Role of Obesity in the Perception of Wellness among American Indians

Obesity is epidemic among American Indians. Understanding the complex factors associated with obesity, perceptions of wellness, and barriers to wellness among this population will improve interventions, as well as help direct local, tribal, state and national health policy for Indigenous people. A cross-sectional randomized household survey was conducted with 457 American Indian adults who received services at one of 13 healthcare sites in California. Measures included body mass index (BMI), socio-demographic characteristics, wellness perceptions/barriers, general health, spirituality, and abuse history. Females were significantly likely to be obese/morbidly obese (p=.0007). Wellness perceptions and general health status were different between BMI categories (p=.005 and p=.002, respectively). The morbidly obese reported health status limiting activities (p=.003). Differences in obesity status and diseases were seen in diabetes (p=.0004), arthritis (p=.04) and hypertension (p=.03). Morbidly obese were likely to have been physically (p=.002) and sexually (p=0.03) abused in childhood. Poor general health status remained a significant predictor of perceived wellness across BMI comparisons. Higher BMI categories had poorer health status and were more limited in achieving wellness. Our study shows obesity, perceptions of wellness, and physical health status are strongly interconnected, which has important implications at the policy level.