title: Obesity trends by industry of employment in the United States, 2004 to 2011.
abstract: BACKGROUND
  Obesity is associated with increased morbidity, occupational injuries, and premature mortality. Obesity also disproportionately affects blacks and socioeconomically disadvantaged workers. However, few studies have evaluated national trends of obesity by employment industry overall and especially by race.
  
  
  METHODS
  To investigate national trends of obesity by employment industry overall and by race, we estimated the age-standardized obesity prevalence from 2004 to 2011. We used direct age-standardization with the 2000 US Census population as the standard among 136,923 adults in the US National Health Interview Survey. We also estimated prevalence ratios (PRs) for obesity in black women and men compared to their white counterparts for each employment industry using adjusted Poisson regression models with robust variance.
  
  
  RESULTS
  Obesity prevalence increased for men and women over the study period across all employment industry categories, and the healthcare industry had the highest overall age-standardized prevalence (30 %). Black women had a significantly higher obesity prevalence than white women across all employment industry categories, ranging from 33 % (95 % confidence interval (CI): 1.16,1.52) in Professional/Management to 74 % in Education (95 % CI: 1.56,1.93). Obesity prevalence was higher among black than white men for Healthcare (PR = 1.39 [1.15,1.69]), Education (PR = 1.39 [1.17,1.67]), Public Administration (PR = 1.34 [1.20,1.49]), and Manufacturing (PR = 1.19 [1.11,1.27]). Differences in obesity prevalence by race were generally widest in professional/management occupations.
  
  
  CONCLUSIONS
  Obesity trends varied substantially overall as well as within and between race-gender groups across employment industries. These findings demonstrate the need for further investigation of racial and sociocultural disparities in the work-obesity relationship to employ strategies designed to address these disparities while improving health among all US workers. Further research and interventions among workers in industries with an increasing or high prevalence of obesity should be prioritized.
authors.affiliation: Clinical and Translational Science Center, Harvard Catalyst, Harvard Medical School, Boston, MA USA.
authors.forename: Chandra L
authors.initials: CL
authors.lastname: Jackson
authors.affiliation: Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA USA.
authors.forename: Christina C
authors.initials: CC
authors.lastname: Wee
authors.affiliation: Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Hurtado
authors.affiliation: Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA USA.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawachi