Transcript The Burden of Obesity in North Carolina Obesity in Adults The Behavioral Risk Factor Surveillance System (BRFSS)  Established in 1984 by the Centers for.

The Burden of Obesity in
North Carolina
Obesity in Adults
The Behavioral Risk Factor Surveillance
System (BRFSS)

Established in 1984 by the Centers for Disease
Control and Prevention
 State-based system of health surveys that
collect information on:




health risk behaviors
preventive health practices
health care access
Random-digit dialing, individuals age 18 years
and older are randomly selected from each
household called
 Largest telephone health survey in the world
The National Burden of Obesity
2
out of 3 adults are overweight or obese
 None
of the states have experienced a
decrease in obesity for 16 years
 In
the past year, 31 states experienced an
increase in obesity
Obesity Trends* Among U.S. Adults
BRFSS, 2008
No Data
<10%
10%–14%
15%–19%
20%–24%
25%–29%
≥30%
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Source: Behavioral Risk Factor Surveillance System, CDC
The National Health and Nutrition
Examination Survey (NHANES)
 Designed
to assess the health and
nutritional status of adults and children
 Combines
personal interviews and
physical examinations
 Used
to determine the basis for national
standards for such measurements as
height, weight and blood pressure.
The entire adult population is heavier, and the
heaviest have become much heavier since 1980.
Changes in the Distribution of BMI between 1976-1980 and 2005-2006,
United States Adults Aged 20-74 Years
Adult Obesity in N.C.
 65.7%
of N.C. adults are overweight
or obese, above the national
average.


56% are not meeting the physical
activity recommendation
78% are not meeting the fruits or
vegetables recommendation
Adult Obesity in N.C.
 Physical
inactivity and unhealthy eating
combined are the 2nd leading
preventable cause of death in N.C., and
both increase the risk of:
•Heart disease
•Certain types of
cancer
•Diabetes
•High blood
pressure
•Stroke
•Obesity
N.C. Adults, BMI Trends
Percentage of Adults
Trends in BMI Categories, N.C. Adults (1990-2008)
100
80
60
40
20
0
'90
'91
'92
'93
'94
Healthy Weight
'95
'96
'97
'98
'99
'00
'01
'02
Overweight
'03
'04
'05
'06
'07
'08
Obese
Source: North Carolina Behavioral Risk Factor Surveillance System Survey, N.C. State Center for Health Statistics, N.C. Department of Health and
Human Services, (1990-2008)
Healthy People 2010

Launched in January 2000, by The Department
of Health and Human Services

A comprehensive, nationwide health promotion
and disease prevention agenda

Contains objectives to increase quality and
years of healthy life and to eliminate health
disparities by the year 2010
“By 2010, increase the percentage of adults
who are at a healthy weight to 60%.”
100
Percentage of Adults Who Were at a Healthy Weight in
N.C. compared with U.S., Healthy People 2010 Target
(2007)
80
60%
60
40
34%
37%
NC
U.S.
20
0
HP 2010 Target
Healthy People 2010 Objective 19-1. Obesity. "BY 2010, increase the percentage of adults w ho are at a healthy
w eight to 60%." Data Sources DATA2010, CDC, NCHS. Prevalence Data from the Centers for Disease Control
and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S.
Department of Health and Human Services, Centers for Disease Control and Prevention, [2007].
“By 2010, reduce the percentage of adults (20
years old or older) who are obese to 15%.”
Percentage of N.C. Adults Who Were Obese compared
with U.S. Adults, Healthy People 2010 Target
50
40
30
20
18% 16%
23% 21%
29% 26%
Healthy
People
2010 Target
(15%)
N.C.
10
0
1995
2001
2007
U.S.
Percentage of Adults Who Were Obese
Healthy People 2010 Objective 19-2. Obesity. " By 2010, reduce the percentage of adults (20 years old or older) who are obese to 15%." Data
Sources DATA2010, CDC, NCHS. Prevalence Data from the Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor
Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention,
[1995, 2001, 2007].
N.C. Adults Who Were Overweight
or Obese, by Gender
Percentage of Adults
Percentage of N.C. Adults Who Were
Overweight or Obese, by Gender (2008)
100
80
72%
60
30
60%
30
40
20
42
30
Male
Female
0
Overweight
Obese
Source: North Carolina Behavioral Risk Factor Surveillance System Survey, N.C. State Center for Health Statistics, N.C.
Department of Health and Human Services, (2008).
N.C. Adults Who Were Overweight
or Obese, by Age Group
Percentage of Adults
Percentage of N.C. Adults Who Were Overweight or
Obese, by Age Group (2008)
100
80
64%
60
40
20
46%
72%
73%
71%
67%
56%
66%
31
33
34
27
18
30
33
41
38
39
40
39
36
25-34
35-44
45-54
55-64
65-74
75+
All
Adults
31
23
23
0
18-24
Overweight
Obese
Source: North Carolina Behavioral Risk Factor Surveillance System Survey, N.C. State Center for Health
Statistics, N.C. Department of Health and Human Services, (2008).
N.C. Adults Risk Factors, by
Race/Ethnicity
N.C. Adults who were Overweight
or Obese by Income
Percentage of Adults
Percentage of N.C. Adults Who Were Overweight or
Obese, by Household Income (2008)
100
80
60
40
20
70%
68%
67%
72%
68%
35
34
32
33
29
25
35
34
35
39
39
38
Less than
$15,000
$15,000$24,999
$25,000$34,999
$35,000$49,999
$50,000$74,999
$75,000+
63%
0
Overweight
Obese
Source: North Carolina Behavioral Risk Factor Surveillance System Survey, N.C. State Center for Health Statistics, N.C. Department
of Health and Human Services, (2008).
The Burden of Obesity in
North Carolina
Special Populations & Obesity
Special Populations in North Carolina

Life expectancy for North Carolina’s minority
population is almost five years less than the
white population.



