title: Associations between obesity and receipt of screening mammography, Papanicolaou tests, and influenza vaccination: results from the Health and Retirement Study (HRS) and the Asset and Health Dynamics Among the Oldest Old (AHEAD) Study.
abstract: OBJECTIVE
  Obese Americans, who receive more care for chronic diseases, may receive fewer preventive services. We evaluated the association between body mass index (BMI) and receipt of screening mammography and Papanicolaou tests among middle-aged women and the association between BMI and receipt of influenza vaccination among the elderly.
  
  
  METHODS
  We analyzed 2 datasets: the Health and Retirement Study (4439 women aged 50-61 years) and the Asset and Health Dynamics Among the Oldest Old (AHEAD) Study (4045 women and 2154 men aged 70 years or more).
  
  
  RESULTS
  When BMI was greater than 18.5 kg/m2, we found an inverse dose-response relationship between BMI and receipt of screening mammography and Pap tests among White, but not Black, middle-aged women. We found a similar association between BMI and influenza vaccination among the elderly.
  
  
  CONCLUSIONS
  Higher BMI was associated with less frequent receipt of preventive services among middle-aged White women and elderly White women and men. The Healthy People 2010 clinical preventive service goals remain elusive, especially for overweight and obese White persons.
authors.affiliation: Department of Community and Family Medicine, Duke University Medical Center, Durham, NC 27710, USA. truls.ostbye@duke.edu
authors.forename: Truls
authors.initials: T
authors.lastname: Østbye
authors.forename: Donald H
authors.initials: DH
authors.lastname: Taylor
authors.forename: William S
authors.initials: WS
authors.lastname: Yancy
authors.forename: Katrina M
authors.initials: KM
authors.lastname: Krause
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D008297:Male; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology* / Q000208:ethnology; D016017:Odds Ratio; D065006:Papanicolaou Test; D011314:Preventive Health Services / Q000706:statistics & numerical data / Q000600:supply & distribution; D012179:Retirement; D014481:United States; D014611:Vaccination / Q000706:statistics & numerical data; D014626:Vaginal Smears / Q000706:statistics & numerical data*
chemical_list: D007252:Influenza Vaccines