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Biomedical subjects

Paul A Simon

Publications and source records attributed to Paul A Simon.

14 recordsLinked to original sources
PubMed2006

ZIP code correlates of HIV-testing: a multi-level analysis in Los Angeles.

In this study we examine how individuals' residential areas relate to their HIV-testing, regardless of individuals' characteristics. Data from a 1999 random probability sample of Los Angeles (LA) County adults (n = 5475) was used to conduct a multi-level analysis of HIV-testing among respondents in (1) all 233 ZIP codes and (2) the subset of regions with higher rates of higher-risk sex. Results showed that HIV-testing rates varied across individuals' residential ZIP codes. Throughout LA and in higher-risk regions, residents of areas containing concentrations of African Americans were more likely to test for HIV than residents of White or Latino areas, regardless of individuals' own race/ethnicity or the number of AIDS cases or testing sites in ZIP codes. However, residents of Latino areas were no more likely to test than residents of White areas. This is a concern because of increasing rates of HIV-infection among Latinos. We conclude that opportunities exist to increase testing in Latino higher-risk areas.

AIDS Serodiagnosis↗
PubMed2006

School-based physical fitness testing identifies large disparities in childhood overweight in Los Angeles.

Few data are available on the epidemic of childhood overweight in local jurisdictions. To determine the prevalence and identify demographic and socioeconomic correlates of childhood overweight, we assessed height and weight data on 281,630 Los Angeles County, CA, public school students collected during school-based physical fitness testing in 2001. Overweight prevalence was 20.6% overall and varied by race/ethnicity: 25.2% among Latinos, 20.0% among Pacific Islanders, 19.4% among blacks, 17.6% among American Indians, 13.0% among whites, and 11.9% among Asians. By using multilevel analysis, we found that school-level percentage of students enrolled in free or reduced-price meal programs was independently associated with overweight, after controlling for school-level median household income and student-level demographic characteristics. When local overweight prevalence data are unavailable, percentage enrollment in free or reduced-price meal programs might be a useful indicator to identify schools where focused overweight prevention and control interventions are most needed.

Adolescent↗
PubMed2006

Ethnic and sex variations in overweight self-perception: relationship to sedentariness.

OBJECTIVE: With increasing frequency, health promotion messages advocating physical activity are claiming weight loss as a benefit. However, messages promoting physical activity as a weight loss strategy may have limited effectiveness and cross-cultural relevance. We recently found self-perceived overweight to be a more robust correlate of sedentary behavior than BMI in Los Angeles County adults. In this study, we examined ethnic and sex differences in overweight self-perception and their association with sedentariness in this sample. RESEARCH METHODS AND PROCEDURES: We conducted bivariate and multivariate analyses of cross-sectional survey data from a representative sample of Los Angeles County adults. RESULTS: Women were more likely to perceive themselves to be overweight than men overall (73.2% of overweight/non-obese and 24.1% of average weight women vs. 44.5% of overweight/non-obese and 5.6% of average weight men) and within each ethnic group. African-Americans were least likely (41.3% of overweight/non-obese African-Americans self-identified as overweight) and whites were most likely to consider themselves overweight (60.6% of overweight/non-obese whites self-identified as overweight). Overweight (vs. average weight) self-perception was correlated with sedentariness among average weight adults (45.3% vs. 33.0%, p < 0.001), overweight adults (43.4% vs. 33.6%, p < 0.001), men (average and overweight: 38.4% vs. 27.8%, p < 0.001), overweight whites (41.9% vs. 29.7%, p = 0.0012), and African-Americans and Latinos (41.6% vs. 33.9%, p = 0.005). DISCUSSION: These data suggest that our society's emphasis on weight loss rather than lifestyle change may inadvertently discourage physical activity adoption/maintenance among non-obese individuals. However, further research is needed, particularly from prospective cohort and intervention studies, to elucidate the relationship between overweight self-perception and healthy lifestyle change.

Adult↗
PubMed2005

Obesity and longevity.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Risk factors for community-associated methicillin-resistant Staphylococcus aureus skin infections among HIV-positive men who have sex with men.

We investigated community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) skin infections among HIV-positive men who have sex with men. We performed a matched case-control study of 35 case patients and 76 control subjects. CA-MRSA skin infections were associated with high-risk sex and drug-using behaviors and with environmental exposures but not with immune status.

