title: The relationship of overweight and obesity with subjective health and use of health-care services among Spanish women.
abstract: OBJECTIVE
  To examine the relationship of overweight and obesity with subjective health and use of health-care services among women in Spain.
  
  
  METHODS
  Data were drawn from the 1993 Spanish National Health Survey, covering a 13 244-woman sample representative of the non-institutionalised Spanish population aged 16 y and over. Information was collected through home-based interviews. Multiple logistic regression models were used to calculate odds ratios for suboptimal health (fair, poor or very poor) and utilisation of health-care services by women with normal weight (BMI 18.5-24.9 kg/m(2)), overweight (BMI 25.0-29.9 kg/m(2)) and obesity (BMI>or=30 kg/m(2)). Analyses were adjusted for age, education level, occupation, civil status, social support, tobacco use, alcohol consumption, physical activity at work and during leisure time, job status and town of residence.
  
  
  RESULTS
  Frequency of suboptimal health was higher in women with overweight (OR 1.7; 95% CI 1.5-1.9) and obesity (OR 2.1; 95% CI 1.8-2.5) than in those with normal weight. Overweight and obese women visited the physician, used hospital emergency services and took medication with greater frequency than did women of normal weight. There was a positive dose-response relationship (P<0.05) of BMI>or=18.5 kg/m(2) with suboptimal health and utilisation of health-care services. These associations were not wholly explained by BMI-related risk factors and chronic diseases, since their statistical significance remained unchanged and their magnitude was only slightly reduced after adjustment for those factors. The association of overweight and obesity with the use of health-care services did not vary with age, educational level or presence of chronic disease.
  
  
  CONCLUSIONS
  Overweight and obese women have worse subjective health and make greater use of health-care services. This finding is an additional argument for implementing weight-control programmes in Spain.
authors.affiliation: Centro Universitario de Salud Pública, Consejería de Sanidad y Universidad Autónoma de Madrid, Madrid, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Guallar-Castillón
authors.forename: E
authors.initials: E
authors.lastname: López García
authors.forename: L
authors.initials: L
authors.lastname: Lozano Palacios
authors.forename: J L
authors.initials: JL
authors.lastname: Gutiérrez-Fisac
authors.forename: J R
authors.initials: JR
authors.lastname: Banegas Banegas
authors.forename: P J
authors.initials: PJ
authors.lastname: Lafuente Urdinguio
authors.forename: F
authors.initials: F
authors.lastname: Rodriguez Artalejo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology* / Q000523:psychology*; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology; D014932:Women's Health Services / Q000706:statistics & numerical data*