243189 Black-White disparities in overweight and obesity trends among the highly educated in the United States, 1997-2008

Sunday, October 30, 2011

Chandra L. Jackson, MSc , Epidemiology Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Hsin-Chieh Yeh, PhD , Department of Medicine & Epidemiology, Johns Hopkins University, Baltimore, MD
Nae-Yuh Wang, PhD , Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins School of Medicine, Baltimore, MD
Rosemary Dray-Spira, MD, PhD , INSERM U1018, Team 11, Hopital Paul Brousse, 94807 Villejuif Cedex, France
Roland J. Thorpe Jr., PhD , Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Moyses Szklo, MD, DrPH , Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
Frederick Brancati, MD, MHS , Department of Medicine & Epidemiology, Johns Hopkins University, Baltimore, MD
Background: It is well-established that less-educated individuals have been disproportionately affected by the obesity epidemic, but trends in the highly-educated have received less attention. Methods: We analyzed data on a nationally-representative sample of 17,311 Black and 103,109 White adults with greater than a high school education (GHSE) who participated in the National Health Interview Survey from 1997 to 2008. Poisson regressions with robust variances were used to determine prevalence ratios for overweight/obesity (BMI>25kg/m2) in Blacks vs. Whites. Results: Participants' mean age was 41 0.09 years, 50% were men, and 89% White. Mean BMI (henceforth, BMI) was slightly higher in Black vs. White men (28.4 0.9 vs.27.3 0.3kg/m2) and substantially higher in Black vs. White women (28.7 0.8 vs.25.6 0.3kg/m2; all P<0.001). From 1997-2008, BMI increased by at least 1kg/m2 in all sex-race groups. Blacks with GHSE had a consistently higher BMI than Whites in women (27.7 0.19 → 29.5 0.30kg/m2 vs.24.8 0.08 → 26.3 0.13kg/m2; with 2.9-3.1kg/m2 excess in Blacks) and men (27.6 0.10kg/m2 → 28.7 0.30 vs.26.7 0.19kg/m2 → 27.8 0.42kg/m2; with 0.8-1.0kg/m2 excess in Blacks). In age-adjusted analyses, overweight/obesity was greater by 54% (95%CI: 1.50-1.57) in Black vs. White women and 9% (95%CI: 1.07-1.11) in Black vs. White men. Conclusions: BMI increased steadily in all sex-race groups with GHSE from 1997-2008, and Blacks (especially women) had a consistently higher BMI than their White counterparts. Higher education does not appear protective against the obesity epidemic nor racial disparities in overweight/obesity.

Learning Areas:
Epidemiology
Planning of health education strategies, interventions, and programs
Public health or related research
Social and behavioral sciences

Learning Objectives:
1) Describe how trends in overweight/obesity differ over a 12-year study period between a nationally representative sample of Blacks and Whites with greater than a high school education

Keywords: Obesity, Health Disparities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have received formal training in epidemiology, and have conducted the analysis for this research under the supervision of highly qualified academic advisors.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.