Tobacco use prevalence--disentangling associations between Alaska Native race, low socio-economic status and rural disparities.

BACKGROUND: Tobacco use rates are exceptionally high among indigenous people in North America. Alaska Native, low socio-economic status (SES) and rural communities are high-priority populations for Alaska's Tobacco Control program. DESIGN: For the purpose of better informing tobacco control interventions, we conducted a descriptive study to describe high-priority groups using prevalence-based and proportion-based approaches. METHODS: With data from 22,311 adults interviewed for Alaska's 2006-2010 Behavioral Risk Factor Surveillance System (BRFSS), we used stratified analysis and logistic regression models to describe the current use of cigarettes and smokeless tobacco (SLT) (including iq'mik, a unique Alaska Native SLT product) among the 3 populations of interest. RESULTS: "Population segments" were created with combinations of responses for Alaska Native race, SES and community type. We identified the highest prevalence and highest proportion of tobacco users for each type of tobacco by "segment". For cigarette smoking, while the largest proportion (nearly one-third) of the state's smokers are non-Native, high SES and live in urban settings, this group also has lower smoking prevalence than most other groups. Alaska Native, low SES, rural residents had both high smoking prevalence (48%) and represented a large proportion of the state's smokers (nearly 10%). Patterns were similar for SLT, with non-Native high-SES urban residents making up the largest proportion of users despite lower prevalence, and Alaska Native, low SES, rural residents having high prevalence and making up a large proportion of users. For iq'mik use, Alaska Native people in rural settings were both the highest prevalence and proportion of users. CONCLUSION: While Alaska Native race, low SES status and community of residence can be considered alone when developing tobacco control interventions, creating "population segments" based on combinations of factors may be helpful for tailoring effective tobacco control strategies and messaging. Other countries or states may use a similar approach for describing and prioritizing populations.

Predicting the risk of Lyme disease: habitat suitability for Ixodes scapularis in the north central United States.

The distribution and abundance of Ixodes scapularis were studied in Wisconsin, northern Illinois, and portions of the Upper Peninsula of Michigan by inspecting small mammals for ticks and by collecting questing ticks at 138 locations in state parks and natural areas. Environmental data were gathered at a local level (i.e., micro and meso levels), and a geographic information system (GIS) was used with several digitized coverages of environmental data to create a habitat profile for each site and a grid map for Wisconsin and Illinois. Results showed that the presence and abundance of I. scapularis varied, even when the host population was adequate. Tick presence was positively associated with deciduous, dry to mesic forests and alfisol-type soils of sandy or loam-sand textures overlying sedimentary rock. Tick absence was associated with grasslands, conifer forests, wet to wet/mesic forests, acidic soils of low fertility and a clay soil texture, and Precambrian bedrock. We performed a discriminant analysis to determine environmental differences between positive and negative tick sites and derived a regression equation to examine the probability of I. scapularis presence per grid. Both analyses indicated that soil order and land cover were the dominant contributors to tick presence. We then constructed a risk map indicating suitable habitats within areas where I. scapularis is already established. The risk map also shows areas of high probability the tick will become established if introduced. Thus, this risk analysis has both explanatory power and predictive capability.