Background: Asthma is a serious chronic health condition, and social determinants may affect its prevalence.
Methods: Data from the Behavioral Risk Factors Surveillance Survey (BRFSS), the Georgia Asthma Call-back Survey (ACBS), and the Georgia hospital and emergency department survey for patients with a diagnosis of asthma were used. All data were from the years 2011 through 2014. SAS and SUDAAN software were used to calculate weighted prevalence estimates and to perform univariate and multivariate analyses of the association between social determinants, other risk factors, and asthma outcomes.
Results: The prevalence of asthma was highest among non-Hispanic blacks, women, and persons with less than a high school education, with an annual household income below $25,000, and in rural parts of the state (south and northwest Georgia). Those without insurance for more than three years had a higher prevalence of asthma than those who had insurance or had been uninsured less than 6 months. Although the percentage without insurance declined from 2012 to 2014, more than 1 in 5 adults of working age with asthma still lacked health insurance, and more than half had been without it for more than 3 years. One-third of Georgians with asthma could not see a doctor, at least on one occasion, because of cost, and more than a third were currently paying off medical bills. Approximately one quarter did not report having a personal physician, and a similar percentage reported having more than one year since their last check-up. In multivariate analyses, women (adjusted odds ratio [aOR] 1.61), smokers (aOR 1.54), and persons with a higher BMI (aOR 1.56) were all independently associated with having asthma.
Conclusions: For the state of Georgia, there are associations between social determinants, such as education, income, and geography, and the prevalence of asthma, and many patients lack access to care. Addressing social determinants, including having affordable health insurance, is necessary to improve management of asthma.
Background: The Eating and Cooking Healthy (TEACH) Kitchen was founded at the Medical College of Georgia in 2015 as a nutrition-based intervention to combat the high prevalence of obesity and obesity-related chronic diseases in the area of Augusta, Georgia. Despite the importance of diet in the management of chronic diseases, inadequate nutrition education among patients and healthcare providers presents a barrier. The purpose of TEACH Kitchen is to address this gap.
Methods: TEACH Kitchen is as a student-led initiative that promotes healthy cooking among medical students and patients with chronic diseases. Healthy nutrition and cooking classes are held during the academic year. Participants spend four weeks on each of four modules: obesity, hypertension, hyperlipidemia, and diabetes mellitus. Data collection, which began in January 2017, is currently on going. TEACH Kitchen has collaborated with Augusta University, Sodexo, and Kohl's.
Results: Currently, TEACH Kitchen has enrolled 14 patients and 6 children. Anticipated results include measurements of pre-and post-intervention changes in knowledge, attitudes, beliefs, and competence in nutrition, as well as differences in clinical indicators, including body mass index, blood pressure, lipid profile, and HbA1c.
Conclusions: TEACH Kitchen is the first medical school-based nutrition/cooking education initiative in Augusta, Georgia. It provides patients and medical students with hands-on healthy nutrition/cooking experience with the goal of decreasing the prevalence and improving the outcome of obesity-related diseases.