Relationship between community prevalence of obesity and associated behavioral factors and community rates of influenza-related hospitalizations in the United States

Children's Hospital Informatics Program, Children's Hospital Boston, Boston, MA, USA Division of General Pediatrics, Department of Medicine, Children's Hospital Boston, Harvard Medical School, Boston, MA, USA Surveillance Lab, McGill Clinical and Health Informatics, McGill University, Montreal, Canada Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada Agence de la santé et des services sociaux de Montréal, Direction de santé publique, Montreal, Canada Department of Community and Family Medicine, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA Agency for Healthcare Research and Quality, Rockville, MD, USA Division of Science and Environmental Policy, California State University, Monterey Bay, Seaside, CA, USA NASA Ames Research Center, Moffett Field, Sunnyvale, CA, USA.
Influenza and Other Respiratory Viruses (Impact Factor: 2.2). 11/2012; 7(5). DOI: 10.1111/irv.12019
Source: PubMed


Background: Findings from studies examining the association between obesity and acute respiratory infection are inconsistent. Few studies have assessed the relationship between obesity-related behavioral factors, such as diet and exercise, and risk of acute respiratory infection. Objective To determine whether community prevalence of obesity, low fruit/vegetable consumption, and physical inactivity are associated with influenza-related hospitalization rates. Methods Using data from 274 US counties, from 2002 to 2008, we regressed county influenza-related hospitalization rates on county prevalence of obesity (BMI≥30), low fruit/vegetable consumption (<5servings/day), and physical inactivity (<30minutes/month recreational exercise), while adjusting for community-level confounders such as insurance coverage and the number of primary care physicians per 100000 population. Results A 5% increase in obesity prevalence was associated with a 12% increase in influenza-related hospitalization rates [adjusted rate ratio (ARR) 1·12, 95% confidence interval (CI) 1·07, 1·17]. Similarly, a 5% increase in the prevalence of low fruit/vegetable consumption and physical inactivity was associated with an increase of 12% (ARR 1·12, 95% CI 1·08, 1·17) and 11% (ARR 1·11, 95% CI 1·07, 1·16), respectively. When all three variables were included in the same model, a 5% increase in prevalence of obesity, low fruit/vegetable consumption, and physical inactivity was associated with 6%, 8%, and 7% increases in influenza-related hospitalization rates, respectively. Conclusions Communities with a greater prevalence of obesity were more likely to have high influenza-related hospitalization rates. Similarly, less physically active populations, with lower fruit/vegetable consumption, tended to have higher influenza-related hospitalization rates, even after accounting for obesity.

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Available from: David L Buckeridge, Oct 09, 2014
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    ABSTRACT: We examined population-based surveillance data from the Tennessee Emerging Infections Program to determine whether neighborhood socioeconomic status was associated with influenza hospitalization rates. Hospitalization data collected during October 2007-April 2014 were geocoded (N = 1,743) and linked to neighborhood socioeconomic data. We calculated age-standardized annual incidence rates, relative index of inequality, and concentration curves for socioeconomic variables. Influenza hospitalizations increased with increased percentages of persons who lived in poverty, had female-headed households, lived in crowded households, and lived in population-dense areas. Influenza hospitalizations decreased with increased percentages of persons who were college educated, were employed, and had health insurance. Higher incidence of influenza hospitalization was also associated with lower neighborhood socioeconomic status when data were stratified by race.
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