Where is obesity prevention on the map?: distribution and predictors of local health department prevention activities in relation to county-level obesity prevalence in the United States.
J Public Health Manag Pract
; 18(5): 402-11, 2012.
Article
en En
| MEDLINE
| ID: mdl-22836530
ABSTRACT
CONTEXT The system of local health departments (LHDs) in the United States has the potential to advance a locally oriented public health response in obesity control and reduce geographic disparities. However, the extent to which obesity prevention programs correspond to local obesity levels is unknown. OBJECTIVE:
This study examines the extent to which LHDs across the United States have responded to local levels of obesity by examining the association between jurisdiction-level obesity prevalence and the existence of obesity prevention programs.DESIGN:
Data on LHD organizational characteristics from the Profile Study of Local Health Departments and county-level estimates of obesity from the Behavioral Risk Factor Surveillance System were analyzed (n = 2300). Since local public health systems are nested within state infrastructure, multilevel models were used to examine the relationship between county-level obesity prevalence and LHD obesity prevention programming and to assess the impact of state-level clustering.SETTING:
Two thousand three hundred local health department jurisdictions defined with respect to county boundaries.PARTICIPANTS:
Practitioners in local health departments who responded to the 2005 Profile Study of Local Health Departments. MAIN OUTCOMEMEASURES:
Likelihood of having obesity prevention activities and association with area-level obesity prevalence.RESULTS:
The existence of obesity prevention activities was not associated with the prevalence of obesity in the jurisdiction. A substantial portion of the variance in LHD activities was explained by state-level clustering.CONCLUSIONS:
This article identified a gap in the local public health response to the obesity epidemic and underscores the importance of multilevel modeling in examining predictors of LHD performance.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Administración en Salud Pública
/
Directrices para la Planificación en Salud
/
Promoción de la Salud
/
Relaciones Interinstitucionales
/
Gobierno Local
/
Obesidad
Tipo de estudio:
Evaluation_studies
/
Guideline
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Sysrev_observational_studies
Límite:
Humans
País como asunto:
America do norte
Idioma:
En
Año:
2012
Tipo del documento:
Article