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Rummo PE, Kanchi R, Adhikari S, Titus AR, Lee DC, McAlexander T, Thorpe LE, Elbel B. Influence of the food environment on obesity risk in a large cohort of US veterans by community type. Obesity (Silver Spring) 2024; 32:788-797. [PMID: 38298108 DOI: 10.1002/oby.23975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/30/2023] [Accepted: 12/01/2023] [Indexed: 02/02/2024]
Abstract
OBJECTIVE The aim of this study was to examine relationships between the food environment and obesity by community type. METHODS Using electronic health record data from the US Veterans Administration Diabetes Risk (VADR) cohort, we examined associations between the percentage of supermarkets and fast-food restaurants with obesity prevalence from 2008 to 2018. We constructed multivariable logistic regression models with random effects and interaction terms for year and food environment variables. We stratified models by community type. RESULTS Mean age at baseline was 59.8 (SD = 16.1) years; 93.3% identified as men; and 2,102,542 (41.8%) were classified as having obesity. The association between the percentage of fast-food restaurants and obesity was positive in high-density urban areas (odds ratio [OR] = 1.033; 95% CI: 1.028-1.037), with no interaction by time (p = 0.83). The interaction with year was significant in other community types (p < 0.001), with increasing odds of obesity in each follow-up year. The associations between the percentage of supermarkets and obesity were null in high-density and low-density urban areas and positive in suburban (OR = 1.033; 95% CI: 1.027-1.039) and rural (OR = 1.007; 95% CI: 1.002-1.012) areas, with no interactions by time. CONCLUSIONS Many healthy eating policies have been passed in urban areas; our results suggest such policies might also mitigate obesity risk in nonurban areas.
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Affiliation(s)
- Pasquale E Rummo
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Rania Kanchi
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Samrachana Adhikari
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Andrea R Titus
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - David C Lee
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
- Department of Emergency Medicine, NYU Langone Health, New York, New York, USA
| | - Tara McAlexander
- Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Lorna E Thorpe
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Brian Elbel
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
- NYU Wagner Graduate School of Public Service, New York, New York, USA
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2
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van Erpecum CPL, van Zon SKR, Bültmann U, Smidt N. Effects of changes in residential fast-food outlet exposure on Body Mass Index change: longitudinal evidence from 92,211 Lifelines participants. Int J Behav Nutr Phys Act 2024; 21:31. [PMID: 38486265 PMCID: PMC10941418 DOI: 10.1186/s12966-024-01577-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 02/24/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Evidence on the association between fast-food outlet exposure and Body Mass Index (BMI) remains inconsistent and is primarily based on cross-sectional studies. We investigated the associations between changes in fast-food outlet exposure and BMI changes, and to what extent these associations are moderated by age and fast-food outlet exposure at baseline. METHODS We used 4-year longitudinal data of the Lifelines adult cohort (N = 92,211). Participant residential addresses at baseline and follow-up were linked to a register containing fast-food outlet locations using geocoding. Change in fast-food outlet exposure was defined as the number of fast-food outlets within 1 km of the residential address at follow-up minus the number of fast-food outlets within 1 km of the residential address at baseline. BMI was calculated based on objectively measured weight and height. Fixed effects analyses were performed adjusting for changes in covariates and potential confounders. Exposure-moderator interactions were tested and stratified analyses were performed if p < 0.10. RESULTS Participants who had an increase in the number of fast-food outlets within 1 km had a greater BMI increase (B(95% CI): 0.003 (0.001,0.006)). Decreases in fast-food outlet exposure were not associated with BMI change (B(95% CI): 0.001 (-0.001,0.004)). No clear moderation pattern by age or fast-food outlet exposure at baseline was found. CONCLUSIONS Increases in residential fast-food outlet exposure are associated with BMI gain, whereas decreases in fast-food outlet exposure are not associated with BMI loss. Effect sizes of increases in fast-food outlet exposure on BMI change were small at individual level. However, a longer follow-up period may have been needed to fully capture the impact of increases in fast-food outlet exposure on BMI change. Furthermore, these effect sizes could still be important at population level considering the rapid rise of fast-food outlets across society. Future studies should investigate the mechanisms and changes in consumer behaviours underlying associations between changes in fast-food outlet exposure and BMI change.
