IDEAS home Printed from https://ideas.repec.org/a/sae/sagope/v9y2019i1p2158244018822385.html
   My bibliography  Save this article

Regional Risk: Mapping Single and Multiple Chronic Conditions in the United States

Author

Listed:
  • Alexandra C. H. Nowakowski
  • Jihyung Shin
  • Henry J. Carretta

Abstract

Prevalence of single and multiple chronic conditions continues to increase in the United States. Chronic conditions predict significant morbidity and health care costs, especially when complicated by additional conditions. Likewise, many conditions are linked to health risk behaviors, and thus amenable to prevention. We examine regional differences in prevalence of single and multiple chronic conditions. In the process, we examine the ability of health risk behaviors to predict condition prevalence in each region. We recommend national prevention strategies with targeted content for specific geographic regions. We used 2009 Behavioral Risk Factor Surveillance System (BRFSS) data ( N = 432,607) for all analyses. After grouping states into nine U.S. Census divisions, we fitted generalized linear mixed regression models and compared regional odds ratios with national averages. Analyses controlled for helpful and harmful behaviors, health insurance coverage, and demographic characteristics. Odds ratios for single and multiple chronic conditions deviated significantly from national averages in all nine regions. Health behaviors significantly predicted prevalence for both single and multiple conditions within regions, but differences in behaviors between regions did not fully account for observed disparities in prevalence. Significant regional differences in disease prevalence suggest priority areas for prevention efforts. Promoting healthy behaviors and mitigating harmful behaviors in high-risk regions may help to reduce overall chronic condition prevalence, but is unlikely to obviate disparities between regions. Targeted needs assessment should be conducted within each region with higher-than-average risk to determine intervention strategies with the greatest likelihood of near-term impact.

Suggested Citation

  • Alexandra C. H. Nowakowski & Jihyung Shin & Henry J. Carretta, 2019. "Regional Risk: Mapping Single and Multiple Chronic Conditions in the United States," SAGE Open, , vol. 9(1), pages 21582440188, January.
    • Handle: RePEc:sae:sagope:v:9:y:2019:i:1:p:2158244018822385
    DOI: 10.1177/2158244018822385
    as

