The Journal of Clinical Endocrinology & Metabolism, 2008
Protective and detrimental associations have been reported between alcohol consumption and the me... more Protective and detrimental associations have been reported between alcohol consumption and the metabolic syndrome. This may be due to variations in drinking patterns and different alcohol effects on the metabolic syndrome components. This study is designed to examine the relationship between alcohol consumption patterns and the metabolic syndrome. The 1999-2002 National Health and Nutrition Examination Survey is a population-based survey of noninstitutionalized U.S. adults. Current drinkers aged 20-84 yr without cardiovascular disease who had complete data on the metabolic syndrome and drinking patterns were included in the analysis (n = 1529). The metabolic abnormalities comprising the metabolic syndrome included having three of the following: impaired fasting glucose/diabetes mellitus, high triglycerides, abdominal obesity, high blood pressure, and low high-density-lipoprotein cholesterol. Measures of alcohol consumption included usual quantity consumed, drinking frequency, and frequency of binge drinking. In multinomial logistic regression models controlling for demographics, family history of cardiovascular disease and diabetes, and lifestyle factors, increased risk of the metabolic syndrome was associated with daily consumption that exceeded U.S. dietary guideline recommendations (more than one drink per drinking day for women and more than two drinks per drinking day for men (odds ratio 1.60, 95% confidence interval 1.22-2.11) and binge drinking once per week or more [odds ratio (95% confidence interval) 1.51 (1.01-2.29]. By individual metabolic abnormality, drinking in excess of the dietary guidelines was associated with an increased risk of impaired fasting glucose/diabetes mellitus, hypertriglyceridemia, abdominal obesity, and high blood pressure. Public health messages should emphasize the potential cardiometabolic risk associated with drinking in excess of national guidelines and binge drinking.
Chronic diseases and conditions (e.g., heart disease, cancer, stroke, and diabetes) are the leadi... more Chronic diseases and conditions (e.g., heart disease, cancer, stroke, and diabetes) are the leading causes of death in the United States. Controlling health risk behaviors and conditions (e.g., smoking, physical inactivity, poor diet, excessive drinking, and obesity) and using preventive health-care services (e.g., physical examination, vaccination, screening for high blood pressure and high cholesterol, consumption of fruits and vegetables, and participation in regular leisure-time physical activity) can reduce morbidity and mortality from chronic diseases. January 2009--December 2009. The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing state-based random-digit--dialed telephone survey of noninstitutionalized adults aged ≥18 years residing in the United States. BRFSS collects data on health risk behaviors and conditions, chronic diseases and conditions, access to health care, and use of preventative health services and practices related to the leading causes of death and disabilities in the United States. This report presents results for 2009 for all 50 states, the District of Columbia, the Commonwealth of Puerto Rico, Guam, the U.S. Virgin Islands, 180 metropolitan and micropolitan statistical areas (MMSAs), and 283 selected counties. In 2009, the estimated prevalence of general health status, use of preventive health-care services, health risk behaviors and conditions, chronic diseases, and health impairments and disabilities varied substantially by state and territory, MMSA, and county. The following is a summary of results listed by BRFSS question topics. Each set of proportions refers to the range of estimated prevalence for the disease, condition, or behavior, as reported by the survey respondent. Adults who reported having fair or poor health: 10.1%--30.9% for states and territories, 7.9%--25.8% for MMSAs, and 4.5%--26.1% for counties. Adults with health-care coverage: 71.4%--94.7% for states and territories, 52.7%--96.3% for MMSAs, and 52.7%--97.6% for counties. Annual routine physical checkup among adults aged ≥18 years: 55.8%--79.3% for states and territories, 51.8%--80.7% for MMSAs, and 49.2%--83.5% for counties. Annual influenza vaccination among adults aged ≥65 years: 26.8%--76.8% for states and territories, 55.4%--81.4% for MMSAs, and 50.5%--83.5% for counties. Pneumococcal vaccination among adults aged ≥65 years: 19.1%--73.9% for states and territories, 52.9%--81.3% for MMSAs, and 41.9%--82.0% for counties. Adults who had