Age at diagnosis of diabetes in Appalachia

Barker, Lawrence; Gerzoff, Robert B.; Crespo, Richard; Shrewsberry, Molly

doi:10.1186/1478-7954-9-54

Cited by 18 publications

(27 citation statements)

References 11 publications

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“…These behaviors and conditions have been identified by the American Heart Association as central determinants of CV health 35 and have been associated with high rates of CVD morbidity and mortality in Central Appalachia. 5,[36][37][38] Similar to our findings, a statewide survey conducted by Narevic and Schoenberg 39 showed that Kentuckians living in areas with high rates of CVD, including Appalachia, have a general awareness of causative factors including unhealthy diet and smoking and, to a lesser extent, physical inactivity. However, a study by Griffith et al 40 revealed that Appalachian residents with high CVD risk, including hypertension, obesity, poor nutrition, and physical inactivity, perceived their health status to be good or excellent.…”

Section: Discussionsupporting

confidence: 89%

Rural Appalachian Perspectives on Heart Health: Social Ecological Contexts

Mudd‐Martin¹,

Biddle²,

Chung³

et al. 2014

Am J Hlth Behav

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Section: Discussionsupporting

confidence: 89%

Rural Appalachian Perspectives on Heart Health: Social Ecological Contexts

Mudd‐Martin¹,

Biddle²,

Chung³

et al. 2014

Am J Hlth Behav

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“…Policylevel strategies that improve economic conditions of deprived rural areas may be effective in improving health outcomes and reducing rural health disparities. Similar to the current study, living in distressed Appalachian counties has been independently associated with a greater likelihood of developing diabetes 52 , and diabetes is diagnosed earlier among residents living in these areas 53 . Findings from this study also complement those of Schoenberg and colleagues 26 who reported that obesity risk is greater among those residing in Appalachian Kentucky, controlling for sociodemographics, days of poor mental health, and smoking.…”

supporting

confidence: 73%

Residing in economically distressed rural Appalachia is independently associated with excess body weight in college students

Abshire

Lennie

Mudd‐Martin

et al. 2017

Rural Remote Health

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A B S T R A C TIntroduction: The prevalence of obesity is greater among adults living in rural compared to urban areas of the USA. Greater obesity risk among rural adults persists after adjusting for obesity-related behaviors and sociodemographic factors. With the ruralurban obesity disparity greatest among younger adults, it is important to examine the complexity of factors that may increase the risk for excess body weight in this population so that effective preventive interventions can be implemented. College students residing in economically deprived rural areas such as rural Appalachia may be particularly at risk for excess body weight from exposure to both rural and college obesogenic environments. The purpose of this study was to determine if living in economically distressed rural Appalachia is independently associated with excess body weight among college students. Methods: College students aged 18-25 years who were lifetime residents of either rural Eastern Appalachian Kentucky (n=55) or urban Central Kentucky (n=54) participated in this cross-sectional study. Students completed questionnaires on sociodemographics, depressive symptoms, and health behaviors including smoking, fruit and vegetable intake, and physical activity. Height and weight were obtained during a brief health examination to calculate body-mass index (BMI). Excess body weight was defined as being overweight or obese with a BMI of 25 kg/m 2 or greater. Binary logistic regression was used to determine if living in economically distressed rural Appalachia was independently associated with excess body weight. Results: The prevalence of excess body weight was higher in the rural Appalachian group than the urban group (50% vs 24%, p<0.001). Depressive symptom scores and smoking prevalence were also greater in the rural Appalachian group. © DA Abshire, TA Lennie, GT Mudd-Martin, DK Moser, 2016. A Licence to publish this material has been given to James Cook University, http://www.jcu.edu.au 2There were no differences in fruit and vegetable intake and vigorous physical activity between the groups. Residing in economically distressed rural Appalachia was associated with more than a six-fold increased risk of overweight or obesity, controlling for sociodemographics, depressive symptoms, and health behaviors (odds ratio=6.36, p=0.002). Conclusions: Living in economically distressed rural Appalachia was associated with excess body weight in college students independent of sociodemographic factors, depressive symptoms, and obesity-related behaviors. Further research is needed to determine other characteristics of this region that are associated with excess body weight so that effective programs to reduce obesity risk can be implemented.

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“…In 2010, 69 percent of these counties were classified as health professional shortage areas (HPSAs) involving either whole or partial county areas; with 91 percent of the most economically distressed counties in Appalachia designated as shortage areas (U.S. Department of Health & Human Services ; Barker et al. ). Appalachia has been designated by the National Cancer Institute as a special area based on its higher cancer incidence and poorer outcomes for most leading cancers (Halverson, Lin, and Harner ; Lengerich et al.…”

mentioning

confidence: 99%

Breast Cancer Screening, Area Deprivation, and Later‐Stage Breast Cancer in Appalachia: Does Geography Matter?

Anderson

Yang

Matthews

et al. 2013

Health Services Research

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Objective To model the relationship of an area-based measure of a breast cancer screening and geographic area deprivation on the incidence of later stage breast cancer (LSBC) across a diverse region of Appalachia. Data Source Central cancer registry data (2006–2008) from three Appalachian states were linked to Medicare claims and census data. Study Design Exploratory spatial analysis preceded the statistical model based on negative binomial regression to model predictors and effect modification by geographic subregions. Principal Findings Exploratory spatial analysis revealed geographically varying effects of area deprivation and screening on LSBC. In the negative binomial regression model, predictors of LSBC included receipt of screening, area deprivation, supply of mammography centers, and female population aged > 75 years. The most deprived counties had 3.31 times rate of LSBC compared to the least deprived. Effect of screening on LSBC was significantly stronger in northern Appalachia than elsewhere in the study region, found mostly for high population counties. Conclusions Breast cancer screening and area deprivation are strongly associated with disparity in LBSC in Appalachia. The presence of geographically varying predictors of later stage tumors in Appalachia suggests the importance of place-based health care access and risk.

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Age at diagnosis of diabetes in Appalachia

Cited by 18 publications

References 11 publications

Rural Appalachian Perspectives on Heart Health: Social Ecological Contexts

Rural Appalachian Perspectives on Heart Health: Social Ecological Contexts

Residing in economically distressed rural Appalachia is independently associated with excess body weight in college students

Breast Cancer Screening, Area Deprivation, and Later‐Stage Breast Cancer in Appalachia: Does Geography Matter?

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