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Affiliation(s)
- Carel-Peter L van Erpecum
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands.
| | - Sander K R van Zon
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands
| | - Ute Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands
| | - Nynke Smidt
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands
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3
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Abstract
BACKGROUND Food insecurity (FI) is an important public health issue for US veterans. For many veterans, civilian life is fraught with service-incurred health issues and socioeconomic challenges, each risk factors for FI. The FI literature on veterans is limited due to insufficient coverage of the topic's complexity and the methods used to study it in this population. No published analysis has evaluated how FI has been examined in US veterans. OBJECTIVES We assessed how FI has been examined in US military veterans by identifying (1) the major content areas, or domains, studied in association with FI and (2) the existing research gaps. METHODS A scoping literature review was conducted to map the main research domains of the FI literature and identify knowledge gaps. Electronic database and hand searches identified potentially relevant studies (n = 61). Data extraction, utilizing a standardized set of design parameters, was completed. Duplicate removal and application of inclusion/exclusion criteria resulted in the studies (n = 21) selected for critical review. RESULTS Eight research domains were determined: FI prevalence, health status, dietary practices, health care utilization, economic instability, homelessness/housing instability, food program participation, and community/emergency preparedness-the most dominant was health status and the least dominant were social determinants (ie, homelessness/housing instability, food program participation). Research on validity and usability of FI assessment methods in veterans was virtually absent. Military service factors, longitudinal effects, FI among women, intervention effectiveness, and other areas lacked sufficient inquiry. CONCLUSION Research is required on lesser examined content areas and methodology to optimize surveillance and policy for veteran FI.
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Affiliation(s)
- Yasmin S Cypel
- Epidemiology Program, Post-Deployment Health Services (12POP5), Office of Patient Care Services, 8267US Department of Veterans Affairs, Veterans Health Administration, Washington, DC, USA
| | - Jodie G Katon
- 49462US Department of Veterans Affairs (VA) Puget Sound Health Care System, Health Services Research and Development (HSR&D) Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, WA, USA.,Department of Health Services, University of Washington School of Public Health, Seattle, WA, USA
| | - Mark B Schure
- Department of Health & Human Development, 1705Montana State University, Bozeman, MT, USA
| | - Shanna Smith
- Epidemiology Program, Post-Deployment Health Services (12POP5), Office of Patient Care Services, 8267US Department of Veterans Affairs, Veterans Health Administration, Washington, DC, USA
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4
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Letarte L, Pomerleau S, Tchernof A, Biertho L, Waygood EOD, Lebel A. Neighbourhood effects on obesity: scoping review of time-varying outcomes and exposures in longitudinal designs. BMJ Open 2020; 10:e034690. [PMID: 32213520 PMCID: PMC7170601 DOI: 10.1136/bmjopen-2019-034690] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
CONTEXT AND OBJECTIVES Neighbourhood effect research on obesity took off in the early 2000s and was composed of mostly cross-sectional observational studies interested in various characteristics of the built environment and the socioeconomic environment. To limit biases related to self-selection and life course exposures, many researchers apply longitudinal designs in their studies. Until now, no review has specifically and exclusively examined longitudinal studies and the specific designs of these studies. In this review, we intend to answer the following research question: how are the temporal measurements of contextual exposure and obesity outcomes integrated into longitudinal studies that explore how neighbourhood-level built and socioeconomic environments impact adult obesity? DESIGN A systematic search strategy was designed to address the research question. The search was performed in Embase, Web of Science and PubMed, targeting scientific papers published before 1 January 2018. The eligible studies reported results on adults, included exposure that was limited to neighbourhood characteristics at the submunicipal level, included an outcome limited to obesity proxies, and reported a design with at least two exposure measurements or two outcome measurements. RESULTS This scoping review identified 66 studies that fit the eligibility criteria. A wide variety of neighbourhood characteristics were also measured, making it difficult to draw general conclusions about associations between neighbourhood exposure and obesity. We applied a typology that classified studies by whether exposure and outcome were measured as varying or fixed. Using this typology, we found that 32 studies reported both neighbourhood exposure and obesity outcomes that were varying in time; 28 reported varying outcomes but fixed exposures; and 6 had fixed outcomes and varying exposures. CONCLUSION Our typology illustrates the variety of longitudinal designs that were used in the selected studies. In the light of our results, we make recommendations on how to better report longitudinal designs and facilitate comparisons between studies.
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Affiliation(s)
- Laurence Letarte
- Planning and Development Research Center, Université Laval, Quebec city, Québec, Canada
- Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Research Institute, Quebec city, Québec, Canada
| | - Sonia Pomerleau
- Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Research Institute, Quebec city, Québec, Canada
- School of Nutrition, Université Laval, Quebec city, Québec, Canada
| | - André Tchernof
- School of Nutrition, Université Laval, Quebec city, Québec, Canada
- Quebec Heart and Lung Institute Research Centre, Université Laval, Quebec city, Québec, Canada
| | - Laurent Biertho
- Quebec Heart and Lung Institute Research Centre, Université Laval, Quebec city, Québec, Canada
- Departement of Surgery, Université Laval, Quebec city, Québec, Canada
| | - Edward Owen D Waygood
- Department of Civil, Geological and Mining Engineering, Polytechnique Montreal, Montreal, Québec, Canada
| | - Alexandre Lebel
- Planning and Development Research Center, Université Laval, Quebec city, Québec, Canada
- Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Research Institute, Quebec city, Québec, Canada
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5
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Kelman J, Pool LR, Gordon-Larsen P, Carr JJ, Terry JG, Rana JS, Kershaw KN. Associations of Unhealthy Food Environment With the Development of Coronary Artery Calcification: The CARDIA Study. J Am Heart Assoc 2020; 8:e010586. [PMID: 30773088 PMCID: PMC6405647 DOI: 10.1161/jaha.118.010586] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background While prior studies have linked the neighborhood environment and development of subclinical atherosclerosis, it is unknown whether living in neighborhoods with greater availability of “unhealthy” food outlets (fast‐food chain restaurants and convenience stores) is associated with risk of developing coronary artery calcification (CAC). Methods and Results We included 2706 CARDIA study (Coronary Artery Risk Development in Young Adults) participants who underwent CAC measurement during follow‐up years 15 (2000–2001), 20 (2005–2006), and 25 (2010–2011). Neighborhood features examined included percentage of all food outlets that were convenience stores and fast‐food chain restaurants within a 3‐km Euclidean buffer distance from each participant's residence. Econometric fixed effects models, which by design control for all time‐invariant covariates, were used to model the longitudinal association between simultaneous within‐person change in percentage food outlet and change in CAC. At baseline (year 15), 9.7% of participants had prevalent CAC. During 10 years of follow‐up, 21.1% of participants developed CAC. Each 1‐SD increase in percentage of convenience stores was associated with a 1.34 higher odds of developing CAC (95% CI: 1.04, 1.72) after adjusting for individual‐ and neighborhood‐level covariates; however, there was no significant association between increased percentage of fast‐food chain restaurants and developing CAC (odds ratio=1.15; 95% CI: 0.96, 1.38). There were no significant associations between increases in either food outlet percentage and progression of CAC. Conclusions Our findings suggest that increases in the relative availability of convenience stores in participants' neighborhoods is related to the development of CAC over time.
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Affiliation(s)
- Julie Kelman
- 1 Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago IL
| | - Lindsay R Pool
- 1 Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago IL
| | - Penny Gordon-Larsen
- 2 Gillings School of Global Public Health University of North Carolina Chapel Hill NC
| | - J Jeffrey Carr
- 3 Department of Radiology Biomedical Informatics and Cardiovascular Medicine Vanderbilt University Nashville TN
| | - James G Terry
- 3 Department of Radiology Biomedical Informatics and Cardiovascular Medicine Vanderbilt University Nashville TN
| | - Jamal S Rana
- 4 Department of Cardiology Kaiser Permanente Northern California Oakland CA
| | - Kiarri N Kershaw
- 1 Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago IL
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6
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Tarlov E, Silva A, Wing C, Slater S, Matthews SA, Jones KK, Zenk SN. Neighborhood Walkability and BMI Change: A National Study of Veterans in Large Urban Areas. Obesity (Silver Spring) 2020; 28:46-54. [PMID: 31804004 PMCID: PMC6925327 DOI: 10.1002/oby.22611] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 07/15/2019] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Improving neighborhood walkability has been proposed as a policy intervention to reduce obesity. The objective of this study was to evaluate longitudinal relationships between neighborhood walkability and body weight among adults living in large urban areas. METHODS In this retrospective longitudinal study of United States military veterans using Department of Veterans Affairs health care, Veterans Affairs clinical and administrative data (2007-2014) were linked to environmental measures constructed from public (2006-2014) and proprietary (2008-2014) sources, and linear regression models with person fixed effects were used to estimate associations between walkability and BMI among 758,434 men and 70,319 women aged 20 to 80 years in 2009 to 2014. RESULTS Neighborhood walkability was associated with small reductions in BMI. Effects were most pronounced among men aged 30 to 49 and 50 to 64. For women, differences were largest in the two youngest age groups, 20 to 29 and 30 to 49, though only estimates for all women combined were statistically significant. For women aged 30 to 49, effect sizes grew when the sample was limited to those who remained in the same neighborhood during the entire follow-up period. CONCLUSIONS Investments in the built environment to improve walkability may be a useful strategy for weight control in some segments of the adult population.
