this heterogeneity. PRIMARY FUNDING SOURCE: National Heart, Lung, and Blood Institute. |
Self-measured blood pressure monitoring among adults with self-reported hypertension in 20 US states and the District of Columbia, 2019
Fang J , Luncheon C , Wall HK , Wozniak G , Loustalot F . Am J Hypertens 2021 34 (11) 1148-1153 BACKGROUND: Hypertension is a major risk factor for cardiovascular disease. Achieving hypertension control requires multiple supportive inventions, including self-measured blood pressure (SMBP). The objective of this study is to report the use of SMBP among US adults. METHODS: Behavioral Risk Factor Surveillance System data were used for this study. The 2019 survey included, for the first time, an optional SMBP module. Twenty states and the District of Columbia (N=159,536) opted to include the module, which assessed whether participants were advised by a healthcare professional to use SMBP, and if they used SMBP monitoring. Among those using SMBP, additional questions assessed the location of SMBP monitoring and whether SMBP readings were shared with a healthcare professional. RESULTS: Among adults in the study population, 33.9% (95% confidence interval 33.4%-34.5%) reported having hypertension (N=66,869). Among them, nearly 70% were recommended to use SMBP by their healthcare professional and approximately 61% reported SMBP use regardless of recommendation. The most common location of SMBP was the home (85.6%). Overall, >80% shared their SMBP reading with their healthcare professional, 74% and 7% were shared in person and via the internet or email, respectively. There were differences in healthcare professional recommendations, use of SMBP, and SMBP information sharing across demographic characteristics and state of residency. CONCLUSIONS: SMBP recommendation was common practice among healthcare professionals, as reported by US adults with hypertension. Data from this study can be used to guide interventions to promote hypertension self-management and control. |
Self-Reported Diabetes Prevalence in Asian American Subgroups: Behavioral Risk Factor Surveillance System, 2013-2019
Shah NS , Luncheon C , Kandula NR , Cho P , Loustalot F , Fang J . J Gen Intern Med 2021 37 (8) 1902-1909 BACKGROUND: Diabetes mellitus (DM) is a leading contributor to morbidity and mortality in the United States (US). Prior DM prevalence estimates in Asian Americans are predominantly from Asians aggregated into a single group, but the Asian American population is heterogenous. OBJECTIVE: To evaluate self-reported DM prevalence in disaggregated Asian American subgroups to inform targeted management and prevention. DESIGN: Serial cross-sectional analysis. PARTICIPANTS: Respondents to the US Behavioral Risk Factor Surveillance System surveys who self-identify as non-Hispanic Asian American (NHA, N=57,001), comprising Asian Indian (N=11,089), Chinese (N=9458), Filipino (N=9339), Japanese (N=10,387), and Korean Americans (N=2843), compared to non-Hispanic White (NHW, N=2,143,729) and non-Hispanic Black (NHB, N=215,957) Americans. MAIN MEASURES: Prevalence of self-reported DM. Univariate Satterthwaite-adjusted chi-square tests compared the differences in weighted DM prevalence by sociodemographic and health status. KEY RESULTS: Self-reported fully adjusted DM prevalence was 8.7% (95% confidence interval 8.2-9.3) in NHA, compared to 14.3% (14.0-14.6) in NHB and 10.0% (10.0-10.1) in NHW (p<0.01 for difference). In NHA subgroups overall, DM prevalence was 14.4% (12.6-16.3) in Filipino, 13.4% (10.9-16.2) in Japanese, 10.7% (9.6-11.8) in Asian Indian, 5.1% (4.2-6.2) in Chinese, and 4.7% (3.4-6.3) in Korean Americans (p<0.01). Among those aged ≥65 years, DM prevalence was highest in Filipino (35.0% (29.4-41.2)) and Asian Indian (31.5% (25.9-37.8)) Americans. Adjusted for sex, education, and race/ethnicity-specific obesity category, NHA overall had a 21% higher DM prevalence compared to NHW (prevalence ratio 1.21 [1.14-1.27]), while prevalence ratios were 1.42 (1.24-1.63) in Filipinos and 1.29 (1.14-1.46) in Asian Indians. CONCLUSIONS: Adjusted self-reported DM prevalence is higher in NHA compared with NHW. Disaggregating NHA reveals heterogeneity in self-reported DM prevalence, highest in Filipino and Asian Indian Americans. |
Self-reported prevalence of hypertension and antihypertensive medication use among Asian Americans: Behavioral Risk Factor Surveillance System 2013, 2015 and 2017
