Sociodemographic disparities in the prevalence of obesity -- INVITED

Although the prevalence of obesity has steadily increased among all United States (US) population groups over the past several decades, data from national surveys consistently demonstrate that women, individuals with lower socioeconomic status (lower income and/or educational attainment), and minority racial/ethnic groups have the highest rates of obesity. In 2009, 25.2% of adult non-Hispanic whites (“whites”) were obese compared with 36.8% of adult non-Hispanic blacks (“blacks) and 30.7% of adult Hispanics. Whereas there were virtually no gender differences in obesity prevalence among whites (men 27.1% versus women 23.3% women) and Hispanics (men 30.6% versus women 30.8%), 41.9% of black women were obese compared with 30.9% of black men. In 2008, among US children (age 2-19 years), Hispanic boys had significantly higher odds of having high BMI compared with white boys while there was no difference between white and black boys. Black girls were significantly more likely than white girls to have high BMI whereas there was no difference between Hispanic and white girls. These interactions between gender and race/ethnicity only begin to touch upon the complex and not yet fully understood inter-relationships among obesity, gender, age, race/ethnicity, and SES. Understanding the factors contributing to disparities in obesity between US population groups is essential to ameliorating this growing epidemic and achieving the national priority to eliminate health disparities. Many believe that sociodemographic disparities in obesity are largely due to restricted access to health-enhancing knowledge and resources among disadvantaged social groups. Differential rates of access to healthy activities (e.g., physical fitness facilities, parks) and foods (e.g., grocery stores, restaurants), and cultural factors (e.g., food preferences, habits, self-perception of weight) may help explain why obesity does not affect all population groups equally. In addition, access to and use of weight loss interventions vary by patient sociodemographic characteristics. Racial/ethnic minorities, and individuals with less education lower income, are significantly less likely to use commercial weight-loss programs, prescription weight-loss medications, and bariatric surgery. Until disparities in access to resources that prevent and treat obesity have been redressed, this healthcare crisis will continue to disproportionately affect underserved or disadvantaged groups, resulting in avoidable morbidity, mortality, and healthcare system costs.