Health Policy

Determining Chronic Disease Prevalence in Local Populations Using Emergency Department Surveillance.

Determining Chronic Disease Prevalence in Local Populations Using Emergency Department Surveillance.
13. Lee DC, Long JA, Wall SP, Braithwaite RS, Elbel B. Determining Chronic Disease Prevalence in Local Populations Using Emergency Department Surveillance. American Journal of Public Health. In press.

Lee DC, Long JA, Wall SP, Braithwaite RS, Elbel B.
09/10/2015

Development and Evaluation of the US Healthy Food Diversity Index.

Development and Evaluation of the US Healthy Food Diversity Index.
Vadiveloo M, Dixon LB, Mijanovich T, Elbel B, Parekh N. Development and Evaluation of the US Healthy Food Diversity Index. British Journal of Nutrition. 2014; 112(9): 1562-1574.

Vadiveloo M, Dixon LB, Mijanovich T, Elbel B, Parekh N.
09/10/2015

Varied diets are diverse with respect to diet quality, and existing dietary variety indices do not capture this heterogeneity. We developed and evaluated the multidimensional US Healthy Food Diversity (HFD) index, which measures dietary variety, dietary quality and proportionality according to the 2010 Dietary Guidelines for Americans (DGA). In the present study, two 24 h dietary recalls from the 2003-6 National Health and Nutrition Examination Survey (NHANES) were used to estimate the intake of twenty-six food groups and health weights for each food group were informed by the 2010 DGA. The US HFD index can range between 0 (poor) and 1 - 1/n, where n is the number of foods; the score is maximised by consuming a variety of foods in proportions recommended by the 2010 DGA. Energy-adjusted Pearson's correlations were computed between the US HFD index and each food group and the probability of adequacy for fifteen nutrients. Linear regression was run to test whether the index differentiated between subpopulations with differences in dietary quality commonly reported in the literature. The observed mean index score was 0·36, indicating that participants did not consume a variety of healthful foods. The index positively correlated with nutrient-dense foods including whole grains, fruits, orange vegetables and low-fat dairy (r 0·12 to 0·64) and negatively correlated with added sugars and lean meats (r - 0·14 to - 0·23). The index also positively correlated with the mean probability of nutrient adequacy (r 0·41; P< 0·0001) and identified non-smokers, women and older adults as subpopulations with better dietary qualities. The US HFD index may be used to inform national dietary guidance and investigate whether healthful dietary variety promotes weight control.

Dietary Variety is Inversely Associated with Body Adiposity among US Adults Using a Novel Food Diversity Index.

Dietary Variety is Inversely Associated with Body Adiposity among US Adults Using a Novel Food Diversity Index.
Vadiveloo M, Dixon LB, Mijanovich T, Elbel B, Parekh N. Dietary Variety is Inversely Associated with Body Adiposity among US Adults Using a Novel Food Diversity Index. Journal of Nutrition. 2015; 145(3): 555-563.

Vadiveloo M, Dixon LB, Mijanovich T, Elbel B, Parekh N.
09/10/2015

BACKGROUND:

Consuming a variety (vs. monotony) of energy-poor, nutrient-dense foods may help individuals adhere to dietary patterns favorably associated with weight control.

OBJECTIVE:

The objective of this study was to examine whether greater healthful food variety quantified using the US Healthy Food Diversity (HFD) index favorably influenced body adiposity.

METHODS:

Men and nonpregnant, nonlactating women aged ≥20 y with two 24-h recalls from the cross-sectional NHANES 2003-2006 (n = 7470) were included in this study. Dietary recalls were merged with the MyPyramid Equivalent database to generate the US HFD index, which ranges from 0 to ∼1, with higher scores indicative of diets with a higher number and proportion of healthful foods. Multiple indicators of adiposity including BMI, waist-to-height ratio, android-to-gynoid fat ratio, fat mass index (FMI), and percentage body fat were assessed across US HFD index quintiles. ORs and 95% CIs were computed with use of multivariable logistic regression (SAS v. 9.3).

RESULTS:

The US HFD index was inversely associated with most adiposity indicators in both sexes. After multivariable adjustment, the odds of obesity, android-to-gynoid ratio >1, and high FMI were 31-55% lower (P-trend < 0.01) among women in quintile 5 vs. quintile 1 of the US HFD index. Among men, the odds of obesity, waist-to-height ratio ≥0.5, and android-to-gynoid ratio >1 were 40-48% lower (P-trend ≤ 0.01) in quintile 5 vs. quintile 1 of the US HFD index.