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Affiliation(s)
- Elizabeth Tarlov
- College of Nursing, University of Illinois at Chicago, Illinois, USA
- Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Hines, IL, USA
| | - Abigail Silva
- Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Hines, IL, USA
- Department of Public Health Sciences, Loyola University Chicago, Maywood, IL, USA
| | - Coady Wing
- School of Public and Environmental Affairs, Indiana University, Bloomington, IN, USA
| | - Sandy Slater
- School of Pharmacy, Concordia University Wisconsin, Mequon, WI, USA
| | - Stephen A. Matthews
- Department of Sociology and Criminology, Department of Anthropology, The Pennsylvania State University, University Park, PA, USA
| | - Kelly K. Jones
- National Socio-Environmental Synthesis Center, Annapolis, MD, USA
| | - Shannon N. Zenk
- College of Nursing, University of Illinois at Chicago, Illinois, USA
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7
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Golembiewski E, Allen KS, Blackmon AM, Hinrichs RJ, Vest JR. Combining Nonclinical Determinants of Health and Clinical Data for Research and Evaluation: Rapid Review. JMIR Public Health Surveill 2019; 5:e12846. [PMID: 31593550 PMCID: PMC6803891 DOI: 10.2196/12846] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 05/23/2019] [Accepted: 07/19/2019] [Indexed: 02/06/2023] Open
Abstract
Background Nonclinical determinants of health are of increasing importance to health care delivery and health policy. Concurrent with growing interest in better addressing patients’ nonmedical issues is the exponential growth in availability of data sources that provide insight into these nonclinical determinants of health. Objective This review aimed to characterize the state of the existing literature on the use of nonclinical health indicators in conjunction with clinical data sources. Methods We conducted a rapid review of articles and relevant agency publications published in English. Eligible studies described the effect of, the methods for, or the need for combining nonclinical data with clinical data and were published in the United States between January 2010 and April 2018. Additional reports were obtained by manual searching. Records were screened for inclusion in 2 rounds by 4 trained reviewers with interrater reliability checks. From each article, we abstracted the measures, data sources, and level of measurement (individual or aggregate) for each nonclinical determinant of health reported. Results A total of 178 articles were included in the review. The articles collectively reported on 744 different nonclinical determinants of health measures. Measures related to socioeconomic status and material conditions were most prevalent (included in 90% of articles), followed by the closely related domain of social circumstances (included in 25% of articles), reflecting the widespread availability and use of standard demographic measures such as household income, marital status, education, race, and ethnicity in public health surveillance. Measures related to health-related behaviors (eg, smoking, diet, tobacco, and substance abuse), the built environment (eg, transportation, sidewalks, and buildings), natural environment (eg, air quality and pollution), and health services and conditions (eg, provider of care supply, utilization, and disease prevalence) were less common, whereas measures related to public policies were rare. When combining nonclinical and clinical data, a majority of studies associated aggregate, area-level nonclinical measures with individual-level clinical data by matching geographical location. Conclusions A variety of nonclinical determinants of health measures have been widely but unevenly used in conjunction with clinical data to support population health research.
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Affiliation(s)
| | - Katie S Allen
- IUPUI Richard M Fairbanks School of Public Health, Indianapolis, IN, United States.,Regenstrief Institute, Inc, Indianapolis, IN, United States
| | - Amber M Blackmon
- IUPUI Richard M Fairbanks School of Public Health, Indianapolis, IN, United States
| | | | - Joshua R Vest
- IUPUI Richard M Fairbanks School of Public Health, Indianapolis, IN, United States.,Regenstrief Institute, Inc, Indianapolis, IN, United States
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8
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Hobbs M, Green MA, Wilkins E, Lamb KE, McKenna J, Griffiths C. Associations between food environment typologies and body mass index: Evidence from Yorkshire, England. Soc Sci Med 2019; 239:112528. [PMID: 31499332 DOI: 10.1016/j.socscimed.2019.112528] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 07/29/2019] [Accepted: 08/29/2019] [Indexed: 01/06/2023]
Abstract
International research linking food outlets and body mass index (BMI) is largely cross-sectional, yielding inconsistent findings. However, addressing the exposure of food outlets is increasingly considered as an important adult obesity prevention strategy. Our study investigates associations between baseline food environment types and change in BMI over time. Survey data were used from the Yorkshire Health Study (n=8,864; wave one: 2010-2012, wave two: 2013-2015) for adults aged 18-86. BMI was calculated using self-reported height (cm) and weight (kg). Restaurants, cafés, fast-food, speciality, convenience and large supermarkets were identified from the Ordnance Survey Point of Interest database within 1600m radial buffer of home postcodes. K-means cluster analysis developed food environment typologies based on food outlets and population density. Large supermarkets, restaurants, cafés, fast-food, speciality and convenience food outlets all clustered together to some extent. Three neighbourhood typologies were identified. However, multilevel models revealed that relative to cluster one all were unrelated to change in BMI (cluster 2, b= -0.146 [-0.274, 0.566]; cluster 3, b= 0.065 [-0.224, 0.356]). There was also little evidence of gender-based differences in these associations when examined in a three-way interaction. Policymakers may need to begin to consider multiple types of food outlet clusters, while further research is needed to confirm how these relate to changed BMI.