their cholesterol checked within the preceding 5 years: 67.5%--85.3% for states and territories, 58.2%--88.8% for MMSAs, and 58.2%--92.4% for counties. Adults who consumed at least five servings of fruits and vegetables per day: 14.6%--31.5% for states and territories, 12.6%--33.0% for MMSAs, and 13.4%--34.9% for counties. Adults who engaged in moderate or vigorous physical activity: 28.0%--60.7% for states and territories, 34.6%--64.9% for MMSAs, and 33.6%--67.3% for counties. Adults who engaged in only vigorous physical activity: 13.7%--40.1% for states and territories, 13.8%--43.3% for MMSAs, and 14.2%--50.0% for counties. Current cigarette smoking among adults: 6.4%--25.6% for states and territories, 5.7%--29.0% for MMSAs, and 5.6%--29.8% for counties. Binge drinking among adults: 6.8%--23.9% for states and territories, 3.5%--23.2% for MMSAs, and 3.4%--26.3% for counties. Heavy drinking among adults: 1.9%--8.1% for states and territories, 1.0%--11.1% for MMSAs, and 0.9%--11.1% for counties. Adults who reported no leisure-time physical activity: 15.8%--45.6% for states and territories, 13.3%--40.2% for MMSAs, and 10.5%--40.2% for counties. Adults aged ≥18 years who were overweight: 31.6%--38.7% for states and territories, 28.7%--44.1% for MMSAs, and 25.6%--46.7% for counties. Adults aged ≥20 years who were obese: 19.7%--36.0% for states and territories, 15.4%--43.6% for MMSAs, and 13.8%--45.7% for counties. Adults aged ≥18 years who did not get enough rest or sleep: 34.3%--52.6% for states and territories, 28.2%--54.8% for MMSAs, and 24.5%--55.6% for counties. Adults who had received a high blood pressure diagnosis: 22.1%--38.5% for states and territories, 18.8%--43.9% for MMSAs, and 17.2%--43.6% for counties. Adults who had a high blood cholesterol diagnosis: 24.9%--42.2% for states and territories, 27.5%--47.8% for MMSAs, and 26.7%--51.4% for counties. Adults who had received a diagnosis of coronary heart disease: 2.5%--10.3% for states and territories, 2.6%--11.6% for MMSAs, and 1.6%--12.3% for counties. Adults who had received a stroke diagnosis: 1.4%--3.9% for states and territories, 0.8%--5.9% for MMSAs, and 0.8%--6.6% for counties. Adults who had received a diabetes diagnosis: 5.8%--12.9% for states and territories, 2.8%--15.4% for MMSAs, and 2.8%--14.7% for counties. Adults who had received a cancer diagnosis: 3.0%--12.6% for states and territories, 5.8%--15.1% for MMSAs, and 3.9%--16.2% for counties. Adults who had asthma: 4.4%--11.1% for…
Race information in the United States is used to identify populations at risk for cardiovascular ... more Race information in the United States is used to identify populations at risk for cardiovascular disease (CVD) or associated risk factors. Behavioral Risk Factor Surveillance System data from 1999 and 2001 were used to examine shifts in racial distributions and CVD risk factors after a multiracial category was added in 2001. We compared age-adjusted, weighted, race-specific prevalence estimates of self-reported high blood pressure (HBP) and high blood cholesterol (HBC) from 1999 and 2001 with descriptive statistics and 95% confidence intervals. The proportion of non-Hispanic Whites decreased significantly after the multiracial category was added. Overall, the prevalence of HBC did not significantly change, but HBP increased significantly, from 24.2% in 1999 to 25.6% in 2001 (P<.05). Among racial groups, only non-Hispanic Whites showed a statistically significant increase in HBP prevalence from 23.1% to 24.4% (P<.05); however, larger percentage increases in HBP were seen among ...
Background: An estimated 730,000 US residents have chronic hepatitis B infection, but routine sur... more Background: An estimated 730,000 US residents have chronic hepatitis B infection, but routine surveillance is characterized by sparse data. Objective: Our purpose was to measure the impact of supplemental funding on completeness of reporting. Methods: CDC-supported Emerging Infections Program (EIP) sites (Colorado, San Francisco, Minnesota, 34 counties in New York State, and Connecticut) were provided supplemental funding to actively investigate hepatitis B cases. Among chronic HBV cases reported in 2009, EIP sites selected a subset of cases for active investigation specifically to obtain better data for race/ethnicity and behavioral risk factors. All other cases not in the subset were routine. A variable was defined as complete if a valid value was documented; unknown or missing results were counted as incomplete. We compared percent complete among active and routine cases. Results: Of the 3,875 chronic hepatitis B cases reported, 907 (23.4%) were active. Active and routine cases w...
