Active school transport and fast food intake: are there racial and ethnic differences?

Objectives To investigate whether active school transport was associated with fast food consumption, and to examine differences across racial/ethnic groups. Methods Adolescent data (n = 3194) from the 2009 California Health Interview Survey were analyzed with logistic regression models to examine the association between active school transport (AST) and fast food intake across racial/ethnic groups. Results In the overall sample, AST during 1–2 days in the past week was associated with greater likelihood of fast food intake (OR: 1.58; 95% CI: 1.03–2.43), compared with zero days of AST, controlling for demographic and other factors. The association between AST and fast food intake differed significantly by race/ethnicity (p < 0.01). Among Latino adolescents, greater frequency of AST was significantly associated with greater likelihood of fast food intake (1–2 days OR, 2.37, 95%CI: 1.05–5.35; 3–4 days OR, 2.78, 95% CI: 1.04–7.43; 5 days OR, 2.20, 95%CI: 1.23–3.93). Among White and Asian adolescents, there was a curvilinear pattern: relative to adolescents who reported zero days of AST, those who did AST 1–2 days/week had greater likelihood of fast food intake, but AST of 3–4 days and 5 days/week was associated respectively, with higher and lower likelihood of fast food intake among both groups. Conclusions AST appears to be a risk factor for fast food intake, and may expose some ethnic groups more than others to increased opportunity to purchase and consume fast food. Programs and policies to promote AST among adolescents should incorporate efforts to encourage healthy eating and discourage concentration of fast food outlets near schools

Gender and ethnic disparities contributing to overweight in California adolescents

To explore differences in health behaviors and factors contributing to overweight among 12 to 17 year olds in California. Data from the 2005 California Health Interview Survey for 3,315 adolescents self-identified as Latino, Asian, or white were reviewed. Adolescents reported their weight, height, gender, ethnicity, parents’ educational level, household income, physical activity, sedentary activity, breakfast consumption, and family meals. Overall 34% of boys and 22% of girls in this study were overweight (&gt;85th percentile for age and gender). Approximately 38% of Latinos, 25% of whites, and 16% of Asians were overweight. Latinos were more than twice as likely to be overweight as whites (2.07) and Asians (2.53). Younger adolescents (12–13 years old) and adolescents whose family income is less than 200% of the federal poverty level were more likely to be overweight. Low level of parental education is a risk factor for Latino and Asian girls and white and Latino boys. White girls with a lower socioeconomic status and white boys with more than 2 h daily of television, video, and computer time were more likely to be overweight. Results suggest gender and ethnic variations in factors that contribute to overweight in California adolescents. To influence the current overweight epidemic, clinicians must develop culturally sensitive and gender-specific interventions that address the unique needs of an ethnically diverse adolescent population

The Effects of Child-Only Insurance Coverage and Family Coverage on Health Care Access and Use: Recent Findings among Low-Income Children in California

OBJECTIVE: To compare the extent with which child-only and family coverage (child and parent insured) ensure health care access and use for low income children in California and discuss the policy implications of extending the State Children's Health Insurance Program (California's Healthy Families) to uninsured parents of child enrollees. DATA SOURCES/SETTING: We used secondary data from the 2001 California Health Interview Survey (CHIS), a representative telephone survey. STUDY DESIGN: We conducted a cross-sectional study of 5,521 public health insurance–eligible children and adolescents and their parents to examine the effects of insurance (family coverage, child-only coverage, and no coverage) on measures of health care access and utilization including emergency room visits and hospitalizations. DATA COLLECTION: We linked the CHIS adult, child, and adolescent datasets, including the adolescent insurance supplement. FINDINGS: Among the sampled children, 13 percent were uninsured as were 22 percent of their parents. Children without insurance coverage were more likely than children with child-only coverage to lack a usual source of care and to have decreased use of health care. Children with child-only coverage fared worse than those with family coverage on almost every access indicator, but service utilization was comparable. CONCLUSIONS: While extending public benefits to parents of children eligible for Healthy Families may not improve child health care utilization beyond the gains that would be obtained by exclusively insuring the children, family coverage would likely improve access to a regular source of care and private sector providers, and reduce perceived discrimination and breaks in coverage. These advantages should be considered by states that are weighing the benefits of expanding health insurance to parents