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The Burden of Obesity in North Carolina Obesity in Adults.
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The Burden of The Burden of Obesity in North Obesity in North Carolina Carolina Obesity in Adults Obesity in Adults
Transcript of The Burden of Obesity in North Carolina Obesity in Adults.
The Burden of Obesity in The Burden of Obesity in North CarolinaNorth Carolina
Obesity in AdultsObesity in Adults
The Behavioral Risk Factor Surveillance The Behavioral Risk Factor Surveillance System (BRFSS)System (BRFSS)
Established in 1984 by the Centers for Disease Established in 1984 by the Centers for Disease Control and Prevention Control and Prevention
State-based system of health surveys that State-based system of health surveys that collect information on: collect information on: health risk behaviors health risk behaviors preventive health practices preventive health practices health care accesshealth care access
Random-digit dialing, individuals age 18 years Random-digit dialing, individuals age 18 years and older are randomly selected from each and older are randomly selected from each household calledhousehold called
Largest telephone health survey in the worldLargest telephone health survey in the world
The National Burden of ObesityThe National Burden of Obesity
2 out of 3 adults are overweight or obese2 out of 3 adults are overweight or obese
None of the states have experienced a None of the states have experienced a decrease in obesity for 16 years decrease in obesity for 16 years
In the past year, 31 states experienced an In the past year, 31 states experienced an increase in obesityincrease in obesity
Obesity Trends* Among U.S. AdultsBRFSS, 2008
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Source: Behavioral Risk Factor Surveillance System, CDC
The National Health and Nutrition The National Health and Nutrition Examination Survey (NHANES)Examination Survey (NHANES)
Designed to assess the health and Designed to assess the health and nutritional status of adults and children nutritional status of adults and children
Combines personal interviews and Combines personal interviews and physical examinations physical examinations
Used to determine the basis for national Used to determine the basis for national standards for such measurements as standards for such measurements as height, weight and blood pressure. height, weight and blood pressure.
The entire adult population is heavier, and the The entire adult population is heavier, and the heaviest have become much heavier since 1980. heaviest have become much heavier since 1980.
Changes in the Distribution of BMI between 1976-1980 and 2005-2006, United States Adults Aged 20-74 Years
Adult Obesity in N.C.Adult Obesity in N.C.
65.7% of N.C. adults are overweight 65.7% of N.C. adults are overweight or obese, or obese, aboveabove the national the national average. average. 56% are 56% are notnot meeting the physical meeting the physical
activity recommendationactivity recommendation 78% are 78% are notnot meeting the fruits or meeting the fruits or
vegetables recommendationvegetables recommendation
Adult Obesity in N.C.Adult Obesity in N.C.
Physical inactivity and unhealthy eating Physical inactivity and unhealthy eating combined are the combined are the 2nd leading 2nd leading preventable cause of death in N.C.,preventable cause of death in N.C., and and both increase the risk of:both increase the risk of:
•Heart diseaseHeart disease•Certain types of Certain types of cancercancer•DiabetesDiabetes
•High blood High blood pressurepressure•StrokeStroke•ObesityObesity
N.C. Adults, BMI TrendsN.C. Adults, BMI Trends
Trends in BMI Categories, N.C. Adults (1990-2008)
0
20
40
60
80
100
'90 '91 '92 '93 '94 '95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08
Pe
rce
nta
ge
of
Ad
ult
s
Healthy Weight Overweight Obese
Source: North Carolina Behavioral Risk Factor Surveillance System Survey, N.C. State Center for Health Statistics, N.C. Department of Health and Human Services, (1990-2008)
Healthy People 2010Healthy People 2010
Launched in January 2000, by The Department Launched in January 2000, by The Department of Health and Human Servicesof Health and Human Services
A comprehensive, nationwide health promotion A comprehensive, nationwide health promotion and disease prevention agendaand disease prevention agenda
Contains objectives to increase quality and Contains objectives to increase quality and years of healthy life and to eliminate health years of healthy life and to eliminate health disparities by the year 2010disparities by the year 2010
““By 2010, increase the percentage of adults By 2010, increase the percentage of adults who are at a healthy weight to 60%.”who are at a healthy weight to 60%.”
Percentage of Adults Who Were at a Healthy Weight in N.C. compared with U.S., Healthy People 2010 Target
(2007)
60%
37%34%
0
20
40
60
80
100
NC U.S. HP 2010 Target
Healthy People 2010 Objective 19-1. Obesity. "BY 2010, increase the percentage of adults w ho are at a healthy w eight to 60%." Data Sources DATA2010, CDC, NCHS. Prevalence Data from the Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, [2007].
““By 2010, reduce the percentage of adults (20 By 2010, reduce the percentage of adults (20 years old or older) who are obese to 15%.”years old or older) who are obese to 15%.”