Background: Liver transplants represent a costly, albeit infrequent outcome of end stage liver di... more Background: Liver transplants represent a costly, albeit infrequent outcome of end stage liver disease. As the cohort of US residents with chronic viral hepatitis B and C infection age, complications of infection will substantially impact the healthcare system. Surveillance of liver transplants can reflect missed opportunities for secondary prevention. Methods: We examined data from the Organ Procurement and Transplantation Network as of Mar 4, 2011 and selected liver transplants from Jan 2000 through Dec 2010. Transplant recipients were categorized as having viral hepatitis B, C, both, none, or pooled as recipients with viral hepatitis (RVH) and compared to recipients without viral hepatitis (not-RVH). Results: From 2000 – 2010, a total of 65,891 liver transplants were reported in the United States. The number overall increased 25.8%, from 5,001 in 2000 to 6,291 in 2010 (p<0.001). Of the total, 35.9% of recipients had hepatitis C, 3.6% had hepatitis B, and 0.7% had both. During ...
We explore the relationships between socially assigned race ("How do other people usually cl... more We explore the relationships between socially assigned race ("How do other people usually classify you in this country?"), self-identified race/ethnicity, and excellent or very good general health status. We then take advantage of subgroups which are discordant on self-identified race/ethnicity and socially assigned race to examine whether being classified by others as White conveys an advantage in health status, even for those who do not self-identify as White. Analyses were conducted using pooled data from the eight states that used the Reactions to Race module of the 2004 Behavioral Risk Factor Surveillance System. The agreement of socially assigned race with self-identified race/ethnicity varied across the racial/ethnic groups currently defined by the United States government. Included among those usually classified by others as White were 26.8% of those who self-identified as Hispanic, 47.6% of those who self-identified as American Indian, and 59.5% of those who self-...
An examination of mortality from 12 causes of death was tabulated for the state of Texas for resi... more An examination of mortality from 12 causes of death was tabulated for the state of Texas for residents in the Lower Rio Grande Valley; for residents of border counties; for residents of Dallas, Harris, and Tarrant counties, along with residents of east Texas from 1980 to 1989. The ninth revised edition of the International Classification of Diseases was used to categorize causes of mortality. The mortality data were obtained from mortality data tapes obtained from the Texas Department of Health and archived at the University of Texas School of Public Health. From 1980 to 1989, an average of 1543 deaths per year was attributed to these 12 selected causes in Texas. Thirty-two percent of deaths were due to hypertensive heart disease, 30% to pneumonia and bronchitis, 11% to cervical cancer, and 6% to rheumatic fever. Pneumonia and bronchitis were the leading causes of death among those aged 15 to 44 years.
MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control, Jan 20, 2013
This report contains CDC guidance that augments the 2011 recommendations of the Advisory Committe... more This report contains CDC guidance that augments the 2011 recommendations of the Advisory Committee on Immunization Practices (ACIP) for evaluating hepatitis B protection among health-care personnel (HCP) and administering post-exposure prophylaxis. Explicit guidance is provided for persons working, training, or volunteering in health-care settings who have documented hepatitis B (HepB) vaccination years before hire or matriculation (e.g., when HepB vaccination was received as part of routine infant [recommended since 1991] or catch-up adolescent [recommended since 1995] vaccination). In the United States, 2,890 cases of acute hepatitis B were reported to CDC in 2011, and an estimated 18,800 new cases of hepatitis B occurred after accounting for underreporting of cases and asymptomatic infection. Although the rate of acute hepatitis B virus (HBV) infections have declined approximately 89% during 1990-2011, from 8.5 to 0.9 cases per 100,000 population in the United States, the risk fo...
