Scott Shimotsu - Academia.edu (original) (raw)

Papers by Scott Shimotsu

Sosiaalilaaketieteellinen Aikakauslehti, 2010

Families, Systems, & Health, 2016

The health status and psychosocial needs of the Medicaid expansion population have been estimated... more The health status and psychosocial needs of the Medicaid expansion population have been estimated but not measured. This population includes childless adults predicted to have high rates of mental illness, especially among the homeless. Given limitations in access to mental health services, it is unclear how prepared the U.S. health care system is to care for the needs of the expansion population. Using enrollment and claims data from the Minnesota Department of Human Services, this study presents prevalence rates of mental illness diagnoses and measures of unstable housing in Minnesota's childless-adult early Medicaid expansion population. Rates are compared with prior predictions of serious psychological distress and mental illness constructed from the National Survey on Drug Use and Health (NSDUH) using χ2 and t tests. Diagnoses of mental illness in Minnesota's childless-adult early Medicaid expansion population were more than 15% higher than prevalence measures of mental illness/distress for the current Medicaid population. Diagnosis rates fell within confidence intervals of estimates of mental illness for Minnesota's Medicaid expansion population. Almost 1 in 3 enrollees had a marker of unstable housing; of this group, half had mental illness and/or distress. Findings support predictions of the high burden of mental illness and unstable housing among the Medicaid expansion population. Minnesota offers lessons to other regions working to care for such populations: (a) the use of flexible financing structures to build integrated care systems and (b) passage of legislation to allow data sharing among mental health, social services, and medical care. (PsycINFO Database Record

Journal of primary care & community health, Jan 18, 2015

Missed appointments have been linked to adverse outcomes known to affect racial/ethnic minorities... more Missed appointments have been linked to adverse outcomes known to affect racial/ethnic minorities. However, the association of missed appointments with race/ethnicity has not been determined. We sought to determine the relationships between race/ethnicity and missed appointments by performing a cross-sectional study of 161 350 patients in a safety net health system. Several race/ethnicity categories were significantly associated with missed appointment rates, including Hispanic/Latino patients, American Indian/Alaskan Native patients, and Black/African American patients, as compared with White non-Hispanic patients. Other significant predictors included Mexico as country of origin, medical complexity, and major mental illness. We recommend additional research to determine which interventions best reduce missed appointments for minority populations in order to improve the care of vulnerable patients.

International Journal of Behavioral Nutrition and Physical Activity, 2008

Background: There is overwhelming evidence of the benefits of physical activity and the physical ... more Background: There is overwhelming evidence of the benefits of physical activity and the physical environment is increasingly recognized as a promising determinant of physical activity participation. The influence of the environment on physical activity has not been evaluated among black Africans and no specific measure exists for assessing environmental factors related to physical activity in an African environment. The IPAQ E-module was designed to assess environmental factors for physical activity participation and was considered to be relevant to all countries regardless of the stage of economic development. The objective of this study was to assess the testretest reliability of IPAQ E-module in an African population. Methods: One hundred and three clinical students of a University in Nigeria were invited to participate in the reliability testing of IPAQ E-module. Sixteen of the 17-items on the environmental measure were assessed for test-retest reliability using intraclass correlation coefficient (ICC) with 95% Confidence interval (CI) overall and by gender. The measure addressed items regarding residential density, access to destinations, neighborhood infrastructures, aesthetic qualities, social environment, street connectivity and neighborhood safety. Results: Of the total respondents, 51.5% were males and 48.5% were females. Overall, the intraclass correlation coefficient (ICC) ranged from 0.43 to 0.91. The item regarding many interesting things to look at (aesthetic) produced the overall highest reliability score (ICC = 0.91, 95% CI = 0.86-0.94), while the item regarding safety from crime during the day (neighborhood safety) produced the lowest overall score (ICC = 0.43, 95% CI = 0.26-0.57). Reliability of items on neighborhood infrastructures ranged between substantial agreement to almost perfect agreement overall (ICC = 0.66-0.88) and by gender (male-ICC = 0.68-0.90 and female-ICC = 0.63-0.86). The access to destination items (ICC = 0.49-0.74), social environment (ICC = 0.62) and street connectivity (ICC = 0.78) all had acceptable reliability overall. Meaningful differences were found between males and females on two items on neighborhood safety and one item on access to destinations. Conclusion: The test-retest of IPAQ E-module resulted in moderate to almost perfect agreement for most of the items with few meaningful differences by gender. Environmental items of physical activity in an African population exhibited reliability similar to that in other environments. These results suggest that IPAQ E-module may be a useful measure for assessing environmental correlates of physical activity among population in Africa.

