Characteristics of hospice patients utilizing hospice inpatient/residential facilities.

Given the increasing popularity of a hospice inpatient/residential facility (HIRF) among hospice patients and their family members, examining who uses HIRFs has been of increasing importance. Using the 2007 National Home and Hospice Care Survey (NHHCS), we found that about 14% of the hospice patients received care in an HIRF in 2007. Characteristics of patients associated with HIRF use largely match the industry norm for a general inpatient level of care and include having no caregiver or having an incapable caregiver; having imminent death; and being directly admitted to a hospice after discharge from a hospital. Given a recent stricter enforcement of reimbursement rules, however, we call for close monitoring of any change in the number of HIRF beds--particularly in rural and low-income urban areas.

Disparity in disaster preparedness between racial/ethnic groups.

Objective The objective of this study was to examine the association between race/ethnicity (including language subgroups among Hispanics) and disaster preparedness among Behavioral Risk Factor Surveillance System (BRFSS) survey respondents. Methods BRFSS data were obtained for eight states which implemented the optional general preparedness module from 2006 through 2010. Three dependent variables were analyzed including presence of four preparedness items (i.e., food, water, flashlight, and radio), emergency evacuation plan, and 3-d supply of medication. Primary independent variable included race/ethnicity accounting for language of survey. Data were analyzed in 2011 and accounted for BRFSS sampling design. Results Black (OR = 0.66, 95% CI = 0.56, 0.79), English-speaking Hispanic (OR = 0.48, 95% CI = 0.34, 0.69) and Spanish-speaking Hispanic respondents (OR = 0.20, 95% CI = 0.13, 0.29) were less likely than non-Hispanic white respondents to live in a household in which all members requiring medication had a 3-d supply. Results varied regarding presence of four preparedness items and an emergency evacuation plan. Conclusions Racial/ethnic minority groups were less likely to have medication supplies but only Spanish-speaking Hispanics were less likely to have an emergency evacuation plan than white respondents. Public health officials can use these findings to support targeting racial/ethnic minorities to increase the presence of preparedness items important to mitigate the effects of disasters, with particular emphasis on medication supplies and Spanish-speaking Hispanics.

Associations between food insecurity, supplemental nutrition assistance program (SNAP) benefits, and body mass index among adult females.

Obesity disproportionately affects low-income and minority individuals and has been linked with food insecurity, particularly among women. More research is needed to examine potential mechanisms linking obesity and food insecurity. Therefore, this study's purpose was to examine cross-sectional associations between food insecurity, Supplemental Nutrition Assistance Program (SNAP) benefits per household member, perceived stress, and body mass index (BMI) among female SNAP participants in eastern North Carolina (n=202). Women were recruited from the Pitt County Department of Social Services between October 2009 and April 2010. Household food insecurity was measured using the validated US Department of Agriculture 18-item food security survey module. Perceived stress was measured using the 14-item Cohen's Perceived Stress Scale. SNAP benefits and number of children in the household were self-reported and used to calculate benefits per household member. BMI was calculated from measured height and weight (as kg/m(2)). Multivariate linear regression was used to examine associations between BMI, SNAP benefits, stress, and food insecurity while adjusting for age and physical activity. In adjusted linear regression analyses, perceived stress was positively related to food insecurity (P<0.0001), even when SNAP benefits were included in the model. BMI was positively associated with food insecurity (P=0.04). Mean BMI was significantly greater among women receiving <$150 in SNAP benefits per household member vs those receiving ≥$150 in benefits per household member (35.8 vs 33.1; P=0.04). Results suggest that provision of adequate SNAP benefits per household member might partially ameliorate the negative effects of food insecurity on BMI.

Disaster preparedness among medically vulnerable populations.

BACKGROUND: Vulnerable populations such as those with poor health, disabilities, and chronic diseases are at an increased risk of adverse health outcomes resulting from natural disasters. PURPOSE: The objective of this study was to examine the association of general health status, disability status, and chronic disease status, respectively, with disaster preparedness, among Behavioral Risk Factor Surveillance System (BRFSS) survey respondents. METHODS: BRFSS data were obtained for six states that implemented the optional general preparedness module from 2006 through 2008. Three dependent variables were analyzed, including presence of four preparedness items (i.e., food, water, flashlight, radio); emergency evacuation plan; and 3-day supply of medication. Primary independent variables included perceived health status, disability status, and number of chronic diseases. Data were analyzed in 2010 and accounted for BRFSS complex sampling design. RESULTS: Respondents with fair/poor perceived health (OR=0.76, 95% CI=0.65, 0.89); a disability (activity limitation; OR=0.81, 95% CI=0.73, 0.90); and three or more chronic diseases (OR=0.77, 95% CI=0.58, 1.02) were less likely to have all four preparedness items than their healthier counterparts. However, all these groups were more likely to have a 3-day supply of medication than their healthier counterparts. Results varied for presence of an emergency evacuation plan. CONCLUSIONS: Vulnerable populations were generally less likely to have household preparedness items but more likely to have medication supplies than their counterparts. Public health officials should target these groups to increase levels of disaster preparedness.