Inadequately controlled chronic diseases may present a threat to life and well-being during the e... more Inadequately controlled chronic diseases may present a threat to life and well-being during the emergency response to natural disasters. An estimate of the possible numbers of people who may require treatment for chronic diseases should help in planning a response, but such information for local areas is not easily accessible. We explored how a current surveillance system could be used to provide estimates of the potential needs for emergency treatment of chronic diseases in the wake of a natural disaster. We used data from adults aged 18 years or older who participated in the Behavioral Risk Factor Surveillance System (BRFSS) in 2004 to estimate the prevalence and numbers of people with diabetes, heart disease, stroke, hypertension, and current asthma who lived in the New Orleans-Metairie-Kenner, La, metropolitan statistical area. About 9.0% of participants had diabetes, 4.6% had angina or coronary heart disease, 3.0% had had a myocardial infarction, 2.0% had had a stroke, and 6.3%...
Our purpose was to determine the prevalence and correlates of self-reported symptoms of depressio... more Our purpose was to determine the prevalence and correlates of self-reported symptoms of depression and physician-diagnosed depression and anxiety in Florida adults by using the 2006 Florida Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS is an ongoing, state-based telephone health survey of noninstitutionalized adults that uses random-digit dialing. In 2006, an Anxiety and Depression Module was administered in Florida. Eight questions were used to examine current depression. Two additional questions assessed health care provider diagnosis of depressive and anxiety disorders. We used SUDAAN version 9.0 to evaluate the data to accommodate the complex sampling design. Approximately 9% of Florida adults experienced current depression; about 13% had had a diagnosis of depression in their lifetime and 11% had a diagnosis of anxiety in their lifetime. Approximately 44% of respondents with current depression had not had a diagnosis of depression. Current depression and lifetim...
In this study, we build on the previous findings of increased diabetes prevalence among American ... more In this study, we build on the previous findings of increased diabetes prevalence among American Indian/Alaska Native (AI/AN) young adults, by studying the rate at which annual prevalence estimates of diagnosed diabetes increased from 1994 to 2007. For this study, BRFSS data for 1994-2007 from the 50 states, District of Columbia, Puerto Rico, Guam, and the Virgin Islands were analyzed. Only non-institutionalized adults aged 18 years and older were eligible to participate in the Behavioral Risk Factor Surveillance System survey. To examine the existence and strength of a trend, we analyzed plots and Spearman's rank correlation coefficients of annual prevalence estimates for each group of young adults. Mantel-Haenszel tests were employed to study the relationship of diagnosed diabetes prevalence and race (AI/ AN, non-Hispanic White), while controlling for the time periods 1994-2000 and 2001-2007. To quantify increases in the disparity of diagnosed diabetes prevalence and race (AI/...
Objectives: We explore the relationships be tween socially assigned race (''How do other... more Objectives: We explore the relationships be tween socially assigned race (''How do other people usually classify you in this country?''), self- identified race/ethnicity, and excellent or very good general health status. We then take advantage of subgroups which are discordant on self-identified race/ethnicity and socially assigned race to examine whether being classified by others as White conveys an advantage in
To highlight the close association of cardiovascular disease (CVD) with depression and anxiety in... more To highlight the close association of cardiovascular disease (CVD) with depression and anxiety in US non-institutionalized adults and examine the sociodemographic correlates of depression and anxiety among CVD survivors. The data were obtained from 38 states which administered an Anxiety and Depression Module as part of the 2006 Behavioral Risk Factor Surveillance System. CVD was assessed with three questions on coronary heart disease and stroke. Adjusted prevalence ratios (APRs) were obtained after adjustment for demographic characteristics using SUDAAN 9.0. The prevalence of a CVD history was 15.3% among studied population (sample size n=129,499). Persons with a CVD history were more likely than those without to experience current depression (15.8% versus 7.1%, APR [95% CI]=1.69 [1.54-1.85]), to have a lifetime diagnosis of depressive disorders (22.3% versus 15.1%, APR [95% CI]=1.56 [1.45-1.67]) or anxiety disorders (16.6% versus 10.0%, APR [95% CI]=1.46 [1.37-1.54]). CVD survivors with low education attainment or minority background were less likely to receive a diagnosis of depression though their experience of depression was comparable with or higher than their counterparts. CVD is associated significantly with depression and anxiety. Disparities exist among CVD survivors on the diagnosis of depression and anxiety.