BackgroundLow back pain (LBP) is prevalent, management benefits from high-quality clinical practi... more BackgroundLow back pain (LBP) is prevalent, management benefits from high-quality clinical practice guidelines, and yet LBP is a common source of low value care. The purpose of this retrospective cohort study was to examine the association between the type of initial contact health care provider (HCP), service utilization, and total episode cost for the management of LBP.MethodsEpisode of care was used to analyze a US national sample of LBP episodes completed in 2017-2019. A combined surgical and non-surgical (pooled) sample and a non-surgical sample were separately analyzed. The primary independent variable was the type of the initial contact HCP. Dependent measures included rate and timing of use of 14 types of health care services and total episode cost. The association between initial contact HCP, total episode cost and rate of prescription opioid and NSAID use was tested using a mixed effects model.ResultsThe study included 616,766 continuously insured individuals aged 18 years...

Emerging Infectious Diseases

Journal of community health, Jan 22, 2017

Immigrants and refugees are less likely to meet diabetes management goals than the general US pop... more Immigrants and refugees are less likely to meet diabetes management goals than the general US population. Those with limited English proficiency (LEP) and who need interpreter services (IS) for health care encounters, maybe at higher risk for encountering barriers to optimal diabetes management, and while most receive diabetes care in primary care settings, little is known about the association between IS need and diabetes outcomes. This study aims to determine adherence with diabetes process and outcomes measures among LEP patients in primary care settings, and is a retrospective cohort study of patients with type II diabetes at two large primary care networks in Minnesota from January 1, 2012 through December 31, 2013. Diabetes outcome measure goals were defined as hemoglobin A1C <8%, LDL-C <100 mg/dL, and blood pressure <140/90 mmHg. Process measure goals were defined as hemoglobin A1C measured within the previous 6 months and LDL cholesterol (LDL-C) measured within the ...

ABSTRACT Purpose: The neighborhoods where people live can shape the dietary and alcohol choices t... more ABSTRACT Purpose: The neighborhoods where people live can shape the dietary and alcohol choices they make. Poor neighborhoods tend to have fewer resources for promoting good health, but it is not know whether neighborhood access to food and alcohol are related, and whether the relationship between food and alcohol access differs by socioeconomic status. The purpose of this study is to examine whether access to supermarkets and grocery stores is associated with access to liquor stores and whether this relationship differs by neighborhood socioeconomic status. Methods: Data for this study were drawn from the U.S. Census and InfoUSA Business Datasets (2002) which were linked by census tract areas. Neighborhoods were defined as census tracts within Hennepin County, Minnesota. Census 2000 was used to assess neighborhood socioeconomic status. InfoUSA data were used to estimate counts of 3318 food and liquor stores. Measures of socioeconomic position included education, employment status, median household income, and poverty level. Poisson models were used to estimate effects and included zero-inflated poisson models. Results: Higher counts of liquor stores were positively associated with counts of supermarkets and grocery stores after adjusting for socioeconomic status (RR=1.36, 95% CI: 1.20, 1.55). Lower counts of supermarkets and grocery stores were associated with lower income neighborhoods (RR=0.98, 95% CI: 0.95, 0.99). The relationship between access to liquor stores and grocery stores did not vary by socioeconomic status (p=0.89). Discussion: Food and liquor stores tend to cluster together in neighborhoods. Future studies should examine the mechanisms through which food and liquor stores co-occur.

... I also thank my sister, Misa, my brother in law, Bobby, and my nephew, Kalen. I love you guys... more ... I also thank my sister, Misa, my brother in law, Bobby, and my nephew, Kalen. I love you guys so much. Lastly, to my wife, Kassy, who was willing to walk this long road with me. You are my best friend. Page 4. ... ii Dedication For my wife, Kassy. Page 5. Shimotsu, 2011 iii Abstract ...

