Background: Food insecurity is a public health problem. There is limited data on food insecurity in Mississippi. Methods: We analyzed data from the 2015 Mississippi Behavioral Risk Factor Surveillance System, which included the Social Context Module for 5870 respondents. Respondents who indicated that in the past 12 months they were “always”, “usually”, or “sometimes” “worried or stressed about having enough money to buy nutritious meals” were considered food insecure. Food insecurity was compared across sociodemographic and health characteristics using chi-square tests, and the association between food insecurity and select cardiovascular disease risk factors was assessed using logistic regression. Results: The prevalence of food insecurity was 42.9%. Compared to the referent group, Mississippi adults with high blood pressure had 51% higher odds, those with diabetes had 30% higher odds, those who were not physically active had 36% higher odds, and those who consumed fewer than five fruits and vegetables daily had 50% higher odds of being food insecure. Conclusion: Among Mississippi adults, food insecurity is associated with high blood pressure, diabetes, obesity, fruit and vegetable consumption, physical inactivity, and smoking.

IntroductionApproximately 26.3 million people in the United States have chronic kidney disease and many more are at risk of developing the condition. The association between specific metabolic syndrome components and chronic kidney disease in African American individuals is uncertain.MethodsBaseline data from 4,933 participants of the Jackson Heart Study were analyzed. Logistic regression models were used to estimate the odds and 95% confidence intervals of chronic kidney disease associated with individual components, metabolic syndrome, the number of components, and specific combinations of metabolic syndrome components.ResultsMetabolic syndrome was common with a prevalence of 42.0%. Chronic kidney disease was present in 19.4% of participants. The prevalence of metabolic components was high: elevated blood pressure (71.8%), abdominal obesity (65.8%), low fasting high density lipoprotein cholesterol (37.3%), elevated fasting glucose (32.2%) and elevated triglycerides (16.2%). Elevated blood pressure, triglycerides, fasting blood glucose, and abdominal obesity were significantly associated with increased odds of chronic kidney disease. Participants with metabolic syndrome had a 2.22-fold (adjusted odds ratio (AOR) 2.22; 95% CI, 1.78–2.78) increase in the odds of chronic kidney disease compared to participants without metabolic syndrome. The combination of elevated fasting glucose, elevated triglycerides, and abdominal obesity was associated with the highest odds for chronic kidney disease (AOR 25.11; 95% CI, 6.94–90.90).ConclusionMetabolic syndrome as well as individual or combinations of metabolic syndrome components are independently associated with chronic kidney disease in African American adults.

IntroductionCardiovascular disease is a leading cause of death and health disparities in Mississippi. Identifying populations with poor cardiovascular health may help direct interventions toward those populations disproportionately affected, which may ultimately increase cardiovascular health and decrease prominent disparities. Our objective was to assess racial differences in the prevalence of cardiovascular health metrics among Mississippi adults.MethodsWe used data from the 2009 Mississippi Behavioral Risk Factor Surveillance System to determine age-standardized prevalence estimates and 95% confidence intervals of cardiovascular health metrics among 2,003 black and 5,125 white adults. Logistic regression models were used to evaluate the relationship between race and cardiovascular health metrics. The mean cardiovascular metrics score and percentage of the population with ideal and poor cardiovascular health were calculated by subgroup.ResultsApproximately 1.3% of blacks and 2.6% of whites exhibited ideal levels of all 7 cardiovascular health metrics. The prevalence of 4 of the 7 cardiovascular health metrics was significantly lower among the total population of blacks than among whites, including a normal body mass index (20.8% vs 32.3%, P < .001), no history of diabetes (85.1% vs 91.3%, P < .001), no history of hypertension (53.9% vs 67.9%, P < .001), and physical activity (52.8% vs 62.2%, P < .001). The logistic regression models revealed significant race-by-sex interactions; differences between blacks and whites for normal body mass index, no history of diabetes mellitus, and no current smoking were found among women but not among men.ConclusionCardiovascular health is poor among Mississippi adults overall, and racial differences exist.

