Wayne H Giles's research while affiliated with Centers for Disease Control and Prevention and other places

Publications (265)

Article
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Cardiovascular disparities remain pervasive in the United States. Unequal disease burden is evident among population groups based on sex, race, ethnicity, socioeconomic status, educational attainment, nativity, or geography. Despite the significant declines in cardiovascular disease mortality rates in all demographic groups during the last 50 years...
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Background: Although the overall life expectancy at birth has increased for both blacks and whites and the gap between these populations has narrowed, disparities in life expectancy and the leading causes of death for blacks compared with whites in the United States remain substantial. Understanding how factors that influence these disparities var...
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Problem/Condition: Persons living in rural areas are recognized as a health disparity population because the prevalence of disease and rate of premature death are higher than for the overall population of the United States. Surveillance data about health-related behaviors are rarely reported by urban-rural status, which makes comparisons difficult...
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Introduction: Five key health-related behaviors for chronic disease prevention are never smoking, getting regular physical activity, consuming no alcohol or only moderate amounts, maintaining a normal body weight, and obtaining daily sufficient sleep. The objective of this study was to estimate the clustering of these 5 health-related behaviors am...
Article
Objective: To determine variability of arthritis prevalence in 4 US population health surveys. Methods: We estimated annualized arthritis prevalence in 2011/12, among adults ≥ 20 years, using 2 definition methods, both based on self-report: 1) doctor/health care provider diagnosed arthritis in the Behavioral Risk Factor Surveillance Survey (BRFS...
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Mental health and sleep are intricately linked. This study characterized associations of psychological distress with short (≤6 hours) and long (≥9 hours) sleep duration among adults aged ≥18 years. 2013 Behavioral Risk Factor Surveillance System data ( n = 36 ,859) from Colorado, Minnesota, Nevada, Tennessee, and Washington included the Kessler 6...
Conference Paper
Background: Studies have linked adverse childhood experiences (ACE) to harmful health behaviors and the development of chronic diseases in adulthood. However, gender differences have not been comprehensively evaluated in a population-based sample. Methods: Using data from 15,844 women and 10,134 men aged ≥18 years in 4 states of the 2012 Behaviora...
Conference Paper
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Background: Improving mental health through prevention and increasing public knowledge of how adequate sleep improves health are Healthy People 2020 goals. Serious psychological distress (SPD) is associated with depression, anxiety, and mood disorders. However, it is not known whether SPD is linked to short sleep duration or long sleep duration in...
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Contemporary public health professionals must address the health needs of a diverse population with constrained budgets and shrinking funds. Economic evaluation contributes to evidence-based decision making by helping the public health community identify, measure, and compare activities with the necessary impact, scalability, and sustainability to...
Article
Objective: Insomnia is a prevalent disorder in the United States and elsewhere, has been associated with a range of somatic and psychiatric conditions, and adversely affects quality of life, productivity at work, and school performance. The objective of this study was to examine the trend in self-reported reported insomnia and excessive daytime sle...
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We assessed the relationship between active duty status and daily insufficient sleep in a telephone survey. U.S. military service status (recent defined as past 12 months and past defined as >12 months ago) and daily insufficient sleep in the past 30 days were assessed among 566,861 adults aged 18 to 64 years and 271,202 adults aged ≥65 years in th...
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PURPOSE: Adverse childhood experiences (ACEs) before age 18 have been repeatedly associated with several chronic diseases in adulthood such as depression, heart disease, cancer, diabetes, and stroke. We examined sex-specific relationships between individual ACEs and the number of ACEs with chronic obstructive pulmonary disease (COPD) in the general...
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Study Objective: To examine recent national trends in outpatient visits for sleep related difficulties in the United States and prescriptions for sleep medications. Design: Trend analysis. Setting: Data from the National Ambulatory Medical Care Survey from 1999 to 2010. Participants: Patients age 20 y or older. Measurements and Results: The num...
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Background: COPD remains a leading cause of morbidity and mortality. The objectives of this study were to estimate (1) national US COPD-attributable annual medical costs by payer (direct) and absenteeism (indirect) in 2010 and projected medical costs through 2020 and (2) state-specific COPD-attributable medical and absenteeism costs in 2010. Meth...
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The extent to which patients with COPD are receiving indicated treatment with medications to improve lung function and recent trends in the use of these medications is not well documented in the United States. The objective of this study was to examine trends in prescription medications for COPD among adults in the United States from 1999 to 2010....
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Abstract Recent trends in prescriptions for medicines used to treat chronic obstructive pulmonary disease (COPD) in the United States have received little attention. Our objective was to examine trends in prescribing practices for medications used to treat COPD. We examined data from surveys of national samples of office visits to non-federal emplo...
