16 research outputs found
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Influence of the Local Food Environment on Hispanics’ Perceptions of Healthy Food Access in New York City
Introduction: Studies have characterized food environments and documented its impact on access and consumption of healthy foods as well as diet-related health conditions. This study aims to characterize the local food environment in New York City’s Washington Heights and Inwood community and to examine its influence on Hispanics’ perceptions of healthy food access. Methods: Person-level local food environments were created by spatially modeling food retailers selling fresh fruits and vege- tables or low-fat products within a participant’s 400- and 800-m residential radius buffers. Data were analyzed using multivariate binary logistic regression. Results: Fruit/vegetable markets significantly increased participants’ odds of perceiving the availability of a large selection as well as the high quality of fresh fruits and vegetables in their neighborhood. Medium-/large-size super- markets/groceries within 400-m radius significantly increased participants’ odds of perceiving the high quality of fresh fruits and vegetables in their neighborhood, whereas meat markets significantly lowered the odds. Fruit/vegetable markets and medium-/ large-size supermarkets/groceries significantly increased participants’ odds of perceiving the availability of a large selection of low- fat products in their neighborhood. Conclusion: Study findings advance our understanding of the relationships between local food environment and perceived healthy food access among urban Hispanics
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The Relationship between the Neighborhood Food Environment, Health Behaviors and Health Outcomes among Urban Hispanics in New York City
Background: Hispanics account for more than half of the total United States (US) population growth between 2000 and 2010. To gain a comprehensive understanding of a predominantly Hispanic urban community in Northern Manhattan, the aims of this cross-sectional observational study were: (1) to characterize the actual and perceived neighborhood food environment in Northern Manhattan, (2) to understand the relationship between the actual and perceived neighborhood food environment, sociodemographic characteristics and the likelihood of consuming five or more servings of fruits and vegetables per day, and (3) to describe the contribution of participants’ sociodemographic characteristics and health behavior to their health outcomes.
Methods: This cross-sectional observational study was undertaken as part of the larger Washington Heights/Inwood Informatics Infrastructure for Comparative Effectiveness Research (WICER) project. English or Spanish-speaking Hispanic participants (n=4,019) 18 years and older living in Northern Manhattan’s five ZIP codes were recruited and interviewed by English-Spanish bilingual community health workers. Food outlets selling fruits and vegetables were identified using the North American Industry Classification System (NAICS) definitions obtained from the ReferenceUSA’s national business database. The neighborhood food environment was characterized by integrating the geocoded addresses of WICER study participants with external geographic-level data on food outlets present in the participants’ respective 0.25-mile and 0.5-mile residential radii. Data were analyzed using bivariate and multivariate binary logistic regressions.
Results: The food outlet types that sell fruit and vegetable in Northern Manhattan include small and medium/large size Supermarket/Grocery store, Meat Market, and Fruit and Vegetable Market. The majority of these food outlets (91.5%) are single location stores that have a smaller store space. The presence of Fruit and Vegetable Markets (2+ Stores in 0.25-mile: OR=1.59, p = 0.003; 1 Store in 0.5-mile: OR=2.28, p = 0.008; 2+ Stores in 0.5-mile: OR=3.10, p = 0.00) significantly increase the odds of participant’s perception that a large selection of fresh fruits and vegetables is available in their neighborhood. The presence of Fruit and Vegetable Markets (2+ Stores in 0.25-mile: OR=1.51, p = 0.003; 1 Store in 0.5-mile: OR=2.25, p = 0.004; 2+ Stores in 0.5-mile: OR=3.31, p = 0.00) as well as the presence of medium/large size Supermarket/Grocery in 0.25-mile (OR=1.05, p = 0.013) significantly increase the odds of participant’s perception that the fresh fruits and vegetables in their neighborhood are of high quality whereas the presence of Meat Market in the participant’s 0.25-mile (OR=0.74, p = 0.002) significantly lower the odds. The presence of Fruit and Vegetable Markets (1 Store in 0.25-mile: OR=1.23, p = 0.047; 2+ Stores in 0.25-mile: OR=1.37, p = 0.020; 2+ Stores in 0.5-mile: OR=1.94, p = 0.018) as well as the presence of medium/large size Supermarket/Grocery (0.25-mile: OR=1.05, p = 0.020; 0.5-mile: OR=1.05, p = 0.018) significantly increase the odds of participant’s perception that a large selection of low-fat products is available in their neighborhood whereas the presence of Meat Market in the participant’s 0.25-mile (OR=0.83, p = 0.042) significantly lowers the odds.
