Disparities in smoking between the lesbian, gay, and bisexual population and the general population in California.

OBJECTIVES: We conducted a large, population-based study to assess tobacco use in California's lesbian, gay, and bisexual (LGB) population. METHODS: Standard measures of tobacco use from 2 separate, statewide household-based studies were used to compare basic prevalence rates in the LGB population and the general population in California. Data were derived from a 2003-2004 survey of LGB individuals living in California as well as from the 2002 version of the California Tobacco Survey, which gathered data on the state's general population. RESULTS: Smoking prevalence rates were higher in our sample of lesbians, bisexual women, and women who have sex with women than among women in the general California population. In the case of men, the only significant difference was that rates were higher among gay men than among men in the general population. Disparities in tobacco use between the LGB population and the general population were still evident after we controlled for key demographic variables and in comparisons with other tobacco use indicators such as average cigarette consumption. CONCLUSIONS: Tobacco control efforts targeting the LGB population are needed to reduce this group's high rate of cigarette smoking.

Promoting Health Equity And Population Health: How Americans' Views Differ.

To increase understanding of what Americans think about personal and public health, a national survey of US adults was conducted in 2015-16 to develop a typology of values and beliefs. The survey was commissioned by the Robert Wood Johnson Foundation for its Culture of Health initiative. Six specific population groupings, or segments, were identified. Three segments included people who supported an active government role in health, two segments were characterized by people who were skeptical toward government, and one segment was characterized by people with conflicted attitudes toward government in health. One of the segments, labeled "supportive," included people who had broad concerns about equity and social solidarity and believed in health disparities and the importance of the social determinants of health. People in two of the other segments that supported an active government role in health shared some of these concerns. There is clearly the potential to mobilize all three of these segments in efforts to improve population health and health equity in the United States. For people whose beliefs put them in the more skeptical segments, a focus on building healthier communities at the local level may garner significant support as long as there is private-sector leadership for the effort.

Using a Toolbox of tailored educational lessons to improve fruit, vegetable, and physical activity behaviors among African American women in California.

OBJECTIVE: Evaluate the effectiveness of the Fruit, Vegetable, and Physical Activity Toolbox for Community Educators (Toolbox), an intervention originally designed for Spanish- and English-speaking audiences, in changing knowledge, attitudes, and behavior among low-income African American women. DESIGN: Quasi-experimental design with treatment and control groups. SETTING: Four community-based organizations and direct health service provider sites. PARTICIPANTS: African American women ages 18-54 (156 treatment, 171 control), 75% of whom were low income. INTERVENTION: Six 1-hour Toolbox classes. MAIN OUTCOME MEASURES: Knowledge, attitudes, self-efficacy, empowerment, and behavior change related to fruits and vegetables and physical activity. ANALYSIS: Dependent t tests pre- to posttest and chi-square test between control and treatment groups. RESULTS: Women in the treatment group reported significant changes in 9 measures of attitude, compared to 1 measure in the control group, as well as 12 measures of confidence and 5 measures of empowerment for which the control group showed no changes. Compared to those in the control group, women in the treatment group were also more likely to make behavioral changes to meet recommendations for fruit and vegetable consumption and physical activity. CONCLUSIONS AND IMPLICATIONS: Toolbox lessons were effective in increasing participants' knowledge, attitudes, self-efficacy, empowerment, and reported fruit and vegetable- and physical activity-related behaviors.

Cigar and smokeless tobacco use in the lesbian, gay, and bisexual population.

Large population-based studies of alternative tobacco use in the lesbian, gay, and bisexual (LGB) population are needed to more fully measure tobacco use outcomes. This descriptive study used standard measures of alternative tobacco use from two separate, statewide household-based studies to compare basic prevalence rates in the LGB population and the general population in California. A total of 1,950 adult lesbians, bisexual women, heterosexual women who have sex with women, gay men, bisexual men, and heterosexual men who have sex with men, all living in California, completed surveys between 2003 and 2004. From a general population-based sample (California Tobacco Survey, 2002), a total of 11,037 adult women and 9,488 men were used as comparisons. The prevalence rates for lifetime and current cigar smoking and smokeless tobacco use were lower for all LGB subpopulations compared with the general population.