Preventive care in relation to obesity: an analysis of a large, national survey.
BACKGROUND
Reports from the 1990s observed lower receipt of preventive care services among obese individuals, but a few recent studies in older adults and Department of Veterans Affairs (VA) patients have failed to do so. Additional studies, using population-based samples, are needed to understand whether disparities in care by obesity continue to exist in the U.S.


OBJECTIVE
To investigate whether receipt of preventive care services varies in relation to BMI.


METHODS
This study used data from the 2008 and 2009 Behavioral Risk Factor Surveillance System (analyzed in 2011), a state-based national telephone survey of non-institutionalized U.S. adults, to examine associations between receipt of preventive services (influenza and pneumococcal vaccination; cholesterol and HIV screening; fecal occult blood test; colonoscopy/sigmoidoscopy, mammogram, and Pap) and BMI category (normal, 18.5-24.9; overweight, 25-29.9; obese Class I, 30-34.9; obese Class II, 35-39.9; and obese Class III, ≥40), after adjusting for confounding factors.


RESULTS
Receipt was lower for mammography and Pap testing (6.1 and 5.6 percentage points, respectively, relative to normal weight women) in obese Class III women. For immunizations, cholesterol screening, and colon cancer screening, receipt was similar or greater in overweight and obese individuals.


CONCLUSIONS
This study suggests that for most services, obese individuals received as much if not more preventive health care as normal-weight individuals. Although these findings are reassuring, the evidence for disparities for cervical and breast cancer screening in obese women demonstrates that efforts to ensure more equitable service delivery are still needed.
Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, Washington 98101, USA. alyson@u.washington.edu
Alyson J
AJ
Littman
Thomas D
TD
Koepsell
Christopher W
CW
Forsberg
Edward J
EJ
Boyko
William S
WS
Yancy
D000293:Adolescent; D000328:Adult; D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D015992:Body Mass Index; D003695:Delivery of Health Care / Q000592:standards; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D050177:Overweight / Q000453:epidemiology; D011314:Preventive Health Services / Q000592:standards / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014611:Vaccination / Q000706:statistics & numerical data; D055815:Young Adult