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Background: National spirometric surveillance data in the United States were last collected during 1988-1994. The objective of this study was to provide current estimates for obstructive and restrictive impairment of lung function and to examine changes since 1988-1994. Methods: We used data from 14,360 participants aged 20 to 79 years from the...
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BACKGROUND: This report updates surveillance results for chronic obstructive pulmonary disease (COPD) in the United States. METHODS: For 1999 to 2011, data from national data systems for adults aged ≥25 years were analyzed. RESULTS: In 2011, 6.5% of adults (∼13.7 million) reported having been diagnosed with COPD. From 1999 to 2011, the overall age-...
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Public health and clinical strategies for meeting the emerging challenges of multiple chronic conditions must address the high prevalence of lifestyle-related causes. Our objective was to assess prevalence and trends in the chronic conditions that are leading causes of disease and death among adults in the United States that are amenable to prevent...
Article
The Centers for Disease Control and Prevention (CDC) has long recognized that its major constituents, the state and local health departments, have the primary role for targeting resources and efforts to prevent and control disease. However, state and local level information about disease burden may be more relevant to local and state decision-maker...
Article
Chronic obstructive pulmonary disease (COPD) is a group of progressive, debilitating respiratory conditions, including emphysema and chronic bronchitis, characterized by difficulty breathing, lung airflow limitations, cough, and other symptoms. COPD often is associated with a history of cigarette smoking and is the primary contributor to mortality...
Article
To determine the optimum strategy for increasing up-to-date (UTD) levels in older Americans, while reducing disparities between White, Black, and Hispanic adults, aged 65 years and older. Data were analyzed from the 2008 Behavioral Risk Factor Surveillance System, quantifying the proportion of older Americans UTD with influenza and pneumococcal vac...
Article
Epidemiologists have long contributed to policy efforts to address health disparities. Three examples illustrate how epidemiologists have addressed health disparities in the United States and abroad through a "social determinants of health" lens. To identify examples of how epidemiologic research has been applied to reduce health disparities, we qu...
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The burden of preventable chronic diseases is straining our nation's health and economy. Diseases caused by obesity and tobacco use account for the largest portions of this preventable burden. CDC funded 50 communities in 2010 to implement policy, systems, and environmental (PSE) interventions in a 2-year initiative. Funded communities developed PS...
Article
People with type 2 diabetes may need insulin therapy to compensate for their underlying pathogenic abnormalities and to improve glycemic control. We examined trends of insulin use among US adults aged ≥40 years with type 2 diabetes. We analyzed data from the Behavioral Risk Factor Surveillance System collected annually during 1995-2007. Insulin use...
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Although differences in heart failure (HF) hospitalization rates by race and sex are well documented, little is known about geographic variations in hospitalizations for HF, the most common discharge diagnosis for Medicare beneficiaries. Using exploratory spatial data analysis techniques, the authors examined hospitalization rates for HF as the fir...
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Substantial racial/ethnic health disparities exist in the United States. Although the populations of racial and ethnic minorities are growing at a rapid pace, large-scale community-based surveys and surveillance systems designed to monitor the health status of minority populations are limited. CDC conducts the Racial and Ethnic Approaches to Commun...
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Much research has been conducted relating total carotenoids--and β-carotene in particular--to risk of cancer and cardiovascular disease (CVD). Limited data are emerging to implicate the important role of α-carotene in the development of CVD or cancer. We assessed the direct relationship between α-carotene concentrations and risk of death among 15,3...
Article
In 2002, the US Institute of Medicine (IOM) reached the conclusion ‘Disparities in health care are one of the nation's most serious health care problems. Research has extensively documented the pervasiveness of racial and ethnic disparities.’1 The disparities noted by the IOM are widespread. In the US, deaths from heart disease are 30% higher amon...
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ABSTRACT: After the publication of this work [1], we became aware that Table 5 incorrectly duplicated the information in Table 6. We have corrected this error and have inserted the correct Table 5 below.
Article
Although occupational factors have been associated with symptomatic ischemic heart disease, associations between job strain (low decision latitude and high psychological demands) and risk for subclinical atherosclerosis measured by coronary artery calcium (CAC) have not been assessed. CAC was measured in 3695 participants in the Coronary Artery Ris...
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We sought to assess the associations of testosterones and sex hormone-binding globulin (SHBG) with metabolic syndrome and insulin resistance in men. We defined metabolic syndrome according to the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Among men aged >or=20 yea...
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Microalbuminuria, a biomarker of endothelial dysfunction, is associated with increased cardiovascular, renal, and cerebrovascular morbidity and mortality, especially among ethnic minorities. A total of 16,567 adults in the National Health and Nutrition Examination Survey (NHANES) from 1999 through 2006 were categorized according to JNC 7 blood pres...
