Obesity and blood pressure trends in rural adolescents over a decade.

This study determined the association between overweight and obesity, demographic variables, elevated blood pressure, and frequency of health care referrals in rural adolescents. Annual school health screenings were conducted. Analysis is limited to student observations from 1996-2005, grades 9 through 12 (4,263 observations), using a repeated-measures, cross-sectional model. A significant upward trend revealed the odds of being overweight to be 1.43 times greater in 2005 compared to 1996. Rates of overweight and obesity were 23% and 17%, respectively. The greatest prevalence of obesity was among young adolescent non-Caucasian males. The odds of having elevated blood pressure was 6.9 times higher in obese versus normal-weight students. A significant association between overweight and receipt of referral for care was observed. Being overweight was significantly associated with poverty and the low education level of the head of the household. Interventions prior to adolescence are needed to reduce the rate of obesity and cardiovascular complications.

Children's health insurance status, access to and utilization of health services, and unmet health needs in a rural Alabama school system.

PURPOSE: This study examines the relationship between children's health insurance status and utilization of health services, establishment of a medical home, and unmet health needs over a 3-year period (1996-1998) in a rural Alabama K-12 school system. METHODS: As part of a children's health insurance outreach program, questionnaires were administered to parents of 754 children regarding health and health care access. In addition, noninvasive head-to-toe physical assessments of children were conducted on-site at 4 schools. FINDINGS: A relationship between health care utilization and insurance status was observed. Results found that insured children had 1.183 (P < .0115) times the number of medical visits as uninsured children. Among uninsured children, the time since last dental visit was 1.6 (P < .001) times longer than that of insured children. Also, insured children were 5.21 times more likely than uninsured (P < .0001) to report having a medical home. No significant differences between insured and uninsured children were found regarding unmet health needs as measured by referrals made after the children's physical assessments. CONCLUSIONS: Child health coverage is an important determining factor in the ability of families to access and utilize health care services. These findings have implications for populations in similar rural communities across the nation.

Strategy to increase agricultural medicine practice: an exploratory study to predict interest among generalists.

Across the nation, farmers, farmworkers and their families experience an increased risk of death, illness and disability. A major concern is to determine how medical education and the medical profession can realize their potential to benefit the agricultural community. This exploratory study was completed to identify factors that might predict interest in practice of agricultural medicine among primary care physicians. Two hundred seventy-eight Alabama primary care physicians, almost equally distributed as urban and rural, completed a questionnaire that surveyed interest in agromedicine practice, experience regarding 13 agromedicine topics, and other physician characteristics. Through a logistic regression model, interest in agromedicine practice was predicted by a high proportion of practice experience in smaller communities, agromedicine experience through personal hobby or avocation, and through professional literature. These three significant variables correctly predicted a moderate to high level of interest in agromedicine practice in 65% of the physicians in the study. If these results hold up with confirmatory study, the authors recommend that targeted efforts to produce physicians for agricultural medicine should prepare physicians whose backgrounds are rural and whose interests include agricultural and family medicine, thus predicting location and practice relevant to the needs of the agricultural community.