Jennifer Mandelbaum

The association between neighborhood-built environment and body mass index (BMI) is well-characterized, whereas fewer studies have explored the mechanisms underlying the relationship between neighborhood social environment and obesogenic behaviors. Using data from a random sample of 16,820 residents ≥18 years from all 169 Connecticut towns and seven ZIP Codes in New York, this study examines the influence of neighborhood social environment on residents’ mental wellbeing, physical activity, and BMI. Structural equation modeling was conducted to estimate direct and indirect effects of neighborhood social environment on BMI, using mental wellbeing and physical activity as intermediate variables. There were significant total [β(SE) = 0.741 (0.170), p < 0.0001], direct [β(SE) = 0.456 (0.1890), p = 0.016], and indirect [β(SE) = 0.285 (0.061), p < 0.0001] effects of neighborhood social environment on BMI. Low physical activity was a partial mediator of the effect of non-favorable neighborhood social environment on BMI [β(SE) = −0.071 (0.011), p < 0.0001]. The association between neighborhood social environment and BMI was also mediated by mental wellbeing [β(SE) = 0.214 (0.060), p < 0.0001], and by mental wellbeing through physical activity [β(SE) = 0.071 (0.011), p < 0.0001]. Study findings provide further support for building strong social environments to improve population health and suggest that strategies prioritizing mental wellbeing may benefit behavioral interventions aimed at reducing obesity risk and should be a focus of prevention efforts in and of itself.

Preventing Chronic Disease (PCD) is a peer-reviewed electronic journal established by the National Center for Chronic Disease Prevention and Health Promotion. PCD provides an open exchange of information and knowledge among researchers, practitioners, policy makers, and others who strive to improve the health of the public through chronic disease prevention.

Background: One in four South Carolinians lives in a county along a nearly 200-mile stretch of Interstate 95 (I-95). Stretching from North Carolina to Georgia, this region is among the most rural, economically depressed, and racially/ethnically diverse in the state. Research is needed to identify social factors contributing to adverse health outcomes along the I-95 corridor, guide interventions, and establish a baseline for measuring progress. This study assessed social determinants of health in counties in South Carolina’s I-95 corridor relative to the rest of the state. Method: Data for South Carolina’s 46 counties were extracted from the Centers for Disease Control and Prevention Minority Health Social Vulnerability Index (SVI), which grouped 34 census variables into six themes: socioeconomic status, household composition and disability, minority status and language, housing type and transportation, health care infrastructure, and medical vulnerability. Each theme was ranked from 0 (least vulnerable) to 1 (most vulnerable). Measures between regions were compared using the Wilcoxon–Mann–Whitney test. Results: Compared with counties outside the I-95 corridor (n = 29), counties in the corridor (n = 17) scored higher on socioeconomic status vulnerability (.67 and .82, respectively) and medical vulnerability (.65 and .79, respectively). No statistically significant differences were found across other themes. Conclusion: Identifying social determinants of health in South Carolina’s I-95 corridor is a crucial first step toward alleviating health disparities in this region. Interventions and policies should be developed in collaboration with local stakeholders to address distal social factors that create and reinforce health disparities.

Objectives: Primary care is an opportune setting to promote healthy behaviors for children and families. In 2007, an expert committee recommended that pediatric primary care clinicians assess nutrition and physical activity at wellness visits and offer recommendations; however, little is known about what pediatric primary care clinicians perceive their role as in childhood weight management. This...

As public health practitioners and program evaluators for a state health department, we look forward to public health conferences for the opportunity to hear from leaders in the field and inform our own practice. While we feel that most presentations describe the work and why it matters, many of us leave sessions thinking, “Now what?” In other words, how do we apply what we learned to public health practice? As American Public Health Association (APHA) looks to celebrate its 150th year in 2022, now is an ideal time to focus on expanding the impact of our work. We offer several suggestions for how conference presenters can make their work more applicable to public health practitioners. We ground our recommendations in John Driscoll’s reflective model for health care practitioners. This framework guides the audience through three questions designed to move from a description of what happened (“what?”) to the potential significance of their findings (“so what?”) and finally to the actions we can take as a result (“now what?”). These strategies are meant to help presenters describe processes and implications in addition to outcomes and theory. We hope that public health professionals can continue to look to the APHA Annual Meeting and other public health conferences as not only sources of innovative research but also as forums for practitioners to share the practical applications of their work.

Food insecurity is a growing issue among older adults, with evidence indicating that 7.7% of adults ages 65 and older in the United States in 2017 lived in a food-insecure household.1 Between 2001 and 2017, the number of older adults who are food insecure more than doubled, reaching 5.5 million.1 Recentstudies have shown that food insecurity has reached unprecedented levels since the onset of the...

Diabetes and heart disease are among the leading causes of death and disability in the United States, and these conditions are especially prevalent in the South. South Carolina’s persistent racial and socioeconomic disparities in chronic disease outcomes are well-documented, yet little is known about how health care practices in medically underserved areas are addressing these challenges. Data were collected through a cross-sectional survey as part of two complementary 5-year cooperative agreements between the Centers for Disease Control and Prevention and the Division of Diabetes and Heart Disease Management (the Division) at the South Carolina Department of Health and Environmental Control. The Division fielded a survey to (a) assist in determining which Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) were best poised to implement specific strategies as part of these cooperative agreements and (b) provide data to establish the baseline for performance measures. FQHCs and RHCs in the top 25% of counties with the highest diabetes and heart disease burden were surveyed about eight domains: staffing/services, electronic health records, team-based care policies, lifestyle change programs, medication therapy management, telehealth, quality improvement collaboratives, and patient demographics. Data representing 71 practices revealed contrasts between RHCs and FQHCs and opportunities for improvement. For example, while most practices reported they were not implementing evidence-based lifestyle change programs (e.g., the National Diabetes Prevention Program), most RHCs and FQHCs expressed interest in starting such programs. Findings are being used to guide efforts to improve diabetes and heart disease prevention and management in South Carolina.

Government health departments at all levels make meaningful contributions to advancing the public health of communities, yet state health departments lack the time and infrastructure to share their findings with the broader scientific community. To address this gap in data dissemination, the South Carolina Department of Health and Environmental Control developed a “collaborative writing team” (CWT) pilot. As part of this pilot program, teams of staff members leveraged existing data to advance the public health knowledge base, with an emphasis on public health practice. The six steps of the CWT included (1) identify team members’ skills/strengths, (2) discuss available data, (3) determine opportunities to share data, (4) divide responsibilities based on team members’ strengths, (5) write and submit product, and (6) debrief. Between December 2019 and November 2020, the team had six abstracts accepted to two national conferences, one abstract accepted to a state public health conference, and one editorial published in a peer-reviewed journal. Feedback from participants indicated that self-efficacy in areas including writing, project facilitation, and analysis had increased among team. CWTs are a framework for people working within public health practice settings to disseminate findings.