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We examined trends in smoking prevalence from 2002 through 2006 in 4 Asian communities served by the Racial and Ethnic Approaches to Community Health (REACH) intervention. Annual survey data from 2002 through 2006 were gathered in 4 REACH Asian communities. Trends in the age-standardized prevalence of current smoking for men in 2 Vietnamese communi...
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Problem: Chronic diseases (e.g., heart disease, cancer, stroke, and diabetes) are the leading causes of death in the United States. Controlling health risk behaviors (e.g., smoking, physical inactivity, poor diet, and excessive drinking) and using preventive health-care services (e.g., cancer, hypertension, and cholesterol screenings) can reduce mo...
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Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States and a major cause of morbidity and disability. To update national estimates and examine trends for hospitalization with COPD between 1990 and 2005, we analyzed data from the National Hospital Discharge Survey (NHDS). The results indicated that an...
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Strong relationships between exposure to childhood traumatic stressors and smoking behaviours inspire the question whether these adverse childhood experiences (ACEs) are associated with an increased risk of lung cancer during adulthood. Baseline survey data on health behaviours, health status and exposure to adverse childhood experiences (ACEs) wer...
Data
Table A1. Risk of death from lung cancer (× 1000-1 population) by age and number of categories of adverse childhood experiences.
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Relationships between cardiac murmurs detected during physical examination and coronary heart disease mortality among the general population are not well described. To assess the relationship between cardiac murmurs detected during physical examination and coronary heart disease mortality. This relationship was examined with Cox regression analyses...
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Strong, graded relationships between exposure to childhood traumatic stressors and numerous negative health behaviors and outcomes, healthcare utilization, and overall health status inspired the question of whether these adverse childhood experiences (ACEs) are associated with premature death during adulthood. This study aims to determine whether A...
Article
Little is known about the distributions of percentage body fat (PBF), total body fat (TBF), and fat-free mass (FFM) in the adult population in the United States. We sought to estimate the means and percentile cutoffs of PBF, TBF, and FFM and to assess the differences by sex, age, race-ethnicity, and body mass index in US adults. Data from the Natio...
Article
Higher risk and burden of stroke have been observed within the southeastern states (the Stroke Belt) compared with elsewhere in the United States. We examined reasons for these disparities using a large data set from a nationwide cross-sectional study. Self-reported data from the 2005 and 2007 Behavioral Risk Factor Surveillance System were used (n...
Article
Migraine with aura is a risk factor for ischemic stroke, but the mechanism by which these disorders are associated remains unclear. Both disorders exhibit familial clustering, which may imply a genetic influence on migraine and stroke risk. Genes encoding for endothelial function are promising candidate genes for migraine and stroke susceptibility...
Article
Highly controlled research projects demonstrated success in preventing and controlling cardiovascular diseases. Community-based programs have yet to demonstrate significant influence. Data on large-scale community-level interventions targeting minority communities are limited. The aim of this study is to measure the impact of the Racial and Ethnic...
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COPD represents an important public health challenge, in the US and globally, that is both preventable and treatable. We describe the average age at death from COPD, a leading cause of death in the US, using data from the National Vital Statistics System for the periods 1980-85, 1990-95, and 2000-05. Average age at death from COPD increased 3-4 yea...
Article
COPD represents an important public health challenge, in the US and globally, that is both preventable and treatable. We describe the average age at death from COPD, a leading cause of death in the US, using data from the National Vital Statistics System for the periods 1980–85, 1990–95, and 2000–05. Average age at death from COPD increased 3–4 yea...
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To assess the association between adverse childhood experiences (ACEs), including childhood abuse and neglect, and serious household dysfunction, and premature death of a family member. Because ACEs increase the risk for many of the leading causes of death in adults and tend to be familial and intergenerational, we hypothesized that persons who rep...
Article
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Chronic obstructive pulmonary disease (COPD) is a heterogeneous group of slowly progressive diseases characterized by airflow obstruction that interferes with normal breathing. In 2005, approximately one in 20 deaths in the United States had COPD as the underlying cause. Smoking is estimated to be responsible for at least 75% of COPD deaths. Excess...
Article
Although cigarette smoking is known to be a risk factor for ischemic stroke, there are few data on the dose-response relationship between smoking and stroke risk in a young ethnically diverse population. We used data from the Stroke Prevention in Young Women Study, a population-based case-control study of risk factors for ischemic stroke in women a...
Article
Behavioral risk factors such as smoking, poor diet, physical inactivity, and excessive drinking are linked to the leading causes of death in the United States. Controlling these behavioral risk factors and using preventive health services (e.g., influenza vaccinations and cholesterol screenings) can reduce morbidity and mortality in the U.S. popula...
