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Where Is Obesity Prevention on the Map? Distribution and Predictors of Local Health Department Prevention Activities in Relation to County-Level Obesity Prevalence in the US
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2012
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Source: J Public Health Manag Pract. 18(5):402-411
[PDF-1.84 MB]
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Alternative Title:J Public Health Manag Pract
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Description:Context
The system of local health departments (LHD) in the US has potential to advance a locally-oriented public health response in obesity control and reduce geographic disparities. However, the extent to which obesity prevention programs correspond to local obesity levels is unknown.
Objective
This study examines the extent to which LHDs across the US have responded to local levels of obesity by examining the association between jurisdiction level obesity prevalence and the existence of obesity prevention programs.
Design
Data on LHD organizational characteristics from the Profile Study of Local Health Departments and county-level estimates of obesity from the Behavioral Risk Factor Surveillance System were analyzed (n=2,300). Since local public health systems are nested within state infrastructure, multilevel models were used to examine the relationship between county-level obesity prevalence and LHD obesity prevention programming and to assess the impact of state-level clustering.
Setting
2,300 local health department jurisdictions defined with respect to county boundaries
Participants
Practitioners in local health departments who responded to the 2005 Profile Study of Local Health Departments.
Main Outcome Measures
Likelihood of having obesity prevention activities and association with area-level obesity prevalence
Results
The existence of obesity prevention activities was not associated with prevalence of obesity in the jurisdiction. A substantial portion of the variance in LHD activities was explained by state-level clustering.
Conclusions
This paper identified a gap in the local public health response to the obesity epidemic and underscores the importance of multilevel modeling in examining predictors of LHD performance.
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Pubmed ID:22836530
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Pubmed Central ID:PMC3711616
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