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Introduction This study examines the associations of neighborhood environments with BMI, HbA1c, and diabetes across 6 years in Hispanic/Latino adults. Methods Participants from the Hispanic Community Health Study/Study of Latinos San Diego site (n=3,851, mean age=39.4 years, 53.3% women, 94.0% Mexican heritage) underwent assessment of metabolic risk factors and diabetes status (categorized as normoglycemia, prediabetes, and diabetes) at baseline (2008–2011) and approximately 6 years later (2014–2017). In the Study of Latinos Community and Surrounding Areas Study ancillary study (2015–2020), participant baseline addresses were geocoded, and neighborhoods were defined using 800-meter circular buffers. Neighborhood variables representing socioeconomic deprivation, residential stability, social disorder, walkability, and greenness were created using Census and other public databases. Analyses were conducted in 2020–2021. Results Complex survey regression analyses revealed that greater neighborhood socioeconomic deprivation was associated with higher BMI (β=0.14, p

Menthol in cigarettes increases nicotine dependence and decreases the chances of successful smoking cessation. In New York City (NYC), nearly half of current smokers usually smoke menthol cigarettes. Female and non-Latino Black individuals were more likely to smoke menthol-flavored cigarettes compared to males and other races and ethnicities. Although the US Food and Drug Administration recently announced that it will ban menthol cigarettes, it is unclear how the policy would affect population health and health disparities in NYC. To inform potential policymaking, we used a microsimulation model of cardiovascular disease (CVD) to project the long-term health and economic impact of a potential menthol ban in NYC. Our model projected that there could be 57,232 (95% CI: 51,967–62,497) myocardial infarction (MI) cases and 52,195 (95% CI: 47,446–56,945) stroke cases per 1 million adult smokers in NYC over a 20-year period without the menthol ban policy. With the menthol ban policy, 2,862 MI cases and 1,983 stroke cases per 1 million adults could be averted over a 20-year period. The model also projected that an average of $1,836 in healthcare costs per person, or $1.62 billion among all adult smokers, could be saved over a 20-year period due to the implementation of a menthol ban policy. Results from subgroup analyses showed that women, particularly Black women, would have more reductions in adverse CVD outcomes from the potential implementation of the menthol ban policy compared to males and other racial and ethnic subgroups, which implies that the policy could reduce sex and racial and ethnic CVD disparities. Findings from our study provide policymakers with evidence to support policies that limit access to menthol cigarettes and potentially address racial and ethnic disparities in smoking-related disease burden.

Using a tool integrated into the electronic health record, we determined prevalence of 10 social needs among 377 people with HIV (PWH) and 27,833 patients without HIV receiving care in the Montefiore Health System. PWH (median age 53) were 55% women, 41% Black, 44% Hispanic. 33% of PWH reported at least one social need vs. 18% among patients without HIV, with healthcare transportation and housing needs significantly higher among PWH in adjusted analyses. PWH reporting transportation needs were 27% less likely to be virologically suppressed ( 200 copies/mL, adjusted prevalence ratio 0.73, 95% CI 0.55-0.96) compared with PWH without transportation needs.Por medio del uso de encuestas integradas en el registro electrónico de salud, determinamos la prevalencia de 10 necesidades sociales entre 377 personas con VIH (PCV) y 27 833 pacientes sin VIH que reciben atención en el Montefiore Health System. PCV (edad mediana de 53 años) fueron 55% mujeres, 41% negras, 44% hispanas. 33% de PCV reportó al menos una necesidad social vs. 18% de los pacientes sin VIH, siendo las necesidades de transporte a cuidados de salud y de vivienda significativamente mayores en PCV en análisis multivariable ajustado. PCV con necesidades de transportación fueron 27% menos probables de tener supresión viral ( 200 copias/ml, razón de prevalencias ajustada 0.73, IC 95% 0.55–0.96) comparada con PCV sin necesidades de transportación.

