The relationship between body weight and health care among German women.
OBJECTIVE
To investigate the relationship between body weight and the use of health care services among women from southern Germany.


METHODS
Data were drawn from the 1994 to 1995 Monitoring of Trends and Determinants in Cardiovascular Disease Augsburg survey, covering a population-representative sample of women 25 to 74 years old (n = 2301). Logistic regression models were used to calculate odds ratios (ORs) for the use of medical services by women with overweight (BMI 25.0 to 29.9 kg/m(2)) or obesity (BMI >or= 30 kg/m(2)) in comparison with normal-weight women (BMI < 25.0 kg/m(2)).


RESULTS
In multivariable analysis, obese women 50 to 74 years old were more likely than normal-weight women to delay cancer screening procedures, such as manual breast examination and Papanicolaou smear (OR 0.52, 95% confidence interval 0.37 to 0.74) in the previous 12 months. However, the relationship between obesity and cancer screening was not found to be significant in 25- to 49-year-old women (OR 0.92, 95% confidence interval 0.62 to 1.36). Neither in the 25- to 49-year-old age group nor in the 50- to 74-year-old age group were independent relationships between higher body weight and total physician visits, hospitalizations, or medication use observed.


CONCLUSIONS
Obese women tended to use medical services with greater frequency due to obesity-related diseases. However, postmenopausal women with a BMI >or= 30 kg/m(2) were more likely to delay routine cancer screening, putting them at a greater risk for death from breast, cervical, and endometrial cancer. Thus, obese postmenopausal women should be targeted for increased screening.
Central Hospital of Augsburg, MONICA/KORA Augsburg Myocardial Infarction Registry, Stenglinstrasse 2, D-86156 Augsburg, Germany. christa.meisinger@gsf.de.
Christa
C
Meisinger
Margit
M
Heier
Hannelore
H
Loewel
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking; D015992:Body Mass Index; D001835:Body Weight; D001943:Breast Neoplasms / Q000517:prevention & control; D004522:Educational Status; D005260:Female; D005858:Germany; D006304:Health Status; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D016015:Logistic Models; D008403:Mass Screening; D008875:Middle Aged; D009369:Neoplasms / Q000517:prevention & control; D009765:Obesity / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D016017:Odds Ratio; D065006:Papanicolaou Test; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D014626:Vaginal Smears