Families, Systems, & Health, 2016

The health status and psychosocial needs of the Medicaid expansion population have been estimated... more The health status and psychosocial needs of the Medicaid expansion population have been estimated but not measured. This population includes childless adults predicted to have high rates of mental illness, especially among the homeless. Given limitations in access to mental health services, it is unclear how prepared the U.S. health care system is to care for the needs of the expansion population. Using enrollment and claims data from the Minnesota Department of Human Services, this study presents prevalence rates of mental illness diagnoses and measures of unstable housing in Minnesota&amp;amp;amp;amp;amp;amp;amp;amp;#39;s childless-adult early Medicaid expansion population. Rates are compared with prior predictions of serious psychological distress and mental illness constructed from the National Survey on Drug Use and Health (NSDUH) using χ2 and t tests. Diagnoses of mental illness in Minnesota&amp;amp;amp;amp;amp;amp;amp;amp;#39;s childless-adult early Medicaid expansion population were more than 15% higher than prevalence measures of mental illness/distress for the current Medicaid population. Diagnosis rates fell within confidence intervals of estimates of mental illness for Minnesota&amp;amp;amp;amp;amp;amp;amp;amp;#39;s Medicaid expansion population. Almost 1 in 3 enrollees had a marker of unstable housing; of this group, half had mental illness and/or distress. Findings support predictions of the high burden of mental illness and unstable housing among the Medicaid expansion population. Minnesota offers lessons to other regions working to care for such populations: (a) the use of flexible financing structures to build integrated care systems and (b) passage of legislation to allow data sharing among mental health, social services, and medical care. (PsycINFO Database Record

Journal of Alcohol Drug Education, Dec 1, 2012

Objective: A major aim of our study was to learn how the local context affects a city's abili... more Objective: A major aim of our study was to learn how the local context affects a city's ability to regulate alcohol products such as high-alcohol content malt liquor, a beverage associated with heavy drinking and a spectrum of nuisance crimes in urban areas. Methods: We conducted a qualitative case study comparing cities that adopted policies to restrict malt liquor sales with cities that considered, but did not adopt policies in 9 large U.S. cities in 7 states. Qualitative data were obtained from key informant interviews (n=56) and media articles (n=360). Key informants included City legislators and staff, alcohol enforcement personnel, police, neighborhood groups, business associations, alcohol retailers and industry representatives. Similarities and differences in major themes among and across Adopted and Considered cities were identified. Results: Cities faced multiple barriers in addressing malt liquor-related problems, including a lack of enforcement tools, alcohol industr...

Purpose: The neighborhoods where people live can shape the dietary and alcohol choices they make.... more Purpose: The neighborhoods where people live can shape the dietary and alcohol choices they make. Poor neighborhoods tend to have fewer resources for promoting good health, but it is not know whether neighborhood access to food and alcohol are related, and whether the relationship between food and alcohol access differs by socioeconomic status. The purpose of this study is to examine whether access to supermarkets and grocery stores is associated with access to liquor stores and whether this relationship differs by neighborhood socioeconomic status. Methods: Data for this study were drawn from the U.S. Census and InfoUSA Business Datasets (2002) which were linked by census tract areas. Neighborhoods were defined as census tracts within Hennepin County, Minnesota. Census 2000 was used to assess neighborhood socioeconomic status. InfoUSA data were used to estimate counts of 3318 food and liquor stores. Measures of socioeconomic position included education, employment status, median ho...

Purpose: Malt liquor is a cheap, high-alcohol beer that is widely available in inner cities, wher... more Purpose: Malt liquor is a cheap, high-alcohol beer that is widely available in inner cities, where it is associated with problems such as public inebriation, violence, and crime. Cities such as Washington D.C. and Seattle, WA have adopted policies to restrict malt liquor sales. Other cities have considered such policies, but have not implemented them. While the experience of these cities may be useful to others wishing to restrict malt liquor sales, it is not known what factors may facilitate or impede policy adoption. Methods: Data were drawn from in-person key informant interviews (n=57) in 10 U.S. cities that have adopted or considered policies to restrict malt liquor sales. Key informants were selected if they had substantive knowledge of the malt liquor policies, and included neighborhood groups and local residents, alcohol advocacy groups, alcohol retailers, city officials, and local police. Transcripts were initially coded by one researcher which transformed the data from dia...