INTRODUCTION: Health systems are increasingly interested in addressing the social determinants of health via social risk screening. The objective of this study is to understand the variability in the number and types of social risks overall and in population subgroups among primary care patients routinely screened in a large urban health system. METHODS: Between April and December 2018, a total of 24,633 primary care patients completed a 10-item screener across 19 ambulatory sites within a health system in the Bronx, NY. The prevalence of any social risk and specific social risks was estimated overall and for population subgroups. Wald tests were used to determine statistically significant differences by subgroup. Data were analyzed in winter/spring 2019. RESULTS: Twenty percent of patients presented with at least 1 social risk. The most frequently reported risks included housing quality (6.5%) and food insecurity (6.1%). Middle-aged (30–59 years) respondents (24.7%, 95% CI=23.6%, 25.7%) compared with those aged 18–29 years (17.7%, 95% CI=16.4%, 19.2%, p

Hispanic/Latino populations may experience significant neighborhood disadvantage, but limited research has explored whether these factors affect their health behaviors. Associations between perceived neighborhood factors at Visit 1 and health behaviors and related outcomes at Visit 2 in the Hispanic Community Health Study/Study of Latinos were evaluated. Multivariable logistic regression assessed cross-sectional and longitudinal relationships between perceived neighborhood social cohesion (NSC, 5 items), and neighborhood problems (NP, 7 items), with cancer screening, current smoking, excessive/binge drinking, hypertension, obesity, physical activity, and poor diet by gender and birthplace. NSC and NP scores were converted into quartiles. Mean age of participants was 42.5 years and 62.1% were women. Perceived NP, but not perceived NSC, differed by gender (p 0.001). In unstratified models, no significant associations were observed between perceived NSC and any health behavior, whereas greater perceived NP was associated with less adherence to colon cancer screening (moderate level: aOR = 0.68, 95% CI = 0.51, 090) and more physical activity (very high level: aOR = 1.34, 95% CI = 1.06, 1.69) compared to low perceived NP. Women with moderate perceived NP, versus low NP, had a lower odds of colon cancer screening at Visit 1 (aOR = 0.62, 95% CI = 0.43, 0.91) and higher odds of mammogram adherence at Visit 2 (aOR = 2.86, 95% CI = 1.44, 5.68). Men with high perceived NP had a higher odds of excessive or binge drinking at Visit 2 (aOR = 1.99, 95% CI = 1.19, 3.31). We conclude that perceived NP were significantly related to health behaviors among HCHS/SOL individuals. Perceptions of neighborhood environment may be considered modifiable factors of structural neighborhood environment interventions.

OBJECTIVE: Equations for predicting Body Surface Area (BSA) produce flawed estimates, especially for individuals with obesity. We aimed to compare BSA measured by a 3-dimensional photonic scanner (BSA(3DPS)) to BSA predicted by six commonly cited prediction equations, and to develop new prediction equations if warranted. METHODS: We validated the 3DPS against manual measurements by breadth caliper for body thicknesses measured at three anatomical sites on a mannequin. BSA was derived from 3DPS whole body scans of 67 males and 201 females, ages 18-83; BMIs 17.8-77.8 kg/m(2), and varied race/ethnicities. RESULTS: Width and depth measurements by 3DPS and caliper were within 1%, except for hip, error 1.8%. BSA(3DPS) differed from BSA predicted by each equation (p

Purpose The purpose of this study was to identify patient and program delivery characteristics associated with engagement and weight loss in a Diabetes Prevention Program (DPP) implemented in an urban hospital system. Methods Patient and program delivery data were collected between July 2015 and December 2017. DPP eligibility was determined based on age, body mass index (BMI), and hemoglobin A1C data via the electronic health record. Engagement was measured at 3 levels: ≤3 sessions, 4 to 8 sessions, and ≥9 sessions. Weight was measured at each DPP session. Results Among the eligible patients (N = 31 524), referrals and engagement were lower in men than women, in Spanish speakers than English speakers, in younger (18-34 years) and middle-aged (35-54 years) than older adults, and in patients receiving Medicaid than other patients. Referral and engagement were higher in patients with higher BMIs and those prescribed ≥5 medications. Current smokers were less frequently engaged. Prior health care provider contact was associated with higher engagement. Overall, 28% of DPP participants achieved ≥5% weight loss; younger and middle-aged patients and those who gained weight in the prior 2 years were less likely to lose weight. Conclusion This assessment identified characteristics of patients with lower levels of referral and engagement. The DPP staff may need to increase outreach to address barriers to referral and during all points of engagement among men, younger patients, and Spanish speakers. Future research is needed to increase understanding with regard to why referrals and engagement are lower among these groups.

