obesity among hispanics - a brief demographic account

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Obesity among Hispanics - a brief demographic account Rodolfo Valdez, Ph.D., M. Sc. Division of Diabetes Translation Centers for Disease Control and Prevention Atlanta, GA

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Obesity among Hispanics - a brief demographic account. Rodolfo Valdez, Ph.D., M. Sc. Division of Diabetes Translation Centers for Disease Control and Prevention Atlanta, GA. Introduction. Hispanics are at increased risk for obesity. - PowerPoint PPT Presentation

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Page 1: Obesity among Hispanics - a brief demographic account

Obesity among Hispanics- a brief demographic account

Rodolfo Valdez, Ph.D., M. Sc.Division of Diabetes TranslationCenters for Disease Control and

PreventionAtlanta, GA

Page 2: Obesity among Hispanics - a brief demographic account

Introduction

• Hispanics are at increased risk for obesity.

• The population of Hispanics in the United States increased from 22.4 million in 1990 to 35.3 million in 2000.

• There is a need for identifying modifiable risk factors associated with the excess prevalence of obesity among Hispanics.

Page 3: Obesity among Hispanics - a brief demographic account

Objectives

• To assess the prevalence of obesity in Puerto Rico and several states of the U.S. with large Hispanic populations.

• To examine the association between obesity and some demographic variables in these populations.

Page 4: Obesity among Hispanics - a brief demographic account

Methods I

• Comparison of frequencies obtained from CDC’s Behavioral Risk Factor Surveillance System (BRFSS) .

• Software: SAS, SUDAAN.• The BRFSS uses telephone health

surveys designed to continuously monitor the risk behaviors for chronic disease, injuries, and death in the U.S. population, state by state.

Page 5: Obesity among Hispanics - a brief demographic account

Methods II

• Populations selected were from Puerto Rico and six states (NY, NJ, IL, FL, TX, CA) that represent the high density and the diversity of origins of the Hispanic population in the United States.

• Sample size: five years of the BRFSS (1998-2002), n = 134,802. Results are the weighted average over five years.

• Age-standardization: U.S. Census 2000.

Page 6: Obesity among Hispanics - a brief demographic account
Page 7: Obesity among Hispanics - a brief demographic account

Definition of ObesityBody Mass Index [weight (kg)/height (m)2]

BMI Category

Lean <18.5 Underweight

18.5 – 24.9 Normal weight

Overweight 25.0 – 29.9 Overweight

Obesity 30.0 – 34.9 Obesity (Class 1)

35.0 – 39.9 Obesity (Class 2)

40+ Extreme Obesity

Page 8: Obesity among Hispanics - a brief demographic account

Hispanic population in 6 states and Puerto Rico as a percentage of the total U.S. Hispanic population and

of the total intra-state population (U.S. 2000 Census)

11

4

8

19

31

10

1412

17

32 32

NY, NJ IL FL TX CA PR

%

% total US Hispanic population

% total intra-state population

Page 9: Obesity among Hispanics - a brief demographic account

Age distribution of Hispanic and non-Hispanic white BRFSS participants from six states (NY, NJ, IL, FL,

TX, CA) and Puerto Rico (BRFSS 1998-2002).

16

8 8

47

1813

22

68

18 - 44 45 - 54 55 - 64 65+

Age (years)

%

HispanicNon-Hispanic white

Page 10: Obesity among Hispanics - a brief demographic account

Prevalence of obesity in adults by age and ethnicity in six states (NY, NJ, IL, FL, TX, CA) and Puerto Rico

(pooled data)

20.7

30.2

26.9

23.3

14.9

21.9 22.6

16.3

18 - 44 45 - 54 55 - 64 65+

Age (years)

%

HispanicNon-Hispanic white

Page 11: Obesity among Hispanics - a brief demographic account

Crude prevalence of obesity in adults by ethnicity in six states and Puerto Rico

(BRFSS 1998-2002).

18.9

24.1

19.1

27.9

23.5

20.8

16.718.7

16.6

19.317.2

NY, NJ IL FL TX CA PR

%

Hispanic Non-Hispanic white

Page 12: Obesity among Hispanics - a brief demographic account

Age-standardized prevalence of obesity in adults by ethnicity in six states and Puerto

Rico(BRFSS 1998-2002).

