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co
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d
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w
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h
e
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t
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icate
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at
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Stu
d
y
Me
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r
es:
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ter
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MI
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ased
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r
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d
d
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n
o
s
is
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MI
w
as
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m
p
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n
th
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ased
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n
th
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llo
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te
g
o
r
ies:
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5
K,
1
5
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5
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2
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5
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3
5
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th
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ce
w
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s
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ased
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ar
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m
e
ter
s
r
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lted
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a
f
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m
p
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ize
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n
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.
Data
A
n
a
l
y
s
is
:
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h
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b
asic
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tiv
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ar
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f
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d
d
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al
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al
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ip
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co
n
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c
ted
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th
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t a
d
d
itio
n
al
w
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ig
h
ti
n
g
o
f
t
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ata.
3.
RE
SU
L
T
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A
ND
D
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SCU
SS
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Sa
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ar
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2
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ab
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p
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b
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f
t
h
i
s
an
al
y
s
i
s
ar
e
p
r
esen
ted
in
T
ab
le
3
.
Evaluation Warning : The document was created with Spire.PDF for Python.
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171
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C
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m
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V
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:
R
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q
u
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d
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.
0
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B
o
l
d
e
d
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t
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ms
p
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se
n
t
s
t
a
t
i
s
t
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l
l
y
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g
n
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f
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c
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n
t
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e
su
l
t
s
a
t
t
h
e
α=
p
<
0
.
0
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T
h
e
Po
s
t
Ho
c
an
al
y
s
es
i
n
d
icat
es
th
at
B
MI
d
if
f
er
en
ce
s
o
n
r
ac
e
ar
e
r
ev
ea
led
b
et
w
ee
n
B
lac
k
an
d
o
th
er
,
No
n
-
H
is
p
an
ics
(
MD
=
1
.
5
1
d
if
f
er
en
ce
in
B
MI
)
,
f
o
llo
w
ed
b
y
d
if
f
er
en
ce
b
et
w
ee
n
B
lack
a
n
d
W
h
ite
(
MD
=
0
.
5
1
d
if
f
er
e
n
ce
in
B
MI
)
.
T
h
e
A
v
er
ag
e
B
MI
f
o
r
th
e
W
h
ite
,
B
lack
,
an
d
o
th
er
in
d
iv
id
u
al
s
w
ith
d
i
ag
n
o
s
is
o
f
d
iab
etes
is
p
r
esen
ted
in
T
ab
le
5
.
T
ab
le
5
.
A
v
er
ag
e
B
MI
o
f
th
o
s
e
w
it
h
d
iab
etes d
iag
n
o
s
i
s
W
h
i
t
e
B
l
a
c
k
O
t
h
e
r
<
1
5
K
3
5
.
1
3
4
.
0
3
9
.
8
15
-
25K
3
2
.
7
3
3
.
4
2
6
.
0
25
-
35K
3
2
.
8
3
2
.
3
2
9
.
7
35
-
50K
3
1
.
6
3
1
.
4
3
2
.
2
5
0
K
o
r
mo
r
e
3
2
.
4
3
0
.
6
2
5
.
2
As
in
d
icate
d
ab
o
v
e,
B
lack
i
n
d
iv
id
u
al
s
ar
e
lik
el
y
to
b
e
d
iag
n
o
s
ed
w
i
th
d
iab
etes
at
lo
w
e
r
av
er
ag
e
B
MI
.
T
h
is
tr
en
d
i
n
cr
ea
s
es
a
s
t
h
e
i
n
co
m
e
le
v
el
o
f
th
e
B
lac
k
in
d
iv
id
u
als
in
cr
ea
s
e
s
.
A
g
r
ap
h
ical
r
ep
r
esen
tatio
n
o
f
th
e
i
n
ter
ac
tio
n
b
et
w
ee
n
r
ac
e
an
d
d
iab
etes d
iag
n
o
s
i
s
o
n
B
MI
is
p
r
esen
ted
in
Fi
g
u
r
e
1
.
