Vincent L. Mendy

Racial differences in ideal cardiovascular health metrics among Mississippi adults, 2009 Mississippi Behavioral Risk Factor Surveillance System.

Introduction Cardiovascular disease is a leading cause of death and health disparities in Mississippi. Identifying populations with poor cardiovascular health may help direct interventions toward those populations disproportionately affected, which may ultimately increase cardiovascular health and decrease prominent disparities. Our objective was to assess racial differences in the prevalence of cardiovascular health metrics among Mississippi adults. Methods We used data from the 2009 Mississippi Behavioral Risk Factor Surveillance System to determine age-standardized prevalence estimates and 95% confidence intervals of cardiovascular health metrics among 2,003 black and 5,125 white adults. Logistic regression models were used to evaluate the relationship between race and cardiovascular health metrics. The mean cardiovascular metrics score and percentage of the population with ideal and poor cardiovascular health were calculated by subgroup. Results Approximately 1.3% of blacks and 2.6% of whites exhibited ideal levels of all 7 cardiovascular health metrics. The prevalence of 4 of the 7 cardiovascular health metrics was significantly lower among the total population of blacks than among whites, including a normal body mass index (20.8% vs 32.3%, P < .001), no history of diabetes (85.1% vs 91.3%, P < .001), no history of hypertension (53.9% vs 67.9%, P < .001), and physical activity (52.8% vs 62.2%, P < .001). The logistic regression models revealed significant race-by-sex interactions; differences between blacks and whites for normal body mass index, no history of diabetes mellitus, and no current smoking were found among women but not among men. Conclusion Cardiovascular health is poor among Mississippi adults overall, and racial differences exist.

Trends in major risk factors for cardiovascular disease among adults in the Mississippi Delta region, Mississippi Behavioral Risk Factor Surveillance System, 2001-2010.

Introduction The prevalences of major modifiable risk factors for cardiovascular disease (CVD) are disproportionately high in the 18-county Mississippi Delta region, and many of these risk factors disproportionately affect blacks. Temporal trends in the prevalence of CVD risk factors in the Mississippi Delta have not been determined. We examined trends in CVD risk factors from 2001 to 2010 in the region. Methods Longitudinal trends in prevalence of high blood pressure, high cholesterol, diabetes, obesity, physical inactivity, and current smoking were investigated using self-reported data from the Behavioral Risk Factor Surveillance System. Joinpoint regression models were used to examine annual percentage change (APC) in the prevalence of these risk factors. Results Overall, from 2001 to 2010, we observed significant increases in the prevalence of high cholesterol (APC, 4.22%), obesity (APC, 3.65%), and diabetes (APC, 3.54%). Among blacks, we found significant increases in the prevalence of high cholesterol (APC, 3.41%), obesity (APC, 3.48%), and diabetes (APC, 4.96%). Among whites, we found significant increases in high blood pressure (APC, 2.18%), high cholesterol (APC, 4.78%), obesity (APC, 4.18%), and physical inactivity (APC, 3.06%). We also observed a significant decrease in smoking among whites (APC, −1.99%). Conclusion From 2001 to 2010, we found a significant increase in the prevalence of high cholesterol, diabetes, and obesity in the Mississippi Delta. We also observed racial differences in those prevalences.

Trends in Heart Disease Mortality among Mississippi Adults over Three Decades, 1980-2013.

Heart disease (HD) remains the leading cause of death among Mississippians; however, despite the importance of the condition, trends in HD mortality in Mississippi have not been adequately explored. This study examined trends in HD mortality among adults in Mississippi from 1980 through 2013 and further examined these trends by race and sex. We used data from Mississippi Vital Statistics (1980–2013) to calculate age-adjusted HD mortality rates for Mississippians age 25 or older. Cases were identified using underlying cause of death codes from the International Classification of Diseases, Ninth Revision (ICD-9: 390–398, 402, 404–429) and Tenth Revision (ICD-10), including I00-I09, I11, I13, and I20-I51. Joinpoint software was used to calculate the average annual percent change in HD mortality rates for the overall population and by race and sex. Overall, the age-adjusted HD mortality rate among Mississippi adults decreased by 36.5% between 1980 and 2013, with an average annual percent change of -1.60% (95% CI -2.00 to -1.30). This trend varied across subgroups: HD mortality rates experienced an average annual change of -1.34% (95% CI -1.98 to -0.69) for black adults; -1.60% (95% CI -1.74 to -1.46) for white adults; -1.30% (95% CI -1.50 to -1.10) for all women, and -1.90% (95% -2.20 to -1.50) for all men. From 1980 to 2013, there was a continuous decrease in HD mortality among adult Mississippians. However, the magnitude of this reduction differed by race and sex.

