American journal of preventive medicine
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This study evaluated recent trends in the prevalence of coronary heart disease in the U.S. population aged ≥40 years. ⋯ The overall prevalence of coronary heart disease including angina and myocardial infarction decreased significantly over the 12-year survey period. However, this reduction was seen mainly among persons without established coronary heart disease risk factors. There was no change in coronary heart disease prevalence among those with specific coronary heart disease risk factors.
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Racial/ethnic disparities in colorectal cancer (CRC) screening and diagnostic testing present challenges to CRC prevention programs. Thus, it is important to understand how differences in CRC screening approaches between healthcare systems are associated with racial/ethnic disparities. ⋯ Racial/ethnic differences in CRC screening vary across healthcare systems, particularly for blacks, and may be more pronounced in systems with intensive CRC screening approaches.
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The delivery of prevention services to children and adolescents through traditional healthcare settings is challenging for a variety of reasons. Parent- and community-focused services are typically not reimbursable in traditional medical settings, and personal healthcare services are often designed for acute and chronic medical treatment rather than prevention. To provide preventive services in a setting that reaches the widest population, those interested in public health and prevention often turn to school settings. ⋯ Such an integration of systems will require a concerted effort on the part of various stakeholders, as well as a shared vision to promote child health via community and institutional stakeholder partnerships. This paper includes (1) examination of some key system features necessary for delivery of preventive services that improve child outcomes; (2) a review of the features of some common models of school health services for their relevance to prevention services; and (3) policy and implementation strategy recommendations to further the delivery of preventive services in schools. These recommendations include the development of common metrics for health outcomes reporting, facilitated data sharing of these metrics, shared organization incentives for integration, and improved reimbursement and funding opportunities.
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Substantial research has been dedicated to understanding the reasons for the dramatic rise in obesity rates in the U.S. in the last 2 decades. Animal studies and epidemiologic studies in children have suggested that air pollution might contribute to weight gain. This study investigates the association between ambient air pollution and weight gain over 16 years of follow-up (1995-2011) in a large cohort of African-American women in the U.S. ⋯ The results do not provide support for an association of air pollution with weight gain in African-American adult women.
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In 2012, the updated U.S. Department of Agriculture school meals standards and a competitive food law similar to the fully implemented version of the national Smart Snack standards went into effect in Massachusetts. This study evaluated the impact of these updated school meal standards and Massachusetts' comprehensive competitive food standards on school food revenues and school lunch participation. ⋯ Schools experienced initial revenue losses after implementation of the standards, yet longer-term school food revenues were not impacted and school meal participation increased among children eligible for reduced-price meals. Weakening the school meal or competitive food guidelines based on revenue concerns appears unwarranted.