The Journal of Clinical Endocrinology & Metabolism, 2008
Protective and detrimental associations have been reported between alcohol consumption and the me... more Protective and detrimental associations have been reported between alcohol consumption and the metabolic syndrome. This may be due to variations in drinking patterns and different alcohol effects on the metabolic syndrome components. This study is designed to examine the relationship between alcohol consumption patterns and the metabolic syndrome. The 1999-2002 National Health and Nutrition Examination Survey is a population-based survey of noninstitutionalized U.S. adults. Current drinkers aged 20-84 yr without cardiovascular disease who had complete data on the metabolic syndrome and drinking patterns were included in the analysis (n = 1529). The metabolic abnormalities comprising the metabolic syndrome included having three of the following: impaired fasting glucose/diabetes mellitus, high triglycerides, abdominal obesity, high blood pressure, and low high-density-lipoprotein cholesterol. Measures of alcohol consumption included usual quantity consumed, drinking frequency, and frequency of binge drinking. In multinomial logistic regression models controlling for demographics, family history of cardiovascular disease and diabetes, and lifestyle factors, increased risk of the metabolic syndrome was associated with daily consumption that exceeded U.S. dietary guideline recommendations (more than one drink per drinking day for women and more than two drinks per drinking day for men (odds ratio 1.60, 95% confidence interval 1.22-2.11) and binge drinking once per week or more [odds ratio (95% confidence interval) 1.51 (1.01-2.29]. By individual metabolic abnormality, drinking in excess of the dietary guidelines was associated with an increased risk of impaired fasting glucose/diabetes mellitus, hypertriglyceridemia, abdominal obesity, and high blood pressure. Public health messages should emphasize the potential cardiometabolic risk associated with drinking in excess of national guidelines and binge drinking.
Chronic diseases and conditions (e.g., heart disease, cancer, stroke, and diabetes) are the leadi... more Chronic diseases and conditions (e.g., heart disease, cancer, stroke, and diabetes) are the leading causes of death in the United States. Controlling health risk behaviors and conditions (e.g., smoking, physical inactivity, poor diet, excessive drinking, and obesity) and using preventive health-care services (e.g., physical examination, vaccination, screening for high blood pressure and high cholesterol, consumption of fruits and vegetables, and participation in regular leisure-time physical activity) can reduce morbidity and mortality from chronic diseases. January 2009--December 2009. The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing state-based random-digit--dialed telephone survey of noninstitutionalized adults aged ≥18 years residing in the United States. BRFSS collects data on health risk behaviors and conditions, chronic diseases and conditions, access to health care, and use of preventative health services and practices related to the leading causes of death and disabilities in the United States. This report presents results for 2009 for all 50 states, the District of Columbia, the Commonwealth of Puerto Rico, Guam, the U.S. Virgin Islands, 180 metropolitan and micropolitan statistical areas (MMSAs), and 283 selected counties. In 2009, the estimated prevalence of general health status, use of preventive health-care services, health risk behaviors and conditions, chronic diseases, and health impairments and disabilities varied substantially by state and territory, MMSA, and county. The following is a summary of results listed by BRFSS question topics. Each set of proportions refers to the range of estimated prevalence for the disease, condition, or behavior, as reported by the survey respondent. Adults who reported having fair or poor health: 10.1%--30.9% for states and territories, 7.9%--25.8% for MMSAs, and 4.5%--26.1% for counties. Adults with health-care coverage: 71.4%--94.7% for states and territories, 52.7%--96.3% for MMSAs, and 52.7%--97.6% for counties. Annual routine physical checkup among adults aged ≥18 years: 55.8%--79.3% for states and territories, 51.8%--80.7% for MMSAs, and 49.2%--83.5% for counties. Annual influenza vaccination among adults aged ≥65 years: 26.8%--76.8% for states and territories, 55.4%--81.4% for MMSAs, and 50.5%--83.5% for counties. Pneumococcal vaccination among adults aged ≥65 years: 19.1%--73.9% for states and territories, 52.9%--81.3% for MMSAs, and 41.9%--82.0% for counties. Adults who had