Chronic Disease

 

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Research Areas

Asthma

Nearly six million Californians suffer from asthma or asthma-like symptoms. Chronic Disease Program staff engage in collection, analysis, interpretation and dissemination of data about this prevalent chronic condition. Program research includes omnibus reporting of asthma prevalence and trends at the state, regional and county levels. We also examine disparities in asthma among vulnerable populations, such as children, racial/ethnic minorities, immigrants and the poor. Epidemiological studies include examinations of the relationship between severe asthma prevalence and social position (poverty level, age, gender, race and ethnicity), environmental exposure (traffic, air and other trigger pollutants near or in homes and schools), heath care (access to care, disease management, and patient-provider communications) and health behaviors (such as smoking, overweight/obesity). In conjunction with the Center’s Health Economics & Evaluation Research Program, evaluation studies have been conducted on access, utilization and quality of care among Medicare, MediCal and commercial enrollees with asthma. In addition to research, Program staff provide data and expertise to community health organizations to create policy and advocacy materials, such as a legislative briefing kit created with Community Action to Fight Asthma network.

Overweight and Obesity

More than half of California adults and one-fourth of adolescents are overweight or obese. Obesity increases the risk of serious medical conditions such as Type 2 diabetes, cardiovascular disease and stroke. To aid policymakers, health planners and advocates in addressing this serious problem, Chronic Disease Program staff conduct research on the prevalence of, and disparities in, obesity as well as the social and environmental factors that contribute to obesity. Recent research includes an examination of the strong link between obesity and income disparities. Program staff have also examined the link between obesity and neighborhood characteristics such as high concentrations of fast food restaurants and low concentrations of safe parks and recreational opportunities. The Program provides data and expertise to community organizations to create policy and advocacy materials, such as a “Retail Food Environment” index used to correlate the mix of fast-food food outlets in a given neighborhood with rates of diabetes and obesity. Program staff also provided customized maps of obesity prevalence and related neighborhood characteristics to local community groups in Los Angeles County.

Diabetes

Two million Californians have been diagnosed with diabetes and the disease, particularly Type 2 diabetes, is a growing problem in California and nationally. Program researchers investigate the prevalence, management and impact of diabetes in California, with emphasis on both omnibus reporting of broad demographic and geographic health trends as well as specific examinations of social and environmental influences, racial, ethnic, gender and age-based disparities, as well as diabetes disease management programs. Recent research has focused on the role food environments play in diabetes and obesity prevalence, care and management. In addition to research, Program staff also provide data and expertise to community organizations to create policy and advocacy materials, such as a “Retail Food Environment” index used to correlate the mix of food outlets in a given neighborhood with rates of diabetes and obesity. Program staff have also provided customized maps of diabetes prevalence and related neighborhood characteristics to local community groups in Los Angeles County.

Health Promotion and Disease Prevention

Chronic conditions such as heart disease, diabetes and obesity are among the most common and costly health problems. They are also among the most preventable. The Chronic Disease Program conducts research that focuses on promoting healthy living (more physical activity and better diet) and preventing the development of chronic diseases. Recent research has focused on the role of neighborhood characteristics in promoting or inhibiting physical activity and good dietary behaviors. Program staff have also examined the factors that promote and inhibit active transport (walking and biking) to school among adolescents. 

Healthy Environments

There is growing evidence that neighborhood, family and social environments are important contributors to health. The Chronic Disease Program conducts research aimed at identifying modifiable environmental characteristics linked with a variety of health outcomes such as obesity rates, asthma exacerbations, physical activity and consumption of soda and other sweetened beverages. Recent research projects have investigated the link between asthma and high-traffic environments, such as neighborhoods situated close to freeways. Program staff have also examined how high concentrations of fast food restaurants and low concentrations of safe, accessible parks and recreation centers are linked to rates of diabetes and obesity. The Program also provides data and expertise to community organizations to create policy and advocacy materials, such as a “Retail Food Environment” index used to correlate the mix of food outlets in a given neighborhood with rates of diabetes and obesity.

Data and Statistics

Local and state-level data and analyses that monitor the health of Californians provide critical information for policy makers and can be important tools for community health and advocacy groups. The Chronic Disease Program works to bridge the gap between data and analysis on the one hand and community groups and policy makers on the other. We apply a range of analytic tools and approaches including small area estimation, GIS and mapping and hierarchical modeling. Our researchers and staff regularly provide data and analyses to a wide range of community health and advocacy groups to inform their policy work. These groups include the California Center for Public Health Advocacy, the California Pan-Ethnic Health Network, Community Healthy Councils, Community Action to Fight Asthma, and California Food Policy Advocates. In addition, our staff have provided expert testimony to several legislative bodies including the California Senate Select Committee on Obesity and Diabetes, the California Senate Select Committee on Air Quality and Asthma in Central Valley, the Legislative Task Force on Diabetes and Obesity, and the National Association of Latino Elected and Appointed Officials (NALEO). 

Cancer

Early detection, healthy living and treatment are key to cancer prevention and survival. The Chronic Disease Program places particular emphasis on cancer screening and its role in preventing and surviving cancer. Our research includes examinations of racial and ethnic disparities in screening for breast, cervical, colorectal, prostate and other types of cancer and among a range of populations including Asian Americans, African Americans, Latinos and American Indians. The Program has also investigated the effect of physical fitness programs on cancer prevention; distress and social dysfunction following prostate cancer treatments; the use of complementary and alternative medicine among those with cancer; and, the use of the Human Papillomavirus vaccine.

Other Chronic Conditions

Program staff have investigated the prevalence of other chronic conditions, such as heart disease, hypertension, arthritis and chronic obstructive pulmonary disease (COPD).  In conjunction with the Center’s Health Economics & Evaluation Research Program, staff have conducted evaluations of the impact of disease management programs on HIV/AIDS, asthma, diabetes, heart disease and COPD. Researchers have approached these and other issues through both focused research as well as through cross-cutting research reports on health insurance and racial and ethnic disparities, among other topics.