Health affairs (Project Hope), 2014

Health care payment and delivery models that challenge providers to be accountable for outcomes h... more Health care payment and delivery models that challenge providers to be accountable for outcomes have fueled interest in community-level partnerships that address the behavioral, social, and economic determinants of health. We describe how Hennepin Health--a county-based safety-net accountable care organization in Minnesota--has forged such a partnership to redesign the health care workforce and improve the coordination of the physical, behavioral, social, and economic dimensions of care for an expanded community of Medicaid beneficiaries. Early outcomes suggest that the program has had an impact in shifting care from hospitals to outpatient settings. For example, emergency department visits decreased 9.1 percent between 2012 and 2013, while outpatient visits increased 3.3 percent. An increasing percentage of patients have received diabetes, vascular, and asthma care at optimal levels. At the same time, Hennepin Health has realized savings and reinvested them in future improvements. ...

Journal of the American Dietetic Association, 2008

The household setting may be the most important level at which to understand the food choices of ... more The household setting may be the most important level at which to understand the food choices of individuals and how healthful food choices can be promoted. However, there are few available measures of the food purchase behaviors of households and little consensus on the best way to measure it. This review explores the currently available measures of household food purchasing behavior. Three main measures are described, evaluated, and compared: home food inventories, food and beverage purchase records and receipts, and Universal Product Code bar code scanning. The development of coding, aggregation, and analytical methods for these measures of household food purchasing behavior is described. Currently, annotated receipts and records are the most comprehensive, detailed measure of household food purchasing behavior, and are feasible for population-based samples. Universal Product Code scanning is not recommended due to its cost and complexity. Research directions to improve household food purchasing behavior measures are discussed.

International Journal of Behavioral Nutrition and Physical Activity, 2009

Background: Accurate measurement of household food purchase behavior (HFPB) is important for unde... more Background: Accurate measurement of household food purchase behavior (HFPB) is important for understanding its association with household characteristics, individual dietary intake and neighborhood food retail outlets. However, little research has been done to develop measures of HFPB. The main objective of this paper is to describe the development of a measure of HFPB using annotated food purchase receipts.

Sosiaalilaaketieteellinen Aikakauslehti, 2010

Families, Systems, & Health, 2016

The health status and psychosocial needs of the Medicaid expansion population have been estimated... more The health status and psychosocial needs of the Medicaid expansion population have been estimated but not measured. This population includes childless adults predicted to have high rates of mental illness, especially among the homeless. Given limitations in access to mental health services, it is unclear how prepared the U.S. health care system is to care for the needs of the expansion population. Using enrollment and claims data from the Minnesota Department of Human Services, this study presents prevalence rates of mental illness diagnoses and measures of unstable housing in Minnesota&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s childless-adult early Medicaid expansion population. Rates are compared with prior predictions of serious psychological distress and mental illness constructed from the National Survey on Drug Use and Health (NSDUH) using χ2 and t tests. Diagnoses of mental illness in Minnesota&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s childless-adult early Medicaid expansion population were more than 15% higher than prevalence measures of mental illness/distress for the current Medicaid population. Diagnosis rates fell within confidence intervals of estimates of mental illness for Minnesota&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Medicaid expansion population. Almost 1 in 3 enrollees had a marker of unstable housing; of this group, half had mental illness and/or distress. Findings support predictions of the high burden of mental illness and unstable housing among the Medicaid expansion population. Minnesota offers lessons to other regions working to care for such populations: (a) the use of flexible financing structures to build integrated care systems and (b) passage of legislation to allow data sharing among mental health, social services, and medical care. (PsycINFO Database Record

Journal of primary care & community health, Jan 18, 2015

Missed appointments have been linked to adverse outcomes known to affect racial/ethnic minorities... more Missed appointments have been linked to adverse outcomes known to affect racial/ethnic minorities. However, the association of missed appointments with race/ethnicity has not been determined. We sought to determine the relationships between race/ethnicity and missed appointments by performing a cross-sectional study of 161 350 patients in a safety net health system. Several race/ethnicity categories were significantly associated with missed appointment rates, including Hispanic/Latino patients, American Indian/Alaskan Native patients, and Black/African American patients, as compared with White non-Hispanic patients. Other significant predictors included Mexico as country of origin, medical complexity, and major mental illness. We recommend additional research to determine which interventions best reduce missed appointments for minority populations in order to improve the care of vulnerable patients.

