emily miller, fred croom, tene franklin hamilton, kimberly glenn
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- Emily Miller, Fred Croom, Tene Franklin Hamilton, Kimberly Glenn
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- This project is intended for the Office of Minority Health and Disparities Elimination in the Tennessee Department of Health as a product of a student internship. The work will be presented to East Tennessee State University as a sign of completing objectives defined by the College of Public Health for the required internship for the Masters program and is a part of the students culminating experience.
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- This study hopes to address the link between cardiac deaths and access to healthy foods for Knox County, TN
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- Definition For this study we used Death Statistical Systems data from Vital Records in the Tennessee Department of Health ICD-10 codes for myocardial infarction, heart failure, stroke, and coronary artery disease. The events were selected as being the Underlying Cause of Death, which includes codes: I21.0-I21.4, I21.9-122.1, I22.8- I23.6, I23.8; I11.0, I13.0, I42.0-I42.9, I50.0, I50.1, I50.9, I51.7; I60.0-I60.9, I61.0-I61.9, I63.0-I63.9, I64, I65.0- I65.9; I20.0, I20.8, I20.9, I21.0-I25.9 and I51.6.
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- Age-Adjustment Since age is a risk factor associated with cardiac deaths it is important that we use age-adjusted rates in order to compare two populations
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- Data from the 2010 census was used for demarcating populations within Knox County This was better than zip code data since these lines fall outside of county boundaries
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- Census Data from 2010 was used for this report
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- Healthy Food Financing Initiative (HFFI) Low-income Census tracts that meet the Treasury Departments New Markets Tax Credit (NMTC) Low Access A substantial number of residence with low access to a supermarket or large grocery store
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- Using the Healthy Food Financing Initiative (HFFI) criteria to define the Census Tracts in Knox County that are considered a food desert.
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- Quantile Distribution Using the cardiac death rates found they were then classified into 5 levels
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- Age adjusted cardiac death rates were calculated using SAS for each census tract. A quantile distribution of rates were used to classify into 5 levels
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- Comparing Rates between Census Tracts Using ArcMap to export data to excel a two-tailed t-test was used to assess the cardiac rates in census tracts considered to be food deserts and cardiac death rates in census tracts not considered to be a food desert
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- Cardiac Death Rates compared between census tracts considered to be a food desert and those that were not.
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- Comparing Rates between Census Tracts T-test resulted in a p-value of 0.078252 This shows significance with alpha= 0.10 Therefore we have 90% confidence that there is a significant difference between cardiac death rates for the food desert tracts compared to the non-food desert tracts However, we are not 95% confident
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- To gain understanding of healthy food access, the location of healthy food retailers were obtained via communication with the Department of Agriculture
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- List of all Food Retailers for Knox County was provided by the Department of Agriculture Food Retailers included in the study based upon definition of food retailers by the Department of Agriculture
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- Inclusion: 23-Retail Fish Market-Deli 43-Meat Market-Deli 51-Market W Meat Dept & Deli 52-Market W Meat Dept & Deli, 50 or more seats 81-Market 82-Market W Food Service 101-Retail Produce Market 103-Retail Produce Market W Deli 141-Health Food Store
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- Geocode Addresses The list of food retailers include addresses which were used to geocode their locations
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- The stars on the map depict the healthy food locations designated by the definition for type of food retail they get from the Department of Agriculture
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- One mile buffer was assigned to each healthy food retailer to better understand the healthy food distribution in Knox County
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- The healthy food retailers were added to the map in order to understand their relationship with cardiac deaths and with food deserts.
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- There is a significant difference in the rate of cardiac deaths for individuals living within a food desert compared to those living outside a food desert at the 90% confidence level.
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- Difficulty in defining food deserts
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- Because of the geographical nature of Knox county identifying food deserts can be difficult. Walkability improves access to retailers Increased
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