T
h
e
r
esu
lts
o
f
th
e
c
u
r
r
en
t
i
n
v
esti
g
a
tio
n
p
r
o
v
id
e
s
o
m
e
in
s
i
g
h
t
in
to
th
e
r
elatio
n
s
h
ip
b
et
w
e
en
B
MI
,
a
d
iab
etes
d
iag
n
o
s
is
,
i
n
co
m
e
le
v
el,
a
n
d
r
ac
e
f
o
r
t
h
e
i
n
d
iv
id
u
als
i
n
clu
d
ed
i
n
t
h
e
p
r
o
v
id
ed
d
ata
s
et.
Si
m
ilar
to
p
r
ev
io
u
s
r
esear
ch
,
th
e
s
e
r
esu
l
ts
s
u
g
g
est
th
a
t
th
er
e
ar
e
s
ig
n
i
f
ica
n
t
d
if
f
er
en
ce
s
i
n
B
MI
ac
r
o
s
s
d
if
f
er
e
n
t
r
ac
es,
an
d
s
ig
n
i
f
ica
n
t
d
if
f
er
en
ce
s
i
n
B
MI
b
ased
o
n
a
p
r
io
r
d
iag
n
o
s
is
o
f
d
iab
etes
[
1
-
3
,
1
5
,
2
6
]
.
H
o
w
e
v
er
,
r
esu
lts
d
id
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N:
2
2
5
2
-
8
8
0
6
I
n
t.
J
.
P
u
b
lic
Hea
lth
Sci
.
Vo
l.
1
0
,
No
.
1
,
Ma
r
ch
20
21
:
1
6
9
–
17
4
172
n
o
t
s
u
p
p
o
r
t
a
f
in
d
i
n
g
o
f
s
i
g
n
i
f
ica
n
t
d
if
f
er
e
n
ce
s
i
n
B
MI
ac
r
o
s
s
d
if
f
er
en
t
i
n
co
m
e
le
v
el
s
[
3
]
.
R
esu
lts
i
n
d
icat
e
th
at
B
lack
p
ar
ticip
an
t
w
it
h
a
p
r
io
r
d
ia
b
etes
d
iag
n
o
s
i
s
h
a
v
e
th
e
h
ig
h
es
t
av
er
a
g
e
B
M
I
,
w
h
e
r
ea
s
th
e
W
h
i
te
an
d
H
is
p
an
ic
p
ar
ticip
a
n
ts
w
it
h
a
p
r
io
r
d
iab
etes
d
iag
n
o
s
i
s
h
a
v
e
t
h
e
lo
w
es
t
av
er
a
g
e
B
MI
s
.
T
h
ese
r
esu
lt
s
ar
e
p
r
eli
m
in
ar
y
a
n
d
b
ased
o
n
a
li
m
ited
s
u
b
s
et
o
f
d
ata
f
o
r
th
e
State
o
f
Oh
io
.
A
d
d
itio
n
all
y
,
th
e
d
ata
w
as
a
n
al
y
ze
d
w
it
h
o
u
t a
p
p
l
y
in
g
w
ei
g
h
ti
n
g
.
Fig
u
r
e
1
.
R
ac
e
an
d
d
iab
etes le
v
els o
n
a
v
er
ag
e
B
MI
Help
in
g
th
e
B
lack
co
m
m
u
n
it
y
to
av
o
id
o
b
esit
y
a
n
d
d
iab
etes
w
ill
r
eq
u
ir
e
a
m
u
lt
i
-
le
v
el
i
n
ter
v
e
n
tio
n
p
lan
t
h
at
f
o
cu
s
e
s
o
n
a
w
ar
en
ess
,
ad
ap
tio
n
,
a
n
d
av
ai
lab
ilit
y
.
P
s
y
c
h
o
ed
u
ca
tio
n
o
f
th
e
B
lack
co
m
m
u
n
i
t
y
is
n
ec
es
s
ar
y
i
n
o
r
d
er
to
p
r
ev
en
t
o
b
esit
y
a
n
d
d
iab
etes.
