Changes in alcohol consumption and binge drinking during the COVID-19 pandemic among American Indians residing in California and Oklahoma.

Background: This study explored the increased quantity and frequency of alcohol use in the American Indian (AI) population during the COVID-19 pandemic.Objectives: The aims of this study were to explore possible associations between covariables and both binge drinking and alcohol consumption during COVID-19.Methods: This cross-sectional survey study analyzed data from a sample of AI individuals (63% female) residing in California (n = 411) and Oklahoma (n = 657) between October 2020-January 2021. Analysis included summary statistics and multivariable logistic regression, including a variety of socio-economic, COVID-19 concern, and tobacco and marijuana use variables.Results: One or more alcohol binge episodes were reported between October 2020-January 2021 in 19.3% of participants and elevated overall alcohol consumption was reported by 21.6% of participants. Higher odds of elevated alcohol consumption occurred in women and those following more social distancing measures. The odds of binge drinking or elevated alcohol consumption in those using both marijuana and tobacco (aOR/ adjusted odds ratio:18.9, 95% CI = 8.5, 42.2, and aOR:3.9, 95% CI = 1.7, 8.6, respectively) were higher compared to those using neither. Similarly, the odds of binge drinking or elevated alcohol consumption in those using tobacco only (aOR:4.7, 95% CI = 2.9, 7.7 and aOR: 2.0, 95% CI = 1.1, 3.5, respectively) were higher compared to those using neither.Conclusions: This study found high rates of alcohol use and bingeing during the COVID-19 pandemic. Offering collaborative, culturally sensitive, and affordable support services are important components of intervention and preparation for future stressful events on local, as well as global levels.

Nourishing Farm to School Practice with Data to Inform Program Needs: An Evaluation of Participation among California Public Districts during the 2018-19 School Year.

BACKGROUND: The U.S. Department of Agriculture promotes farm to school (F2S) as an evidence-based approach to help school meals meet updated nutrition standards that promote health. California (CA) is a key agricultural state with strong support for F2S to promote local agriculture and equitable access to nutritious food for all students. OBJECTIVE: Examine district characteristics associated with F2S participation among CA public districts during the 2018-19 school year. DESIGN: Cross-sectional evaluation of 2019 USDA Farm to School Census data. PARTICIPANTS/SETTING: CA public districts responding to the 2019 USDA F2S Census (n = 572). MAIN OUTCOME MEASURE: Reported participation in F2S activities in 2018-19. Covariates included district size, annual per-pupil spending, urbanicity, racial/ethnic composition, and percent free and reduced-price meal (% FRPM) eligibility. STATISTICAL ANALYSIS: Descriptive statistics (unweighted frequency, weighted percent) were reported for demographic characteristics. Weighted, multiple logistic regression assessed associations between demographics and F2S participation, reported as OR (95% CI). RESULTS: Nearly 78% of CA respondents reported F2S participation. Top activities were serving local food in school lunch (73%) and breakfast (65%) and local food promotion at school (45.5%). The odds of participation among districts with enrollments > 1,000 were 1.79 (1.15-2.79) times higher than smaller districts and 1.57 (1.08-2.28) times higher in districts with lower annual per-pupil spending (< $13,707). No significant differences were found by racial/ethnic composition, % FRPM eligibility, or urbanicity. CONCLUSIONS: Disparities in F2S participation exist for small districts and those with high annual per-pupil spending that may lack the advantages of economies of scale. Grant incentives and support networks for these groups are recommended along with increased monitoring focused on the quality of F2S engagement. Administration of a brief annual state F2S Census could support more timely monitoring and accountability to align with state goals and improve opportunities for data sharing and community engagement.

Patterns and co-occurrence of risk factors for hepatocellular carcinoma in four Asian American communities: a cross-sectional study.

OBJECTIVES: To investigate risk factor patterns and the simultaneous occurrence of multiple risk factors in the viral, metabolic and lifestyle domains among Asian Americans, who have had the highest mortality rates from hepatocellular carcinoma (HCC). SETTING: Sacramento County, California, USA. PARTICIPANTS: Eligible participants were county residents ages 18 and older who had not been screened for chronic hepatitis B virus (HBV) and were born in a CDC-defined endemic area or whose parent was born in that area. Of 1004 enrolled, 917 were foreign-born Chinese (130 women, 94 men), Hmong (133 women, 75 men), Korean (178 women, 90 men) or Vietnamese (136 women, 81 men) with complete risk factor data. PRIMARY AND SECONDARY OUTCOME MEASURES: We tested participants for HBV and chronic hepatitis C virus (HCV); measured haemoglobin A1c and waist circumference; and recorded self-reported history of diabetes, hypertension, alcohol use and smoking status. We identified risk factor patterns using cluster analysis and estimated gender-specific age-standardised prevalence rates. RESULTS: We identified four patterns: (1) viral (chronic HBV or HCV); (2) lifestyle (current smoker or alcohol user, no viral); (3) metabolic (≥2 metabolic, no lifestyle or viral); and (4) lower risk (≤1 metabolic, no lifestyle or viral). Vietnamese men (16.3%, 95% CI 7.4% to 25.3%) and Hmong women (15.1%, 95% CI 7.8% to 22.5%) had the highest viral pattern prevalence. Hmong women had the highest metabolic (37.8%, 95% CI 29.8% to 45.9%), and Vietnamese men the highest lifestyle (70.4%, 95% CI 59.1% to 81.7%) pattern prevalence. In multiple domains, Hmong men and women were most likely to have viral+metabolic risk factors (men: 14.4%, 95% CI 6.0% to 22.7%; women: 11.9%, 95% CI 5.6% to 18.3%); Vietnamese men were most likely to have lifestyle+viral (10.7%, 95% CI 2.7% to 18.8%), and lifestyle+metabolic but not viral (46.4%, 95% CI 34.4% to 58.5%) risk factors. CONCLUSIONS: Efforts to reduce HCC must comprehensively address multiple risk factors. TRIAL REGISTRATION NUMBER: NCT02596438.