Stallings‐Smith, Sericea

Purpose To examine changes in obesity prevalence among US adults after the COVID-19 pandemic by level of stay-at-home order and sociodemographic characteristics. Design Quasi-experimental study using repeated cross-sectional data. Setting Behavioral Risk Factor Surveillance System (BRFSS). Sample Pooled data for US adults ages ≥26 years (n = 1,107,673) from BRFSS (2018-2021). Measures States/territories were classified into three levels of stay-at-home order: none, advisory/only for persons at risk, or mandatory for all. Individual-level sociodemographic characteristics were self-reported. Analysis The difference-in-differences method was conducted with weighted multiple logistic regression analysis to examine obesity (body mass index ≥30 kg/m 2 ) prevalence by stay-at-home order level and sociodemographic characteristics before/after the COVID-19 pandemic (January 2018-February 2020 vs March 2020-February 2022). Results After adjusting for a secular trend and multiple covariates, adults in states/territories with mandatory stay-at-home orders experienced a larger increase in obesity prevalence (adjusted odds ratio: 1.05; 95% confidence interval: 1.01, 1.11) than adults in states/territories with no stay-at-home order. Younger adults (vs ≥65 years) and individuals with <high school education (vs ≥4-year college) experienced larger increases in obesity prevalence. Conclusion Increases in obesity prevalence were perpetuated 2 years after implementation of stay-at-home orders, indicating that longer-term health implications are co-occurring during the pandemic recovery period. Future research should focus on successful methods for staying active and healthy during social distancing and beyond.

Abstract Background Community engagement is commonly used to address social inequities. The Carnegie Foundation offers an optional designation for which U.S. colleges and universities may apply to facilitate better educational outcomes through the institutionalization of community engagement. This study is the first to examine the relationship between Carnegie community engaged status and community health outcomes. Methods Ordinal logistic regression was conducted to investigate the association between the presence of a community engaged institution and county health outcomes, including health behaviors, clinical care relating to access and quality, social and economic factors, and physical environment from the 2016 Robert Wood Johnson County Health Rankings and 2015 New England Resource Center for Higher Education Community engaged list. We examined 820 U.S. counties containing a university or college, 240 of which had a community engaged designation. Results Findings indicated that the presence of a community-engaged institution was positively associated with Clinical Care (OR = 1.99; 95% CI: 1.09, 3.64). Other county health factors were not similarly associated. Conclusions Our findings suggest that community engagement status may be most relevant for achieving better access and quality of clinical care. More research is needed to explore this association in the U.S. and internationally.