INFLUENCES ON PHYSICAL
ACTIVITY (cont’d)
• Causal pathways in health and disease
A1
B1
A2
B2
C
A3
B3
A4
Causal Factors
Cellular/Biochemical/
Physiologic changes
Disease
Source: Bauman et al (2002)
INFLUENCES ON PHYSICAL
ACTIVITY (cont’d)
• Mediators, moderators, and confounders
– Mediator or intervening causal variable is on the
causal pathway between exposure to the intervention
and program effects or outcomes
– Moderator or effect modifier may vary the strength
of the relationship between a program and the
outcome
– Confounder is a predictor of the outcome, but is also
associated with exposure
INFLUENCES ON PHYSICAL
ACTIVITY (cont’d)
• Mediators, moderators, confounders (cont’d)
M2
Mediators (M)
A
M1
Program
Confounder (B)
M3
C
Mediators
A
Outcome
C
B
Moderator (effect modifier)
Levels of moderator
B1
B2
B3
A
A
A
C
C
C
Source: Bauman et al (2002)
NORTH CAROLINA AND PITT
COUNTY HEALTH STATISTICS
North Carolina - Total Estimated Population by 2005 (based on U.S.
Census 2001)
Race
Race/Sex
White
Minority
6,479,70
2
2,202,36
4
(74.63%)
(25.37%)
Sex
White
male
White
female
Minority
male
Minority
female
3,231,002
3,248,70
0
1,046,090
1,156,274
(12.05%)
(13.32%)
(37.21%)
(37.42%)
Male
Female
Total
4,277,09
2
4,404,97
4
8,682,06
6
(49.26%)
(50.74%)
(100%)
Source: NC Dept. of Health and Human Services/Center for Health Statistics (2007)
NORTH CAROLINA AND PITT COUNTY
HEALTH STATISTICS (cont’d)
Pitt County - Total Estimated Population by 2005 (based on U.S.
Census 2001)
Race
Race/Sex
Sex
White
Minority
White
male
White
female
Minority
male
Minority
female
Male
Female
Total
91,150
52,057
44,521
46,629
23,695
28,362
68,216
74,991
143,207
(63.65%)
(36.35%)
(31.09%)
(32.56%)
(16.55%)
(19.80%)
(47.63%)
(52.37%)
(100%)
(1.65%)
Source: NC Dept. of Health and Human Services/Center for Health Statistics (2007)
NORTH CAROLINA AND PITT COUNTY
HEALTH STATISTICS (cont’d)
North Carolina – Race-specific and Sex-specific Age-adjusted*
Leading Death Rates/100,000 (*Std = Year 2000 U.S. Population)
Rate
Total #
Rate
Total #
Rate
Total #
Rate
Total
Rate
218.5
19,436
259.4
45,315
285.5
45,741
183.0
226.8
191.2
17,335
223.6
42,952
252.6
38,476
162.0
197.7
6,219
85.2
9,790
65.8
15,825
63.0
64.7
Whites
Minorities
Total #
Males
Females
Hearth Diseases
71,620
Cancers
64,093
Cerebrovascular Disease
19,396
59.8
Chronic Lower Respiratory Diseases
16,600
50.3
2,200
30.0
9,457
61.0
9,343
38.6
46.9
21.8
4,041
53.8
5,156
30.4
6,117
25.3
27.6
Diabetes Mellitus
7,232
Source: NC Dept. of Health and Human Services/Center for Health Statistics (2007)
NORTH CAROLINA AND PITT COUNTY
HEALTH STATISTICS (cont’d)
Pitt County – Race-specific and Sex-specific Age-adjusted* Leading
Death Rates/100,000 (*Std = Year 2000 U.S. Population)
Rate
Total #
Rate
Total #
Rate
Total #
Rate
Total
Rate
223.9
461
256.9
629
305.9
658
187.8
234.4
185.7
477
264.0
610
273.2
579
173.6
210.9
168
96.8
134
70.6
253
71.8
72.1
Whites
Total #
Minorities
Males
Females
Hearth Diseases
826
Cancers
712
Cerebrovascular Disease
219
60.4
Chronic Lower Respiratory Diseases
193
52.7
41
23.3
119
62.8
115
34.2
43.9
23.4
103
59.4
91
42.6
100
29
34.7
Diabetes Mellitus
88
Source: NC Dept. of Health and Human Services/Center for Health Statistics (2007)
NORTH CAROLINA AND PITT COUNTY
HEALTH STATISTICS (cont’d)
North Carolina’s Rate Ratios for Leading Causes of Death
Rate Ratios
Cause
Minorities/Whites
Males/Females
Diseases of heart
1.19
1.56
Cancers
1.17
1.56
Cerebrovascular Disease
1.42
1.04
Chronic Lower Respiratory Diseases
0.60
1.58
Diabetes Mellitus
2.47
1.20
Alzheimer’s Disease
0.73
0.73
Unintentional Motor Vehicle Injuries
1.01
2.32
Nephritis, Nephrotic Syndrome & Nephrosis
2.36
1.32
NORTH CAROLINA AND PITT COUNTY
HEALTH STATISTICS (cont’d)
Pitt County’s Rate Ratios for Leading Causes of Death
Rate Ratios
Cause
Minorities/Whites
Males/Females
Diseases of heart
1.15
1.63
Cancers
1.42
1.57
Cerebrovascular Disease
1.60
0.98
Chronic Lower Respiratory Diseases
0.44
1.84
Diabetes Mellitus
2.54
1.47
Nephritis, Nephrotic Syndrome & Nephrosis
2.93
1.07
Unintentional Motor Vehicle Injuries
0.90
2.98
Septicemia
2.20
0.90
HEALTH STATISTICS AND THE
BUILT ENVIRONMENT
• Obesity and associated problems:
– Diabetes
– Cardiovascular Diseases
– Orthopedic injuries
Source: Koop (2006)
HEALTH
STATISTICS
AND THE BUILT
ENVIRONMENT
(cont’d)
Source:
http://www.greenvillenc.gov/departments/community_development/information/default.aspx?id=1051
HEALTH STATISTICS AND THE
BUILT ENVIRONMENT (cont’d)
City of Greenville - Planning Division
The City of Greenville Planning Division serves as the administrative and
technical coordinator for land development and zoning requests throughout the
city's 65-square-mile planning jurisdiction... The division assists developers and
general citizens in the submission, analysis, recommendation and approval of
both citizen and administratively-initiated development proposals and plans.
The Division includes a Zoning Compliance/Enforcement Section, a Site Plan
Section, a Subdivision Section, an Annexation/Environmental Services Section,
a Zoning/Land Use Section and a Geographic Information System (GIS)
Section. In addition, the Division collects and interprets data related to future
land use needs and prepares and maintains long range planning studies, including
the Horizons Comprehensive Plan.
Source:
http://www.greenvillenc.gov/departments/community_development/information/default.aspx?id=1067