Objective: Housing status is a primary social determinant of health that is not typically not collected in clinical settings. Residential address data collected during clinical visits can identify patients at high-risk for cardio­metabolic disease (CMD) residing in public housing. Design: This study examined CMD and related risk factors among patients living in public housing and a comparison group not living in public housing. Setting: All patients (n=173,568) were receiving primary care in a large hospital system in the Bronx, New York between January 1, 2016 and December 31, 2017. Results: Patients in public housing were more likely to be women, to be Black or Hispanic, and to be on Medicaid compared with patients not living in public housing. Women in public housing were more likely than men to have had a higher prevalence of CMD and related risk factors. Conclusion: The burden of CMD among public housing residents shows sex disparities where women have a higher prevalence of CMD and related risk factors than men. Ethn Dis. 2019;29(3):463-468; doi:10.18865/ed.29.3.463

Background The risk of mortgage foreclosure disproportionately burdens Hispanic/Latino populations perpetuating racial disparities in health. In this study, we examined the relationship between area-level mortgage foreclosure risk, homeownership, and the prevalence of cardiovascular disease risk factors among participants of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Methods HCHS/SOL participants were age 18–74 years when recruited from four U.S. metropolitan areas. Mortgage foreclosure risk was obtained from the U.S. Department of Housing and Urban Development. Homeownership, sociodemographic factors, and cardiovascular disease risk factors were measured at baseline interview between 2008 and 2011. There were 13,856 individuals contributing to the analysis (median age 39 years old, 53% female). Results Renters in high foreclosure risk areas had a higher prevalence of hypertension and hypercholesterolemia but no association with smoking status compared to renters in low foreclosure risk areas. Renters were more likely to smoke cigarettes than homeowners. Conclusion Among US Hispanic/Latinos in urban cities, area foreclosure and homeownership have implications for risk of cardiovascular disease.

Purpose Limited research has examined maternal experiences of racial/ethnic discrimination in relation to child cardiometabolic health. In this study, we investigated whether maternal experiences of ethnic discrimination were associated with cardiometabolic risk in Hispanic/Latino youth several years later. Methods Our sample included 1146 youth (8–16 years) from the Study of Latino Youth (2012–2014), who were children of the Hispanic Community Health Study/Study of Latinos participants (2008–2011). We used regression models to examine the prospective associations between maternal report of ethnic discrimination in relation to her child's body mass index (BMI) z-score, metabolic syndrome score (MetS), and high sensitivity C-reactive protein (hsCRP) levels 2 years later. Results Maternal ethnic discrimination was associated with youth hsCRP, but not BMI or MetS (P-values >.05). Adjusting for age, nativity, and national background, maternal ethnic discrimination was associated with higher (log) hsCRP levels (β = 0.18, 95% CI = 0.04 to 0.32) in children. This association was robust to adjustment for maternal and household characteristics (β = 0.17, 95% CI = 0.04 to 0.31), as well as maternal depression and maternal BMI. Conclusions Maternal ethnic discrimination is associated with inflammation among Hispanic/Latino youth, and not BMI z-score or MetS. Studies are needed to address temporality and pathways.

In this study of low-income Hispanic/Latino adults living in 291 individual apartments in the Bronx, New York, the apartment layout was significantly associated with the odds of depressive symptomology. Women living in apartments in which the most central rooms were the living, dining, or kitchen (i.e., rooms commonly used for communal activities) were less likely to have depressive symptomology (OR = 0.44, 95% CI = 0.22–0.86) than women in apartments where the central rooms were lobbies or corridors, adjusting for demographics, health conditions, and housing and neighborhood characteristics. No statistically significant association was observed in men. We present the logic underlying the use of layout variables in this study and discuss the implications it may have for understanding the role of the home environment on psychological distress among inhabitants. The results of this study show how space syntax analysis can be used to better understanding disparities in the risk of depression and offer an additional opportunity for public health stakeholders to identify those most at risk for depression.

