305559
Trends in upstate NY adult health indicators: Longitudinal county- level results, 1997-2012
Methods. Secondary data analyses compared 4 cross-sectional surveys (collected in 1997, 2000, 2006, 2012) to study acial/ethnic disparities across five health outcomes (BMI, insurance coverage, smoking, mental health and self-reported health). Data from cross-sectional telephone surveys, items adapted from national surveys, were designed to provide valid representation of prevalence estimates of adult health status and behavior indicators. Survey questions changed over time; variables were collapsed or recoded to allow for longitudinal analyses; missing observations were excluded. Sample sizes across survey years varied (1579 to 2272). Raking was performed to appropriately weight and report population level outcomes. Covariates included age, gender, education and residence (city/suburb).
Results. Results presented for two outcomes.
Current Smoker: Despite declines from 1997 to 2012 in overall prevalence and among non-Hispanic (NH) Blacks and Hispanics, disparities persisted (2012: NH-Whites: 12.4%, NH-Blacks: 23.9%; Hispanics: 16.5%). Unadjusted ORs: 1.8[95%CI:1.1,2.9] and 1.3[95%CI:0.4,1.1] (NH-Black and Hispanic (vs. NH-White)) changed dramatically after covariate adjustment: 0.6[95%CI:0.4,1.1] and 0.5[95%CI:0.3,1.1] respectively.
BMI: Despite increases overall and among Blacks and Hispanics, rates of overweight were similar for NH-Blacks and NH-Whites (ranging from 31.1-38.1% over the four surveys). Hispanics’ rates were generally >5% lower.
Obesity prevalence rates among NH-Blacks were approximately twice those of NH-Whites over all surveys (e.g. 1997: obese: 30.8% vs. 14.2%; 2012: obese: 46.3% vs. 27.9%). Obesity rates among Hispanics were similar to NH-Whites in 1997, but approached those of NH-Blacks by 2012.
For NH-Blacks vs. NH-Whites, after adjustment, ORs showed only slight differences (e.g. 2012: overweight: crude OR: 1.4[95%CI: 0.8,2.5]; adjOR: 1.8[95%CI:1.0,3.3]; obese: crude OR: 1.9[95%CI:1.2,3.2]; adjOR: 1.4[95%CI:0.8,2.5]). Comparisons between crude and adjusted ORs for Hispanics vs. NH-Whites also showed few differences.
Conclusions. Observed racial/ethnic disparities may be better understood after accounting for other covariates. Using local data and accounting for covariates in disparity analyses identifies areas of greater or lesser impact and opportunities to focus programs and target funding.
Learning Areas:
Chronic disease management and preventionEpidemiology
Learning Objectives:
Discuss data collection methods, disparity analysis and use of longitudinal community level data for planning and evaluation.
Keyword(s): Health Disparities/Inequities, Data Collection and Surveillance
Qualified on the content I am responsible for because: I am the Lead Evaluator for the project from which the data in this presentation are drawn. I helped design the survey and interpret the findings. I am an PhD prepared nurse and an Associate Professor in Public Health Sciences
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.