Fang J , Luncheon C , Patel A , Ayala C , Gillespie C , Greenlund KJ , Loustalot F . J Immigr Minor Health 2020 23 (1) 26-34 Asian Americans are one of the fastest growing races in the US. The objectives of this report were to assess self-reported hypertension prevalence and treatment among Asian Americans. Merging 2013, 2015, and 2017 Behavioral Risk Factor Surveillance System data, we estimated self-reported hypertension and antihypertensive medication use among non-Hispanic Asian Americans (NHA) and compared estimates between NHA and non-Hispanic whites (NHW), and by NHA subgroup (Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese/other). The prevalence of hypertension was 20.8% and 33.5%, respectively, for NHAs and NHWs (p < 0.001). Among those with hypertension, the prevalence of antihypertensive medication use was 71.6% and 78.2%, respectively, for NHAs and NHWs (p < 0.001). Among NHA subgroups, a wide range of hypertension prevalence and medication use was found. Overall NHA had a lower reported prevalence of hypertension and use of antihypertensive medication than NHW. Certain NHA subgroups had a burden comparable to high-risk disparate populations. |
Awareness of stroke signs and symptoms and calling 9-1-1 among US adults: National Health Interview Survey, 2009 and 2014
Patel A , Fang J , Gillespie C , Odom E , King SC , Luncheon C , Ayala C . Prev Chronic Dis 2019 16 E78 INTRODUCTION: Early recognition of stroke symptoms and recognizing the importance of calling 9-1-1 improves the timeliness of appropriate emergency care, resulting in improved health outcomes. The objective of this study was to assess changes in awareness of stroke symptoms and calling 9-1-1 from 2009 to 2014. METHODS: We analyzed data among 27,211 adults from 2009 and 35,862 adults from 2014 using the National Health Interview Survey (NHIS). The NHIS included 5 questions in both 2009 and 2014 about stroke signs and symptoms and one about the first action to take when someone is having a stroke. We estimated the prevalence of awareness of each symptom, all 5 symptoms, the importance of calling 9-1-1, and knowledge of all 5 symptoms plus the importance of calling 9-1-1 (indicating recommended stroke knowledge). We assessed changes from 2009 to 2014 in the prevalence of awareness. Data analyses were conducted in 2016. RESULTS: In 2014, awareness of stroke symptoms ranged from 76.1% (sudden severe headache) to 93.7% (numbness of face, arm, leg, side); 68.3% of respondents recognized all 5 symptoms, and 66.2% were aware of all recommended stroke knowledge. After adjusting for sex, age, educational attainment, and race/ethnicity, logistic regression results showed a significant absolute increase of 14.7 percentage points in recommended stroke knowledge from 2009 (51.5%) to 2014 (66.2%). Among US adults, recommended stroke knowledge increased from 2009 to 2014. CONCLUSION: Stroke awareness among US adults has improved but remains suboptimal. |
Awareness of heart attack symptoms and response among adults - United States, 2008, 2014, and 2017
Fang J , Luncheon C , Ayala C , Odom E , Loustalot F . MMWR Morb Mortal Wkly Rep 2019 68 (5) 101-106 Heart disease is the leading cause of death in the United States (1). Heart attacks (also known as myocardial infarctions) occur when a portion of the heart muscle does not receive adequate blood flow, and they are major contributors to heart disease, with an estimated 750,000 occurring annually (2). Early intervention is critical for preventing mortality in the event of a heart attack (3). Identification of heart attack signs and symptoms by victims or bystanders, and taking immediate action by calling emergency services (9-1-1), are crucial to ensure timely receipt of emergency care and thereby improve the chance for survival (4). A recent report using National Health Interview Survey (NHIS) data from 2014 found that 47.2% of U.S. adults could state all five common heart attack symptoms (jaw, neck, or back discomfort; weakness or lightheadedness; chest discomfort; arm or shoulder discomfort; and shortness of breath) and knew to call 9-1-1 if someone had a heart attack (5). To assess changes in awareness and response to an apparent heart attack, CDC analyzed data from NHIS to report awareness of heart attack symptoms and calling 9-1-1 among U.S. adults in 2008, 2014, and 2017. The adjusted percentage of persons who knew all five common heart attack symptoms increased from 39.6% in 2008 to 50.0% in 2014 and to 50.2% in 2017. The adjusted percentage of adults who knew to call 9-1-1 if someone was having a heart attack increased from 91.8% in 2008 to 93.4% in 2014 and to 94.9% in 2017. Persistent disparities in awareness of heart attack symptoms were observed by demographic characteristics and cardiovascular risk group. Public health awareness initiatives and systematic integration of appropriate awareness and action in response to a perceived heart attack should be expanded across the health system continuum of care. |