their cholesterol checked within the preceding 5 years: 67.5%--85.3% for states and territories, 58.2%--88.8% for MMSAs, and 58.2%--92.4% for counties. Adults who consumed at least five servings of fruits and vegetables per day: 14.6%--31.5% for states and territories, 12.6%--33.0% for MMSAs, and 13.4%--34.9% for counties. Adults who engaged in moderate or vigorous physical activity: 28.0%--60.7% for states and territories, 34.6%--64.9% for MMSAs, and 33.6%--67.3% for counties. Adults who engaged in only vigorous physical activity: 13.7%--40.1% for states and territories, 13.8%--43.3% for MMSAs, and 14.2%--50.0% for counties. Current cigarette smoking among adults: 6.4%--25.6% for states and territories, 5.7%--29.0% for MMSAs, and 5.6%--29.8% for counties. Binge drinking among adults: 6.8%--23.9% for states and territories, 3.5%--23.2% for MMSAs, and 3.4%--26.3% for counties. Heavy drinking among adults: 1.9%--8.1% for states and territories, 1.0%--11.1% for MMSAs, and 0.9%--11.1% for counties. Adults who reported no leisure-time physical activity: 15.8%--45.6% for states and territories, 13.3%--40.2% for MMSAs, and 10.5%--40.2% for counties. Adults aged ≥18 years who were overweight: 31.6%--38.7% for states and territories, 28.7%--44.1% for MMSAs, and 25.6%--46.7% for counties. Adults aged ≥20 years who were obese: 19.7%--36.0% for states and territories, 15.4%--43.6% for MMSAs, and 13.8%--45.7% for counties. Adults aged ≥18 years who did not get enough rest or sleep: 34.3%--52.6% for states and territories, 28.2%--54.8% for MMSAs, and 24.5%--55.6% for counties. Adults who had received a high blood pressure diagnosis: 22.1%--38.5% for states and territories, 18.8%--43.9% for MMSAs, and 17.2%--43.6% for counties. Adults who had a high blood cholesterol diagnosis: 24.9%--42.2% for states and territories, 27.5%--47.8% for MMSAs, and 26.7%--51.4% for counties. Adults who had received a diagnosis of coronary heart disease: 2.5%--10.3% for states and territories, 2.6%--11.6% for MMSAs, and 1.6%--12.3% for counties. Adults who had received a stroke diagnosis: 1.4%--3.9% for states and territories, 0.8%--5.9% for MMSAs, and 0.8%--6.6% for counties. Adults who had received a diabetes diagnosis: 5.8%--12.9% for states and territories, 2.8%--15.4% for MMSAs, and 2.8%--14.7% for counties. Adults who had received a cancer diagnosis: 3.0%--12.6% for states and territories, 5.8%--15.1% for MMSAs, and 3.9%--16.2% for counties. Adults who had asthma: 4.4%--11.1% for…
Race information in the United States is used to identify populations at risk for cardiovascular ... more Race information in the United States is used to identify populations at risk for cardiovascular disease (CVD) or associated risk factors. Behavioral Risk Factor Surveillance System data from 1999 and 2001 were used to examine shifts in racial distributions and CVD risk factors after a multiracial category was added in 2001. We compared age-adjusted, weighted, race-specific prevalence estimates of self-reported high blood pressure (HBP) and high blood cholesterol (HBC) from 1999 and 2001 with descriptive statistics and 95% confidence intervals. The proportion of non-Hispanic Whites decreased significantly after the multiracial category was added. Overall, the prevalence of HBC did not significantly change, but HBP increased significantly, from 24.2% in 1999 to 25.6% in 2001 (P<.05). Among racial groups, only non-Hispanic Whites showed a statistically significant increase in HBP prevalence from 23.1% to 24.4% (P<.05); however, larger percentage increases in HBP were seen among ...
Background: An estimated 730,000 US residents have chronic hepatitis B infection, but routine sur... more Background: An estimated 730,000 US residents have chronic hepatitis B infection, but routine surveillance is characterized by sparse data. Objective: Our purpose was to measure the impact of supplemental funding on completeness of reporting. Methods: CDC-supported Emerging Infections Program (EIP) sites (Colorado, San Francisco, Minnesota, 34 counties in New York State, and Connecticut) were provided supplemental funding to actively investigate hepatitis B cases. Among chronic HBV cases reported in 2009, EIP sites selected a subset of cases for active investigation specifically to obtain better data for race/ethnicity and behavioral risk factors. All other cases not in the subset were routine. A variable was defined as complete if a valid value was documented; unknown or missing results were counted as incomplete. We compared percent complete among active and routine cases. Results: Of the 3,875 chronic hepatitis B cases reported, 907 (23.4%) were active. Active and routine cases w...