19.8

25.1

19.2

28.8

24.5

21.0

16.318.3

16.5

19.116.9

NY, NJ IL FL TX CA PR

%

Hispanic Non-Hispanic white

Page 13: Obesity among Hispanics - a brief demographic account

Distribution of educational attainment in U.S. Hispanic and non-Hispanic white from six states

(NY, NJ, FL, IL, TX, CA) BRFSS 1998-2002

37.1

28.0

21.6

13.3

7.2

28.8 29.3

34.7

<High School High School Some College College ormore

%

Hispanic Non-Hispanic white

Page 14: Obesity among Hispanics - a brief demographic account

Age-standardized prevalence of obesity in adults by ethnicity and educational attainment in six states

(NY, NJ, FL, IL, TX, CA) and Puerto Rico. Pooled data.(BRFSS 1998-2002).

27.5

22.120.5

17.1

22.9

19.718.1

14.0

<High School High School Some College College ormore

%

Hispanic Non-Hispanic white

Page 15: Obesity among Hispanics - a brief demographic account

Distribution of U.S. Hispanic and non-Hispanic white adult populations by income in six states (NY, NJ,

FL, IL, TX, CA)(Pooled data, BRFSS 1998-2002).

46.6

25.6

15.512.3

19.7

28.8

40.0

11.5

< 25 25 - 49 50+ Unknown

Annual household income ($) x 1,000

%

Hispanic Non-Hispanic white

Page 16: Obesity among Hispanics - a brief demographic account

Age-standardized prevalence of obesity in adults by ethnicity and income in six states (NY, NJ, IL, FL,

TX, CA) and Puerto Rico (Pooled data, BRFSS 1998-2002).

25.123.7

20.4 20.920.619.4

14.813.7

< 25 25 - 49 50+ Unknown

Annual household income ($) x 1,000

%

Hispanic Non-Hispanic white

Page 17: Obesity among Hispanics - a brief demographic account

Percentage distribution of the Duncan Socioeconomic Index in adults (25-64 years) by

ethnicity(The San Antonio Heart Study).

62

20 18

10

35

55

3835

27

Lowest Middle Highest

Duncan Socioeconomic Index

%

Foreign-bornMexican AmericanNon-HispanicwhiteU.S.-born MexicanAmerican

Wei M et al. Ann Epidemiol 1996; 6: 307-313

Page 18: Obesity among Hispanics - a brief demographic account

Prevalence of diabetes in Mexican American adults (25-64 years) by migration and acculturation status

(NHANES III, adjusted for age and education).

5.0

6.9

12.8 13.5

7.06.1

Men Women

%

Mexican-born

U.S.-born Spanish-speakingU.S.-born English-speaking

Sundquist J & Winkleby MA. Am J Public Health 1999; 89: 723-730

Page 19: Obesity among Hispanics - a brief demographic account

Percentage of adult women (25-64 years) with no leisure-time activity during the past month by ethnicity and years of education (NHANES III).

61

47

30

18

46

2825

12

< 9 9 - 11 12 > 12

Years of education

%

Mexican-AmericanNon-Hispanic white

Winkleby MA et al. JAMA 1998; 280: 356-362

Page 20: Obesity among Hispanics - a brief demographic account

Age- and sex-adjusted prevalence of obesity in U.S. adolescents (7th-12th grade) by generation of birth (National Longitudinal Study of Adolescent Health).

24.0

24.6

31.8

31.4

Non-HispanicWhite

Hispanic, firstgeneration

Hispanic, secondgeneration

Hispanic, thirdgeneration

% Obesity(> 85th BMI percentile, 1995 WHO standard)

Popkin BM & Udry JR.. Journal of Nutrition 1998; 128:701-706.

Page 21: Obesity among Hispanics - a brief demographic account

Summary

• The prevalence of obesity varies among the different Hispanic groups.

• Income and education are inversely associated with obesity rates in both Hispanics and non-Hispanic whites.

• Hispanics outnumber non-Hispanic whites at the high-risk end of the income and education distributions.

Page 22: Obesity among Hispanics - a brief demographic account

Conclusions

• Hispanics in the U.S. and Puerto Rico are undergoing a health transition.

• The transition involves over exposure to social factors that seem to favor the development of obesity.

• As the social condition of Hispanics improves, the high prevalence of obesity among them may recede.

• Prevention campaigns may accelerate the health transition