Variables that significantly increase the participants’ odds of consuming five or more servings of fruits and vegetables per day include having more than a high school education (0.25-mile and 0.5-mile models: OR=1.62, p = 0.004) and being foreign-born (0.25-mile model: Foreign-born in Dominican Republic: OR=1.77, p = 0.032; Foreign-born outside of the United States or the Dominican Republic: OR=2.44, p = 0.007; 0.5-mile model: Foreign-born in the Dominican Republic: OR=1.73, p = 0.040; Foreign-born outside of the United States or the Dominican Republic: OR=2.48, p = 0.006). In contrast, the participants’ perception that a large selection of fresh fruits and vegetables is available in their neighborhood (0.25-mile model: OR=0.63, p = 0.011; 0.5-mile model: OR=0.64, p = 0.016) and the presence of Fruit and Vegetable Market in their 0.5-mile radius (1 Store: OR=0.32, p = 0.006; 2+ Stores: OR=0.38, p = 0.009) significantly lower the odds.
Variables that significantly increase the odds of body mass index (BMI) in the overweight range were age (OR=1.02, p = 0.00), being foreign-born outside of the United States or the Dominican Republic (OR=1.76, p = 0.006), self-reported diabetes (OR=1.37, p = 0.026), and perceived weight as overweight (OR=4.46, p = 0.00) whereas being female (OR=0.67, p = 0.00) significantly lowers the odds. Variables that significantly increase the odds of BMI in the obese range were age (OR=1.02, p = 0.00), self-reported diabetes (OR=1.78, p = 0.00), and perceived weight as overweight (OR=19.39, p = 0.00) whereas having more than a high school education (OR=0.72, p = 0.021) significantly lowers the odds.
Variables that significantly increase the odds of hypertension were age (OR = 1.04, p = 0.00) and self-reported diabetes (OR = 1.57, p = 0.00) whereas being female (OR = 0.72, p = 0.00) significantly lowers the odds. Education (>High School) significantly increases the odds (OR=1.43, p = 0.00) of self-report of good health. In contrast, variables that significantly lower the odds were age (OR=0.98, p = 0.00), being female (OR=0.60, p = 0.00), higher fruit and vegetable consumption (OR=0.66, p = 0.007), self-reported diabetes (OR=0.51, p = 0.00), and obesity (OR=0.64, p = 0.00).
Variables that significantly increase the odds of self-report of good health include having more than a high school education (OR = 1.43, p = 0.00) whereas age (OR = 0.98, p = 0.00), female gender (OR = 0.60, p = 0.00), higher fruit and vegetable consumption (OR = 0.66, p = 0.007), self-reported diabetes (OR = 0.51, p = 0.00), and obesity (OR = 0.64, p = 0.00) significantly lower the odds.
Conclusion: This study contributed to our understanding of the relationships among neighborhood food environment, health behaviors, and health outcomes in a predominantly Hispanic underserved urban community in New York City. While most findings were similar to those reported in the literature, our findings related to the relationship between participants’ perceived neighborhood food environment and actual healthy food access and fruit and vegetable consumption were in contrast to other studies in that increased perceived availability and actual availability lowered the odds of consuming five or more servings of fruits and vegetables per day. This surprising finding merits additional qualitative and quantitative research to examine the complex relationships among perceived access, availability, and consumption of healthy foods as well as improved measures of fruit and vegetable consumption
SOSORT consensus paper: school screening for scoliosis. Where are we today?
This report is the SOSORT Consensus Paper on School Screening for Scoliosis discussed at the 4th International Conference on Conservative Management of Spinal Deformities, presented by SOSORT, on May 2007. The objectives were numerous, 1) the inclusion of the existing information on the issue, 2) the analysis and discussion of the responses by the meeting attendees to the twenty six questions of the questionnaire, 3) the impact of screening on frequency of surgical treatment and of its discontinuation, 4) the reasons why these programs must be continued, 5) the evolving aim of School Screening for Scoliosis and 6) recommendations for improvement of the procedure
Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.
BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700