B
lack
s
n
ee
d
in
f
o
r
m
atio
n
o
n
b
asic
n
u
tr
i
tio
n
to
p
ics
s
u
c
h
a
s
s
er
v
ici
n
g
s
izes
an
d
r
ea
d
in
g
f
o
o
d
la
b
els;
h
o
w
to
ch
o
o
s
e
a
d
iet
th
at
is
lo
w
in
to
tal
f
at,
s
atu
r
ated
f
at,
an
d
ch
o
lest
er
o
l;
h
o
w
to
ch
o
o
s
e
b
ev
er
ag
es
an
d
f
o
o
d
s
lo
w
in
s
u
g
ar
;
h
o
w
to
p
r
ep
ar
e
f
o
o
d
s
w
it
h
le
s
s
s
alt,
ea
t
a
v
ar
iet
y
o
f
g
r
ain
s
d
ail
y
;
an
d
e
at
a
v
ar
iet
y
o
f
f
r
u
its
a
n
d
v
eg
etab
les
d
ail
y
[
2
7
]
.
Hea
lth
ca
r
e
p
r
o
f
ess
io
n
als
al
s
o
n
ee
d
to
b
e
a
w
ar
e
t
h
at
o
b
esit
y
is
h
i
g
h
l
y
co
m
o
r
b
id
,
p
ar
ticu
lar
l
y
f
o
r
B
lack
w
o
m
e
n
,
an
d
t
h
e
o
th
er
e
f
f
ec
ts
o
f
o
b
esit
y
an
d
d
iab
etes
o
n
th
e
h
ea
lt
h
o
f
B
lack
s
.
Stre
s
s
an
d
n
eg
at
iv
e
li
f
e
ev
e
n
ts
e
x
p
er
ien
ce
d
d
u
e
to
a
s
h
ar
ed
s
o
cio
cu
lt
u
r
al
g
r
o
u
p
s
tat
u
s
,
as
w
ell
a
s
c
u
lt
u
r
al
b
elie
f
s
a
n
d
v
alu
e
s
m
a
y
b
e
i
m
p
o
r
tan
t
in
u
n
d
er
s
ta
n
d
in
g
an
d
tr
ea
tin
g
B
lack
s
[
2
8
]
.
Hea
lth
C
ar
e
P
r
o
f
ess
io
n
s
ca
n
u
s
e
t
h
e
in
f
o
r
m
atio
n
ab
o
u
t
t
h
eir
c
u
r
r
en
t
clie
n
t
s
w
h
o
ar
e
b
ein
g
tr
ea
ted
f
o
r
o
b
esit
y
an
d
d
iab
etes
to
id
en
tify
s
e
g
m
en
ts
o
f
th
e
p
o
p
u
latio
n
an
d
co
m
m
u
n
it
y
th
a
t
s
h
o
u
ld
b
e
tar
g
eted
f
o
r
ed
u
ca
tio
n
al
p
r
o
g
r
a
m
s
a
n
d
h
ea
lt
h
p
r
o
m
o
tio
n
ch
a
n
n
el
s
to
r
ea
ch
th
e
tar
g
et
g
r
o
u
p
[
2
7
]
.
Hea
lth
C
ar
e
P
r
o
f
ess
io
n
als
m
u
s
t
b
ec
o
m
e
a
w
ar
e
o
f
in
te
r
v
en
tio
n
s
th
at
ar
e
ad
ap
t
ab
le
to
B
lack
s
.
C
u
l
tu
r
all
y
ad
ap
ted
i
n
ter
v
e
n
ti
o
n
s
ar
e
a
n
i
m
p
o
r
tan
t
w
a
y
to
ac
k
n
o
w
led
g
e
s
o
cio
cu
lt
u
r
al
f
ac
to
r
s
an
d
p
r
o
d
u
ce
ex
p
ec
ted
o
u
tco
m
es
w
it
h
in
a
s
p
ec
if
ic
g
r
o
u
p
[
2
8
]
.
A
n
e
x
a
m
p
le
o
f
a
n
e
m
p
o
w
er
in
g
a
n
d
ef
f
ec
tiv
e
c
u
lt
u
r
all
y
ad
ap
ted
in
ter
v
e
n
tio
n
p
r
o
g
r
am
i
s
B
’
m
o
r
e
Hea
l
th
y
C
o
m
m
u
n
it
ies
f
o
r
Kid
s
(
B
HC
K)
.
