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In spite of the National Asthma Education and Prevention Program guidelines outlining how to diagnose, treat, and educate asthmatics, asthma morbidity and mortality rates are still mounting. Furthermore, the minority population has disproportionately higher rates of unfavorable outcomes from asthma, thereby diminishing their quality of life. The study's theoretical framework was based on the health belief model and explored associations of asthma control with self-efficacy and asthma education. Few studies focus on asthma inequity. The purpose of this quantitative study was to assess relationships between asthma control, race, asthma education, and healthcare utilization amongst asthmatic children residing in the Midwest. Secondary data from the Centers for Disease Control's Behavioral Risk Factor Surveillance System's Asthma Call-back Survey were used (n=477,221). Participant characteristics were examined using descriptive statistics. A sequence of bivariate and logistic regression analysis was used to test each hypothesis. The findings revealed significant associations amongst asthma control, race, asthma education, and healthcare utilization. In addition, children with uncontrolled asthma have greater visits to the emergency department and to their pediatrician's office due to their asthma symptoms. Moreover, the study results indicated that African American children experienced uncontrolled asthma at a higher rate when compared to other children, consequently decreasing their quality of life. The study showed the need for policy change to expand funding and programs aimed at decreasing uncontrolled asthma by improving asthma education, especially in African American communities, in hope of empowering asthmatics to play a vital role in their health and increasing their quality of life.

Low-income populations in the United States consume less healthful diets than higher-income populations, specifically relating to fruit and vegetable consumption. The supplemental nutrition program Women, Infants, and Children (WIC) is intended to bridge this gap by providing nutrition education and vouchers for nutritious foods. The purpose of this study was to determine if the 2009 WIC food package revisions impacted fruit and green vegetable consumption in 18 to 24-year-old females in California. Using the social ecological model as a guide, a population of WIC (N = 115) and non-WIC (N = 276) participants from the California Behavioral Risk Factor Surveillance System survey were analyzed for trends on daily fruit and green vegetable consumption over the period of years 2009, 2011, 2013, and 2015. ANCOVA analysis showed that WIC and non-WIC populations did not consume significantly different amounts of green vegetables, but did consume significantly different amounts of fruits, p = .120 and p = .028 respectively. Additionally, WIC participant fruit consumption did not significantly increase over the years, p = .376. However, a decrease of .031 (95%CI [.019,.584], p = .037) was identified in green vegetable consumption between 2009 and 2015. Due to mean differences between samples and years it is evident that there are influencing factors driving fruit and vegetable consumption outside of income barriers, such as possible social or environmental factors. This study adds to the literature regarding the WIC food package revisions and may promote positive social change by encouraging future researchers to identify barriers to healthful diets in WIC populations and determine if additional food package revisions may be needed to increase healthful diets in low-income populations.

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Introduction: Oral health impacts much more than a person’s teeth and smile. Research indicates a connection between oral health and illnesses like cardiovascular disease and depression. Poor oral health could lead to social stigmatization and affects a person’s quality of life. Increased dental visits help detect and treat dental disease and offer opportunities for preventive care. Notably, the proportion of older adults in Tennessee is rapidly increasing, coupled with the growing complexity of older adults’ dental treatment. The first aim of this longitudinal study was to examine the prevalence of dental care visits among older persons (≥60 years) in Tennessee from 2010 to 2018. Our second aim was to examine the determinants of dental care visits among our target population. Methods: This study used five even years of Behavioral Risk Factor Surveillance system (BRFSS) data including years 2010, 2012, 2014, 2016, and 2018. BRFSS is a network of health-related telephone surveys conducted by all 50 states, the District of Columbia, and participating US territories. Our data was limited to Metropolitan and Micropolitan statistical areas, including East, Middle, and West Tennessee, while focusing on seniors (≥60 years old). Descriptive statistics were conducted. Weighting was conducted to account for the complex sampling design. Logistic regression analysis was performed to determine the factors associated with dental clinic visits among Tennessee seniors from 2010 to 2018. A p-value<0.05 was considered statistically significant. Results: The current study comprised of 5,362 Tennessee seniors. The year 2012 had the most seniors (1,324) and 2018 had the least number of seniors (787). About 64% of participants visited dentists or dental clinics within the past year while 18% reported that their last dental visit was ≥ 5 years ago. The percentage of older individuals visiting dental clinics within one year gradually decreased from 76.46% in 2010 to 71.17% in 2018. The majority of participants were females (51.7%), Whites (81.3%), never-smokers (46.3%), had good/better health (71.2%), and were located in Middle Tennessee (43.5%). Approximately 19% of Tennessee seniors removed all their permanent teeth. Logistic regression showed that those more likely to visit dentists or dental clinics included females (OR: 1.40; 95% CI: 1.11-1.77), former smokers (OR: 2.23; 95% CI: 1.46-3.41), never-smokers (OR: 2.21;95% CI: 1.46-3.35), individuals who had some college education (OR: 1.64 ;95% CI: 1.11-2.44), and graduated from college (OR: 2.74; 95% CI: 1.78-4.20). Likewise, individuals with a higher level of socioeconomic status, including a high income of $>50,000 (OR: 5.49; 95%CI: 3.60-8.36), were more likely to report dental visits. Conversely, Blacks (OR: 0.60; 95% CI: 0.43-0.82), participants with fair/poor health (OR: 0.67; 95% CI: 0.51-0.84), and those that have never-married (OR: 0.46;95% CI: 0.29-0.74) were less likely to report dental visits. Conclusions: The percent of Tennessee seniors visiting dental clinics within one year has gradually decreased from 76.46% in 2010 to 71.17% in 2018. The factors associated with a higher likelihood of seeking dental care include non-smoking status, identifying as females, and high socioeconomic status. Effective interventions to improve dental visits should take the identified factors into account.

