Behavior change, health, and health disparities: An introduction

Kurti

Redner

et al. 2016

Self Cite

Introduction Relatively little has been reported characterizing cumulative risk associated with co-occurring risk factors for cigarette smoking. The purpose of the present study was to address that knowledge gap in a U.S. nationally representative sample. Methods Data were obtained from 114,426 adults (≥ 18 years) in the U.S. National Survey on Drug Use and Health (years 2011–13). Multiple logistic regression and classification and regression tree (CART) modeling were used to examine risk of current smoking associated with eight co-occurring risk factors (age, gender, race/ethnicity, educational attainment, poverty, drug abuse/dependence, alcohol abuse/dependence, mental illness). Results Each of these eight risk factors was independently associated with significant increases in the odds of smoking when concurrently present in a multiple logistic regression model. Effects of risk-factor combinations were typically summative. Exceptions to that pattern were in the direction of less-than-summative effects when one of the combined risk factors was associated with generally high or low rates of smoking (e.g., drug abuse/dependence, age ≥65). CART modeling identified subpopulation risk profiles wherein smoking prevalence varied from a low of 11% to a high of 74% depending on particular risk factor combinations. Being a college graduate was the strongest independent predictor of smoking status, classifying 30% of the adult population. Conclusions These results offer strong evidence that the effects associated with common risk factors for cigarette smoking are independent, cumulative, and generally summative. The results also offer potentially useful insights into national population risk profiles around which U.S. tobacco policies can be developed or refined.

Section: Discussionmentioning

confidence: 99%

Co-occurring risk factors for current cigarette smoking in a U.S. nationally representative sample

Kurti

Redner

et al. 2016

Self Cite

“…As was discussed in the Introduction to the prior Special Issue (Higgins, 2014), these health systems evolved largely to manage infectious disease and acute illnesses. While those earlier foci remain important, the mission has had to broaden considerably to accommodate the growing influence of chronic health conditions, especially those where personal behavior is a proximal cause.…”

Section: Behavior Change Health and Health Disparitiesmentioning

confidence: 99%

“…Contributions in our prior Special Issue reviewed national and international efforts to curtail the cigarette smoking and obesity epidemics (see Henningfield;, 2014; Higgins, 2014; Kaplan, 2014). However, we did not provide a perspective from the state level in that issue, a gap that is addressed in this issue by the commentary from Chen (2015–in this issue) in his role as Vermont Commissioner of Health.…”

Section: Physical Inactivity Obesity Cigarette Smoking and Other Tobamentioning

confidence: 99%

“…Each of the contributors to these Special Issues is an accomplished contributor to the general topic area of behavior and health. Contributors for these Special Issues are selected from among participants in the Annual Conference on Behavior Change, Health, and Health Disparities that is organized by the Vermont Center on Behavior and Health, a National Institutes of Health (NIH) and Food and Drug Administration (FDA) supported research center located at the University of Vermont (http://www.uvm.edu/medicine/behaviorandhealth/). Each contribution undergoes thorough peer-review overseen by the Editor-in-Chief in coordination with the Guest Editor.…”

Section: Introductionmentioning

confidence: 99%

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Editorial: 2nd Special Issue on behavior change, health, and health disparities

2015

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This Special Issue of Preventive Medicine (PM) is the 2nd that we have organized on behavior change, health, and health disparities. This is a topic of fundamental importance to improving population health in the U.S. and other industrialized countries that are trying to more effectively manage chronic health conditions. There is broad scientific consensus that personal behavior patterns such as cigarette smoking, other substance abuse, and physical inactivity/obesity are among the most important modifiable causes of chronic disease and its adverse impacts on population health. As such behavior change needs to be a key component of improving population health. There is also broad agreement that while these problems extend across socioeconomic strata, they are overrepresented among more economically disadvantaged populations and contribute directly to the growing problem of health disparities. Hence, behavior change represents an essential step in curtailing that unsettling problem as well. In this 2nd Special Issue, we devote considerable space to the current U.S. prescription opioid addiction epidemic, a crisis that was not addressed in the prior Special Issue. We also continue to devote attention to the two largest contributors to preventable disease and premature death, cigarette smoking and physical inactivity/obesity as well as risks of co-occurrence of these unhealthy behavior patterns. Across each of these topics we included contributions from highly accomplished policymakers and scientists to acquaint readers with recent accomplishments as well as remaining knowledge gaps and challenges to effectively managing these important chronic health problems.

“…Cigarette smoking and overweight and obesity are the two leading causes of premature death and morbidity in the U.S. and other developed countries, and they share important determinants at the neurobiological, behavioral, and social levels (Higgins, 2014; Mercer et al, 2003; Schroeder, 2007). As such, it seems reasonable to expect that factors that promote progress on one might inform efforts to curb the other.…”

mentioning

confidence: 99%

Borrowing from tobacco control to curtail the overweight and obesity epidemic: Leveraging the U.S. Surgeon General's Report

2015

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There is broad agreement that more needs to be done to curtail the U.S. overweight and obesity epidemic. Fifty years of regular Surgeon General's Reports on the health consequences of smoking appear to have been a highly effective contributor to the notable successes that have been made in reducing smoking prevalence. Comparing the rate of Surgeon General's Reports on smoking and obesity reveals striking differences, with more than a five-fold lower rate of reporting on the latter. Developing practices that more effectively leverage the power of the U.S. Surgeon General's Office in efforts to reduce obesity is a relatively straightforward but potentially powerful additional step that warrants consideration.