T
h
e
B
’
m
o
r
e
Hea
lt
h
y
C
o
m
m
u
n
i
ties
f
o
r
Kid
s
(
B
HC
K)
tr
ial
is
a
m
u
lt
i
-
lev
el
c
h
ild
o
b
esit
y
p
r
ev
en
tio
n
i
n
ter
v
e
n
tio
n
,
s
u
p
p
o
r
ted
as
p
ar
t
o
f
an
U5
4
g
r
an
t
to
th
e
J
o
h
n
s
Ho
p
k
in
s
B
lo
o
m
b
er
g
Sch
o
o
l
o
f
P
u
b
lic
Hea
lt
h
to
f
u
n
d
t
h
e
J
o
h
n
s
Ho
p
k
i
n
s
Glo
b
al
O
b
esit
y
P
r
ev
en
t
io
n
C
e
n
ter
.
T
h
e
B
HC
K
in
ter
v
en
tio
n
is
g
u
id
ed
b
y
s
o
cial
co
g
n
iti
v
e
th
eo
r
y
(
SC
T
)
,
s
o
cial
ec
o
lo
g
y
,
a
n
d
s
y
s
te
m
s
t
h
eo
r
y
T
h
is
in
ter
v
e
n
tio
n
p
r
e
v
en
t
s
c
h
i
ld
h
o
o
d
o
b
esit
y
b
y
w
o
r
k
i
n
g
at
m
u
ltip
le
lev
el
s
o
f
th
e
f
o
o
d
an
d
s
o
cial
en
v
ir
o
n
m
en
ts
to
in
cr
ea
s
e
ac
ce
s
s
to
,
d
em
an
d
f
o
r
,
an
d
co
n
s
u
m
p
tio
n
o
f
h
ea
lt
h
ier
f
o
o
d
s
.
B
HC
K
w
o
r
k
s
to
cr
ea
te
s
y
s
te
m
s
-
le
v
el
c
h
an
g
e
b
y
p
ar
tn
er
i
n
g
w
it
h
cit
y
p
o
lic
y
m
ak
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s
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m
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lev
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s
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f
t
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f
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o
d
en
v
ir
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t
(
w
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o
lesale
r
s
,
co
r
n
er
s
to
r
es,
ca
r
r
y
o
u
t
r
es
tau
r
an
t
s
)
,
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d
th
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s
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cial
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n
v
ir
o
n
m
e
n
t
(
p
ee
r
s
an
d
f
a
m
ilies
)
.
I
n
ad
d
itio
n
,
ex
ten
s
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e
ev
al
u
atio
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w
ill
b
e
co
n
d
u
cted
at
ea
ch
lev
el
o
f
t
h
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in
t
er
v
en
tio
n
to
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s
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ter
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n
tio
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f
f
ec
tiv
e
n
es
s
v
ia
b
o
th
p
r
o
ce
s
s
an
d
i
m
p
ac
t
m
e
asu
r
es
[
2
9
]
.
I
n
d
ev
elo
p
i
n
g
a
w
ar
e
n
ess
,
Af
r
ica
n
-
Am
er
ica
n
p
o
p
u
latio
n
s
m
a
y
b
e
m
o
r
e
co
m
f
o
r
tab
le
d
is
cu
s
s
i
n
g
s
en
s
iti
v
e
to
p
ics
as
cu
lt
u
r
al
co
n
g
r
u
e
n
ce
w
it
h
o
th
er
Af
r
ican
-
Am
er
ica
n
s
[
3
0
]
.
T
h
is
f
i
n
al
i
n
ter
v
e
n
tio
n
to
p
r
ev
en
t
o
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n
d
d
iab
etes
w
i
th
i
n
t
h
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lt
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s
o
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th
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d
s
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en
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m
e
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t
s
to
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e
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ce
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s
to
,
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em
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n
d
f
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d
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n
s
u
m
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n
o
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h
ea
lth
ier
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o
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s
[
1
5
,
18
-
2
9
]
.
I
n
cr
ea
s
in
g
t
h
e
a
cc
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lack
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a
v
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ets
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p
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e
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iet
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u
alit
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f
at
in
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f
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it
a
n
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v
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n
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d
ec
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e
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e
d
is
p
ar
ities
in
o
b
esit
y
r
ates
a
m
o
n
g
gr
o
u
p
s
[
2
9
]
.