Percentage of N.C. Adults Who Were Obese compared with U.S. Adults, Healthy People 2010 Target
18%23%
29%
16%21%
26%
0
10
20
30
40
50
1995 2001 2007
Percentage of Adults Who Were Obese
N.C.
U.S.
Healthy People 2010 Target (15%)
Healthy People 2010 Objective 19-2. Obesity. "By 2010, reduce the percentage of adults (20 years old or older) who are obese to 15%." Data Sources DATA2010, CDC, NCHS. Prevalence Data from the Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, [1995, 2001, 2007].
N.C. Adults Who Were Overweight N.C. Adults Who Were Overweight or Obese, by Genderor Obese, by Gender
Percentage of N.C. Adults Who Were Overweight or Obese, by Gender (2008)
42 30
3030
0
20
40
60
80
100
Male Female
Per
cen
tag
e o
f A
du
lts
Overweight Obese
Source: North Carolina Behavioral Risk Factor Surveillance System Survey, N.C. State Center for Health Statistics, N.C. Department of Health and Human Services, (2008).
72%60%
N.C. Adults Who Were Overweight N.C. Adults Who Were Overweight or Obese, by Age Groupor Obese, by Age Group
Percentage of N.C. Adults Who Were Overweight or Obese, by Age Group (2008)
23 33 41 38 39 40 39 36
2331
31 33 34 27 18 30
0
20
40
60
80
100
18-24 25-34 35-44 45-54 55-64 65-74 75+ AllAdults
Per
cen
tag
e o
f A
du
lts
Overweight Obese
Source: North Carolina Behavioral Risk Factor Surveillance System Survey, N.C. State Center for Health Statistics, N.C. Department of Health and Human Services, (2008).
72% 71% 73% 67%56%
66%64%46%
N.C. Adults Risk Factors, by N.C. Adults Risk Factors, by Race/EthnicityRace/Ethnicity
N.C. Adults who were Overweight N.C. Adults who were Overweight or Obese by Incomeor Obese by Income
Percentage of N.C. Adults Who Were Overweight or Obese, by Household Income (2008)
35 34 35 39 39 38
35 34 32 33 29 25
0
20
40
60
80
100
Less than$15,000
$15,000-$24,999
$25,000-$34,999
$35,000-$49,999
$50,000-$74,999
$75,000+
Per
cen
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e o
f A
du
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Overweight ObeseSource: North Carolina Behavioral Risk Factor Surveillance System Survey, N.C. State Center for Health Statistics, N.C. Department of Health and Human Services, (2008).
70% 68% 67% 72% 68%63%
The Burden of Obesity in The Burden of Obesity in North CarolinaNorth Carolina
Special Populations & ObesitySpecial Populations & Obesity
Special Populations in North CarolinaSpecial Populations in North Carolina
Life expectancy for North Carolina’s minority Life expectancy for North Carolina’s minority population is almost five years less than the population is almost five years less than the white population.white population.
African Americans are the largest minority group, African Americans are the largest minority group, accounting for 21 percent of the population. accounting for 21 percent of the population.
Hispanics now comprise approximately seven Hispanics now comprise approximately seven percent of the population, six times the percentage percent of the population, six times the percentage in 1990.in 1990.
About one percent of North Carolinians are About one percent of North Carolinians are American Indian. American Indian.
N.C. Risk Factor Percentages by Race/Ethnicity
Behavioral Risk Factors* (percentages) 2007:
White,Non-
Hispanic
African American,
Non-Hispanic
American Indian,Non-
Hispanic
Other Races,Non-
HispanicLatino/
Hispanic TOTAL
Adults with high blood pressure 28.2 39.7 29.3 16.7 12.7 28.8
Adults who smoke 23.2 23.3 32.9 18.8 19.2 22.9
Adults who are obese 26.4 39.2 26.7 22.9 25.4 28.7
Adults with no leisure time physical activity 21.2 28.7 36.6 20.5 40.6 24.3
Percent of adults in fair/poor health 16.6 21.8 26.8 14.6 29.7 18.7
* N.C. Behavioral Risk Factor Surveillance System (BRFSS), State Center for Health Statistics. BRFSS is an ongoing, monthly telephone survey through which data are collected from randomly selected, non-institutionalized N.C. adults (age 18 and older) in households with telephones. Survey responses are weighted to represent the demographics of all adults in the state.
Racial & Ethnic Disparities and ObesityRacial & Ethnic Disparities and Obesity
African Americans African Americans were more likely than were more likely than whites to be obese, whites to be obese, have high blood have high blood pressure, be physically pressure, be physically inactive, and have inactive, and have inadequate fruit and inadequate fruit and vegetable vegetable consumption.consumption.
N.C. Adults by RaceN.C. Adults by Race
Percentage of N.C. Adults Who Are Overweight or Obese, by Race (2008)
36 34 33 34 44 36
27
1
3527
3041
0
20
40
60
80
100
White AfricanAmerican
Asian NativeAmerican
OtherMinorities
All Adults
Per
cen
tag
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f A
du
lts
Overweight Obese
Source: North Carolina Behavioral Risk Factor Surveillance System Survey, N.C. State Center for Health Statistics, N.C. Department of Health and Human Services, (2008).