Adult↗
PubMed2005

Impact of restaurant hygiene grade cards on foodborne-disease hospitalizations in Los Angeles County.

Although health departments routinely inspect restaurants to assess compliance with established hygienic standards, few data are available on the effectiveness of these efforts in preventing foodborne disease. The study reported here assessed the impact on foodborne-disease hospitalizations in Los Angeles County of a restaurant hygiene grading system that utilized publicly posted grade cards. The grading systm was introduced in January 1998. Hospital discharge data on foodborne-disease hospitalizations were analyzed for Los Angeles County and, as a control, for the rest of California during the period 1993-2000. Ordinary least-squares regression analysis was done to measure the effect of the grading progam on these hospitalizations. After baseline temporal and geographic trends were adjusted for, the restaurant hygiene grading program was associated with a 13.1 percent decrease (p < .01) in the number of foodborne-disease hospitalizations in Los Angeles County in the year following implementation the program (1998). This decrease was sustained over the next two years (1999-2000). The results suggest that restaurant hygiene grading with public posting of results is an effective intervention for reducing the burden of foodborne disease.

Bacterial Infections↗
PubMed2004

Physical inactivity and overweight among Los Angeles County adults.

OBJECTIVES: The present study examines sociodemographic, health status, health behavioral, and health-related self-perception correlates of physical inactivity in a large, multiethnic urban population. METHODS: A random-digit-dialed telephone survey of a representative sample of 8353 Los Angeles County adults aged >/= 18 years was conducted between September 17, 1999 and December 31, 2000. Data were analyzed to assess the prevalence and identify independent correlates of physical inactivity, defined as <10 minutes of continuous physical activity weekly ("sedentary"). RESULTS: Overall, the prevalence of sedentary adults was 41%. Lower educational attainment, female gender, advancing age, non-U.S. birthplace, poorer self-perceived health status, self-perceived depression, smoking, leisure-time television watching/computer use, and receiving a diabetes diagnosis were significantly related to sedentariness in both bivariate and multivariate analyses. CONCLUSIONS: Mental and physical health status were prominent correlates of sedentariness. Lower socioeconomic class was also associated with sedentary behavior. Further research is needed to understand the relationship between self-perceived overweight and sedentary behavior.

Adult↗
PubMed2004

Prevalence and predictors of food insecurity among low-income households in Los Angeles County.

OBJECTIVES: To assess the prevalence and identify the predictors of food insecurity among households in Los Angeles County with incomes below 300% of the federal poverty level. METHODS: The Six-Item Short Form of the US Department of Agriculture's Household Food Security Scale was used as part of a 1999 county-wide, population-based, telephone survey. RESULTS: The prevalence of food insecurity was 24.4% and was inversely associated with household income. Other independent predictors of food insecurity included the presence of children in the household (odds ratio (OR) 1.7, 95% confidence interval (CI) 1.2-2.3) and a history of homelessness in the past five years (OR 5.6, 95% CI 3.4-9.4). CONCLUSION: Food insecurity is a significant public health problem among low-income households in Los Angeles County. Food assistance programmes should focus efforts on households living in and near poverty, those with children, and those with a history of homelessness.

Adult↗
PubMed2003

Prevalence of childhood asthma and associated morbidity in Los Angeles County: impacts of race/ethnicity and income.

Racial/ethnic and socioeconomic disparities in the prevalence of childhood asthma have been reported nationally but few population-based studies in local and regional settings have been reported. To assess variation in the prevalence of childhood asthma and associated morbidity across race/ethnic and income groups in the Los Angeles County population, we analyzed data on a random sample of 6004 children (< or = 17 years old) enrolled in a countywide health survey from September 1999 through April 2000. The prevalence of childhood asthma was highest in blacks (15.8%), intermediate in whites (7.3%) and Asians (6.0%), and lowest in Latinos (3.9%; p < 0.001). These differences persisted after controlling for income, measures of health care access, and other covariates. Asthma prevalence was inversely related to income in all racial/ethnic groups except Latinos from Spanish-speaking households. Among children with asthma, blacks and Latinos were more likely than whites to report asthma-related limitations in physical activity and need for urgent medical services. These findings indicate marked disparities in asthma prevalence and related morbidity in this large urban child population and highlight the importance of efforts to identify high-risk subpopulations for focused prevention and treatment interventions.