Introduction The reach of the New York State YMCA's Diabetes Prevention Program (DPP) to at-risk populations may be increased through integration with primary care settings. Although considerable effort has been made in the referral and retention of patients, little is known about the factors associated with the placement of potential participants into YMCA's DPP. Methods Among Montefiore Health System (MHS) patients referred to YMCA's DPP (n = 1,249) from July 10, 2010, through November 11, 2015, we identified demographic factors (eg, age, preferred language) and primary care practice-level factors (eg, time between referral and start of session, session season) associated with placement into a session and subsequent drop-out. We also evaluated factors associated with weight loss. Results Patients were predominantly female (71%) and aged 45 years or older (71%). Patients preferring sessions in Spanish were less often placed in sessions. Patients aged 18 to 44 years were less often placed (P = .01) and enrolled (P = .001) than patients aged 60 years or older. Sessions conducted in the summer and spring had higher enrollment than fall and winter months. Patients who started the YMCA's DPP within 2 months of their referral date were more often enrolled (54.4%) than patients who waited 4 or more months (21.6%) to start their sessions. Patients aged 45 to 59 years lost marginally less weight than those aged 60 years or older (-3.1% vs -3.8%; P = .07). Conclusion Although this evaluation gives some insight into the barriers to placement and enrollment in YMCA's DPP, challenges remain. Efforts are under way to increase referral of patients to community-based DPPs.

From February through December 2012, we examined responses to health behavior questions integrated into the electronic medical record of primary care centers in the Bronx, New York in the context of New York City Community Health Survey data. We saw a higher proportion of unhealthy behaviors among patients than among the neighborhood population. Analyzing clinical data in the neighborhood context can better target at-risk populations.

Studies have shown that households subsidized with vouchers live in higher quality units and exhibit fewer physical, mental, and social problems than do their peers living in public housing. However, none of these studies have included cardiovascular outcomes. The objective of this study was to assess if use/type of rental assistance is independently associated with poor cardiovascular health among Latino adults (ages ≥ 18) who are eligible for federal low-income rental assistance and living in the Bronx, NY. Data from the cross-sectional, Affordable Housing as an Obesity Mediating Environment study, collected over 18 months (January 2011 to August 2012) were used. The prevalence of cardiovascular disease (CVD) outcomes was determined by measured high blood pressure and self-reported heart attack and/or stroke. Type of housing status was defined as: public housing units, units subsidized by section 8 vouchers, and units unassisted by either federal program. Statistical techniques used were analysis of variance and multivariate logistic regression. The prevalence of CVD was significantly higher among public housing residents than unassisted participants even in the presence of all individual level covariates. Public housing residents also have higher levels of CVD than do section 8 participants. The prevalence of CVD was similar for unassisted and section 8 participants. These findings point to the potential for health benefits arising from housing voucher use even within a fairly delimited geographic area.

Federal rental assistance programs, in the form of the traditional public housing program and the Housing Choice Voucher Program (HCVP—formerly known as Section 8), are designed to reduce the economic rental burden for low-income residents. While residents using federal housing vouchers, which allow low-income residents in public housing to move out of public housing to rent-subsidized homes, have been found to be have better cardiovascular outcomes compared to the cardiovascular outcomes of low-income public housing residents, the mechanisms explaining these associations remains an understudied area. The aim of this study is to assess whether residents participating in HCVP or unassisted residents had greater access to healthy foods such as fruits and vegetables, and less access to unhealthy foods such as fast food and sugar sweetened beverages, when compared to residents living in public housing (referent group). The Affordable Housing as an Obesity Mediating Environment (AHOME) study is a cross-sectional study of Latinos residing in low-income housing in the Bronx, NY (n = 362). Participants were interviewed to assess food patterns and perceptions of neighborhood environment. The analytic sample was primarily female (74.5 %) with a mean age of 46.4 years (SD = 14.68). Residents participating in HCVP had similar availability of fruits and vegetables in the home compared to residents receiving no assistance or public housing residents. HCVP participants consumed more fast food (β = 0.34; CI = 0.10–0.58) but had similar sugar sweetened beverage consumption compared to public housing residents. Unassisted residents had more fast food consumption (β = 0.25; CI = 0.01–0.49) but less sugar sweetened beverage consumption (β = −0.52; CI = −0.76–−0.28) than public housing residents. Perceptions of neighborhood food environment were not significantly associated with dietary patterns. This study shows variability in consumption of sugar sweetened beverage consumption and fast food consumption, but not in availability of fruits and vegetables, across residents participating in HCVP, public housing residents, and unassisted residents. Evaluating the health benefits associated with low-income housing mobility programs, such as HCVP, requires examining how housing may influence dietary patterns above and beyond an individual’s socioeconomic position.

The study examined whether characteristics of the urban physical environment are associated with child and maternal body mass index (BMI) in a sample of 3 year-old children and their mothers from 18 US cities (N=1997 dyads). BMI was determined based on measured height and weight. Characteristics of the interior and exterior physical environment, assessed and rated by trained interviewers, were related to child BMI at age 3 and to their mother's BMI. Negative aspects of the physical environment were more strongly related to maternal BMI among whites than among African-Americans or Hispanics.