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Affiliation(s)
- M Hobbs
- Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QT, United Kingdom; GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Christchurch, New Zealand.
| | - M A Green
- School of Environmental Sciences, University of Liverpool, Liverpool, United Kingdom
| | - E Wilkins
- Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QT, United Kingdom
| | - K E Lamb
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, 3052, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Victoria, 3052, Australia
| | - J McKenna
- Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QT, United Kingdom
| | - C Griffiths
- Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QT, United Kingdom
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9
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Powell LM, Jones K, Duran AC, Tarlov E, Zenk SN. The price of ultra-processed foods and beverages and adult body weight: Evidence from U.S. veterans. ECONOMICS AND HUMAN BIOLOGY 2019; 34:39-48. [PMID: 31204255 PMCID: PMC6897320 DOI: 10.1016/j.ehb.2019.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 05/22/2019] [Accepted: 05/28/2019] [Indexed: 05/02/2023]
Abstract
The consumption of ultra-processed foods in the U.S. and globally has increased and is associated with lower diet quality, higher energy intake, higher body weight, and poorer health outcomes. This study drew on individual-level data on measured height and weight from U.S. Department of Veterans Affairs medical records for adults aged 20 to 64 from 2009 through 2014 linked to food and beverage price data from the Council for Community and Economic Research to examine the association between the price of ultra-processed foods and beverages and adult body mass index (BMI). We estimated geographic fixed effects models to control for unobserved heterogeneity of prices. We estimated separate models for men and women and we assessed differences in price sensitivity across subpopulations by socioeconomic status (SES). The results showed that a one-dollar increase in the price of ultra-processed foods and beverages was associated with 0.08 lower BMI units for men (p ≤ 0.05) (price elasticity of BMI of -0.01) and 0.14 lower BMI units for women (p ≤ 0.10) (price elasticity of BMI of -0.02). Higher prices of ultra-processed foods and beverages were associated with lower BMI among low-SES men (price elasticity of BMI of -0.02) and low-SES women (price elasticity of BMI of -0.07) but no statistically significant associations were found for middle- or high-SES men or women. Robustness checks based on the estimation of an individual-level fixed effects model found a consistent but smaller association between the price of ultra-processed foods and beverages and BMI among women (price elasticity of BMI of -0.01) with a relatively larger association for low-SES women (price elasticity of BMI of -0.04) but revealed no association for men highlighting the importance of accounting for individual-level unobserved heterogeneity.
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Affiliation(s)
- Lisa M Powell
- Health Policy and Administration, School of Public Health, University of Illinois at Chicago, United States.
| | - Kelly Jones
- Health Systems Science, College of Nursing, University of Illinois at Chicago, United States
| | | | - Elizabeth Tarlov
- College of Nursing, University of Illinois at Chicago, Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, United States
| | - Shannon N Zenk
- Health Systems Science, College of Nursing, University of Illinois at Chicago
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10
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Weisberg-Shapiro P, Devine C. Food Activity Footprint: Dominican Women’s Use of Time and Space for Food Procurement. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2019. [DOI: 10.1080/19320248.2019.1613276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | - Carol Devine
- Division of Nutritional Sciences, Cornell University, Ithaca, NY
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11
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Slater SJ, Tarlov E, Jones K, Matthews SA, Wing C, Zenk SN. Would increasing access to recreational places promote healthier weights and a healthier nation? Health Place 2019; 56:127-134. [PMID: 30738347 PMCID: PMC6878109 DOI: 10.1016/j.healthplace.2019.01.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 12/23/2018] [Accepted: 01/15/2019] [Indexed: 11/22/2022]
Abstract
Addressing gaps in evidence on causal associations, this study tested the hypothesis that better access to recreational places close to home helps people to maintain lower body mass index (BMI) using a retrospective longitudinal study design and up to 6 years of data for the same individuals (1,522,803 men and 183,618 women). Participants were military veterans aged 20-64 who received healthcare through the U.S. Department of Veterans Affairs in 2009-2014 and lived in a metropolitan area. Although there were cross-sectional associations, we found no longitudinal evidence that access to parks and fitness facilities was associated with BMI for either men or women in the full sample or in subgroups of residential movers and stayers. Our findings suggest that simply increasing the number of parks and fitness facilities may not be enough to achieve needed population-level reductions in weight.
