CONTEXT: The system of local health departments (LHDs) in the United States has the 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 United States 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 = 2300). 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: Two thousand three hundred 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 the prevalence of obesity in the jurisdiction. A substantial portion of the variance in LHD activities was explained by state-level clustering. CONCLUSIONS: This article 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.
CONTEXT: The system of local health departments (LHDs) in the United States has the 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 United States 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 = 2300). 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: Two thousand three hundred 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 the prevalence of obesity in the jurisdiction. A substantial portion of the variance in LHD activities was explained by state-level clustering. CONCLUSIONS: This article 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.
Authors: Mia A Papas; Anthony J Alberg; Reid Ewing; Kathy J Helzlsouer; Tiffany L Gary; Ann C Klassen Journal: Epidemiol Rev Date: 2007-05-28 Impact factor: 6.222
Authors: Ross C Brownson; Paula Ballew; Kathrin L Brown; Michael B Elliott; Debra Haire-Joshu; Gregory W Heath; Matthew W Kreuter Journal: Am J Public Health Date: 2007-08-29 Impact factor: 9.308
Authors: Donna Spruijt-Metz; Eric Hekler; Niilo Saranummi; Stephen Intille; Ilkka Korhonen; Wendy Nilsen; Daniel E Rivera; Bonnie Spring; Susan Michie; David A Asch; Alberto Sanna; Vicente Traver Salcedo; Rita Kukakfa; Misha Pavel Journal: Transl Behav Med Date: 2015-09 Impact factor: 3.046
Authors: Jackson P Sekhobo; Lynn S Edmunds; Karen Dalenius; Jan Jernigan; Christopher F Davis; Mark Giddings; Catherine Lesesne; Laura Kettel Khan Journal: Prev Chronic Dis Date: 2014-10-16 Impact factor: 2.830
Authors: Rozhin Naghshizadian; Amir A Rahnemai-Azar; Kruthi Kella; Michael M Weber; Marius L Calin; Shahida Bibi; Daniel T Farkas Journal: J Obes Date: 2014-12-29
Authors: Jonathon P Leider; Brian C Castrucci; Jenine K Harris; Shelley Hearne Journal: Int J Environ Res Public Health Date: 2015-08-06 Impact factor: 3.390