Fragile Families and Wellbeing Study (FFS) data were analyzed to examine the relationships between obesity, household instability, and area poverty in urban mothers and their children (N=1,449). The FFS was conducted in 20 U.S. cities between 2001 and 2004. Household instability was defined as a tenuous home environment where certain psychosocial and economic constraints are present. Area poverty was determined according to the 2000 U.S. Census. Relative weight increased with level of household instability in mothers but not in children. Mothers with the highest level of household instability within areas of low poverty (i.e., relatively little poverty) were more likely than others to be obese (Odds Ratio=1.8, 95% CI 1.2-2.6). Household instability was not associated with overweight in children. These results suggest that home stability should be considered as a possible risk factor for obesity in mothers with infant children, particularly those residing in low poverty areas.

Introduction The Diabetes Prevention Program has been translated to community settings with varying success. Although primary care referrals are used for identifying and enrolling eligible patients in the Diabetes Prevention Program, little is known about the effects of strategies to facilitate and sustain eligible patient referrals using electronic health record systems. Methods To facilitate and sustain patient referrals, a modification to the electronic health record system was made and combined with provider education in 6 federally qualified health centers in the Bronx, New York. Referral data from April 2012 through November 2014 were analyzed using segmented regression analysis. Results Patient referrals increased significantly after the modification of the electronic health record system and implementation of the provider education intervention. Before the electronic system modification, 0 to 2 patients were referred per month. During the following year (September 2013 through August 2014), which included the provider education intervention, referrals increased to 1 to 9 per month and continued to increase to 5 to 11 per month from September through November 2014. Conclusions Modification of an electronic health record system coupled with a provider education intervention shows promise as a strategy to identify and refer eligible patients to community-based Diabetes Prevention Programs. Further refinement of the electronic system for facilitating referrals and follow-up of eligible patients should be explored.

Studies show that those residing in households subsidized with federal housing vouchers exhibit fewer mental health problems than residents of public housing. The role of housing conditions and neighborhood quality in this relationship is unclear. This study investigated the relationship between rental assistance, housing and neighborhood conditions, and the risk of depressive symptomology and hostile affect among low-income Latino adults living in the Bronx, NY. Latino adults participating in the Affordable Housing as an Obesity Mediating Environment (AHOME) study were used for analysis. All AHOME participants were eligible for federal low-income housing rental assistance (n = 385) and living in the Bronx, New York (2010–2012). Housing (crowding and structural deficiencies) and neighborhood (physical disorder and social cohesion) were measured by questionnaire during in-home interview. Depressive symptomology was measured using the Center for Epidemiologic Studies Depression Scale Short Form, CES-D 10 (score ≥10). Hostile affect was measured using items from the Cook-Medley Hostility Scale (score ≥ 4). Results suggest residents of Section 8 housing have similar levels of depressive symptomology and hostility compared to residents in public housing or those receiving no federal housing assistance. However, depressive symptomology was significantly associated with maintenance deficiencies [OR = 1.17; CI 1.02, 1.35] and social cohesion [OR = 0.71; CI 0.55, 0.93]. Hostility was significantly associated with perceived crowding [OR = 1.18; CI 1.16, 2.85], neighborhood physical disorder [OR = 1.94; CI 1.12, 3.40], and social cohesion [OR = 0.70; CI 0.50, 0.98]. Low-income housing assistance did not have an independent effect on mental health outcomes. However, characteristics of the housing and neighborhood environments were associated with depressive symptomology and hostility.

To examine the relationship between serum iron and body composition in a multiracial adult cohort.The analysis consisted of 670 participants on whom blood analysis and anthropometric data were available. The participants were recruited as part of the Rosetta Study (1990-2000), which was designed to assess body composition in a multiethnic cohort of healthy adults. Fasting iron level was measured as part of a biochemistry panel. Dual x-ray absorptiometry was used to assess fat mass. Anthropometric measures included waist circumference and body mass index (BMI; calculated as kg/m(2)) as an index of abdominal adiposity and overall body fatness, respectively.In the study cohort the mean age was 54+/-17 years and 60.9% were overweight or obese (BMIor =25). Men had higher serum iron levels (94.91+/-34.52 microg/dL [16.99+/-6.18 micromol/L] vs 82.17+/-32.62 microg/dL [14.71+/-5.84 micromol/L]) and larger waist circumference (91.98+/-11.87 cm vs 85.24+/-12.37 cm) compared with women (P0.001). Iron was inversely correlated with BMI (r=-0.23, P0.001), waist circumference (r=-0.19, P0.05), and fat mass (r=-0.19, P0.05) among Hispanic women but not among African-American, white, or Asian women or in men of any race/ethnic group.The results of this study show an inverse association of measures of body fat distribution and total fat mass with serum iron level in Hispanic women. Studies designed to explore how micronutrients are used by the body at varying degrees of body fatness could provide useful information on the micronutrient-related comorbidities of obesity.