International Journal of Behavioral Nutrition and Physical Activity, 2008

Background: There is overwhelming evidence of the benefits of physical activity and the physical ... more Background: There is overwhelming evidence of the benefits of physical activity and the physical environment is increasingly recognized as a promising determinant of physical activity participation. The influence of the environment on physical activity has not been evaluated among black Africans and no specific measure exists for assessing environmental factors related to physical activity in an African environment. The IPAQ E-module was designed to assess environmental factors for physical activity participation and was considered to be relevant to all countries regardless of the stage of economic development. The objective of this study was to assess the testretest reliability of IPAQ E-module in an African population. Methods: One hundred and three clinical students of a University in Nigeria were invited to participate in the reliability testing of IPAQ E-module. Sixteen of the 17-items on the environmental measure were assessed for test-retest reliability using intraclass correlation coefficient (ICC) with 95% Confidence interval (CI) overall and by gender. The measure addressed items regarding residential density, access to destinations, neighborhood infrastructures, aesthetic qualities, social environment, street connectivity and neighborhood safety. Results: Of the total respondents, 51.5% were males and 48.5% were females. Overall, the intraclass correlation coefficient (ICC) ranged from 0.43 to 0.91. The item regarding many interesting things to look at (aesthetic) produced the overall highest reliability score (ICC = 0.91, 95% CI = 0.86-0.94), while the item regarding safety from crime during the day (neighborhood safety) produced the lowest overall score (ICC = 0.43, 95% CI = 0.26-0.57). Reliability of items on neighborhood infrastructures ranged between substantial agreement to almost perfect agreement overall (ICC = 0.66-0.88) and by gender (male-ICC = 0.68-0.90 and female-ICC = 0.63-0.86). The access to destination items (ICC = 0.49-0.74), social environment (ICC = 0.62) and street connectivity (ICC = 0.78) all had acceptable reliability overall. Meaningful differences were found between males and females on two items on neighborhood safety and one item on access to destinations. Conclusion: The test-retest of IPAQ E-module resulted in moderate to almost perfect agreement for most of the items with few meaningful differences by gender. Environmental items of physical activity in an African population exhibited reliability similar to that in other environments. These results suggest that IPAQ E-module may be a useful measure for assessing environmental correlates of physical activity among population in Africa.

BackgroundLow back pain (LBP) is prevalent, management benefits from high-quality clinical practi... more BackgroundLow back pain (LBP) is prevalent, management benefits from high-quality clinical practice guidelines, and yet LBP is a common source of low value care. The purpose of this retrospective cohort study was to examine the association between the type of initial contact health care provider (HCP), service utilization, and total episode cost for the management of LBP.MethodsEpisode of care was used to analyze a US national sample of LBP episodes completed in 2017-2019. A combined surgical and non-surgical (pooled) sample and a non-surgical sample were separately analyzed. The primary independent variable was the type of the initial contact HCP. Dependent measures included rate and timing of use of 14 types of health care services and total episode cost. The association between initial contact HCP, total episode cost and rate of prescription opioid and NSAID use was tested using a mixed effects model.ResultsThe study included 616,766 continuously insured individuals aged 18 years...

Emerging Infectious Diseases

Journal of community health, Jan 22, 2017

Immigrants and refugees are less likely to meet diabetes management goals than the general US pop... more Immigrants and refugees are less likely to meet diabetes management goals than the general US population. Those with limited English proficiency (LEP) and who need interpreter services (IS) for health care encounters, maybe at higher risk for encountering barriers to optimal diabetes management, and while most receive diabetes care in primary care settings, little is known about the association between IS need and diabetes outcomes. This study aims to determine adherence with diabetes process and outcomes measures among LEP patients in primary care settings, and is a retrospective cohort study of patients with type II diabetes at two large primary care networks in Minnesota from January 1, 2012 through December 31, 2013. Diabetes outcome measure goals were defined as hemoglobin A1C <8%, LDL-C <100 mg/dL, and blood pressure <140/90 mmHg. Process measure goals were defined as hemoglobin A1C measured within the previous 6 months and LDL cholesterol (LDL-C) measured within the ...