Awareness of Heart Attack Signs and Symptoms and Calling 9-1-1 Among U.S. Adults
Patel A , Fang J , Gillespie C , Odom E , Luncheon C , Ayala C . J Am Coll Cardiol 2018 71 (7) 808-809 Healthy People 2020 (HP2020), the primary objectives monitoring the nation’s health, has called for increased awareness of the early warning signs and symptoms of a heart attack and the importance of accessing emergency care by dialing 9-1-1. 1 Poor knowledge of the signs and symptoms of a heart attack has been associated with delayed hospital admission and unfavorable health outcomes.2 There are five classic symptoms of heart attack: 1) pain or discomfort in the jaw, neck or back; 2) feeling weak, lightheaded or faint; 3) chest pain or discomfort; 4) pain or discomfort in the arms or shoulder; and 5) shortness of breath.3 Healthy People 2020 (HP2020), the primary objectives monitoring the nation’s health, has called for increased awareness of the early warning signs and symptoms of a heart attack and the importance of accessing emergency care by dialing 9-1-1.1 To complement national objectives, it is important to understand sociodemographic disparities associated with the awareness of the signs and symptoms to target public health messages. To address this gap, we used data from the National Health Interview Survey (NHIS) in 2008 and 2014 to: 1) assess the disparities in the prevalence of awareness of signs and symptoms of a heart attack and calling 9-1-1 in 2014; and 2) determine the change in prevalence of awareness of the signs and symptoms of a heart attack and calling 9-1-1 between 2008 and 2014. |
Adults with an epilepsy history, notably those 45-64 years old or at the lowest income levels, more often report heart disease than adults without an epilepsy history
Zack M , Luncheon C . Epilepsy Behav 2018 86 208-210 From 95,196 sample adults in the combined 2010, 2013, and 2015 U.S. National Health Interview Survey, we estimated the association between histories of epilepsy and heart disease after accounting for sociodemographic characteristics and behavioral risk factors. Adults 18years old or older with an epilepsy history reported heart disease (21%) about nine percentage points more often than those without such a history (12%), overall and within levels of characteristics and risk factors. These increases in heart disease history for adults with an epilepsy history compared with adults without such a history were greater in those 45-64 years old or at the lowest family income levels. These increases of heart disease in adults with an epilepsy history highlight two needs-to prevent the occurrence of heart disease and to reduce its consequences. Because comorbidity from heart disease can complicate epilepsy management, physicians caring for those with epilepsy should be aware of these increased risks, identify risk factors for heart disease, and recommend to their patients with epilepsy ways to diminish these risks. |
Use of outpatient rehabilitation among adult stroke survivors - 20 states and the District of Columbia, 2013, and four states, 2015
Ayala C , Fang J , Luncheon C , King SC , Chang T , Ritchey M , Loustalot F . MMWR Morb Mortal Wkly Rep 2018 67 (20) 575-578 Stroke is a leading cause of mortality and disability in the United States (1,2). Approximately 800,000 American adults experience a stroke each year (2,3). Currently, approximately 6 million stroke survivors live in the United States (2). Participation in stroke rehabilitation (rehab), which occurs in diverse settings (i.e., in-hospital, postacute care, and outpatient settings), has been determined to reduce stroke recurrence and improve functional outcomes and quality of life (3,4). Despite longstanding national guidelines recommending stroke rehab, it remains underutilized, especially in the outpatient setting. Professional associations and evidence-based guidelines support the increasing stroke rehab use in health systems and are promoted by the public health community (3-6). An analysis of 2005 Behavioral Risk Factor Surveillance System (BRFSS) data revealed that 30.7% of stroke survivors reported participation in outpatient rehab for stroke after hospital discharge in 21 states and the District of Columbia (DC) (7). To update these estimates, 2013 and 2015 BRFSS data were analyzed to assess outpatient rehab use among adult stroke survivors. Overall, outpatient rehab use was 31.2% (20 states and DC) in 2013 and 35.5% (four states) in 2015. Disparities were evident by sex, race, Hispanic origin, and level of education. Focused attention on system-level interventions that ensure participation is needed, especially among disparate populations with lower levels of participation. |