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Affiliation(s)
- Sandy J Slater
- Department of Pharmaceutical Sciences Concordia University Wisconsin School of Pharmacy, 12800 N. Lake Shore Drive, Mequon, WI 53097, United States.
| | - Elizabeth Tarlov
- Department of Health Systems Science, College of Nursing, University of Illinois at Chicago, United States
| | - Kelly Jones
- Department of Health Systems Science, College of Nursing, University of Illinois at Chicago, United States
| | - Stephen A Matthews
- Department of Sociology & Criminology, Department of Anthropology, Pennsylvania State University, United States
| | - Coady Wing
- School of Public and Environmental Affairs, Indiana University, United States
| | - Shannon N Zenk
- Department of Health Systems Science, College of Nursing, University of Illinois at Chicago, United States
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12
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Duran AC, Zenk SN, Tarlov E, Duda S, Smith G, Lee JM, Berbaum ML. Foreclosures and weight gain: Differential associations by longer neighborhood exposure. Prev Med 2019; 118:23-29. [PMID: 30026119 PMCID: PMC6322928 DOI: 10.1016/j.ypmed.2018.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 07/07/2018] [Accepted: 07/16/2018] [Indexed: 10/28/2022]
Abstract
While home foreclosure can lead to mental and physical health declines in persons experiencing the foreclosure, whether neighborhood foreclosures can affect the health of other residents is debatable. Using a racially/ethnically diverse sample of Chicago metropolitan area residents linked to foreclosure data from 2008 to 2014, we assessed whether exposure to neighborhood foreclosure fillings was associated with changes in objectively measured body mass index (BMI) over time. Using a retrospective longitudinal design, we employed fixed-effects regression models that controlled for individual- and neighborhood-level covariates to test the association of neighborhood foreclosures and BMI in >60,000 individuals and for individuals who did not move during the follow-up period. We also adjusted for the non-linear association of age and BMI and comorbidities and employed a series of sensitivity analysis to test for robustness. In fully adjusted models, a standard-deviation increase in neighborhood foreclosure filings within 500 m was associated with increases in BMI for individuals who did not move (nonmovers) (mean = 0.03 BMI units, 95% confidence interval: 0.01, 0.06). Neighborhood foreclosure rates were not associated with changes in BMI for the full sample. Given the potential deleterious effects of neighborhood foreclosure on individuals with longer exposure to the local vicinity, clarifying the potential health effects of neighborhood foreclosures would help policymakers when planning actions to prevent home losses, predatory home loans, and that aim to more efficiently return foreclosure properties to productive uses.
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Affiliation(s)
- Ana Clara Duran
- Department of Health Systems Science, University of Illinois at Chicago, Chicago, IL, USA; Center for Food Studies, University of Campinas, Campinas, SP, Brazil.
| | - Shannon N Zenk
- Department of Health Systems Science, University of Illinois at Chicago, Chicago, IL, USA
| | - Elizabeth Tarlov
- Department of Health Systems Science, University of Illinois at Chicago, Chicago, IL, USA; Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Hines, IL, USA
| | - Sarah Duda
- Institute for Housing Studies, DePaul University, Chicago, IL, USA
| | - Geoff Smith
- Institute for Housing Studies, DePaul University, Chicago, IL, USA
| | - Jin Man Lee
- Institute for Housing Studies, DePaul University, Chicago, IL, USA
| | - Michael L Berbaum
- Institute for Health Research and Policym, University of Illinois at Chicago, Chicago, IL, USA
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13
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Lachance L, Quinn M, Kowalski-Dobson T. The Food & Fitness Community Partnerships: Results From 9 Years of Local Systems and Policy Changes to Increase Equitable Opportunities for Health. Health Promot Pract 2018; 19:92S-114S. [PMID: 30176779 DOI: 10.1177/1524839918789400] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Food & Fitness (F&F) community partnerships, funded by the W.K. Kellogg Foundation from 2007 to 2016, were established to create community-determined change in the conditions that affect health and health equity in neighborhoods. The focus of the work has been to increase access to locally grown good food (food that is healthy, sustainable, fair, and affordable), and safe places for physical activity for children and families in communities with inequities across the United States through changes in policies, community infrastructure, and systems at the local level. This article describes the outcomes related to systems and policy change over 9 years of community change efforts in the F&F partnerships. Characteristics of the F&F communities where the work took place; the change model that emerged from the work; efforts and changes achieved related to community food, school food, and active living/built environment; overall factors in the community that helped or hindered the work of the partnerships; and a depiction of the community-determined process for change employed by the partnerships are described. Local systems and policy change is a long-term process. Community-determined efforts that build capacity for systems change, commitment to long-term funding, and provision of technical assistance tailored to community needs were elements that contributed to success in the F&F work. Achieving intermediate outcomes on the road to policy and systems change created a way to monitor success and make midcourse corrections when needed.