Overweight, Obesity, and Extreme Obesity Among Mississippi Adults, 2001–2010 and 2011–2015

Introduction In 2015, about 1.5 million adults in Mississippi were overweight or obese. Obesity is associated with increased risk for diabetes and cardiovascular problems. We examined trends in the prevalence of overweight, obesity, and extreme obesity from 2001 through 2010 and 2011 through 2015. Methods We used data from the Mississippi Behavioral Risk Factor Surveillance System to analyze trends in the prevalence of overweight, obesity, and extreme obesity among adults from 2001 through 2010 and 2011 through 2015. Joinpoint software was used to examine annual percentage change (APC) in the prevalence of each condition overall and by sex and race. Results We observed a significant decrease in overweight prevalence from 2001 to 2010, both overall (APC, −1.3%) and among men (APC, −2.0%), blacks (APC, −1.0%), and whites (APC, −1.5%), but not among women. The overall prevalence of both obesity (APC, 2.9%) and extreme obesity (APC, 3.6%) increased significantly, and these increases occurred across all subgroups for both obesity (men APC, 3.5%; women APC, 2.5%; blacks APC, 1.9%; and whites APC, 3.8%) and extreme obesity (men APC, 6.7%; women APC, 2.5%; blacks APC, 2.2%; and whites APC, 5.0%). From 2011 to 2015, the only significant change was an increase in the prevalence of extreme obesity among whites (APC, 2.6%). Conclusion The increasing proportion of adult Mississippians in the 2 highest-risk BMI categories warrants urgent community and clinical obesity interventions. Community-tailored and sustained obesity prevention, treatment, and control programs that include diet and physical activity are needed to address the obesity epidemic.

Planning for the Strategic Recruitment of Barbershops for Blood Pressure Screening and Referral in the Mississippi Delta Region

Figure. Planning for the strategic recruitment of barbershops for blood pressure screening and referral in the Mississippi Delta region. The maps show heart disease death rates by county and concentrations of adult black men at census block group level and locations of partner and potential partner barbershops. Together these maps help public health professionals identify communities that may be interested in improving hypertension awareness and treatment among black men by participating in the B.R.O.T.H.E.R.S. initiative to provide blood pressure screenings at barbershops. Heart disease is defined by the International Classification of Diseases, 10th edition, categories I11, I13, and I20 through I51 (2). [A text description of this map is also available.] The 18-county Mississippi Delta region covers approximately 11,000 square miles of the northwest part of the state of Mississippi between the Mississippi and Yazoo rivers. In 2010, its population was 554,754; 49.7% of residents were black, and 46.9% were white (1). Heart disease and stroke are the second and fourth leading causes of death among black men in the region (2). blood pressure is a risk factor for heart disease and stroke and disproportionately affects black men (4); the prevalence of high blood pressure is higher among black men than among other racial/ethnic groups in the state (5). Efforts to reduce heart disease and stroke prevalence and disparities include prevention, early detection, and awareness of high blood pressure among high-risk and hard-to-reach populations. The Mississippi Delta Health Collaborative (MDHC) is a 5-year cooperative agreement between the Centers for Disease Control and Prevention (CDC) and the Mississippi State Department of Health designed to prevent heart disease, stroke, and related chronic diseases in the Mississippi Delta region. MDHC is implementing programs that target high blood pressure and hypertension prevention among at-risk populations in the Mississippi Delta region. One such program is the Barbers Reaching Out to Help Educate on Routine Screenings (B. screen adult black men in the Mississippi Delta region, thereby increasing awareness of high blood pressure, and to refer clients with high blood pressure to a health care provider. Clients who are screened are provided resources on identifying local health care providers and education materials for promoting lifestyle changes and are encouraged to schedule routine checkups with a health care provider to monitor their overall health. in partnership with a local community-based organization (Mississippi Action for Community Education, Inc), barbers were recruited by MDHC through a request-for-proposal process and …