African Americans are the largest minority group,
accounting for 21 percent of the population.
Hispanics now comprise approximately seven
percent of the population, six times the percentage
in 1990.
About one percent of North Carolinians are
American Indian.
N.C. Risk Factor Percentages by
Race/Ethnicity
Behavioral Risk Factors* (percentages) 2007:
White,
NonHispanic
African
American,
NonHispanic
American
Indian,
NonHispanic
Other
Races,
NonHispanic
Latino/
Hispanic
TOTAL
Adults with high
blood pressure
28.2
39.7
29.3
16.7
12.7
28.8
Adults who smoke
23.2
23.3
32.9
18.8
19.2
22.9
Adults who are obese
26.4
39.2
26.7
22.9
25.4
28.7
Adults with no
leisure time physical
activity
21.2
28.7
36.6
20.5
40.6
24.3
Percent of adults in
fair/poor health
16.6
21.8
26.8
14.6
29.7
18.7
* N.C. Behavioral Risk Factor Surveillance System (BRFSS), State Center for Health Statistics. BRFSS is an ongoing, monthly telephone survey through which data are collected from randomly selected,
non-institutionalized N.C. adults (age 18 and older) in households with telephones. Survey responses are weighted to represent the demographics of all adults in the state.
Racial & Ethnic Disparities and Obesity

African Americans
were more likely than
whites to be obese,
have high blood
pressure, be physically
inactive, and have
inadequate fruit and
vegetable
consumption.
N.C. Adults by Race
Percentage of Adults
Percentage of N.C. Adults Who Are Overweight or
Obese, by Race (2008)
100
80
75%
63%
60
27
41
40
20
69%
36
34
White
African
American
34%
35
1
33
34
71%
27
66%
30
44
36
Other
Minorities
All Adults
0
Asian
Overweight
Native
American
Obese
Source: North Carolina Behavioral Risk Factor Surveillance System Survey, N.C. State Center for Health Statistics, N.C. Department
of Health and Human Services, (2008).
Older Adults and Obesity
 In
2008, 72.3% of adults in the 55-64
age group were overweight or obese.
Older U.S. Adults and Obesity
Health Behaviors
%
C.I.*
Year
Rank†
No Leisure-Time Physical
Activity
30.4
(28.6 - 32.4)
2004
19
Eating ≥ 5 Fruits and
Vegetables Daily
27.9
(25.3 - 30.7)
2003
37
Obesity
22.0
(20.3 - 23.8)
2004
37
*A confidence interval (CI) describes the level of uncertainty of an estimate and specifies the range in which the true value is likely to fall. The State of Aging and
Health in America online report uses a 95 percent level of significance, which means that 95 percent of the time, the true value falls within these boundaries.
†Rankings are based on the relative numeric scores for each indicator, with a ranking of "1" indicating the highest rank.
[i]
Centers for Disease Control and Prevention and The Merck Company Foundation. The State of Aging and Health in America 2007.
Whitehouse Station, NJ: The Merck Company Foundation; 2007. www.cdc.gov/aging/saha.htm
Educational and Socio-economic
Disparities and Obesity
 In
general, among white children, obesity
typically declines as income and parental
education increase. Only rates of obesity
for white girls decrease as family income
rises.
 Obesity
rates for African American girls are
higher in the lowest and highest income
ranges than in the in-between bracket.
Educational Disparities
N.C. Children and Youth who are Overweight or Obese
Percentage of Children and
Youth
Percentage of N.C. Children (Age 10-17) Who Are Overweight or
Obese, by Parent Education (2008)
60
50%
50
40
30
20
10
30
43%
19
38%
26%
19
11
20
24
19
15
Less than High
School
High School
Graduate
Some College
College
Graduate
Obese*
Overweight*
0
Parent Education
*Weight category based percentile (overw eight= equal to or greater than the 85th, but less than the 95th percentile, obese=
equal to or greater than the 95th percentile) for age and gender. Percentiles rank the position of an individual by indicating
w hat percent of the reference population the individual w ould equal or exceed. Data Source: North Carolina Child Health
Assessment and Monitoring Program (CHAMP) Survey Data (2008): State Center for Health Statistics, Raleigh NC.
Economic Constraints
 In
2007, nearly 5%
of N.C. primary
caregivers cut the
size of their child’s
meals because
there was not
enough money for
food.
Economic Constraints

Food insecurity and obesity are linked:




Low-income families may consume lower-cost foods
with relatively higher levels of calories per dollar,
Families sacrifice food quality for food quantity to
stretch limited resources,
Mothers in particular sacrifice their own nutrition to
feed their children, yet may overeat when food is
available again, and
The body may store fat more efficiently to conserve
energy when there are periods of food deprivation.
Rural Areas and Obesity
 Nationally,
rural areas have higher rates of
adult obesity than urban areas.
 Nearly
14% of children in rural N.C. had
early risk factors for diabetes and heart
disease.
 In
N.C., the odds of being obese were
50% higher for rural children.
Environmental Factors

Keeping adolescents in their same environments
and changing only family income and parental
education had a limited effect on the disparities
in obesity prevalence.

Efforts to reduce obesity disparities between
ethnic groups should look at other factors, such
as environmental, contextual, biological, and
socio-cultural factors.