IntroductionThe consumption of sugar-sweetened beverages (SSBs) is linked to excessive weight gain, diabetes, and risk of cardiovascular disease. We examined the association between SSB consumption and sociodemographic characteristics among Mississippi adults.MethodsWe used data from the 2012 Mississippi Behavioral Risk Factor Surveillance System, which collected information on SSB consumption from 7,485 respondents. We used logistic regression models to calculate adjusted prevalence ratios (APRs) and 95% confidence intervals (CIs) for characteristics associated with SSB consumption.ResultsIn 2012, 40.8% of Mississippi adults reported consuming at least one SSB daily. The likelihood of consuming SSBs at least once daily among respondents aged 18 to 34 years was 2.81 times higher (APR, 2.81; 95% CI, 2.49–3.18) than among those aged 65 years or older. The prevalence among men was 20% higher (APR, 1.20; 95% CI, 1.11–1.30) than among women and 23% higher (APR, 1.23; 95% CI, 1.13–1.35) among black respondents than among white respondents. The prevalence among respondents with less than a high school education was 25% higher (APR, 1.25; 95% CI, 1.11–1.41) than among those who with more than a high school education and 33% higher (APR, 1.33; 95% CI, 1.16–1.52) among those with an annual household income of less than $20,000 than among those with an income of $50,000 or more.ConclusionAmong Mississippi adults, age, sex, race, education level, and income are associated with an increased likelihood of SSB consumption. Findings highlight the need for policies and interventions to address SSB consumption and promote alternatives to SSBs among Mississippians.

IntroductionThe prevalences of major modifiable risk factors for cardiovascular disease (CVD) are disproportionately high in the 18-county Mississippi Delta region, and many of these risk factors disproportionately affect blacks. Temporal trends in the prevalence of CVD risk factors in the Mississippi Delta have not been determined. We examined trends in CVD risk factors from 2001 to 2010 in the region.MethodsLongitudinal trends in prevalence of high blood pressure, high cholesterol, diabetes, obesity, physical inactivity, and current smoking were investigated using self-reported data from the Behavioral Risk Factor Surveillance System. Joinpoint regression models were used to examine annual percentage change (APC) in the prevalence of these risk factors.ResultsOverall, from 2001 to 2010, we observed significant increases in the prevalence of high cholesterol (APC, 4.22%), obesity (APC, 3.65%), and diabetes (APC, 3.54%). Among blacks, we found significant increases in the prevalence of high cholesterol (APC, 3.41%), obesity (APC, 3.48%), and diabetes (APC, 4.96%). Among whites, we found significant increases in high blood pressure (APC, 2.18%), high cholesterol (APC, 4.78%), obesity (APC, 4.18%), and physical inactivity (APC, 3.06%). We also observed a significant decrease in smoking among whites (APC, −1.99%).ConclusionFrom 2001 to 2010, we found a significant increase in the prevalence of high cholesterol, diabetes, and obesity in the Mississippi Delta. We also observed racial differences in those prevalences.