    Download full text from publisher

    File URL: https://journals.sagepub.com/doi/10.1177/2158244018822385
    Download Restriction: no
    File URL: https://libkey.io/10.1177/2158244018822385?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Diez Roux, A.V., 2001. "Investigating neighborhood and area effects on health," American Journal of Public Health, American Public Health Association, vol. 91(11), pages 1783-1789.
    2. Resnicow, K. & Jackson, A. & Wang, T. & De, A.K. & McCarty, F. & Dudley, W.N. & Baranowski, T., 2001. "A motivational interviewing intervention to increase fruit and vegetable intake through Black churches: Results of the eat for life trial," American Journal of Public Health, American Public Health Association, vol. 91(10), pages 1686-1693.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Marcia G. Ory & Shinduk Lee & Samuel D. Towne & Starr Flores & Olga Gabriel & Matthew Lee Smith, 2020. "Implementing a Diabetes Education Program to Reduce Health Disparities in South Texas: Application of the RE-AIM Framework for Planning and Evaluation," IJERPH, MDPI, vol. 17(17), pages 1-19, August.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Olsen, Jonathan R. & Thornton, Lukar & Tregonning, Grant & Mitchell, Richard, 2022. "Nationwide equity assessment of the 20-min neighbourhood in the scottish context: A socio-spatial proximity analysis of residential locations," Social Science & Medicine, Elsevier, vol. 315(C).
    2. Chen, Duan-Rung & Wen, Tzai-Hung, 2010. "Socio-spatial patterns of neighborhood effects on adult obesity in Taiwan: A multi-level model," Social Science & Medicine, Elsevier, vol. 70(6), pages 823-833, March.
    3. McNeill, Lorna Haughton & Kreuter, Matthew W. & Subramanian, S.V., 2006. "Social Environment and Physical activity: A review of concepts and evidence," Social Science & Medicine, Elsevier, vol. 63(4), pages 1011-1022, August.
    4. Eleonore M Veldhuizen & Karien Stronks & Anton E Kunst, 2013. "Assessing Associations between Socio-Economic Environment and Self-Reported Health in Amsterdam Using Bespoke Environments," PLOS ONE, Public Library of Science, vol. 8(7), pages 1-10, July.
    5. Agee, Mark D. & Atkinson, Scott E. & Crocker, Thomas D., 2010. "The Effects of Children's Time Use and Home and Neighborhood Quality on their Body Weight and Cognitive/Behavioral Development," 2010 Annual Meeting, July 25-27, 2010, Denver, Colorado 91713, Agricultural and Applied Economics Association.
    6. Kendrick, Denise & Mulvaney, Caroline & Burton, Paul & Watson, Michael, 2005. "Relationships between child, family and neighbourhood characteristics and childhood injury: A cohort study," Social Science & Medicine, Elsevier, vol. 61(9), pages 1905-1915, November.
    7. Erica Ann Felker-Kantor & Colette Cunningham-Myrie & Lisa-Gaye Greene & Parris Lyew-Ayee & Uki Atkinson & Wendel Abel & Pernell Clarke & Simon G Anderson & Katherine P Theall, 2019. "Neighborhood crime, disorder and substance use in the Caribbean context: Jamaica National Drug Use Prevalence Survey 2016," PLOS ONE, Public Library of Science, vol. 14(11), pages 1-15, November.
    8. Clarke, Christina A. & Miller, Tim & Chang, Ellen T. & Yin, Daixin & Cockburn, Myles & Gomez, Scarlett L., 2010. "Racial and social class gradients in life expectancy in contemporary California," Social Science & Medicine, Elsevier, vol. 70(9), pages 1373-1380, May.
    9. Brewer, Mackenzie & Kimbro, Rachel Tolbert, 2014. "Neighborhood context and immigrant children's physical activity," Social Science & Medicine, Elsevier, vol. 116(C), pages 1-9.
    10. Jill Furzer & Boriana Miloucheva, 2020. "The Long Arm of the Clean Air Act: Pollution Abatement and COVID-19 Racial Disparities," Working Papers tecipa-668, University of Toronto, Department of Economics.
    11. Peter Congdon, 2021. "COVID-19 Mortality in English Neighborhoods: The Relative Role of Socioeconomic and Environmental Factors," J, MDPI, vol. 4(2), pages 1-16, May.
    12. Kamyar Hasanzadeh & Tiina Laatikainen & Marketta Kyttä, 2018. "A place-based model of local activity spaces: individual place exposure and characteristics," Journal of Geographical Systems, Springer, vol. 20(3), pages 227-252, July.
    13. Eva Anna Christina Hart & Jeroen Lakerveld & Martin McKee & Jean-Michel Oppert & Harry Rutter & Hélène Charreire & Ruut Veenhoven & Helga Bárdos & Sofie Compernolle & Ilse De Bourdeaudhuij & Johannes , 2018. "Contextual correlates of happiness in European adults," PLOS ONE, Public Library of Science, vol. 13(1), pages 1-17, January.
    14. Craig A. Talmage & Chad Frederick, 2019. "Quality of Life, Multimodality, and the Demise of the Autocentric Metropolis: A Multivariate Analysis of 148 Mid-Size U.S. Cities," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 141(1), pages 365-390, January.
    15. Low, Chien Tat & Lai, Poh Chin & Li, Han Dong & Ho, Wai Kit & Wong, Paulina & Chen, Si & Wong, Wing Cheung, 2016. "Neighbourhood effects on body constitution–A case study of Hong Kong," Social Science & Medicine, Elsevier, vol. 158(C), pages 61-74.
    16. Elena Pirani & Silvana Salvini, 2012. "Place of living and health inequality: a study for elderly Italians," Statistical Methods & Applications, Springer;Società Italiana di Statistica, vol. 21(2), pages 211-226, June.
    17. Eva Kibele, 2014. "Individual- and area-level effects on mortality risk in Germany, both East and West, among male Germans aged 65+," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 59(3), pages 439-448, June.
    18. Masayoshi Oka, 2022. "Census-Tract-Level Median Household Income and Median Family Income Estimates: A Unidimensional Measure of Neighborhood Socioeconomic Status?," IJERPH, MDPI, vol. 20(1), pages 1-23, December.
    19. Jacob, Brian A. & Ludwig, Jens & Miller, Douglas L., 2013. "The effects of housing and neighborhood conditions on child mortality," Journal of Health Economics, Elsevier, vol. 32(1), pages 195-206.
    20. Merlo, Juan & Ohlsson, Henrik & Chaix, Basile & Lichtenstein, Paul & Kawachi, Ichiro & Subramanian, S.V., 2013. "Revisiting causal neighborhood effects on individual ischemic heart disease risk: A quasi-experimental multilevel analysis among Swedish siblings," Social Science & Medicine, Elsevier, vol. 76(C), pages 39-46.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:sae:sagope:v:9:y:2019:i:1:p:2158244018822385. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: SAGE Publications (email available below). General contact details of provider: .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.