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To assess the association of clusters of multiple cardiovascular disease (CVD) risk factors with health-related quality of life (HRQOL) among US adults aged 18 years or older in 2003. Data from the 2003 Behavioral Risk Factor Surveillance System were analyzed. The four HRQOL questions developed by the Centers for Disease Control and Prevention were...
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Chronic obstructive pulmonary disease (COPD) is an important cause of morbidity and mortality in the U.S. However, little is known about the influence of childhood stressors on its occurrence. Data were from 15,472 adult HMO members enrolled in the Adverse Childhood Experiences (ACE) Study from 1995 to 1997 and eligible for the prospective phase. E...
Article
Implantable cardioverter-defibrillators were first approved for use in the United States in 1985. Their efficacy in improving the survival of patients at risk for sudden cardiac death has been shown, and the number of patients eligible for ICDs has increased. Using data from the National Hospital Discharge Survey (NHDS), hospitalizations for the im...
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Prescription drugs account for approximately 11% of national health expenditures. Prior research on adverse childhood experiences (ACEs), which include common forms of child maltreatment and related traumatic stressors, has linked them to numerous health problems. However, data about the relationship of these experiences to prescription drug use ar...
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Although cigarette smoking is a well-established risk factor for vascular disease, the genetic mechanisms that link cigarette smoking to an increased incidence of stroke are not well understood. Genetic variations within the genes of the inflammatory pathways are thought to partially mediate this risk. Here we evaluate the association of several in...
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Increased C-reactive protein (CRP) concentration and insulin resistance (IR) are associated with increased rates of adverse cardiovascular events. We sought to examine the relationship of CRP with surrogate measures of IR among nondiabetic adults in the US. We conducted analyses using data from the National Health and Nutrition Examination Survey 1...
Article
Background and Objective: Limited studies have shown that elevated waist-to-thigh ratio (WTR) may be associated with increased risk of type 2 diabetes and ischemic heart disease. We sought to examine the association of WTR with history of cardiovascular diseases (CVD) among US adults. Methods: A total of 11,137 men and nonpregnant women aged 20 yea...
Article
Migraine with aura is associated with ischemic stroke, but few studies have investigated the clinical and anatomic features of this association. We assessed the association of probable migraine with and without visual aura with ischemic stroke within subgroups defined by stroke subtype, vascular territory, probable migraine characteristics, and oth...
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To examine relationships between childhood autobiographical memory disturbance (CAMD) and adverse childhood experiences (ACEs) which are defined as common forms of child maltreatment and related traumatic stressors. We use the ACE score (an integer count of eight different categories of ACEs) as a measure of cumulative exposure to traumatic stress...
Article
The purpose of this study was to evaluate the impact of new treatments by examining the changes between 1990 to 1991 and 2000 to 2001 in in-hospital mortality rates and hospital charges in adult patients with stroke. From the Nationwide Inpatient Survey, the largest all-payer inpatient care database in the United States, patients with stroke admitt...
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We sought to examine the association between clustering of multiple healthy lifestyle habits (HLHs) and health-related quality of life (HRQOL) among adults with diabetes. We analyzed the representative sample of the civilian, noninstitutionalized U.S. population aged > or = 18 years with diabetes using data from the 2005 Behavioral Risk Factor Surv...
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Mortality from coronary heart disease in the United States has decreased substantially in recent decades. We conducted a study to determine how much of this decrease could be explained by the use of medical and surgical treatments as opposed to changes in cardiovascular risk factors. We applied a previously validated statistical model, IMPACT, to d...
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Prescription drugs are one of the fastest growing healthcare costs in the United States. However, the long-term influence of child abuse and related traumatic stressors on prescriptions for psychotropic medications in adults has not been described. This study assessed the relationship of eight adverse childhood experiences (ACEs) to rates of prescr...
Article
Problem: Chronic diseases (e.g., heart disease, stroke, cancer, and diabetes) are the leading causes of morbidity and mortality in the United States. Engaging in healthy behaviors (e.g., quitting smoking and tobacco use, being more physically active, and eating a nutritious diet) and accessing preventive health-care services (e.g., routine physica...
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Recent studies have suggested that systolic blood pressure (BP) is a better predictor of stroke than diastolic BP in apparently healthy white men. Whether these relationships are similar for women and African Americans remains unclear. We used data from 6667 (3205 men; 3462 women) adults from the Second National Health and Nutrition Examination Sur...
Article
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BACKGROUND: Recent studies have suggested that systolic blood pressure (BP) is a better predictor of stroke than diastolic BP in apparently healthy white men. Whether these relationships are similar for women and African Americans remains unclear. METHODS: We used data from 6667 (3205 men; 3462 women) adults from the Second National Health and Nutr...