Introduction On average, more than 1,700 people in Mississippi die from stroke annually, but data on trends by age, sex, and race in Mississippi are limited. We examined trends in the stroke death rate among adults in Mississippi aged 35 or older by age, sex, and race. Methods We used Mississippi Vital Statistics data to calculate age-specific death rates for stroke among people in Mississippi aged 35 or older from 2000 to 2016. We identified cases according to underlying cause-of-death codes from the International Classification of Diseases, Tenth Revision (ICD-10). We used Joinpoint software to calculate annual percentage change (APC) and the average annual percentage change (AAPC) in death rates for stroke by age, sex, and race (non-Hispanic black and non-Hispanic white). Results Among adults aged 35 or older, the age-adjusted stroke death rate declined 30.7% from 141.3 per 100,000 population in 2000 to 97.9 per 100,000 population in 2016, with an AAPC of −2.4% (95% confidence interval, −3.1% to −1.6%). Stroke death rates declined significantly among both men and women in the first trend segment (2000–2009 for men and 2000–2007 for women) but did not decline in the second trend segment (2009–2016 for men and 2007–2016 for women). Non-Hispanic black men had the smallest decline in stroke death rates during the full study period. Among people aged 55 to 64 and non-Hispanic white men, rates shifted from a significant annual decline during the first segment to a significant annual increase during the second segment. Conclusion Age-adjusted stroke death rates among adults in Mississippi aged 35 or older declined significantly between 2000 and 2016, but trends differed by age, race, and sex. Clinical and community interventions aimed at reducing stroke risk factors, particularly for adults aged 55 to 64, are needed in Mississippi.

IntroductionIn 2015, about 1.5 million adults in Mississippi were overweight or obese. Obesity is associated with increased risk for diabetes and cardiovascular problems. We examined trends in the prevalence of overweight, obesity, and extreme obesity from 2001 through 2010 and 2011 through 2015.MethodsWe used data from the Mississippi Behavioral Risk Factor Surveillance System to analyze trends in the prevalence of overweight, obesity, and extreme obesity among adults from 2001 through 2010 and 2011 through 2015. Joinpoint software was used to examine annual percentage change (APC) in the prevalence of each condition overall and by sex and race.ResultsWe observed a significant decrease in overweight prevalence from 2001 to 2010, both overall (APC, −1.3%) and among men (APC, −2.0%), blacks (APC, −1.0%), and whites (APC, −1.5%), but not among women. The overall prevalence of both obesity (APC, 2.9%) and extreme obesity (APC, 3.6%) increased significantly, and these increases occurred across all subgroups for both obesity (men APC, 3.5%; women APC, 2.5%; blacks APC, 1.9%; and whites APC, 3.8%) and extreme obesity (men APC, 6.7%; women APC, 2.5%; blacks APC, 2.2%; and whites APC, 5.0%). From 2011 to 2015, the only significant change was an increase in the prevalence of extreme obesity among whites (APC, 2.6%).ConclusionThe increasing proportion of adult Mississippians in the 2 highest-risk BMI categories warrants urgent community and clinical obesity interventions. Community-tailored and sustained obesity prevention, treatment, and control programs that include diet and physical activity are needed to address the obesity epidemic.

In 2017, Mississippi had the third highest age-adjusted prevalence of hypertension in the United States. We estimated the prevalence of hypertension by sociodemographic characteristics and occupation and examined the association between hypertension with occupation and sociodemographic characteristics among Mississippi workers. We calculated adjusted prevalence and adjusted prevalence ratios (APRs) by sociodemographic characteristics and occupation among Mississippi adult workers. We analyzed combined 2013, 2015, and 2017 data from the Mississippi Behavioral Risk Factor Surveillance System for 6,965 workers in ten Standard Occupational Classification System major groups. Of the estimated 1.1 million Mississippi workers during the three survey years, 31.4% (95% confidence interval (CI), 30.0–32.8) had hypertension. The likelihood of having hypertension was significantly higher among workers aged 30–44 years, 45–64 years, blacks, and those classified as overweight and obese workers compared to their counterparts. The likelihood of having hypertension among workers in the fields of installation, repair and maintenance, and production were 26% higher (APR, 1.26; 95% CI, 1.03–1.55) and 33% higher (APR, 1.33; 95% CI, 1.11–1.58), respectively, than workers in all other occupational groups. Among Mississippi workers, hypertension prevalence varied by sociodemographic characteristics and occupational groups. Age, race, obesity status, installation, repair, maintenance, and production occupation groups are associated with an increased likelihood of hypertension. Novel and/or community-based or linked programs are needed that could target workers at risk of hypertension that are outside of a single-site workplace.