(i) To estimate the independent and combined effects of race/ethnicity and region on the variety of fruits and vegetables consumed in the USA in 2011; and (ii) to assess whether and to what extent race/ethnicity and region may synergistically influence variety of fruit and vegetable consumption.

Cross-sectional analysis. Multivariate logistic regression predicted the likelihood of meeting fruit and vegetable variety indicators independently and in combination for each race/ethnicity and region. Interaction effects models were used to test for interaction effects between race/ethnicity and region on fruit and vegetable variety.

The 2011 Behavioral Risk Factor Surveillance System (BRFSS).

The sample consisted of 275 864 adult respondents.

Fewer than half of respondents consumed fruit and all vegetable subcategories at least once weekly. The adjusted likelihood of meeting fruit and vegetable variety indicators varied significantly by race/ethnicity and region (P<0·05). Significant interactions between race/ethnicity and region were found for at least once weekly consumption of beans, orange vegetables, all vegetables, and fruit and all vegetables (P<0·05).

Our results reinforce previous findings that the variety of vegetable consumption is lacking and is particularly evident among some population subgroups, such as non-Hispanic blacks in the Midwest USA, who may benefit from targeted dietary interventions.

The emergency preparedness of residents of North Carolina and Montana were compared.

General preparedness was evaluated using responses to 4 questions related to a household's 3-day supply of water, 3-day supply of nonperishable food, a working battery-operated radio, and a working battery-operated flashlight. Each positive answer was awarded 1 point to create an emergency preparedness score that ranged from 0 (minimum) to 4 (maximum). Results were assessed statistically.

The average emergency preparedness score did not differ between the 2 states (P = .513). One factor influencing higher preparedness in both states was being male. Other influencing factors in North Carolina were older age, being a race/ethnicity other than white, having an annual income of $35 000 or more, having children in the household, better (excellent/very good/good) self-reported health, and not being disabled. In contrast, other factors influencing higher emergency preparedness in Montana were having a college degree and being married or partnered.

A divergence was found in factors influencing the likelihood of being prepared. These factors were likely a result of different sociodemographic and geographic characteristics between the 2 states. (Disaster Med Public Health Preparedness. 2014;0:1-4)

This study examined the association between self-reported levels of household disaster preparedness and a range of physical and mental health quality of life outcomes.

Data collected from 14 states participating in a large state-based telephone survey were analyzed (n = 104 654). Household disaster-preparedness items included having a 3-day supply of food, water, and prescription medications; a working battery-powered radio and flashlight; an evacuation plan; and a willingness to evacuate when instructed to do so. Quality-of-life items were categorized into 2 domains: physical health (general health, unhealthy physical days, and activity-limited days) and mental health (unhealthy mental days, social and emotional support, and life satisfaction).

Persons with self-reported impaired mental health were generally less likely to report being prepared for a disaster than those who did not report impairment in each domain. Persons with low life satisfaction were among the least likely to be prepared, followed by those with inadequate social and emotional support, and then by those with frequent mental distress. Persons reporting physical impairments also reported deficits in many of the preparedness items. However, after adjusting for sociodemographic characteristics, some of the associations were attenuated and no longer significant.

Persons reporting impaired quality of life are vulnerable to increased mental and physical distress during a disaster, and their vulnerability is compounded if they are ill-prepared. Therefore, persons reporting impaired quality of life should be included in the list of vulnerable populations that need disaster preparedness and response outreach.

Are there differences in diabetes care between rural and non-rural US adults with diabetes?

Rural Healthy People 2010 includes diabetes as a major health priority, suggesting a possible disparity between diabetes care in rural settings as compared to non-rural locales.

This cross-sectional study using population-based survey data sought to determine if there was a difference in the quality of diabetes care between rural and non-rural US adults (⩾18 years). A diabetes care index was computed from five separate dichotomous care-related variables (HbA1c checked, lipids checked, dilated eye exam, feet checked by health care provider, and diabetes education), with adequate care defined as receiving at least four of these interventions. Multivariate methods were used to detect differences in diabetes care received by individuals living in rural compared to non-rural settings.

Multivariate regression analysis revealed that US adults with diabetes living in rural communities were more likely to receive inadequate care than non-rural residents (OR = 1.205; 95% CI 1.201, 1.209). Rural residents were more likely to receive inadequate diabetes care if they were: <40 years of age, male, Caucasian, not a high school graduate, not partnered, without health insurance, inactive or without an identified health care provider. Those deferring medical care because of cost, or who did not have an annual routine physical or had fewer than two diabetes related office visits annually were also at greater risk for suboptimal care. Routine physical checkups and deferring medical care because of cost had a greater impact on diabetes care for rural adults compared to non-rural adults.

The results of this study indicated that rural residents were less likely to receive adequate diabetes care compared to their non-rural counterparts. The findings suggest that efforts to identify and to address this disparity would likely improve the outcomes for diabetic individuals living in rural communities.