Sto
r
e
o
w
n
er
s
in
B
lack
co
m
m
u
n
itie
s
also
n
ee
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to
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ar
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an
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ca
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p
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b
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s
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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J
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P
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in
)
173
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in
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.
T
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in
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m
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ter
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il
t
e
n
v
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o
n
m
e
n
t.
W
h
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o
b
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is
a
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p
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b
lem
in
t
h
e
U
n
ited
State
s
,
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ed
u
ci
n
g
th
e
o
b
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a
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d
d
iab
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p
r
ev
al
en
ce
i
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t
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B
lack
co
m
m
u
n
it
y
w
ill i
m
p
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e
o
v
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all
q
u
alit
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o
f
li
f
e
f
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th
o
s
e
co
m
m
u
n
itie
s
.
RE
F
E
R
E
NC
E
S
[1
]
Co
n
w
a
y
,
B.
N.,
Ha
n
X
,
M
u
n
ro
.
,
e
t
a
l.
,
“
T
h
e
o
b
e
sity
e
p
id
e
m
ic
a
n
d
risin
g
d
iab
e
tes
in
c
id
e
n
c
e
in
a
lo
w
in
c
o
m
e
ra
c
i
a
ll
y
d
iv
e
rse
so
u
th
e
rn
U
S
c
o
h
o
rt
,
”
PL
O
S
On
e
,
v
o
l
.
1
8
,
n
o
.
1
,
p
p
.
1
-
1
2
,
2
0
1
8
,
d
o
i:
h
tt
p
s:/
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o
i.
o
rg
/1
0
.
1
3
7
1
/j
o
u
rn
a
l.
p
o
n
e
.
0
1
9
0
9
9
3
.
[2
]
Kru
e
g
e
r,
P
.
M
.
&
Re
it
h
e
r,
E.
N.
,
“
M
in
d
t
h
e
G
a
p
:
Ra
c
e
/E
th
n
ic
a
n
d
S
o
c
io
e
c
o
n
o
m
ic
Disp
a
rit
ies
in
Ob
e
sit
y
,
”
Cu
rr
e
n
t
Dia
b
e
tes
Rep
o
rts
,
v
o
l.
1
5
,
n
o
.
1
1
,
p
p
.
1
-
2
2
,
2
0
1
5
,
d
o
i
:
h
t
tp
s://
d
o
i.
o
r
g
/1
0
.
1
0
0
7
/s1
1
8
9
2
-
0
1
5
-
0
6
6
6
-
6
.
[3
]
Li
n
k
,
Ca
ro
l
L
,
a
n
d
Jo
h
n
B
M
c
Kin
lay
.
,
“
Disp
a
rit
ies
in
th
e
p
re
v
a
len
c
e
o
f
d
iab
e
tes
:
is
it
ra
c
e
/eth
n
icity
o
r
so
c
io
e
c
o
n
o
m
ic
sta
tu
s?
Re
su
lt
s
f
r
o
m
th
e
Bo
sto
n
A
re
a
Co
m
m
u
n
it
y
He
a
lt
h
(B
A
CH)
su
rv
e
y
,
”
Et
h
n
ic
it
y
&
D
is
e
a
se
,
v
o
l.
19
,
n
o
.
3
,
p
p
.
2
8
8
-
9
2
,
2
0
0
9
.
[4
]
Af
o
lab
i
,
H.
A
.
,
Za
k
a
ri
y
a
,
Z.
b
in
,
e
t
a
l.
,
“
T
h
e
re
latio
n
sh
ip
b
e
t
w
e
e
n
o
b
e
sity
a
n
d
o
th
e
r
m
e
d
ica
l
c
o
m
o
rb
id
it
ies
,
”
Ob
e
sity M
e
d
icin
e
,
n
o
.
17
,
p
p
.
1
-
6
,
2
0
2
0
,
d
o
i:
h
tt
p
s://
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i.
o
rg
/1
0
.
1
0
1
6
/j
.
o
b
m
e
d
.
2
0
1
9
.
1
0
0
1
6
4
.
[5
]
S
rin
a
g
,
L
.