Sleep is implicated in the risk of many chronic diseases; however, little is known about the living conditions that influence sleep. In this study of 371 low-income Latino residents, household crowding was associated with reduced odds of long sleep duration relative to average and short sleep duration. Neighborhood disorder and perceived building problems were associated with more sleep disturbances and poor sleep quality. Building problems were associated with prolonged sleep latency. There was a significant cumulative effect of adverse housing and neighborhood conditions on sleep outcomes. These results show that adverse conditions of both the housing and neighborhood environments are associated with poor sleep outcomes.

Purpose Metabolic syndrome (MetS), the clustering of several risk factors for cardiovascular disease, is highly prevalent in Hispanics/Latinos. We tested whether all components significantly loaded on the syndrome in Hispanics/Latinos and whether their contribution differed by sex and Hispanic ancestry. We also examined associations of MetS with prevalent diabetes and coronary heart disease in Hispanics/Latinos. Methods Data were obtained from a population-based cohort of n = 15,823 participants in the HCHS/SOL study who self-identified as being of Central American, Cuban, Dominican, Mexican American, Puerto Rican, or South American ancestry and were aged 18 to 74 years at screening. Results A latent variable model of waist circumference, systolic and diastolic blood pressure, triglycerides, high-density lipoprotein cholesterol (HDL-C), and fasting glucose fit the data in men and women, but the contribution of HDL-C was weak. No difference in the latent model of MetS was detected across Hispanic/Latino ancestry groups. MetS was significantly associated with diabetes and coronary heart disease. Conclusions Our results indicate that similar criteria for MetS may be applied across Hispanic/Latino ancestry groups but call into question the role of HDL-C in classifying the MetS in Hispanics/Latinos.

Although multiple social and behavioral risk factors associated with obesity co-occur among young children, most studies have examined them separately. The purpose of this study was to examine the relationship between social risk factors, behavioral problems, health behaviors, and obesity among preschoolers in the Fragile Families and Child Wellbeing Study (N = 1589).A cumulative social risk score was created by summing maternal reports of intimate partner violence, food insecurity, housing insecurity, maternal depressive symptoms, maternal substance use, and father's incarceration, obtained when the child was 3 years old. Mothers reported on the child's internalizing and externalizing behaviors with the Child Behavior Checklist at age 5 years. Mothers also reported on hours the child spent watching television and sleeping as well as servings of soda or juice drinks the child consumed per day. Child height and weight were measured at age 5 years. Obesity was defined as body mass index ≥ 95th percentile.In regression analyses adjusted for health behaviors, behavioral problems, and sociodemographic factors, cumulative social risk was associated with obesity among girls. Externalizing behavioral problems were associated with obesity among girls (prevalence ratios [PRs], 1.5; 95% confidence interval [CI], 1.2-1.7) and boys (PR, 1.3; 95% CI, 1.1-1.6). Short sleep duration was also associated with obesity among girls (PR, 1.2; 95% CI, 1.0-1.4) and boys (PR, 1.3; 95% CI, 1.1-1.5) even after adjusting for behavioral problems and social risk factors. Watching more than 2 hours of television per day was associated with obesity among boys (PR 1.5; 95% CI, 1.2 to 1.9) but not girls.Co-occurring social and behavioral risk factors are associated with obesity among 5-year-old children.