Background: Liver transplants represent a costly, albeit infrequent outcome of end stage liver di... more Background: Liver transplants represent a costly, albeit infrequent outcome of end stage liver disease. As the cohort of US residents with chronic viral hepatitis B and C infection age, complications of infection will substantially impact the healthcare system. Surveillance of liver transplants can reflect missed opportunities for secondary prevention. Methods: We examined data from the Organ Procurement and Transplantation Network as of Mar 4, 2011 and selected liver transplants from Jan 2000 through Dec 2010. Transplant recipients were categorized as having viral hepatitis B, C, both, none, or pooled as recipients with viral hepatitis (RVH) and compared to recipients without viral hepatitis (not-RVH). Results: From 2000 – 2010, a total of 65,891 liver transplants were reported in the United States. The number overall increased 25.8%, from 5,001 in 2000 to 6,291 in 2010 (p<0.001). Of the total, 35.9% of recipients had hepatitis C, 3.6% had hepatitis B, and 0.7% had both. During ...
We explore the relationships between socially assigned race ("How do other people usually cl... more We explore the relationships between socially assigned race ("How do other people usually classify you in this country?"), self-identified race/ethnicity, and excellent or very good general health status. We then take advantage of subgroups which are discordant on self-identified race/ethnicity and socially assigned race to examine whether being classified by others as White conveys an advantage in health status, even for those who do not self-identify as White. Analyses were conducted using pooled data from the eight states that used the Reactions to Race module of the 2004 Behavioral Risk Factor Surveillance System. The agreement of socially assigned race with self-identified race/ethnicity varied across the racial/ethnic groups currently defined by the United States government. Included among those usually classified by others as White were 26.8% of those who self-identified as Hispanic, 47.6% of those who self-identified as American Indian, and 59.5% of those who self-...
An examination of mortality from 12 causes of death was tabulated for the state of Texas for resi... more An examination of mortality from 12 causes of death was tabulated for the state of Texas for residents in the Lower Rio Grande Valley; for residents of border counties; for residents of Dallas, Harris, and Tarrant counties, along with residents of east Texas from 1980 to 1989. The ninth revised edition of the International Classification of Diseases was used to categorize causes of mortality. The mortality data were obtained from mortality data tapes obtained from the Texas Department of Health and archived at the University of Texas School of Public Health. From 1980 to 1989, an average of 1543 deaths per year was attributed to these 12 selected causes in Texas. Thirty-two percent of deaths were due to hypertensive heart disease, 30% to pneumonia and bronchitis, 11% to cervical cancer, and 6% to rheumatic fever. Pneumonia and bronchitis were the leading causes of death among those aged 15 to 44 years.
MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control, Jan 20, 2013
This report contains CDC guidance that augments the 2011 recommendations of the Advisory Committe... more This report contains CDC guidance that augments the 2011 recommendations of the Advisory Committee on Immunization Practices (ACIP) for evaluating hepatitis B protection among health-care personnel (HCP) and administering post-exposure prophylaxis. Explicit guidance is provided for persons working, training, or volunteering in health-care settings who have documented hepatitis B (HepB) vaccination years before hire or matriculation (e.g., when HepB vaccination was received as part of routine infant [recommended since 1991] or catch-up adolescent [recommended since 1995] vaccination). In the United States, 2,890 cases of acute hepatitis B were reported to CDC in 2011, and an estimated 18,800 new cases of hepatitis B occurred after accounting for underreporting of cases and asymptomatic infection. Although the rate of acute hepatitis B virus (HBV) infections have declined approximately 89% during 1990-2011, from 8.5 to 0.9 cases per 100,000 population in the United States, the risk fo...
