Overview of health research: home address and obesity are not linked
Does your address predict your waistline, or is it your salary?
A new study indicates that it could be the latter case, finding that obesity is higher in less populated communities, but that the causes do not appear to be due to the increased presence of drive-through services.
You know the kind that asks if you want fries with that?
The discovery stems from a major new study on health and the so-called “built environment” recently published in the International Journal of Obesity.
For years, health experts have argued that there is a link between where you live and obesity.
According to this work, some communities are more obese than others because they are “obesogenic” – that is, high in fast food outlets and convenience stores and low in parks, sidewalks and grocery stores.
These characteristics are said to cause people to drive more, walk less, and eat high-calorie or take-out foods quickly, thus becoming increasingly obese.
This so-called built environment has been linked to higher rates of obesity in rural communities and urban areas, earning it the designation of “food deserts” by primarily offering only convenience stores and restaurants. fast food to the hungry.
In the United States, “the USDA estimates that 23.5 million people live in urban neighborhoods and rural towns with limited access to fresh, affordable and healthy food,” according to an editorial 2019 in the International Journal of Environmental Research and Public Health.
Although people living in low density communities or in places with less access to grocery stores are more likely to be overweight, so far data has not been able to say whether these environments cause obesity or simply inherited it.
Examining anonymous electronic health records, a new study from the University of Washington has tracked the weight trajectories of more than 100,000 insured patients in the Kaiser Permanente Washington health system for five years.
Looking for associations between where people lived and their weight gain over the study period, data was analyzed based on socioeconomic status, population density, number of supermarkets of the area, fast food restaurants and other variables.
The researchers found that the patient’s built environment predicted whether a person’s starting weight was high or low, but was unrelated to whether a person gained weight over time.
With one exception, the researchers found that those who lived in high-density places had a slightly lower likelihood of gaining weight over time.
In short, “obesogenic” circles have in fact not been found to be obesogenic.
The authors believe that factors beyond building configuration better explain obesity rates in a given community.
“Whether you can afford a healthy diet or have the time to exercise,” lead author and scientist from UW School of Public Health James buszkiewicz said in a statement, “these factors probably outweigh the things we see in terms of the effect on the built environment.”
More than 70% ‘definitely’ plan to be vaccinated against COVID-19
The US Census Bureau’s weekly household pulse survey suggests that reluctance to the COVID-19 vaccine declined significantly between January and the end of March 2021.
The news comes from a recent update from the State Health Access Data Assistance Center (SHADAC), a research communications arm of the University of Minnesota.
Between early 2020 and late March, SHADAC writes, the percentage of U.S. adults surveyed who said they would definitely receive the COVID-19 vaccine rose from 54.5% to 71.6%.
Those who said they would “probably” get the hits were halved over the same period, from 23.7% to 12.4%.
This combination represents 84% of American adults surveyed who are not opposed or have no intention of receiving the COVID-19 vaccine, a percentage well within the range deemed necessary for herd immunity.
While the upward movement among people positive about vaccines was significant, the remaining 16% who were unlikely (8.2%) or categorically opposed (7.8%) to vaccination against COVID-19 were little changed, however, falling only 3.9% and 1.1%. over the period studied.
On a state-by-state comparison, between January and the end of March, COVID-19 vaccine reluctance fell 20 points in North and South Dakota and 10 points in Minnesota. The three neighboring states had different levels of hesitation at the start of the year, with North Dakota the highest and Minnesota the lowest.
Reluctance among black respondents has so far fallen from the highest percentages among demographic groups in 2020, dropping 28 points in the first three months of the year. Those who oppose it remain slightly high compared to the proportions of the Hispanic and white populations.
“As concerns about potential side effects, safety, priority and efficacy have waned, distrust of COVID-19 vaccines and mistrust of the government, as well as not believing that” I I need a COVID-19 vaccine “have all increased as reported reasons for the reluctance to immunize,” James Campbell of the State Health Access Data Assistance Center said in a statement.
“This could be a cause for concern, as these reasons for hesitation may not subside as individuals see more people in their communities being safely vaccinated.”
Providing low-value care doesn’t make patients happier
Here’s another reason doctors refuse treatments that are available but have been determined to offer little benefit: Providing low-value care won’t leave the patient any happier with the experience.
Some hospitals continue to offer so-called low-value treatments on the grounds that if patients want you to offer one, and a doctor explains that it has not been proven to work, the patient will rate their satisfaction lower and The hospital will see its quality scores drop.
These are usually larger and more important hospitals. A rrecent national ranking of hospitals based on their dedication to providing low-value care placed several small community hospitals in Minnesota and the Dakotas at the top, while the state’s reputable providers failed to make the top 50.
In a recently published study in the journal JAMA Internal Medicine, researchers at the University of Chicago and Harvard Medical School gleaned patient satisfaction data from a large survey of healthcare consumers, then cross-checked it with Medicare claims for the eight most frequently provided low-value services.
The eight services studied were:
- PSA test in men over 75 without a history of prostate cancer;
- Imaging of the carotid artery in asymptomatic adults;
- Screening for cervical cancer in women over 65 without symptoms;
- Two types of thyroid tests;
- Imaging of the back for a first episode of low back pain without complications;
- Head imaging for uncomplicated headaches and;
- Spinal injection for lower back pain.
Researchers found no relationship between the provision of these low-value services and patient satisfaction.
“In short, the concern is overblown,” said study co-investigator Michael McWilliams, MD, Ph.D., professor of health care policy at Harvard Medical School and general internist at Brigham and Women’s Hospital.
“Whether it’s because physicians who waste less are adept at educating patients why a requested test or procedure is unnecessary, or because most of the low-value care is due to provider practice models and not demand. of patients, we should be reassured that we can tackle waste in the system without much patient backlash or provider failure on their “dashboards”. “