ABSTRACT Purpose: The neighborhoods where people live can shape the dietary and alcohol choices t... more ABSTRACT Purpose: The neighborhoods where people live can shape the dietary and alcohol choices they make. Poor neighborhoods tend to have fewer resources for promoting good health, but it is not know whether neighborhood access to food and alcohol are related, and whether the relationship between food and alcohol access differs by socioeconomic status. The purpose of this study is to examine whether access to supermarkets and grocery stores is associated with access to liquor stores and whether this relationship differs by neighborhood socioeconomic status. Methods: Data for this study were drawn from the U.S. Census and InfoUSA Business Datasets (2002) which were linked by census tract areas. Neighborhoods were defined as census tracts within Hennepin County, Minnesota. Census 2000 was used to assess neighborhood socioeconomic status. InfoUSA data were used to estimate counts of 3318 food and liquor stores. Measures of socioeconomic position included education, employment status, median household income, and poverty level. Poisson models were used to estimate effects and included zero-inflated poisson models. Results: Higher counts of liquor stores were positively associated with counts of supermarkets and grocery stores after adjusting for socioeconomic status (RR=1.36, 95% CI: 1.20, 1.55). Lower counts of supermarkets and grocery stores were associated with lower income neighborhoods (RR=0.98, 95% CI: 0.95, 0.99). The relationship between access to liquor stores and grocery stores did not vary by socioeconomic status (p=0.89). Discussion: Food and liquor stores tend to cluster together in neighborhoods. Future studies should examine the mechanisms through which food and liquor stores co-occur.

... I also thank my sister, Misa, my brother in law, Bobby, and my nephew, Kalen. I love you guys... more ... I also thank my sister, Misa, my brother in law, Bobby, and my nephew, Kalen. I love you guys so much. Lastly, to my wife, Kassy, who was willing to walk this long road with me. You are my best friend. Page 4. ... ii Dedication For my wife, Kassy. Page 5. Shimotsu, 2011 iii Abstract ...

Families, Systems, & Health, 2016

The health status and psychosocial needs of the Medicaid expansion population have been estimated... more The health status and psychosocial needs of the Medicaid expansion population have been estimated but not measured. This population includes childless adults predicted to have high rates of mental illness, especially among the homeless. Given limitations in access to mental health services, it is unclear how prepared the U.S. health care system is to care for the needs of the expansion population. Using enrollment and claims data from the Minnesota Department of Human Services, this study presents prevalence rates of mental illness diagnoses and measures of unstable housing in Minnesota&amp;amp;amp;amp;amp;amp;amp;amp;#39;s childless-adult early Medicaid expansion population. Rates are compared with prior predictions of serious psychological distress and mental illness constructed from the National Survey on Drug Use and Health (NSDUH) using χ2 and t tests. Diagnoses of mental illness in Minnesota&amp;amp;amp;amp;amp;amp;amp;amp;#39;s childless-adult early Medicaid expansion population were more than 15% higher than prevalence measures of mental illness/distress for the current Medicaid population. Diagnosis rates fell within confidence intervals of estimates of mental illness for Minnesota&amp;amp;amp;amp;amp;amp;amp;amp;#39;s Medicaid expansion population. Almost 1 in 3 enrollees had a marker of unstable housing; of this group, half had mental illness and/or distress. Findings support predictions of the high burden of mental illness and unstable housing among the Medicaid expansion population. Minnesota offers lessons to other regions working to care for such populations: (a) the use of flexible financing structures to build integrated care systems and (b) passage of legislation to allow data sharing among mental health, social services, and medical care. (PsycINFO Database Record

Journal of Alcohol Drug Education, Dec 1, 2012

Objective: A major aim of our study was to learn how the local context affects a city's abili... more Objective: A major aim of our study was to learn how the local context affects a city's ability to regulate alcohol products such as high-alcohol content malt liquor, a beverage associated with heavy drinking and a spectrum of nuisance crimes in urban areas. Methods: We conducted a qualitative case study comparing cities that adopted policies to restrict malt liquor sales with cities that considered, but did not adopt policies in 9 large U.S. cities in 7 states. Qualitative data were obtained from key informant interviews (n=56) and media articles (n=360). Key informants included City legislators and staff, alcohol enforcement personnel, police, neighborhood groups, business associations, alcohol retailers and industry representatives. Similarities and differences in major themes among and across Adopted and Considered cities were identified. Results: Cities faced multiple barriers in addressing malt liquor-related problems, including a lack of enforcement tools, alcohol industr...