Adults with an epilepsy history, especially those 45years or older, those with lower family incomes, and those with a history of hypertension, report a history of stroke five times as often as adults without such a history - 2010, 2013, and 2015 U.S. National Health Interview Survey
Zack MM , Luncheon C . Epilepsy Behav 2018 83 236-238 Stroke is the 5th leading cause of death and a leading cause of serious, long-term disability, despite being largely preventable in most people [1]. Stroke is also a common and serious cardiovascular comorbidity affecting persons with epilepsy, potentially increasing risk of early mortality [2], [3], [4], [5], [6], [7], [8], [9]. Stroke and epilepsy may be bidirectional, resulting from different causal mechanisms or shared risk factors [3], [10], [11]. Adults with epilepsy or seizures report higher levels of cardiovascular disease risk factors, including smoking, physical inactivity, overweight or obesity, and psychological distress [6], [7]. Stroke prevention in the general population including those with epilepsy is critical to reduce epilepsy and overall disability burden. This report uses three recent population-based U.S. adult samples to estimate how often stroke occurs in adults reporting a history of epilepsy, overall and at different levels of demographic characteristics and stroke risk factors. |
Self-reported receipt of advice and action taken to reduce dietary sodium among adults with and without hypertension - nine states and Puerto Rico, 2015
Va P , Luncheon C , Thompson-Paul AM , Fang J , Merritt R , Cogswell ME . MMWR Morb Mortal Wkly Rep 2018 67 (7) 225-229 Hypertension is a major cardiovascular disease risk factor (1,2). Advice given by health professionals can result in lower sodium intake and lower blood pressure (3).The 2017 Hypertension Guideline released by the American College of Cardiology and the American Heart Association emphasizes nonpharmacologic approaches, including sodium reduction, as important components of hypertension prevention and treatment (4). Data from 50,576 participants in the sodium module of the 2015 Behavioral Risk Factor Surveillance System (BRFSS) in nine states and Puerto Rico were analyzed to determine the prevalence of reported sodium reduction advice and action among participants with and without self-reported hypertension. Among participants with self-reported hypertension, adjusted prevalence of receiving sodium reduction advice from a health professional was 41.9%, compared with 12.8% among participants without hypertension. Among those with hypertension, adjusted prevalence of reported action to reduce sodium intake was 80.9% among participants who received advice and 55.7% among those who did not receive advice. Among participants without hypertension, adjusted prevalence of taking action to reduce sodium intake was 72.7% among those who received advice and 46.9% among those who did not receive advice. The provision of advice on sodium reduction by health professionals is associated with respondent action to watch or reduce sodium intake. Fewer than half of patients with hypertension received this advice from their health professionals, a circumstance that represents a substantial missed opportunity to promote hypertension prevention and treatment. |
Use of outpatient cardiac rehabilitation among heart attack survivors - 20 states and the District of Columbia, 2013 and four states, 2015
Fang J , Ayala C , Luncheon C , Ritchey M , Loustalot F . MMWR Morb Mortal Wkly Rep 2017 66 (33) 869-873 Heart disease is the leading cause of death in the United States (1). Each year, approximately 790,000 adults have a myocardial infarction (heart attack), including 210,000 that are recurrent heart attacks (2). Cardiac rehabilitation (rehab) includes exercise counseling and training, education for heart-healthy living, and counseling to reduce stress. Cardiac rehab provides patients with education regarding the causes of heart attacks and tools to initiate positive behavior change, and extends patients' medical management after a heart attack to prevent future negative sequelae (3). A systematic review has shown that after a heart attack, patients using cardiac rehab were 53% (95% confidence interval [CI] = 41%-62%) less likely to die from any cause and 57% (95% CI = 21%-77%) less likely to experience cardiac-related mortality than were those who did not use cardiac rehab (3). However, even with long-standing national recommendations encouraging use of cardiac rehab (4), the intervention has been underutilized. An analysis of 2005 Behavioral Risk Factor Surveillance System (BRFSS) data found that only 34.7% of adults who reported a history of a heart attack also reported subsequent use of cardiac rehab (5). To update these estimates, CDC used the most recent BRFSS data from 2013 and 2015 to assess the use of cardiac rehab among adults following a heart attack. Overall use of cardiac rehab was 33.7% in 20 states and the District of Columbia (DC) in 2013 and 35.5% in four states in 2015. Cardiac rehab use was underutilized overall and differences were evident by sex, age, race/ethnicity, level of education, cardiovascular risk status, and by state. Increasing use of cardiac rehab after a heart attack should be encouraged by health systems and supported by the public health community. |