Emergency preparedness steps taken by individuals in Utah households were evaluated in 3 studies. Study 1 evaluated the 2011 landline and cell phone Behavioral Risk Factor Surveillance System Survey and General Preparedness Optional Module results from two states, Louisiana and Utah, to find factors from demographic and medical data that can be used to predict emergency preparedness in individuals. Stepwise logistical regression analysis ascertained the ability of chosen variables to predict individuals' preparedness. The rate of prepared individuals was lower if they were between the ages of 18 to 54 years, when compared to the reference age group of 65 or older. Also, the rate of prepared participants was lower if they were female, had children under age 18 at home, or were unable to afford a doctor in the past year. Rate of prepared respondents was higher if they owned a home or were married (p <0.05). Study 2 evaluated water stored for emergency purposes in households throughout Utah for coliform, E. coli, free chlorine, and antimony. Ninety one percent of the stored water samples were found to be safe for human consumption. However, 9% of water samples were not considered safe due to over chlorination or the presence of coliform. Of 240 samples, 7 contained coliform and 14 samples had total chlorine levels over the Environmental Protection Agency's 4 ppm limit. Water in clear, polyethylene terephthalate soda bottles, even when stored for >18 months, did not exceed 0.3 ppb antimony, a level significantly lower than the Environmental Protection Agency limit of 6.0 ppb antimony. Study 3 measured for one year the temperature and humidity of food storage areas in 67 households within Utah. In 63% of locations, temperatures exceeded 24 °C, which can be considered abusive for food storage. The maximum temperature reached in a food storage area was 37.9 °C. Percent relative humidity exceeded 60% in 43% of food storage areas, which can be considered abusive for food stored in packaging permeable to moisture. The maximum percent relative humidity reached was 92.5%. In conclusion, most water stored for emergency purposes was considered safe, but temperature and humidity conditions for most food storage areas exceeded recommended maximums, and emergency preparedness of households within Utah needs to be improved.

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Mental illness affects more women than men in the United States. Poor mental health in reproductive-age women has negative implications on population health. The purpose of this quantitative, correlational study was to examine the relationship between household structure and frequency of mental distress, with consideration of the mediation social-emotional support provides for reproductive-age women. The social ecological model was the theoretical framework for this research, in which frequency of mental distress related to the individual-level of the human-environment interaction construct. Household structure and social-emotional support were examined at the relationship-level. Pearson's correlation coefficient and linear regression were used to conduct a cross-sectional analysis of the 2010 Behavioral Risk Factor Surveillance System data set with a total sample size of 65,269 women, 18-44 years old. The confounding variables, health care access, race, income, marital status, number of children in the household, and pregnancy status, were included in the analysis. Although social-emotional support significantly influenced both household structure and frequency of mental distress, significance was not found between household structure and frequency of mental distress indicating that mediation does not exist. This study provides researchers and practitioners information about household structure that should be considered when designing innovative, nonprofessional support programs at the community-level. Positive social change implications include an understanding of the relationship between complex variables associated with social-emotional support, which could improve community support programs focused on mental health wellness of reproductive-age women.

The main aim of this study is to compare the prevalence of diabetes-related complications in white to the prevalence in other racial and ethnic groups in United States using 2009 Behavioral Risk Factor Surveillance System (BRFSS). By constructing the logistic regression model, odds ratios (OR) were calculated to compare the prevalence of diabetes complications in white and other groups. Compared to white, the prevalence of hypertension and stroke in African Americans were higher, while the prevalence of heart attack and coronary heart disease were lower. The Asian Americans or Pacific Islanders, African Americans and Hispanics were more likely to develop retinopathy compared to white. The prevalence of hypertension, hypercholesterolemia, heart attack, coronary heart disease, Stroke in Native Americans and “other” group were not significantly different from the prevalence in white. Asian or Pacific Islanders were less likely to experience stroke.

Background: Significant evidence exists about J-shaped relationship between alcohol consumption and total or cardiovascular disease (CVD)-specific mortality in US middleaged adults. Epidemiologic investigations presume that the J-shaped distribution is the sum of the detrimental effect of high levels of consumption on other causes of death and the protective effect on coronary heart disease (CHD) morbidity and mortality. Several studies demonstrated that moderate alcohol consumption reduces the risk of CHD. However, results have been inconsistent among heavy drinkers. In this study, we investigated the association of heavy alcohol consumption with CHD among adults aged 18-years or older in the US. Methods: Data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS) were used to conduct this study. BRFSS is an annual cross-sectional survey administered to >400,000 adults in all 50 states to collect information about their health-related risk behaviors, chronic health conditions and the use of preventive services. Self-reported responses to BRFSS questionnaire were used to define study variables. Heavy alcohol consumption was defined as greater than 14 drinks (1 drink =12 ounces of beer) per week for men and 7 drinks per week for women. Logistic regression analysis was conducted to determine the association between history of coronary heart disease or angina and heavy alcohol consumption. The model was also adjusted for demographics (age, sex, and race), behaviors (exposure to tobacco smoking, physical activity, fruit consumption), other chronic conditions such as high blood pressure (ever been told having high blood pressure or not), high cholesterol (ever been told having high blood cholesterol or not) and overweight or obese. Results: Approximately 6% of study population reported history of CHD and 5% reported heavy alcohol consumption. The odds of having coronary heart disease or angina among heavy alcohol drinkers was 43% less than those who were not heavy alcohol drinkers (adjusted odds ratio: 0.57, 95% confidence interval: 0.52-0.62, pConclusion: The study findings demonstrate that heavy alcohol consumption is a protective factor for CHD morbidity. Future observational studies should be conducted to determine the overall benefits of heavy alcohol consumption as it relates to coronary heart diseases.