Food Insecurity and Cardiovascular Disease Risk Factors among Mississippi Adults

Background: Food insecurity is a public health problem. There is limited data on food insecurity in Mississippi. Methods: We analyzed data from the 2015 Mississippi Behavioral Risk Factor Surveillance System, which included the Social Context Module for 5870 respondents. Respondents who indicated that in the past 12 months they were “always”, “usually”, or “sometimes” “worried or stressed about having enough money to buy nutritious meals” were considered food insecure. Food insecurity was compared across sociodemographic and health characteristics using chi-square tests, and the association between food insecurity and select cardiovascular disease risk factors was assessed using logistic regression. Results: The prevalence of food insecurity was 42.9%. Compared to the referent group, Mississippi adults with high blood pressure had 51% higher odds, those with diabetes had 30% higher odds, those who were not physically active had 36% higher odds, and those who consumed fewer than five fruits and vegetables daily had 50% higher odds of being food insecure. Conclusion: Among Mississippi adults, food insecurity is associated with high blood pressure, diabetes, obesity, fruit and vegetable consumption, physical inactivity, and smoking.

Aspirin for Prevention of Cardiovascular Disease

We used data from the 2013 Mississippi Behavioral Risk Factor Surveillance System to examine aspirin use for the prevention of primary and secondary cardiovascular disease (CVD), based on the 2009 US Preventive Services Task Force (USPSTF) guidelines, among Mississippi men (aged 45–79 y) and women (aged 55–79 y) and to explore differences in aspirin use by sociodemographic characteristics. Among those without CVD, 39.1% of men and 45.9% of women reported taking aspirin, and among those with CVD, 85.9% of men and 85.1% of women reported taking aspirin. Data on preventive use of aspirin by sociodemographic characteristics yielded mixed results.

Association Between Consumption of Sugar-Sweetened Beverages and Sociodemographic Characteristics Among Mississippi Adults

Introduction The consumption of sugar-sweetened beverages (SSBs) is linked to excessive weight gain, diabetes, and risk of cardiovascular disease. We examined the association between SSB consumption and sociodemographic characteristics among Mississippi adults. Methods We used data from the 2012 Mississippi Behavioral Risk Factor Surveillance System, which collected information on SSB consumption from 7,485 respondents. We used logistic regression models to calculate adjusted prevalence ratios (APRs) and 95% confidence intervals (CIs) for characteristics associated with SSB consumption. Results In 2012, 40.8% of Mississippi adults reported consuming at least one SSB daily. The likelihood of consuming SSBs at least once daily among respondents aged 18 to 34 years was 2.81 times higher (APR, 2.81; 95% CI, 2.49–3.18) than among those aged 65 years or older. The prevalence among men was 20% higher (APR, 1.20; 95% CI, 1.11–1.30) than among women and 23% higher (APR, 1.23; 95% CI, 1.13–1.35) among black respondents than among white respondents. The prevalence among respondents with less than a high school education was 25% higher (APR, 1.25; 95% CI, 1.11–1.41) than among those who with more than a high school education and 33% higher (APR, 1.33; 95% CI, 1.16–1.52) among those with an annual household income of less than

Electronic Cigarette Use among Mississippi Adults, 2015

20,000 than among those with an income of

Trends in mortality rates by subtypes of heart disease in Mississippi, 1980–2013

50,000 or more. Conclusion Among Mississippi adults, age, sex, race, education level, and income are associated with an increased likelihood of SSB consumption. Findings highlight the need for policies and interventions to address SSB consumption and promote alternatives to SSBs among Mississippians.