Monitoring population health for Healthy People 2020: evaluation of the NIH PROMIS((R)) Global Health, CDC Healthy Days, and satisfaction with life instruments
Barile John P , Reeve Bryce B , Smith Ashley Wilder , Zack Matthew M , Mitchell Sandra A , Kobau Rosemarie , Cella David F , Luncheon Cecily , Thompson William W . Qual Life Res 2013 22 (6) 1201-11 PURPOSE: Healthy People 2020 identified health-related quality of life and well-being (WB) as indicators of population health for the next decade. This study examined the measurement properties of the NIH PROMIS((R)) Global Health Scale, the CDC Healthy Days items, and associations with the Satisfaction with Life Scale. METHODS: A total of 4,184 adults completed the Porter Novelli's HealthStyles mailed survey. Physical and mental health (9 items from PROMIS Global Scale and 3 items from CDC Healthy days measure), and 4 WB factor items were tested for measurement equivalence using multiple-group confirmatory factor analysis. RESULTS: The CDC items accounted for similar variance as the PROMIS items on physical and mental health factors; both factors were moderately correlated with WB. Measurement invariance was supported across gender and age; the magnitude of some factor loadings differed between those with and without a chronic medical condition. CONCLUSIONS: The PROMIS, CDC, and WB items all performed well. The PROMIS items captured a broad range of functioning across the entire continuum of physical and mental health, while the CDC items appear appropriate for assessing burden of disease for chronic conditions and are brief and easily interpretable. All three measures under study appear to be appropriate measures for monitoring several aspects of the Healthy People 2020 goals and objectives. |
Satisfaction with life domains in people with epilepsy
Kobau R , Luncheon C , Zack MM , Shegog R , Price PH . Epilepsy Behav 2012 25 (4) 546-551 While commonly used quality-of-life instruments assess perceived epilepsy-associated limitations in life domains and formally document patient concerns, less is known of community-dwelling adults with epilepsy about their satisfaction with broader life domains, such as satisfaction with housing, education, neighborhood, ability to help others, and achievement of goals. The purpose of this study was to examine satisfaction with life domains in a representative sample of community-dwelling adults with self-reported epilepsy from the 2008 HealthStyles survey. Following adjustment for sex, age group, race/ethnicity, education, and income, people with epilepsy were more likely to report frustration in the domains of achievement (e.g., dissatisfaction with education and life goals), compromised social interactions (dissatisfaction with family life, friends, and social life), and compromised physical capability (dissatisfaction with health and energy level). Life satisfaction and other well-being domains can supplement health indicators to guide treatment and program services for people with epilepsy to maximize their well-being. |
Health-related quality of life among US veterans and civilians by race and ethnicity
Luncheon C , Zack M . Prev Chronic Dis 2012 9 E108 INTRODUCTION: Among veterans, having been selected into the military and having easy access to medical care during and after military service may reduce premature mortality but not morbidity from mental distress and may not improve health-related quality of life. The objective of this study was to determine whether veterans in different racial/ethnic groups differ in their health-related quality of life from each other and from their civilian counterparts. METHODS: Among 800,000 respondents to the 2007-2009 Behavioral Risk Factor Surveillance System surveys, approximately 110,000 identified themselves as veterans and answered questions about their sociodemographic characteristics, self-rated health, and recent health-related quality of life. Nonoverlapping 95% confidence intervals of means distinguished veterans and civilians of different racial/ethnic groups. RESULTS: Veteran and civilian American Indians/Alaska Natives reported more physically unhealthy