CONCLUSIONS:

Higher US HFD index values were inversely associated with indicators of body adiposity in both sexes, indicating that greater healthful food variety may protect against excess adiposity. This study explicitly recognizes the potential benefits of dietary variety in obesity management and provides the foundation to support its ongoing evaluation.

Spending at Mobile Fruit and Vegetable Carts and Using SNAP Benefits to Pay, Bronx, New York, 2013 and 2014.

Spending at Mobile Fruit and Vegetable Carts and Using SNAP Benefits to Pay, Bronx, New York, 2013 and 2014.
12. Breck A, Kiszko K, Abrams C, Elbel B. Spending at Mobile Fruit and Vegetable Carts and Using SNAP Benefits to Pay, Bronx, New York, 2013 and 2014. Preventing Chronic Disease. 2015; 12: E87.

Breck A, Kiszko K, Abrams C, Elbel B.
09/10/2015

This study examines purchases at fruit and vegetable carts and evaluates the potential benefits of expanding the availability of electronic benefit transfer machines at Green Carts. Customers at 4 Green Carts in the Bronx, New York, were surveyed in 3 waves from June 2013 through July 2014. Customers who used Supplemental Nutrition Assistance Program benefits spent on average $3.86 more than customers who paid with cash. This finding suggests that there may be benefits to increasing the availability of electronic benefit transfer machines at Green Carts.

Participation in the Wake of Adversity: Blame Attribution and Policy-Oriented Evaluations

Participation in the Wake of Adversity: Blame Attribution and Policy-Oriented Evaluations
Levin, I., Sinclair, J. A., & Alvarez, R. M. (2015). Participation in the Wake of Adversity: Blame Attribution and Policy-Oriented Evaluations. Political Behavior, 1-26.

Levin, Ines and J. Andrew Sinclair and R. Michael Alvarez
09/05/2015

In this paper we investigate to what extent perceptions of economic conditions, policy-oriented evaluations, and blame attribution affected Californians’ involvement in political activities in 2010. We use a statistical methodology that allows us to study not only the behavior of the average citizen, but also the behavior of “types” of citizens with latent predispositions that incline them toward participation or abstention. The 2010 election is an excellent case study, because it was a period when citizens were still suffering the consequences of the 2008 financial crisis and many were concerned about the state’s budgetary crisis. We find that individuals who blamed one of the parties for the problems with the budget process, and who held a position on the 2010 Affordable Care Act, were often considerably more likely to participate. We also find, however, that the impact of economic evaluations, positions on the health care reform, and blame attributions was contingent on citizens’ latent participation propensities and depended on the class of political activity.

Obamacare, five years after the law (French)

Obamacare, five years after the law (French)
Les Tribunes de la santé; (47): 81-89.

Rodwin, VG.
07/24/2015

Obamacare is the most important reform in the American healthcare system since 1965. Its introduction provoked unprecedented controversy between republicans and democrats. Whilst much remains to be done, it has already helped extend health insurance coverage, change the way the healthcare system is funded, establish federal regulations for private insurance, and above all, promote innovation and experiments to modernize the healthcare delivery. Seen from France, it is interesting to follow the array of ongoing experiments in the United States intended to modernize the healthcare system: adaptations to the payment systems for hospitals and doctors and organizational innovations to improve healthcare delivery.

Report on avoidable hospitalizations in the Greater Paris Region (French)

Report on avoidable hospitalizations in the Greater Paris Region (French)
Les hospitalisations potentiellement évitables (HPE), nécessaires au moment de l’admission à l’hôpital, pourraient être évitées par une prise en charge appropriée des soins de premier recours. Quel est l’apport de l’indicateur des HPE dans un diagnostic territorial et dans l’évaluation des parcours de soins?

Laborde, C. and Rodwin, VG.
07/01/2015

Les hospitalisations potentiellement évitables (HPE), nécessaires au moment de l’admission à l’hôpital, pourraient être évitées par une prise en charge appropriée des soins de premier recours. Quel est l’apport de l’indicateur des HPE dans un diagnostic territorial et dans l’évaluation des parcours de soins?

Link to 2 page abstract

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