Small-Area Estimation and Prioritizing Communities for Obesity Control in Massachusetts
Small-Area Estimation and Prioritizing Communities for Obesity Control in Massachusetts
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DOI：
10.2105/ajph.2008.137364
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发表时间：
2009-03-01
影响因子：
12.7
通讯作者：
Reed, George W.
中科院分区：
文献类型：
--
作者：
Li, Wenjun;Kelsey, Jennifer L.;Reed, George W.
目标。我们开发了一种方法来评估社区水平肥胖患病率的地理和时间变化，并使用该方法来确定马萨诸塞州应被视为肥胖控制优先社区的社区。我们开发了小区域估计模型来估计社区生活的18岁或以上成年人的社区水平肥胖患病率。1999年至2005年行为风险因素监测系统的个人层面数据与2000年美国人口普查的社区层面数据进行了整合。小面积估计模型评估了肥胖（体重指数>= 30 kg/m(2)）与个人和社区水平特征的关系。然后，基于肥胖患病率估计的水平和精度的分类系统被用于确定高优先级社区。2005年对社区肥胖流行率的估计在9%至38%之间，1999年至2005年在所有社区都有所增加。不到7%的社区实现了2010年健康人目标，即患病率低于15%。患病率最高的社区以低收入、受教育程度较低和蓝领工人较多为特征。与美国其他地区类似，马萨诸塞州在实现全国肥胖控制目标方面面临着巨大挑战。以小面积估算确定的高优先级社区为目标，可以最大限度地利用有限的资源。[J] .公共卫生，2009;99:511-519。doi: 10.2105 / AJPH.2008.137364)
Objectives. We developed a method to evaluate geographic and temporal variations in community-level obesity prevalence and used that method to identify communities in Massachusetts that should be considered high priority communities for obesity control.Methods. We developed small-area estimation models to estimate community-level obesity prevalence among community-living adults 18 years or older. Individual-level data from the Behavioral Risk Factors Surveillance System from 1999 to 2005 were integrated with community-level data from the 2000 US Census. Small-area estimation models assessed the associations of obesity (body mass index >= 30 kg/m(2)) with individual- and community-level characteristics. A classification system based on level and precision of obesity prevalence estimates was then used to identify high-priority communities.Results. Estimates of the prevalence of community-level obesity ranged from 9% to 38% in 2005 and increased in all communities from 1999 to 2005. Fewer than 7% of communities met the Healthy People 2010 objective of prevalence rates below 15%. The highest prevalence rates occurred in communities characterized by lower income, less education, and more blue-collar workers.Conclusions. Similar to the rest of the nation, Massachusetts faces a great challenge in reaching the national obesity control objective. Targeting high-priority communities identified by small-area estimation may maximize use of limited resources. (Am J Public Health. 2009;99:511-519. doi:10.2105/AJPH.2008.137364)