Physical inactivity is a primary contributor to the obesity epidemic, but may be promoted or hindered by environmental factors. To examine how cumulative environmental quality may modify the inactivity-obesity relationship, we conducted a cross-sectional study by linking county-level Behavioral Risk Factor Surveillance System data with the Environmental Quality Index (EQI), a composite measure of five environmental domains (air, water, land, built, sociodemographic) across all U.S. counties. We estimated the county-level association (N = 3,137 counties) between 2009 age-adjusted leisure-time physical inactivity (LTPIA) and 2010 age-adjusted obesity from BRFSS across EQI tertiles using multi-level linear regression, with a random intercept for state, adjusted for percent minority and rural-urban status. We modelled overall and sex-specific estimates, reporting prevalence differences (PD) and 95% confidence intervals (CI). In the overall population, the PD increased from best (PD = 0.341 (95% CI: 0.287, 0.396)) to worst (PD = 0.645 (95% CI: 0.599, 0.690)) EQI tertile. We observed similar trends in males from best (PD = 0.244 (95% CI: 0.194, 0.294)) to worst (PD = 0.601 (95% CI: 0.556, 0.647)) quality environments, and in females from best (PD = 0.446 (95% CI: 0.385, 0.507)) to worst (PD = 0.655 (95% CI: 0.607, 0.703)). We found that poor environmental quality exacerbates the LTPIA-obesity relationship. Efforts to improve obesity through LTPIA may benefit from considering this relationship.

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The association between physical inactivity and obesity is modified by five domains of environmental quality in U.S. adults: A cross-sectional study.

Factors impacting trauma treatment practice patterns: the convergence/divergence of science and practice.

We examine the emergence and proliferation of payday lenders, fringe businesses that provide small short-term, but high-cost loans. We link the organizational dynamics of these businesses to two trends in consumer lending in the United States: the continuing consolidation of mainstream financial institutions; and the expansion of such institutions in the provision of financial services regarded as similar to payday loans. We explain the coexistence in mature industries of large-scale organizations in the market center and smaller specialists in the periphery by testing and extending the organizational model of resource partitioning. Our focus is on two under-examined aspects of the model: the dynamic underlying the partitioning process, and the conditions under which the market remains partitioned. The empirical analysis covers payday lenders, banks, and credit unions operating in Wisconsin between 1994 and 2008.

Resource Partitioning and the Organizational Dynamics of "Fringe Banking"

The expanding literature on the delivery of health and human services in rural environments is replete with assertions about the "differences" between rural and urban practice [ 1-6]. Researchers, service providers, and policymakers have all assailed the urban bias of the dominant models, structures, and strategies for service delivery and have testified to their inappropriateness for a rural environment. It has been argued that successful practice in small towns and rural communities requires a unique set of skills and knowledge (or at least a reordering of skills). Further, it has been maintained that traditional preservice programs for mental health providers have an urban bias. Much of this rhetoric, however, has been ambiguous and abstract and has not led to a clear articulation of those aspects of rural practice that are unique. Most work in this area to date has been speculative or based on the personal observations of individual practitioners. Empirical verification of any "differences" remains, for the most part, a goal to be achieved.

Distinctive features of rural environments: a frame of reference for mental health practice

https://pdxscholar.library.pdx.edu/cgi/viewcontent.cgi?article=1260&context=sph_facpub

Associations between environmental quality and adult asthma prevalence in medical claims data.

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Fred K. Hines

Papers

Social and Economic Characteristics of the Population in Metro and Nonmetro Counties, 1970. Agricultural Economic Report No. 272.