OBJECTIVES: The goal of this study was to examine the relationship between cumulative social adversity and childhood obesity among preschool-aged children (N = 1605) in the Fragile Families and Child Wellbeing Study. METHODS: Maternal reports of intimate partner violence, food insecurity, housing insecurity, maternal depressive symptoms, maternal substance use, and father’s incarceration were obtained when the child was 1 and 3 years of age. Two cumulative social risk scores were created by summing the 6 factors assessed at ages 1 and 3 years. Child height and weight were measured at 5 years of age. Logistic regression models stratified according to gender were used to estimate the association between cumulative social risk and obesity, adjusting for sociodemographic factors. RESULTS: Seventeen percent of children were obese at age 5 years, and 57% had at least 1 social risk factor. Adjusting for sociodemographic factors, girls experiencing high cumulative social risk (≥2 factors) at age 1 year only (odds ratio [OR]: 2.1 [95% confidence interval [CI]: 1.1–4.1]) or at 3 years only (OR: 2.2 [95% CI: 1.2–4.2]) were at increased odds of being obese compared with girls with no risk factors at either time point. Those experiencing high cumulative risk at age 1 and 3 years were not at statistically significant odds of being obese (OR: 1.9 [95% CI: 0.9–4.0]). No significant associations were noted among boys. CONCLUSIONS: There seems to be gender differences in the effects of cumulative social risk factors on the prevalence of obesity at 5 years of age. Understanding the social context of families could make for more effective preventive efforts to combat childhood obesity.

Objective To examine whether the relationship between obesity and asthma in young girls and boys can be explained by social and physical characteristics of the home environment. Study design We examined the relationship between asthma and obesity in children in the Fragile Families and Child Wellbeing Study (n = 1815). Asthma was determined through maternal report of asthma diagnosis by a doctor (active in past 12 months). Weight and height of child was measured during an in-home visit. Data on home social (maternal depression, intimate partner violence) and physical environmental factors (housing quality, tobacco exposure) were collected via questionnaire. Results Ten percent of children had active asthma, 19% of children were overweight, and 17% of children were obese. In fully adjusted models, obese children had twice the odds of having asthma (OR, 2.3; 95% CI, 1.5-3.3) compared with children of normal body weight. In stratified analyses, overweight boys, but not overweight girls, had increased of odds of asthma. Obese boys and girls had increased odds of asthma compared with boys and girls of normal body weight. Conclusion The relationship between asthma and obesity is present in boys and girls as young as 3 years of age; a relationship between being overweight and asthma is only present among boys. This relationship is not attributable to shared social and environmental factors of the children's home.

Racial and ethnic disparities in obesity persist despite a narrowing in obesity risk associated with socioeconomic status. The household environment has been shown to be important in understanding obesity-promoting behaviors in diverse populations. Our current study was designed to examine the relationship between household density and obesity in young Black and White adults aged 18-30 years from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort. All sociodemographic and leisure-time physical activity (LTPA) information for this study was collected by questionnaire between 1990-1991. Height was collected using a mounted centimeter ruler. Weight was measured on a balance beam scale. Obesity was defined as a body mass indexor = 30 kg/m2. Household density (HD) was defined as the ratio of people to bedrooms in the home. High HD was defined as a ratio1. Bivariate analysis showed that more women tend to live in high density households compared to men (45.4% vs 38.9%; P.01) and more Blacks tend to live in high density households compared to Whites (53.7% vs 31.8%). Leisure-time physical activity index was lower in Blacks than in Whites (2.5% vs 2.6%; P.01). Blacks had a higher prevalence of obesity than Whites (27.1% vs 11.8%; P.01). Logistic regression analysis showed that Black women within high HD were at highest risk for obesity compared to White women living within low HD (OR = 4.88%; 95% CI: 3.56-6.67). HD may provide an important context in understanding racial disparities in obesity-promoting behaviors.

The aim of this study was to examine the relationship of serum Mg with stage of diabetes measured by fasting serum glucose in a cohort of 485 African American and Hispanic adults.The cross sectional Rosetta study was designed to assess body composition in a multi-racial cohort of healthy adults living in New York City. The data utilized for the current analyses were collected during the years 1990 to 2000. Serum Mg and glucose were measured after a 10-12 hour fast. Dual-energy x-ray absorptiometry was used to measure fat mass (FM) and fat free mass (FFM).The mean age of the cohort was 53 +/- 16 years. Hispanics had significantly lower (p0.05) mean serum Mg levels (0.82 +/- 0.07 mmol/L vs. 0.85 +/- 0.07 mmol/L) and FFM (48.8 +/- 10.9 kg vs. 50.9 +/- 10.3 kg) compared to African Americans. In both race/ethnic groups, individuals classified as having diabetes had significantly (p0.001) lower serum concentrations of Mg (0.80 +/- 0.07 mmol/L) compared to the normal group (0.84 +/- 0.07 mmol/L).These results show that in African American and Hispanic adults, those with diabetes have lower serum Mg levels compared to those classified as pre-diabetic or those with normal fasting glucose levels.