,
M
a
ru
th
y
,
K.
N.,
Ka
re
e
m
,
e
t
a
l.
,
“
I
m
p
a
c
t
o
f
o
v
e
r
we
ig
h
t
o
n
c
o
g
n
it
i
o
n
a
n
d
p
sy
c
h
o
m
o
to
r
sk
il
ls
a
m
o
n
g
c
h
il
d
re
n
w
it
h
o
v
e
rw
e
i
g
h
t,
”
Ob
e
sity
M
e
d
icin
e
,
v
o
l.
8
,
p
p
.
2
-
2
9
,
2
0
20
,
d
o
i:
h
tt
p
s:/
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o
i.
o
rg
/1
0
.
1
0
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6
/j
.
o
b
m
e
d
.
2
0
2
0
.
1
0
0
1
9
1
.
[6
]
S
a
n
y
a
o
lu
,
A
.
,
O
k
o
rie,
C.
,
Qi,
X
.
,
e
t
a
l.
,
“
Ch
il
d
h
o
o
d
a
n
d
A
d
o
les
c
e
n
t
Ob
e
sity
in
th
e
Un
it
e
d
S
tate
s:
A
P
u
b
li
c
He
a
lt
h
Co
n
c
e
rn
,
”
Gl
o
b
a
l
Ped
ia
tric He
a
l
t
h
,
v
o
l.
6
,
n
o
.
1
,
p
p
.
1
-
2
2
,
2
0
1
9
,
d
o
i:
h
tt
p
s://
d
o
i
.
o
rg
/1
0
.
1
1
7
7
/
2
3
3
3
7
9
4
X1
9
8
9
1
3
0
5
.
[7
]
S
a
n
c
h
is
-
G
o
m
a
r,
F
.
,
L
a
v
ie,
C.
J.,
e
t
a
l.
,
“
Ob
e
sity
a
n
d
Ou
tco
m
e
s
in
COV
ID
-
1
9
:
W
h
e
n
a
n
Ep
id
e
m
ic
a
n
d
P
a
n
d
e
m
ic
Co
ll
id
e
.
”
M
a
y
o
Cli
n
ic
Pro
c
e
e
d
in
g
s
,
v
o
l.
9
5
,
n
o
.
7
,
p
p
.
1
4
4
5
-
1
4
5
3
,
2
0
2
0
,
d
o
i:
h
tt
p
s:/
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o
i.
o
rg
/1
0
.
1
0
1
6
/j
.
m
a
y
o
c
p
.
2
0
2
0
.
0
5
.
0
0
6
.
[8
]
S
a
m
a
ra
,
A
.
,
A
n
d
e
rse
n
,
P
.
T
.
,
&
A
ro
,
A
.
R.
“
He
a
lt
h
p
ro
m
o
ti
o
n
a
n
d
o
b
e
sity
in
th
e
A
ra
b
g
u
l
f
sta
te
s
:
Ch
a
ll
e
n
g
e
s
a
n
d
g
o
o
d
p
ra
c
ti
c
e
s,
”
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3
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.
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4
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[
On
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].
A
v
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5
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Ce
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ters
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Dise
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P
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.
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[2
6
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Ba
c
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n
,
K.L
.
,
S
tu
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S
.
O.,
Co
z
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r,
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,
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t
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,
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[2
7
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Ja
m
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s,
D.
,
“
F
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to
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In
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s:
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p
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[2
8
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S
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s,
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rica
n
W
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:
A
Qu
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tativ
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lt
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Div
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th
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in
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rity
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2
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[2
9
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G
it
tl
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so
h
n
,
J.,
S
te
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v
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s,
E.
,
M
u
i,
Y.,
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t
a
l.
,
“
B’M
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H
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a
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rica
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Ch
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C
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[3
0
]
G
e
o
rg
e
,
S
.
,
Du
ra
n
,
N.,
&
No
rris,
K.
,
“
A
s
y
ste
m
a
ti
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s,
L
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A
sia
n
A
m
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rica
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s,
a
n
d
P
a
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if
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d
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”
Ame
ric
a
n
J
o
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rn
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Pu
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JP
H .
2
0
1
3
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3
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0
6
.
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