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Affiliation(s)
- Laurie Lachance
- 1 University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Martha Quinn
- 1 University of Michigan School of Public Health, Ann Arbor, MI, USA
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14
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Local Food Environments, Suburban Development, and BMI: A Mixed Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15071392. [PMID: 30004462 PMCID: PMC6068516 DOI: 10.3390/ijerph15071392] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 06/22/2018] [Accepted: 06/26/2018] [Indexed: 11/28/2022]
Abstract
More than half the world’s population now live in urban settlements. Worldwide, cities are expanding at their fringe to accommodate population growth. Low-density residential development, urban sprawl, and car dependency are common, contributing to physical inactivity and obesity. However, urban design and planning can modify urban form and enhance health by improving access to healthy food, public transport, and services. This study used a sequential mixed methods approach to investigate associations between food outlet access and body mass index (BMI) across urban-growth and established areas of Melbourne, Australia, and identify factors that influence local food environments. Population survey data for 3141 adults were analyzed to examine associations, and 27 interviews with government, non-government, and private sector stakeholders were conducted to contextualize results. Fast food density was positively associated with BMI in established areas and negatively associated in urban-growth areas. Interrelated challenges of car dependency, poor public transport, and low-density development hampered healthy food access. This study showed how patterns of suburban development influence local food environments and health outcomes in an urbanized city context and provides insights for other rapidly growing cities. More nuanced understandings of the differential effect of food environments within cities have potential to guide intra-city planning for improving health and reducing inequities.
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15
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Berkowitz SA, Karter AJ, Corbie-Smith G, Seligman HK, Ackroyd SA, Barnard LS, Atlas SJ, Wexler DJ. Food Insecurity, Food "Deserts," and Glycemic Control in Patients With Diabetes: A Longitudinal Analysis. Diabetes Care 2018; 41:1188-1195. [PMID: 29555650 PMCID: PMC5961388 DOI: 10.2337/dc17-1981] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 02/27/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Both food insecurity (limited food access owing to cost) and living in areas with low physical access to nutritious foods are public health concerns, but their relative contribution to diabetes management is poorly understood. RESEARCH DESIGN AND METHODS This was a prospective cohort study. A random sample of patients with diabetes in a primary care network completed food insecurity assessment in 2013. Low physical food access at the census tract level was defined as no supermarket within 1 mile in urban areas and 10 miles in rural areas. HbA1c measurements were obtained from electronic health records through November 2016. The relationship among food insecurity, low physical food access, and glycemic control (as defined by HbA1c) was analyzed using hierarchical linear mixed models. RESULTS Three hundred and ninety-one participants were followed for a mean of 37 months. Twenty percent of respondents reported food insecurity, and 31% resided in an area of low physical food access. In adjusted models, food insecurity was associated with higher HbA1c (difference of 0.6% [6.6 mmol/mol], 95% CI 0.4-0.8 [4.4-8.7], P < 0.0001), which did not improve over time (P = 0.50). Living in an area with low physical food access was not associated with a difference in HbA1c (difference 0.2% [2.2 mmol/mol], 95% CI -0.2 to 0.5 [-2.2 to 5.6], P = 0.33) or with change over time (P = 0.07). CONCLUSIONS Food insecurity is associated with higher HbA1c, but living in an area with low physical food access is not. Food insecurity screening and interventions may help improve glycemic control for vulnerable patients.
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Affiliation(s)
- Seth A Berkowitz
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA .,Diabetes Unit, Massachusetts General Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | - Andrew J Karter
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Giselle Corbie-Smith
- Center for Health Equity Research, Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC.,Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Hilary K Seligman
- Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA.,Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA
| | - Sarah A Ackroyd
- Department of Obstetrics, Gynecology & Reproductive Sciences, Temple University Hospital, Philadelphia, PA
| | - Lily S Barnard
- University of California, San Francisco, School of Medicine, San Francisco, CA
| | - Steven J Atlas
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | - Deborah J Wexler
- Diabetes Unit, Massachusetts General Hospital, Boston, MA.,Harvard Medical School, Boston, MA
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16
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Speakman JR, Mazidi M. Reply to VI Kraak. Am J Clin Nutr 2018; 107:290-291. [PMID: 29529144 DOI: 10.1093/ajcn/nqx026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J R Speakman
- From the State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Chaoyang, Beijing, China.,Institute of Biological and Environmental Science, University of Aberdeen, Scotland, UK (JRS)
| | - M Mazidi
- From the State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Chaoyang, Beijing, China.,University of the Chinese Academy of Sciences, Beijing, China (MM)
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17
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Zenk SN, Tarlov E, Wing CM, Matthews SA, Tong H, Jones KK, Powell L. Long-Term Weight Loss Effects of a Behavioral Weight Management Program: Does the Community Food Environment Matter? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E211. [PMID: 29373556 PMCID: PMC5858280 DOI: 10.3390/ijerph15020211] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/27/2017] [Accepted: 10/29/2017] [Indexed: 12/18/2022]
Abstract
This study examined whether community food environments altered the longer-term effects of a nationwide behavioral weight management program on body mass index (BMI). The sample was comprised of 98,871 male weight management program participants and 15,385 female participants, as well as 461,302 and 37,192 inverse propensity-score weighted matched male and female controls. We measured the community food environment by counting the number of supermarkets, convenience stores, and fast food restaurants within a 1-mile radius around each person's home address. We used difference-in-difference regression models with person and calendar time fixed effects to estimate MOVE! effects over time in sub-populations defined by community food environment attributes. Among men, after an initial decrease in BMI at 6 months, the effect of the program decreased over time, with BMI increasing incrementally at 12 months (0.098 kg/m², p < 0.001), 18 months (0.069 kg/m², p < 0.001), and 24 months (0.067 kg/m², p < 0.001). Among women, the initial effects of the program decreased over time as well. Women had an incremental BMI change of 0.099 kg/m² at 12 months (p < 0.05) with non-significant incremental changes at 18 months and 24 months. We found little evidence that these longer-term effects of the weight management program differed depending on the community food environment. Physiological adaptations may overwhelm environmental influences on adherence to behavioral regimens in affecting longer-term weight loss outcomes.