63%75%
34%
69% 71% 66%
Older Adults and ObesityOlder Adults and Obesity
In 2008,In 2008, 72.3% of adults in the 55-64 72.3% of adults in the 55-64 age group were overweight or obese.age group were overweight or obese.
Older U.S. Adults and Obesity
Health Behaviors % C.I.* Year Rank†
No Leisure-Time Physical Activity
30.4 (28.6 - 32.4) 2004 19
Eating ≥ 5 Fruits and Vegetables Daily
27.9 (25.3 - 30.7) 2003 37
Obesity 22.0 (20.3 - 23.8) 2004 37
*A confidence interval (CI) describes the level of uncertainty of an estimate and specifies the range in which the true value is likely to fall. The State of Aging and Health in America online report uses a 95 percent level of significance, which means that 95 percent of the time, the true value falls within these boundaries. †Rankings are based on the relative numeric scores for each indicator, with a ranking of "1" indicating the highest rank.
[i] Centers for Disease Control and Prevention and The Merck Company Foundation. The State of Aging and Health in America 2007. Whitehouse Station, NJ: The Merck Company Foundation; 2007. www.cdc.gov/aging/saha.htm
Educational and Socio-economic Educational and Socio-economic Disparities and ObesityDisparities and Obesity
In general, among white children, obesity In general, among white children, obesity typically declines as income and parental typically declines as income and parental education increase. Only rates of obesity education increase. Only rates of obesity for white girls decrease as family income for white girls decrease as family income rises.rises.
Obesity rates for African American girls Obesity rates for African American girls are higher in the lowest and highest are higher in the lowest and highest income ranges than in the in-between income ranges than in the in-between bracket.bracket.
Educational DisparitiesEducational Disparities N.C. Children and Youth who are Overweight or Obese N.C. Children and Youth who are Overweight or Obese
Percentage of N.C. Children (Age 10-17) Who Are Overweight or Obese, by Parent Education (2008)
20 24 19 15
30 1919
11
0
10
20
30
40
50
60
Less than HighSchool
High SchoolGraduate
Some College CollegeGraduate
Parent Education
Per
cen
tag
e o
f C
hil
dre
n a
nd
Y
ou
th
Obese*
Overweight*
50%43%
38%26%
*Weight category based percentile (overw eight= equal to or greater than the 85th, but less than the 95th percentile, obese= equal to or greater than the 95th percentile) for age and gender. Percentiles rank the position of an individual by indicating w hat percent of the reference population the individual w ould equal or exceed. Data Source: North Carolina Child Health Assessment and Monitoring Program (CHAMP) Survey Data (2008): State Center for Health Statistics, Raleigh NC.
Economic ConstraintsEconomic Constraints
In 2007, nearly 5% In 2007, nearly 5% of N.C. primary of N.C. primary caregivers cut the caregivers cut the size of their child’s size of their child’s meals because meals because there was not there was not enough money for enough money for food.food.
Economic ConstraintsEconomic Constraints
Food insecurity and obesity are linked: Food insecurity and obesity are linked: Low-income families may consume lower-cost foods Low-income families may consume lower-cost foods
with relatively higher levels of calories per dollar, with relatively higher levels of calories per dollar, Families sacrifice food quality for food quantity to Families sacrifice food quality for food quantity to
stretch limited resources, stretch limited resources, Mothers in particular sacrifice their own nutrition to Mothers in particular sacrifice their own nutrition to
feed their children, yet may overeat when food is feed their children, yet may overeat when food is available again, and available again, and
The body may store fat more efficiently to conserve The body may store fat more efficiently to conserve energy when there are periods of food deprivation.energy when there are periods of food deprivation.
Rural Areas and ObesityRural Areas and Obesity
Nationally, rural areas have higher rates of Nationally, rural areas have higher rates of adult obesity than urban areas.adult obesity than urban areas.
Nearly 14% of children in rural N.C. had Nearly 14% of children in rural N.C. had early risk factors for diabetes and heart early risk factors for diabetes and heart disease.disease.
In N.C., the odds of being obese were In N.C., the odds of being obese were 50% higher for rural children.50% higher for rural children.
Environmental FactorsEnvironmental Factors
Keeping adolescents in their same environments Keeping adolescents in their same environments and changing only family income and parental and changing only family income and parental education had a limited effect on the disparities education had a limited effect on the disparities in obesity prevalence.in obesity prevalence.
Efforts to reduce obesity disparities between Efforts to reduce obesity disparities between ethnic groups should look at other factors, such ethnic groups should look at other factors, such as environmental, contextual, biological, and as environmental, contextual, biological, and socio-cultural factors.socio-cultural factors.
