Duval County 2009, 2011, and 2013 Fruit and Vegetable Intake by Health Zone: Data from the Youth Risk Behavior Survey

The purpose of this study was to compare the results of fruit and vegetable intake data from the 2009, 2011, 2013 Duval County Youth Risk Surveys (YRBS) by health zone. The survey instrument (questionnaire) is administered using a cluster sample design in all ninth grade classes in public schools (except charter schools) every two (odd) years. The surveys are anonymous and there is parental notification. Oversampling is done to allow for sub-county analysis. There were no statistically significant differences across health zones for any of the fruit and vegetable consumption questions for year 2009 however all health zones were below the recommended level of fruit and vegetable intake. For years 2011 and 2013 despite significant statistical differences by health zone in the frequency of consumption for fruits and vegetables, all health zones had a low mean intake of fruits and vegetables for years 2009, 2011 and 2013. Most respondents indicated consuming fruits, green salad, potatoes (not fried), carrots and vegetables “1 to 3 times during the past 7 days.” Overall intake of fruits and vegetables, however, was low for all health zones. Florida Public Health Review, 2016; 13, 29-36. BACKGROUND The Youth Risk Behavior Survey (YRBS) was developed in 1991 to monitor risk behaviors of adolescents and young adults. The YRBS is a component of the Youth Risk Behavior Surveillance System (YRBSS) developed by the Centers for Disease Control and Prevention (CDC). Many representatives from different organizations (including state and local departments of education and health, federal agencies, and national education and health organizations) collaborated in the development of the YRBS. The YRBSS is focused on assessing health behaviors that lead to major causes of mortality and morbidity among youth and to track how these behaviors change over time. The YRBS monitors six categories of behavior: sexual risk behaviors; tobacco use; alcohol and substance use; safety, violence, and unintentional injury; diet, nutrition, and weight, including physical activity; and chronic conditions such as obesity and asthma (Brener et al., 2015). The YRBS can be conducted by states, territories, and urban school districts (Foti et al., 2011). This report summarizes and compares, according to the county’s designated health zones, the results for fruit and vegetable intake of Duval County high school students for the years 2009, 2011, and 2013. Duval County Health Zones Unlike most analyses of YRBS, which focus on the state or local data, the analysis in this paper is unique in that it is based on the city’s health zones. This type of analysis provides data to support initiatives based on results specific to each health zone. Health zones are used in Duval County for sub-county analysis. Duval County includes 6 health zones that are based on zip code data related to county organization and demographics. These zones were created to “increase the statistical reliability of zip code data and for targeted program planning, and surveillance of health indicators” (Duval.floridahealth.gov, 2015). The six health zones were created from 35 zip codes with similar economic, educational, geographic, political, and social boundaries. The health behaviors, prevalence of chronic diseases and mortality rates vary among different health zones. Although cancer, CHD and COPD are the major cause of death in Duval County, Health Zone 1, which represents the urban core, has the shortest life expectancy. Other areas have high rates of illnesses.