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1.  Urban-Rural and Regional Variability in the Prevalence of Food Insecurity: the Survey of the Health of Wisconsin 
Background
Food insecurity is a public health concern and it is estimated to affect 18 million American households nationally, which can result in chronic nutritional deficiencies and other health risks. The relationships between food insecurity and specific demographic and geographic factors in Wisconsin is not well documented. The goals of this paper are to investigate socio-demographic and geographic features associated with food insecurity in a representative sample of Wisconsin adults.
Methods
This study used data from the Survey of the Health of Wisconsin (SHOW). SHOW annually collects health-related data on a representative sample of Wisconsin residents. Between 2008-2012, 2,947 participants were enrolled in the SHOW study. The presence of food insecurity was defined based on the participant's affirmative answer to the question “In the last 12 months, have you been concerned about having enough food for you or your family?”
Results
After adjustment for age, race, and gender, 13.2% (95% Confidence Limit (CI): 10.8%-15.1%) of participants reported food insecurity, 56.7% (95% CI: 50.6%-62.7%) of whom were female. Food insecurity did not statistically differ by state public health region (p=0.30). The adjusted prevalence of food insecurity in the urban core, other urban, and rural areas of Wisconsin was 14.1%, 6.5% and 10.5%, respectively. These differences were not statistically significant (p=0.13).
Conclusions
The prevalence of food insecurity is substantial, affecting an estimated number of 740,000 Wisconsin residents. The prevalence was similarly high in all urbanicity levels and across all state public health regions in Wisconsin. Food insecurity is a common problem with potentially serious health consequences affecting populations across the entire state.
PMCID: PMC4245074  PMID: 25211799
2.  Evaluating Effects of Statewide Smoking Regulations on Smoking Behaviors Among Participants in the Survey of the Health of Wisconsin 
Background
Studies have shown that laws banning smoking in public places reduce exposure to secondhand smoke, but the impact of such laws on exposure to smoke outside the home and on household smoking policies has not been well documented. The goal of this study was to evaluate the effects of 2009 Wisconsin Act 12, a statewide smoke-free law enacted in July 2010, among participants in the Survey of the Health of Wisconsin (SHOW).
Methods
Smoking history and demographic information was gathered from 1341 survey participants from 2008 to 2010. Smoking behaviors of independent samples of participants surveyed before and after the legislation was enacted were compared.
Results
The smoking ban was associated with a reduction of participants reporting exposure to smoke outside the home (from 55% to 32%; P < 0.0001) and at home (13% to 7%; P = 0.002). The new legislation was associated with an increased percentage of participants with no-smoking policies in their households (from 74% to 80%; P = .04). The results were stronger among participants who were older, wealthier, and more educated.
Conclusion
Smoke-free legislation appears to reduce secondhand smoke exposure and to increase no-smoking policies in households. Further research should be conducted to see if these effects are maintained.
PMCID: PMC3529004  PMID: 22970531
3.  The Survey of the Health of Wisconsin (SHOW), a novel infrastructure for population health research: rationale and methods 
BMC Public Health  2010;10:785.
Background
Evidence-based public health requires the existence of reliable information systems for priority setting and evaluation of interventions. Existing data systems in the United States are either too crude (e.g., vital statistics), rely on administrative data (e.g., Medicare) or, because of their national scope (e.g., NHANES), lack the discriminatory power to assess specific needs and to evaluate community health activities at the state and local level. This manuscript describes the rationale and methods of the Survey of the Health of Wisconsin (SHOW), a novel infrastructure for population health research.
Methods/Design
The program consists of a series of independent annual surveys gathering health-related data on representative samples of state residents and communities. Two-stage cluster sampling is used to select households and recruit approximately 800-1,000 adult participants (21-74 years old) each year. Recruitment and initial interviews are done at the household; additional interviews and physical exams are conducted at permanent or mobile examination centers. Individual survey data include physical, mental, and oral health history, health literacy, demographics, behavioral, lifestyle, occupational, and household characteristics as well as health care access and utilization. The physical exam includes blood pressure, anthropometry, bioimpedance, spirometry, urine collection and blood draws. Serum, plasma, and buffy coats (for DNA extraction) are stored in a biorepository for future studies. Every household is geocoded for linkage with existing contextual data including community level measures of the social and physical environment; local neighborhood characteristics are also recorded using an audit tool. Participants are re-contacted bi-annually by phone for health history updates.
Discussion
SHOW generates data to assess health disparities across state communities as well as trends on prevalence of health outcomes and determinants. SHOW also serves as a platform for ancillary epidemiologic studies and for studies to evaluate the effect of community-specific interventions. It addresses key gaps in our current data resources and increases capacity for etiologic, applied and translational population health research. It is hoped that this program will serve as a model to better support evidence-based public health, facilitate intervention evaluation research, and ultimately help improve health throughout the state and nation.
doi:10.1186/1471-2458-10-785
PMCID: PMC3022857  PMID: 21182792

Results 1-3 (3)