This retrospective cohort study examined the relationship of birth weight, family history of diabetes (FamHx), and current weight to insulin resistance in Black girls and boys on the Caribbean island of Barbados. A cohort of 56 low birth weight (LBW) and 120 normal birth weight (NBW) adolescents born between January 1, 1986, and December 31, 1988, were recruited for study participation in 2002. FamHx was ascertained by questionnaire. Body mass index (BMI) and waist circumference (WC) were used to assess fat distribution. Fasting blood glucose and insulin were measured from blood samples drawn from each adolescent participant. Insulin resistance was estimated by the homeostasis model assessment (HOMA) technique. These data show that only among LBW girls was a positive (+) FamHx associated with higher HOMA (FamHx "Yes"=1.22 +/- 0.298 vs "No"=0.811 +/- 0.452; P=.032). No significant relationships were observed among boys. Further analyses revealed that compared to their NBW counterparts, LBW girls without FamHx, had a smaller WC (69.70 +/- 9.88cm vs 76.70 +/- 15.64cm, respectively; P=.055). In contrast, LBW girls with a (+) FamHx had similar mean WC (77.71 +/- 16.46cm) to those of NBW girls with (+) FamHx (WC=71.50 +/- 10.38cm; P=.405). These data indicate that along with a family history of diabetes, catch-up weight may be important in assessing diabetes risk in Black Caribbean LBW adolescent girls.

This study examined the relationship of internalized racism (INR) and hostility to body fat distribution and insulin resistance in black adolescent children age 14-16 years on the Caribbean island of Barbados. Questionnaire data on psychosocial variables and anthropometric measurements, together with a fasting blood sample, were obtained from 53 low-birthweight and 119 normal-birthweight adolescents. Insulin resistance was calculated using the homeostasis model assessment (HOMA). Spearman correlation analyses showed that both INR (r = 0.244) and hostility (r = 0.204) were significantly (p < 0.05) correlated with waist circumference in girls but not boys. Among girls, age- and birthweight-adjusted mean levels of BMI and waist circumference were greater for those with high levels of INR and hostility compared to those with low levels of both variables. In multiple logistic regression analyses, a high INR remained independently associated [odds ratio = 3.30 (95% CI = 1.30-8.36); p = 0.012] with having an elevated HOMA value in models that included age, income, birthweight, hostility, physical activity and family history of diabetes. The results of the current study show that the positive relationship between INR and metabolic health risk seen in African-Caribbean adults also exists in African Caribbean adolescent youth independent of birthweight.

The objective of this study was to determine whether acculturation and psychosocial stress exert differential effects on body fat distribution and insulin resistance among native-born African Americans and African-Caribbean immigrants living in the US Virgin Islands (USVI). Data collected from a non-diabetic sample of 183 USVI-born African Americans and 296 African-Caribbean immigrants age > 20 on the island of St. Croix, USVI were studied. Information on demographic characteristics, acculturation and psychosocial stress was collected by questionnaire. Anthropometric measurements were taken, and serum glucose and insulin were measured from fasting blood samples. Insulin resistance was estimated by the homeostasis model assessment (HOMA) method. The results showed that in multivariate regression analyses, controlling for age, education, gender, BMI, waist circumference, family history of diabetes, smoking and alcohol consumption, acculturation was independently related to logarithm of HOMA (InHOMA) scores among USVI-born African Americans, but not among African-Caribbean immigrants. In contrast, among USVI-born African Americans psychosocial stress was not significantly related to InHOMA, while among African-Caribbean immigrants psychosocial stress was independently related to InHOMA in models that included BMI, but not in those which included waist circumference. This study suggests that acculturation and psychosocial stress may have a differential effect on body fat distribution and insulin resistance among native-born and immigrant blacks living in the US Virgin Islands.

Calculations are presented which correlate the risk of carcinogenesis with various diagnostic radiological procedures. Even though "worst case" conditions are assumed, such as a linear non-threshold dose-response relationship, most of the radiographic procedures appeared to be quite conservative in terms of carcinogenic risk. This was not true, however, for mammography of younger women.