AJPH News Release August 23, 2005

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AJPH NEWS Release

EMBARGOED UNTIL August 23, 2005, 4 PM (ET)
CONTACT: For copies of articles, call Natalie Raynor, (202) 777-2511 or email at natalie.raynor@apha.org

All articles are online at www.ajph.org

American Journal of Public Health September 2005 Highlights

· Fast-food restaurants cluster around schools
· Black and low-income women need tailored weight loss strategies
· Junk food dominates advertising shown during children's programs
· Race and ethnicity a factor in diabetics' risk for complications
· Girls more physically active if exposed to exercise at school
· Obesity and diabetes carry risks for pregnant women

The articles highlighted below appear in the September 2005 issue of the American Journal of Public Health, the Journal of the American Public Health Association.

Fast-food restaurants cluster around schools
Fast-food restaurants are concentrated within a short walking distance of schools, exposing children to "poor quality food environments" on a daily basis.
According to a study of fast-food restaurants in the Chicago area, the median distance of any school from a fast-food restaurant was .52 km or about a third of a mile, a distance an adult can walk easily in five minutes. Almost 80 percent of schools had at least one fast-food restaurant within 800 meters, or less than a half mile. Fast-food restaurants were statistically significantly clustered in areas within a short walking distance from schools, with an estimated 3 to 4 times as many fast-food restaurants within 1.5 km from schools than would be expected if the restaurants were distributed throughout the city in a way unrelated to school locations.
Last year, the Institute of Medicine called on the food industry to voluntarily restrict advertising of unhealthy food to children. The study's authors also point to possible school policies prohibiting off-campus fast food from being brought to school and zoning requirements to limit restaurants' proximity to schools as ways to combat rising obesity rates among children.
[From: "Clustering of Fast-Food Restaurants Around Schools: A Novel Application of Spatial Statistics to the Study of Food Environments." Contact: S. Bryn Austin, ScD, Division of Adolescent and Young Adult Medicine, Children's Hospital, Boston, bryn.austin@childrens.harvard.edu.]

Black and low-income women need tailored weight loss strategies
Weight loss programs need to be race- and income-specific because weight control experiences are far different between black and white women and affluent and poor women, according to a recent study.
Researchers put together focus groups made up of obese women and divided by race and socioeconomic status. They found most of the women had been able to lose weight in the past, but they failed to keep it off. The white women surveyed said physical activity was their key to weight-loss success, while the black women put more emphasis on food choices. Black women in particular said weight loss programs that incorporated spiritual and psychological support would be helpful. And the low-income women surveyed said cost had been a barrier to effective weight loss for them. The study's authors said this points to a need to promote "creative strategies that educate low-[income] women on cost-effective ways to eat healthy and engage in physical activity…"
Black and low-income women are at higher risk for obesity than the general population, but tailored weight-loss programs could help reduce the risk, the study's authors said.
[From: "Racial and Socioeconomic Differences in the Weight-Loss Experiences of Obese Women." Contact: Esa M. Davis, MD, MPH, Department of Family Medicine-Research Division, Case Western Reserve University, Cleveland, edw6@case.edu.]

Junk food dominates food advertising shown during children's programs
Snack, convenience and fast foods continue to dominate the advertising shown during the
programs children view most.
Researchers analyzed 426 food advertisements aimed at children and general audiences as well as the nutritional value of the advertised foods. They found convenience or fast foods and sweets made up 83 percent of advertised foods. Snack time eating was depicted more often than breakfast, lunch and dinner combined. If children eat a diet similar to those advertised during their favorite television programs, they will exceed the daily sodium recommendation and consume almost a cup of added sugar daily, according to the analysis.
[From: "Nutritional Content of Foods Advertised During the Television Programs Children Watch Most." Contact: Kristen Harrison, Department of Speech Communication, University of Illinois, krishar@uiuc.edu.]

Race and ethnicity a factor in diabetics' risk for complications
Hospital readmissions for diabetes-related complications vary both according to race and insurance coverage.
An analysis of non-maternal adult diabetics with Medicare, Medicaid and private insurance showed Hispanics with all types of insurance and blacks who were Medicare beneficiaries had higher readmission rates than whites. The analysis focused on adults who were readmitted to hospitals in five states after being initially hospitalized for diabetes-related complications.
Within each insurance payer, Hispanics from low-income communities had the highest rates of readmission, and among Medicare beneficiaries, blacks and Hispanics had higher readmission rates for acute complications and microvascular conditions, while whites had higher readmission rates for macrovascular conditions. In other words, blacks and Hispanics are at higher risk for being readmitted to the hospitals for conditions that could have been prevented with accurate care following their earlier hospitalization.
[From: "Racial/Ethnic Disparities in Potentially Preventable Readmissions: The Case of Diabetes." Contact: H. Joanna Jiang, PhD, Agency for Healthcare Research and Quality, Rockville, Md., jjiang@ahrq.gov.]

Girls more physically active if exposed to exercise at school
School-based exercise programs can have a profound impact on a girl's likelihood to be physically active.
A study of 2,744 girls at 24 high schools showed those exposed to a school-based "comprehensive physical activity intervention" were more likely to exercise regularly than the girls who had not participated in such an intervention. Researchers found 45 percent of girls in the intervention schools reported regular, vigorous physical activity in the months following the intervention, compared to 36 percent of girls in the control schools.
Increasing physical activity among youth is a critical public health goal, even as school systems are slashing physical education programs due to budget concerns.
[From: "Promotion of Physical Activity Among High School Girls: A Randomized Controlled Trial." Contact: Russell R. Pate, PhD, Department of Exercise Science, Arnold School of Public Health, University of South Carolina, rpate@gwm.sc.edu.]

Obesity and diabetes carry risks for pregnant women
The risks that obesity and diabetes carry for adverse pregnancy outcomes, such as cesarean section and low birth weight, vary among racial and ethnic groups, yet both conditions are bad news for all women hoping for a healthy pregnancy.
Researchers collected data from the 1999, 2000 and 2001 New York City birth files for 329,988 singleton births that included information on the mother's pre-pregnancy weight and weight gain during pregnancy. They found that chronic and gestational diabetes were significant risks for a primary cesarean and for preterm birth in all women. Diabetes as a risk for low birth weight varied by group. For example, whereas chronic diabetes increased the risk for low birth weight among Asians, Hispanics, and whites, it was not a significant predictor of low birth weight among blacks.
The bottom line, say the study's authors: "In this large, population-based study, obesity and diabetes were independently associated with adverse pregnancy outcomes, highlighting the need for women to undergo lifestyle changes to help them control their weight during the childbearing years and beyond."
[From: "Maternal Obesity and Diabetes as Risk Factors for Adverse Pregnancy Outcomes: Differences Among 4 Racial/Ethnic Groups." Contact: Terry Rosenberg, PhD, Medical Health and Research Association, New York, N.Y., trosenberg@mhra.org.]

The American Journal of Public Health is the monthly journal of the American Public Health Association, the oldest organization of public health professionals in the world. APHA is a leading publisher of public health-related books and periodicals promoting high scientific standards, action programs and policy for good health. More information is available at www.apha.org.

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