Factors Associated with Physician Discussion of Health Behaviors with Adolescents

Behaviors developed in adolescence influence health later in life. The purpose of this study was to investigate the frequency of health care provider's discussion of health behaviors with overweight and non-overweight adolescents and identify demographic and health behaviors related to exercise, hours of television viewing, and weight issues associated with these discussions. A Cross sectional survey of urban adolescents was conducted. Trained interviewers administered surveys over a three month period in 2001 at an urban academic pediatric and adolescent clinic. The 252 adolescents surveyed had a mean age of 15 with 49% categorized as being at risk for overweight/overweight and 51% as normal weight using the CDC percentiles for BMI. While 16% of the adolescents reported that their physician or nurse discussed the amount of television they watched, rates of discussion related to exercise (58%), and weight (54%) were much higher. In multivariate analyses, health care provider discussions with adolescents regarding exercise were more common for overweight (O.R.=2.42, 95% C.I. [1.28–4.57]) and at risk for overweight (O.R.=1.98, 95% C.I. [1.03–3.81]) adolescents, whereas physician discussion of television viewing was not associated with weight. Discussions of weight were more common for female (O.R.=2.18, 95% C.I. [1.21–3.95]), African-American (O.R.=2.53, 95% C.I. [1.40–4.57]), and overweight (O.R.=3.92, 95% C.I. [1.97–7.81]) adolescents. Even after adjusting for weight, race and gender strongly influenced the frequency of discussions about weight in physician offices. Although health care providers frequently address weight and exercise with adolescents, more discussions related to sedentary behaviors such as television viewing may be warranted to address adolescent obesity.Received PhD in Epidemiology from University of California, San Diego. Research interests include smoking prevention and cessation among adolescents and health promotion interventions.Received MD from University of Missouri-Kansas City and MPH from Johns Hopkins University. Research interests include health services research and research in support of measurable, systematic improvements in the quality of medical care.Received medical degree from Christian Medical College, Punjab, India and Master of Public Health from University of Kansas School of Medicine. Research interests include diet and physical activity behaviors, role of the environment in obesity and obesity prevention, especially among children and adolescents.Received MBBS from Allama Iqbal Medical College, Punjab University, Lahore, Pakistan and MPH from University of Kansas Medical Center. Research interests include smoking cessation, database design, implementation, data management and analysis, and use of information technology in health care settings.Director, Cancer Prevention, Control, and Population Sciences, Kansas Cancer Institute. Received MD/MPH from Tulane University and MS from Harvard School of Public Health. Research interests include disparities in healthcare; smoking cessation among underserved populations, specifically African Americans; diet, nutrition, obesity, and physical activity.     

An insurer's perspective on reform

Individual health insurance markets differ from state to state, and as a result approaches to individual market reforms need to be different. In evaluating approaches, policy makers need to remember that since the decision to purchase health insurance coverage is voluntary, the potential for adverse selection exists. In addition, rather than putting the focus of individual market reforms almost exclusively on access to health insurance for a small number of persons with high-cost health conditions, more attention needs to be put on how to decrease the number of uninsured persons. This includes making the premiums paid for individual health insurance 100 percent tax deductible, similar to those of employer-based health insurance. Finally, market reforms need to treat all types of coverage issued in the individual market the same, whether they are purchased direct for the insurer or through an out-of-state association.     

Silent citizenship among Asian Americans and Latinos: opting out or left out?

In his classic study, Who Governs?, Robert Dahl interpreted the patterns of political assimilation of ‘white ethnic’ immigrants and their children during the mid-twentieth century as a hopeful sign of the potential of democratic pluralism in the USA. While acknowledging that immigrant groups faced discrimination and structural barriers that might lead them to be silent, Dahl predicted that social mobility and assimilation would eventually erase these deficits in political participation among immigrants. Building from Dahl's analysis, we investigate the extent to which pluralism in the USA can and does work the same way for immigrants who are also racial minorities. We highlight factors that can lead these groups to become silent citizens, including lack of legal status, lower levels of political mobilization by institutions, and discrimination as structural impediments to minority participation. Our findings suggest that both resources as well as structural impediments structure the political behavior of Asian Americans and Latinos, determining whether they are vocal citizens or silent citizens.     

Cost and the calculus of voting

Downs's (1957) theory of voting maintains that individuals balance the costs of voting against anticipated benefits in deciding whether to vote. However, most empirical tests of his theory have concluded that costs play little role in individuals' decisions to vote or abstain, and that benefits are the determining factor. Unfortunately, the existing empirical tests of the theory have been inadequate, especially in regard to the measurement of the cost of voting. Using data from the Comparative State Elections Project, we develop an improved indicator of the cost of voting. When this measure of cost is used in a test of Down's theory, we find, contrary to most earlier research, that the cost of voting seems to be a more important determinant of participation than the factors associated with voting benefits in Downs's model.The authors shared equally in the research reported; the order in which they are listed was determined randomly.     

小城镇服务业人才培养问题研究

劳动力市场人才资源的配置问题是小城镇服务业发展中急需解决的重要问题之一。本文从用人单位满意度分析的基础上,采用模糊综合评价法对当前小城镇服务业劳动力需求与人才培养对接问题现状进行了评价,发现劳动力市场人才资源的配置与人才培养供给之间出现了严重的失衡。人才培养只有遵循劳动力市场需求,动态地调整培训方案与体系,才能够健康持续地发展。