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Affiliation(s)
- Shannon N Zenk
- College of Nursing, University of Illinois at Chicago, Chicago, IL 60612, USA.
| | - Elizabeth Tarlov
- College of Nursing, University of Illinois at Chicago, Chicago, IL 60612, USA.
- Edward Hines Jr. Veterans Affairs Hospital, Hines, IL 60141, USA.
| | - Coady M Wing
- School of Public and Environmental Affairs, Indiana University, Bloomington, IN 47405, USA.
| | - Stephen A Matthews
- Department of Sociology & Criminology and Department of Anthropology, Pennsylvania State University, University Park, PA 16802, USA.
- Department of Anthropology, Pennsylvania State University, University Park, PA 16802, USA.
| | - Hao Tong
- Edward Hines Jr. Veterans Affairs Hospital, Hines, IL 60141, USA.
| | - Kelly K Jones
- College of Nursing, University of Illinois at Chicago, Chicago, IL 60612, USA.
| | - Lisa Powell
- School of Public Health, University of Illinois at Chicago, IL 60612, USA.
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18
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Tarlov E, Zenk SN, Matthews SA, Powell LM, Jones KK, Slater S, Wing C. Neighborhood Resources to Support Healthy Diets and Physical Activity Among US Military Veterans. Prev Chronic Dis 2017; 14:E111. [PMID: 29120701 PMCID: PMC5695640 DOI: 10.5888/pcd14.160590] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction Among the nearly 21 million military veterans living in the United States, 64.0% of women and 76.1% of men are overweight or obese, higher rates than in the civilian population (56.9% of women and 69.9% of men). Attributes of the residential environment are linked to obesity. The objective of this study was to characterize the residential environments of the US veteran population with respect to availability of food and recreational venues. Methods We used American Community Survey data to determine the concentration of veterans (the percentage of veterans among the adult population) in all continental US census tracts in 2013, and we used proprietary data to construct measures of availability of food and recreational venues per census tract. Using descriptive statistics and ordinary least-squares regression, we examined associations between the concentration of veterans per census tract and those residential environmental features. Results In census tracts with high concentrations of veterans, residents had, on average, 0.5 (interquartile range, 0–0.8) supermarkets within a 1-mile radius, while residents in census tracts with low concentrations of veterans had 3.2 (interquartile range, 0.6–3.7) supermarkets. Patterns were similar for grocery and convenience stores, fast food restaurants, parks, and commercial fitness facilities. In adjusted analyses controlling for census-tract–level covariates, veteran concentration remained strongly negatively associated with availability of those food and recreational venues. In nonmetropolitan tracts, adjusted associations were greatly attenuated and even positive. Conclusion Where veterans live is strongly associated with availability of food outlets providing healthy (and unhealthy) foods and with recreational venues, raising questions about the contributions of veterans’ residential environments to their high obesity rates. Additional research is needed to address those questions.
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Affiliation(s)
- Elizabeth Tarlov
- College of Nursing, University of Illinois at Chicago, 845 S Damen Ave, Chicago, IL 60612. .,Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Hines, Illinois
| | - Shannon N Zenk
- College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Stephen A Matthews
- Department of Sociology, Anthropology, and Demography, The Pennsylvania State University, University Park, Pennsylvania
| | - Lisa M Powell
- School of Public Health, University of Illinois at Chicago, Chicago, Illinois
| | - Kelly K Jones
- College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Sandy Slater
- School of Public Health, University of Illinois at Chicago, Chicago, Illinois
| | - Coady Wing
- School of Public and Environmental Affairs, Indiana University-Bloomington, Bloomington, Indiana
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