Using state-issued identification cards for obesity tracking.

Obesity prevention has emerged as one of public health's top priorities. Public health agencies need reliable data on population health status to guide prevention efforts. Existing survey data sources provide county-level estimates; obtaining sub-county estimates from survey data can be prohibitively expensive. State-issued identification cards are an alternate data source for community-level obesity estimates. We computed body mass index for 3.2 million adult Oregonians who were issued a driver license or identification card between 2003 and 2010. Statewide estimates of obesity prevalence and average body mass index were compared to the Oregon Behavioral Risk Factor Surveillance System (BRFSS). After geocoding addresses we calculated average adult body mass index for every census tract and block group in the state. Sub-county estimates reveal striking patterns in the population's weight status. Annual obesity prevalence estimates from identification cards averaged 18% lower than the BRFSS for men and 31% lower for women. Body mass index estimates averaged 2% lower than the BRFSS for men and 5% lower for women. Identification card records are a promising data source to augment tracking of obesity. People do tend to misrepresent their weight, but the consistent bias does not obscure patterns and trends. Large numbers of records allow for stable estimates for small geographic areas.

Elevated occupational transportation fatalities among older workers in Oregon: an empirical investigation.

Older workers have an elevated risk of being killed on the job, and transportation incidents involving vehicles or mobile machinery are especially deadly for this group. The present study was designed to address the research gap in understanding contributing factors to these incidents and recommend evidence-based guidelines for interventions. We gathered and analyzed data from several sources, including the Oregon Fatality Assessment and Control Evaluation program, the Oregon Workers' Compensation system, the Census of Fatal Occupational Injuries, the Bureau of Labor Statistics, and peer reviewed research literatures. Rates and rate ratios (RR) were used to evaluate excess risk among groups. The results of this study show that older workers in Oregon have an elevated risk of fatality both in all events (RR=3.0, 95% CI 2.2-4.0) and transportation events (RR=3.6, 95% CI 2.4-5.4). Additional analyses and extant literature supports our hypotheses that multiple risk factors contribute to the phenomenon, including (a) hazard exposure, (b) organization of work, (c) physical fragility, and (d) normative cognitive, sensory, and psychomotor changes that occur with age. The evidence-based framework proposed may provide valuable guidance for developing safety interventions that protect older workers.

The View-Master Health Study Focus Groups.

Trichloroethylene (TCE), a common groundwater contaminant, was found at high levels at an Oregon work site in 1998. According to a recent report released by the National Research Council, "the evidence on carcinogenic risk and other health hazards from exposure to trichloroethylene has strengthened since 2001." A convenience sample of 13 former workers from the Oregon work site was recruited for a series of focus groups. Information obtained on plant processes, safety procedures, attitudes regarding medical record access, and opinions about proxy accuracy was subjected to qualitative content analysis. Workers recalled few safety policies and no training or support for control of safety. Most thought co-workers and family members would be the best source of proxy exposure information and favored granting access to medical records. Job-role mobility confirmed the importance of using a job or task exposure matrix. Information obtained will be used in development of an exposure assessment interview tool.

Patients with HIV infection and mental illness: a study of clinical identification.

We compared provider diagnosis of mental illness as noted in a chart audit to an indication of mental illness using the Revised Symptom Checklist (SCL-90R). We identified cases of correct diagnoses, over-diagnoses, and missed diagnoses of mental illness by examining mental functioning (using the SF-36). Providers over diagnosed mental illness in 23% of the cases and missed a diagnosis in 9% of the cases. The over-diagnosed group had significantly better mental functioning and the missed-diagnosis group did not have better mental functioning than those who the provider and SCL-90 agreed had mental illness. The SCL-90R had a higher correlation with mental functioning than did the providers' diagnoses, suggesting that such instruments may increase the correct detection of mental illness in the HIV population.