Physical activity and obesity in African Americans: the Jackson Heart Study.

OBJECTIVES: To better understand how obesity and low levels of physical activity (PA) contribute to racial health disparities, we examined the association of PA domains (work, home life, and leisure) with indicators of socioeconomic status and markers of obesity in African Americans. METHODS: These cross sectional analyses of interview and clinical measures from the baseline visit of the Jackson Heart Study of cardiovascular disease (CVD) in African Americans of the Jackson, Mississippi metropolitan statistical area included 3,174 women and 1,830 men aged 21-95 years. The main measures were active living, sport, work, home life, and total PA scores; participation in regular moderate or vigorous intensity leisure physical activity (MVLPA); demographics, body mass index (BMI), waist circumference (WC) and CVD risk factors. RESULTS: The sample was 63% female, 81% high school or college graduates, with 51% aged 45-64 years, and mostly overweight (32%) or obese (53%). Women were less active than men in all domains except home life. Total PA was inversely associated with WC in women and men. The overweight (BMI 25-29.9) group was most active in all domains except work; active living and sport PA and prevalence of MVLPA then declined in a dose response association with increasing BMI. Work PA was associated with the lowest BMI but otherwise with indicators of less favorable socioeconomic status and health. CONCLUSIONS: Observed differences in PA in African Americans by domain and association with obesity biomarkers suggest areas for future study and intervention to reduce health disparities.

Psychosocial issues in the assessment and management of patients undergoing lung transplantation.

This review examines psychosocial issues among lung transplant patients from the time of assessment through the posttransplant period. Although psychological factors are recognized as being important in the transplant evaluation, no standard approach to psychological assessment currently exists. Lung transplant candidates often experience high levels of psychological distress while awaiting transplant, and both pretransplant and posttransplant psychological functioning have been found to predict posttransplant quality of life, adherence to treatment, and, in some cases, medical outcomes. Given the limited long-term survival following transplantation, improving psychosocial functioning is essential for enhancing outcomes among lung transplant recipients. This review summarizes the extant literature on the psychosocial factors in lung transplantation and highlights several innovative efforts to improve psychological outcomes in this challenging patient population.