ObjectiveState-level estimates of obesity based on self-reported height and weight suggest a geographic pattern of greater obesity in the Southeastern US; however, the reliability of the ranking among these estimates assumes errors in self-reporting of height and weight are unrelated to geographic region.Design and MethodsWe estimated regional and state-level prevalence of obesity (body mass index ≥ 30 kg/m2) for non-Hispanic black and white participants aged 45 and over were made from multiple sources: 1) self-reported from the Behavioral Risk Factor Surveillance System (BRFSS 2003-2006) (n = 677,425), 2) self-reported and direct measures from the National Health and Nutrition Examination Study (NHANES 2003-2008) (n = 6,615 and 6,138 respectively), and 3) direct measures from the REasons for Geographic and Racial Differences in Stroke (REGARDS 2003-2007) study (n = 30,239).ResultsData from BRFSS suggest that the highest prevalence of obesity is in the East South Central Census division; however, direct measures suggest higher prevalence in the West North Central and East North Central Census divisions. The regions relative ranking of obesity prevalence differs substantially between self-reported and directly measured height and weight.ConclusionsGeographic patterns in the prevalence of obesity based on self-reported height and weight may be misleading, and have implications for current policy proposals.

Vietnam can be considered a success story in its handling of the COVID-19 pandemic. As of April 27, 2020, the country has had 270 cases (225 recovered), no deaths, and no new cases for the past 10 days (since April 18). On Friday, April 24, two new cases were identified at the airport, but both cases were quarantined at arrival. We provide a few take-home lessons from the Vietnam experience. (Am J Public Health. Published online ahead of print May 28, 2020: e1–e2. doi:10.2105/AJPH.2020.305751)

BackgroundThere is strong evidence that breastfeeding (BF) significantly benefits mothers and infants in various ways. Yet the proportion of breastfed babies in Vietnam is low and continues to decline. This study fills an important evidence gap in BF practices in Vietnam.ObjectiveThis paper examines the trend of early initiation of BF and exclusive BF from 2000 to 2011 in Vietnam and explores the determinants at individual and contextual levels.DesignData from three waves of the Multiple Indicator Cluster Survey were combined to estimate crude and adjusted trends over time for two outcomes – early initiation of BF and exclusive BF. Three-level logistic regressions were fitted to examine the impacts of both individual and contextual characteristics on early initiation of BF and exclusive BF in the 2011 data.ResultsBoth types of BF showed a decreasing trend over time after controlling for individual-level characteristics but this trend was more evident for early initiation of BF. Apart from child's age, individual-level characteristics were not significant predictors of the BF outcomes, but provincial characteristics had a strong association. When controlling for individual-level characteristics, mothers living in provinces with a higher percentage of mothers with more than three children were more likely to have initiated early BF (odds ratio [OR]: 1.06; confidence interval [CI]: 1.02–1.11) but less likely to exclusively breastfeed their babies (OR: 0.94; CI: 0.88–1.01). Mothers living in areas with a higher poverty rate were more likely to breastfeed exclusively (OR: 1.07; CI: 1.02–1.13), and those who delivered by Caesarean section were less likely to initiate early BF.ConclusionsOur results suggest that environmental factors are becoming more important for determining BF practices in Vietnam. Intervention programs should therefore not only consider individual factors, but should also consider the potential impact of contextual factors on BF practices.

An important factor for monitoring health transition is the collection of valid and reliable population data over time. 1 However, given the weaknesses of the national health information systems in low-and middle-income countries such as Vietnam, especially in the area of generating high-quality population-based information, health and demographic surveillance systems (HDSSs) have been shown to generate high-quality population-based data and scientific evidence on the levels, patterns, and trends in health and health care transitions in a country.