days, mentally unhealthy days, and recent activity limitation days than their veteran and civilian counterparts in other racial/ethnic groups. Non-Hispanic white veterans and Hispanic veterans reported more physically unhealthy days, mentally unhealthy days, and recent activity limitation days than their civilian counterparts. CONCLUSION: Unlike findings in other studies, our findings show that veterans' health-related quality of life differs from that of civilians both within the same racial/ethnic group and among different racial/ethnic groups. Because once-healthy soldiers may not be as healthy when they return to civilian life, assessing their health-related quality of life over time may identify those who need help to regain their health. |
Health-related quality of life and the physical activity levels of middle-aged women, California Health Interview Survey, 2005
Luncheon C , Zack M . Prev Chronic Dis 2011 8 (2) A36 INTRODUCTION: Several studies suggest that physical activity may improve health-related quality of life. Other studies have shown that participation in physical activity differs among women of different racial/ethnic groups. This study aimed to determine whether the association between physical activity and health-related quality of life differs among women aged 40 to 64 years from different racial/ethnic groups. METHODS: We explored the association between physical activity level and health-related quality of life with descriptive statistics and multiple regression analyses adjusting for potential confounders among 11,887 women aged 40 to 64 years who identified themselves as Latinas, Asians, African Americans, or whites in the 2005 California Health Interview Survey. RESULTS: Although white women reported more regular physical activity than women of other racial/ethnic groups, Asian women reported fewer mentally and overall unhealthy days than women of other groups. Nonetheless, as physical activity increased, health-related quality of life improved only among white women (fewer physically unhealthy, mentally unhealthy, recent activity limitation, and overall unhealthy days) and among Latinas (fewer overall unhealthy days). CONCLUSION: Future studies should try to confirm if and clarify why the association between physical activity level and health-related quality of life differs among these middle-aged women of different races/ethnicities. If confirmed, this association would imply that health care professionals and those who design public health interventions may need to vary their promotion methods and messages to encourage physical activity among women of different races/ethnicities. |
A prolonged outbreak of Salmonella Montevideo infections associated with multiple locations of a restaurant chain in Phoenix, Arizona, 2008
Patel MK , Chen S , Pringle J , Russo E , Vinaras J , Weiss J , Anderson S , Sunenshine R , Komatsu K , Schumacher M , Flood D , Theobald L , Bopp C , Wannemuehler K , White P , Angulo FJ , Behravesh CB . J Food Prot 2010 73 (10) 1858-63 An outbreak of Salmonella serotype Montevideo infections associated with multiple locations of restaurant chain A in Phoenix, AZ, was identified in July 2008. One infected individual reported eating at a chain A catered luncheon where others fell ill; we conducted a cohort study among attendees to identify the vehicle. Food and environmental samples collected at six chain A locations were cultured for Salmonella. Restaurant inspection results were compared among 18 chain A locations. Routine surveillance identified 58 Arizona residents infected with the outbreak strain. Three chain A locations, one of which catered the luncheon, were named by two or more case patients as a meal source in the week prior to illness onset. In the cohort study of luncheon attendees, 30 reported illness, 10 of which were later culture confirmed. Illness was reported by 30 (61%) of 49 attendees who ate chicken and by 0 of 7 who did not. The outbreak strain was isolated from two of these three locations from uncooked chicken in marinade, chopped cilantro, and a cutting board dedicated to cutting cooked chicken. Raw chicken, contaminated before arrival at the restaurant, was the apparent source of this outbreak. The three locations where two or more case patients ate had critical violations upon routine inspection, while 15 other locations received none. Poor hygiene likely led to cross-contamination of food and work areas. This outbreak supports the potential use of inspections in identifying restaurants at high risk of outbreaks and the need to reduce contamination of raw products at the source and prevent cross-contamination at the point of service. |
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