Inadequately controlled chronic diseases may present a threat to life and well-being during the e... more Inadequately controlled chronic diseases may present a threat to life and well-being during the emergency response to natural disasters. An estimate of the possible numbers of people who may require treatment for chronic diseases should help in planning a response, but such information for local areas is not easily accessible. We explored how a current surveillance system could be used to provide estimates of the potential needs for emergency treatment of chronic diseases in the wake of a natural disaster. We used data from adults aged 18 years or older who participated in the Behavioral Risk Factor Surveillance System (BRFSS) in 2004 to estimate the prevalence and numbers of people with diabetes, heart disease, stroke, hypertension, and current asthma who lived in the New Orleans-Metairie-Kenner, La, metropolitan statistical area. About 9.0% of participants had diabetes, 4.6% had angina or coronary heart disease, 3.0% had had a myocardial infarction, 2.0% had had a stroke, and 6.3%...
Our purpose was to determine the prevalence and correlates of self-reported symptoms of depressio... more Our purpose was to determine the prevalence and correlates of self-reported symptoms of depression and physician-diagnosed depression and anxiety in Florida adults by using the 2006 Florida Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS is an ongoing, state-based telephone health survey of noninstitutionalized adults that uses random-digit dialing. In 2006, an Anxiety and Depression Module was administered in Florida. Eight questions were used to examine current depression. Two additional questions assessed health care provider diagnosis of depressive and anxiety disorders. We used SUDAAN version 9.0 to evaluate the data to accommodate the complex sampling design. Approximately 9% of Florida adults experienced current depression; about 13% had had a diagnosis of depression in their lifetime and 11% had a diagnosis of anxiety in their lifetime. Approximately 44% of respondents with current depression had not had a diagnosis of depression. Current depression and lifetim...
In this study, we build on the previous findings of increased diabetes prevalence among American ... more In this study, we build on the previous findings of increased diabetes prevalence among American Indian/Alaska Native (AI/AN) young adults, by studying the rate at which annual prevalence estimates of diagnosed diabetes increased from 1994 to 2007. For this study, BRFSS data for 1994-2007 from the 50 states, District of Columbia, Puerto Rico, Guam, and the Virgin Islands were analyzed. Only non-institutionalized adults aged 18 years and older were eligible to participate in the Behavioral Risk Factor Surveillance System survey. To examine the existence and strength of a trend, we analyzed plots and Spearman's rank correlation coefficients of annual prevalence estimates for each group of young adults. Mantel-Haenszel tests were employed to study the relationship of diagnosed diabetes prevalence and race (AI/ AN, non-Hispanic White), while controlling for the time periods 1994-2000 and 2001-2007. To quantify increases in the disparity of diagnosed diabetes prevalence and race (AI/...
Objectives: We explore the relationships be tween socially assigned race (''How do other... more Objectives: We explore the relationships be tween socially assigned race (''How do other people usually classify you in this country?''), self- identified race/ethnicity, and excellent or very good general health status. We then take advantage of subgroups which are discordant on self-identified race/ethnicity and socially assigned race to examine whether being classified by others as White conveys an advantage in
To highlight the close association of cardiovascular disease (CVD) with depression and anxiety in... more To highlight the close association of cardiovascular disease (CVD) with depression and anxiety in US non-institutionalized adults and examine the sociodemographic correlates of depression and anxiety among CVD survivors. The data were obtained from 38 states which administered an Anxiety and Depression Module as part of the 2006 Behavioral Risk Factor Surveillance System. CVD was assessed with three questions on coronary heart disease and stroke. Adjusted prevalence ratios (APRs) were obtained after adjustment for demographic characteristics using SUDAAN 9.0. The prevalence of a CVD history was 15.3% among studied population (sample size n=129,499). Persons with a CVD history were more likely than those without to experience current depression (15.8% versus 7.1%, APR [95% CI]=1.69 [1.54-1.85]), to have a lifetime diagnosis of depressive disorders (22.3% versus 15.1%, APR [95% CI]=1.56 [1.45-1.67]) or anxiety disorders (16.6% versus 10.0%, APR [95% CI]=1.46 [1.37-1.54]). CVD survivors with low education attainment or minority background were less likely to receive a diagnosis of depression though their experience of depression was comparable with or higher than their counterparts. CVD is associated significantly with depression and anxiety. Disparities exist among CVD survivors on the diagnosis of depression and anxiety.
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