Ethnic and Racial disparities in overweight and obesity related co-morbidities in Massachusetts

INTRODUCTION: The obesity epidemic affects all racial/ethnic groups but it is particularly prevalent among minority populations. The objective of this study was to evaluate racial and ethnic disparities of overweight and obesity related co-morbidities in Massachusetts.

METHODS: Data for the analysis derived from the Massachusetts Behavioral Risk Factor Surveillance System (BRFSS) for the period 1998-2007. The BRFSS database contains self-reported data of non-institutionalized Massachusetts adults. Multivariate logistic regression analyses were used to evaluate the association between disparities variables and BMI. Disparities variables included race/ethnicity, region of residence, household income, and educational status. The regressions were adjusted for demographic and social variables (gender, age, marital status, employment status, and education) and behavioral variables (fruit and vegetable consumption, alcohol drinking, smoking, and physical activity). Multivariate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated. Parameter estimates were obtained by maximum likelihood techniques and CIs were based on the standard error of model coefficients. Data were analyzed with SAS v9.0 statistical software to account for complex sample design.

RESULTS: In 1998, 35.7% of adults in Massachusetts were overweight, 10.3% obese and 3.9% morbidly obese. In 2007, 37.2% of adults were overweight, 14.1% obese and 7.6% morbidly obese. In 2007, 29.0% (CI 27.9-30.2) of women and 45.6% (CI 43.9-47.4) of men were overweight; and 12.5% (CI 11.6-13.3) of women and 15.9% (CI 14.7-17.1) of men were obese. Overweight/obesity estimates peaked at ages 55–64 with 40.7% of the population overweight and 18.2% obese. Overall, 44.0% (CI 38.3-49.7) of Blacks were overweight, 15.7% (CI 12.0-19.4) obese, and 10.6% morbidly obese; compared with 40.1% (CI 35.4-44.8) of Hispanic overweight, 16.1% (CI 13.0-19.3) obese and 8.9% morbidly obese. Among Whites 36.8% (CI 35.7-37.9) were overweight, 14.5% (CI 13.7-15.3) obese and 7.4% morbidly obese. In 2007, the odds of being obese among Black and Hispanic were 1.5 times higher than among White. The odds of having diabetes, hypercholesterolemia and hypertension, were 3.2, 2.1 and 3.6 times higher respectively for obese than for normal weight individuals. Obesity increases 1.3 times the odds of having a heart attack and 1.7 times the odds of having a coronary heart disease.

CONCLUSIONS: The prevalence of overweight/obesity in Massachusetts is increasing. Prevalence of obesity is highly associated with diabetes, hypertension, high cholesterol, and cardio-vascular diseases. There exist ethnic/racial disparities in prevalence of obesity and obesity related co-morbidities. Implementation of public health programs focusing interventions on racial/ethnic populations disproportionately affected remains critical.