Purpose: The neighborhoods where people live can shape the dietary and alcohol choices they make.... more Purpose: The neighborhoods where people live can shape the dietary and alcohol choices they make. Poor neighborhoods tend to have fewer resources for promoting good health, but it is not know whether neighborhood access to food and alcohol are related, and whether the relationship between food and alcohol access differs by socioeconomic status. The purpose of this study is to examine whether access to supermarkets and grocery stores is associated with access to liquor stores and whether this relationship differs by neighborhood socioeconomic status. Methods: Data for this study were drawn from the U.S. Census and InfoUSA Business Datasets (2002) which were linked by census tract areas. Neighborhoods were defined as census tracts within Hennepin County, Minnesota. Census 2000 was used to assess neighborhood socioeconomic status. InfoUSA data were used to estimate counts of 3318 food and liquor stores. Measures of socioeconomic position included education, employment status, median ho...

Purpose: Malt liquor is a cheap, high-alcohol beer that is widely available in inner cities, wher... more Purpose: Malt liquor is a cheap, high-alcohol beer that is widely available in inner cities, where it is associated with problems such as public inebriation, violence, and crime. Cities such as Washington D.C. and Seattle, WA have adopted policies to restrict malt liquor sales. Other cities have considered such policies, but have not implemented them. While the experience of these cities may be useful to others wishing to restrict malt liquor sales, it is not known what factors may facilitate or impede policy adoption. Methods: Data were drawn from in-person key informant interviews (n=57) in 10 U.S. cities that have adopted or considered policies to restrict malt liquor sales. Key informants were selected if they had substantive knowledge of the malt liquor policies, and included neighborhood groups and local residents, alcohol advocacy groups, alcohol retailers, city officials, and local police. Transcripts were initially coded by one researcher which transformed the data from dia...

Health affairs (Project Hope), 2014

Health care payment and delivery models that challenge providers to be accountable for outcomes h... more Health care payment and delivery models that challenge providers to be accountable for outcomes have fueled interest in community-level partnerships that address the behavioral, social, and economic determinants of health. We describe how Hennepin Health--a county-based safety-net accountable care organization in Minnesota--has forged such a partnership to redesign the health care workforce and improve the coordination of the physical, behavioral, social, and economic dimensions of care for an expanded community of Medicaid beneficiaries. Early outcomes suggest that the program has had an impact in shifting care from hospitals to outpatient settings. For example, emergency department visits decreased 9.1 percent between 2012 and 2013, while outpatient visits increased 3.3 percent. An increasing percentage of patients have received diabetes, vascular, and asthma care at optimal levels. At the same time, Hennepin Health has realized savings and reinvested them in future improvements. ...

Journal of the American Dietetic Association, 2008

The household setting may be the most important level at which to understand the food choices of ... more The household setting may be the most important level at which to understand the food choices of individuals and how healthful food choices can be promoted. However, there are few available measures of the food purchase behaviors of households and little consensus on the best way to measure it. This review explores the currently available measures of household food purchasing behavior. Three main measures are described, evaluated, and compared: home food inventories, food and beverage purchase records and receipts, and Universal Product Code bar code scanning. The development of coding, aggregation, and analytical methods for these measures of household food purchasing behavior is described. Currently, annotated receipts and records are the most comprehensive, detailed measure of household food purchasing behavior, and are feasible for population-based samples. Universal Product Code scanning is not recommended due to its cost and complexity. Research directions to improve household food purchasing behavior measures are discussed.

International Journal of Behavioral Nutrition and Physical Activity, 2009

Background: Accurate measurement of household food purchase behavior (HFPB) is important for unde... more Background: Accurate measurement of household food purchase behavior (HFPB) is important for understanding its association with household characteristics, individual dietary intake and neighborhood food retail outlets. However, little research has been done to develop measures of HFPB. The main objective of this paper is to describe the development of a measure of HFPB using annotated food purchase receipts.