Adolescent↗
PubMed2002

HIV risk behaviors among African American men in Los Angeles County who self-identify as heterosexual.

There are limited data on high-risk behaviors among heterosexual African American men with HIV infection. Risk behaviors were examined in a case-control study of HIV-infected (n = 90) and uninfected (n = 272) African American men who self-identified as heterosexual. Of men who self-identified as heterosexual, 31% (n = 28) of the infected men and 16% (n = 43) of the uninfected men reported having had anal sex with men. Among the heterosexual men reporting anal sex with men, 100% of the infected and 67% of the uninfected men reported inconsistent condom use during anal sex with men. Few of the infected (12%) and uninfected (2%) men reported oral sex with other men. Of the men who self-identified as heterosexual, 46% of those who were HIV-positive and 37% of those who were HIV-negative reported anal sex with women with infrequent condom use. An increasing risk for HIV was associated with decreasing age at first sexual experience (chi2, 9.3; p = .002). A history of injecting drugs (odds ratio [OR], 3.1; 95% confidence intervals [CIs], 1.8, 5.4) and amphetamine (OR, 4.3; 95% CIs, 1.1, 16.7) and methamphetamine (OR, 2.9; 95% CIs, 1.4, 6.3) use were associated with HIV. Innovative HIV prevention strategies are needed that move beyond the traditional gay versus straight model to effectively access hard-to-reach African American men who self-identify as heterosexual.

Adult↗
PubMed2002

Developing a public health Web site: the Los Angeles County experience.

The use of the Internet in public health practice is becoming increasingly widespread. The Internet is an important tool for supporting the mission and core functions of local health departments. However, most local health departments have limited resources and technical capacity to develop, deploy, and encourage use of large and complex Web sites. In Los Angeles County, the local health department was able to build and expand public health information systems on the Internet with a limited investment of financial and technical resources. The development process, key functions, and key factors in the success of this effort are described.

Community Health Planning↗
PubMedDate not supplied

Assessing the burden of disease and injury in Los Angeles County using disability-adjusted life years.

OBJECTIVE: This study was designed to assess the burden of disease and injury in the Los Angeles County population using Disability-Adjusted Life Years (DALYs), a composite measure of premature mortality and disability that equates to years of healthy life lost. METHODS: DALYs, stratified by gender and race/ethnicity, were calculated for 105 health conditions and aggregated groups of conditions for the Los Angeles County population for 1997. Years of Life Lost (YLLs) were calculated using 1997 county mortality statistics and published life tables. Years Lived with Disability (YLDs) were derived from age- and gender-specific disease incidence and disability data from the Global Burden of Disease Study. RESULTS: DALYs produced a substantially different ranking of disease and injury burden than did mortality rates alone. The leading five causes of DALYs for males in the county were ischemic heart disease, violence, alcohol dependence, drug overdose and other intoxications, and depression. For females, the leading five causes were ischemic heart disease, alcohol dependence, diabetes, depression, and osteoarthritis. Differences in the rank order were also observed by race/ethnicity. The age-adjusted rate of DALYs for all health conditions combined was highest in African Americans (190 per 1,000), followed by American Indians (149 per 1,000), whites (113 per 1,000), Latinos (94 per 1,000), and Asians/Pacific Islanders (77 per 1,000). CONCLUSIONS: The DALYs measure is a promising new tool to improve the capacity of local health departments and other health agencies to assess population health and establish an evidence base for public health decisions.

Cause of Death↗
PubMedDate not supplied

Public health and business: a partnership that makes cents.

Historically, public health agencies have had relatively few formal partnerships with private business. However, both groups share an interest in ensuring a healthy population. Businesses have a financial interest in supporting organized public health efforts; in turn, business partnerships can increase the reach and effectiveness of public health. This paper makes the case for the business sector's participation in the broad public health system and its support of governmental public health agencies. Examples of past and current partnerships exemplify how public health efforts benefit business and suggest opportunities for future collaboration to improve the public's health.

Commerce↗