Background
Despite representing nearly 20% of the U.S. population, individuals with disabilities
are invisible in obesity surveillance and intervention efforts.
Purpose
The current study (1) compares obesity and extreme obesity prevalence between Americans
with and without disabilities and (2) examines the association between BMI category
and weight-related chronic disease risk factors in both groups.
Methods
In 2012, six waves of data from the National Health and Nutrition Examination Survey
(NHANES, 1999–2010) were pooled to compare the prevalence of obesity and extreme obesity
between adults (aged ≥20 years, N=31,990) with disabilities (n=11,556) versus without disabilities (n= 20,434). Chronic disease risk factors (blood pressure, lipids, C-reactive protein
[CRP], glucose) were compared across weight categories, by disability severity, and
disability status.
Results
Obesity (41.6%) and extreme obesity (9.3%) prevalence among those with disabilities
were significantly higher than they were among those without disabilities (29.2% and
3.9%, respectively). Disability severity and disability status negatively affected
nearly all chronic disease risk factors. Additionally, there was a disability-by-weight
interaction: people with disabilities at all weight categories were significantly
more likely to report being told they had hypertension, high cholesterol, or diabetes
and to have been prescribed antihypertensive and lipid-lowering medications.
Conclusions
The prevalence of obesity (41.6%) and extreme obesity (9.3%) found in individuals
with disabilities is high. When compared to obese adults without disabilities, obese
adults with disabilities are more likely to have diabetes, high cholesterol, hypertension,
and higher CRP. Thus, the study provides convincing evidence of obesity-related health
disparities between Americans with and without disabilities.
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References
- Americans with disabilities: 2005. Current Population Reports, P70–117.US Census Bureau, Washington DC2008
- The future of disability in America.National Academies Press, Washington DC2007
Department of Defense. U.S. Casualty Status of Operation Iraqi Freedom (OIF), Operation Enduring Freedom (OEF), and Operation New Dawn (OND). 2012. www.defense.gov/news/casualty.pdf.
- Secondary conditions and aging with disability. In:.in: Field M.J. Jette A.M. The future of disability in America. National Academies Press, Washington DC2007
- Obesity and disability: time to act.Am J Prev Med. 2011; 41: 541-545
- Obesity among adults with disabling conditions.JAMA. 2002; 288: 1265-1268
- State-specific prevalence of obesity among adults with disabilities—eight states and the District of Columbia, 1998-1999.MMWR Morb Mortal Wkly Rep. 2002; 51: 805-808
- Disability and health state chartbook, 2006: profiles of health for adults with disabilities.CDC, Atlanta GA2006
- Disability and health in the U.S., 2001-2005.National Center for Health Statistics, DHHS, Hyattsville MD2008
- Validity of overweight and obesity in a nation based on self-report versus measurement device data.Eur J Clin Nutr. 2006; 60: 372-377
- A comparison of direct vs. self-report measures for assessing height, weight, and body mass index: a systematic review.Obes Rev. 2007; 8: 307-326
- Self-reported weight and hegiht: implications for obesity research.Am J Prev Med. 2001; 20: 294-298
- Effects of age on validity of self-reported height, weight, and body mass index: findings from the third National Health and Nutrition Examination Survey, 1988-1994.J Am Dietetic Assoc. 2001; 101: 28-34
- Truth be told: evidence of wheelchair users accuracy in reporting their height and weight.Arch Phys Med Rehabil. 2012; 93: 2055-2061
- Health of community-dwelling adults with mobility limitations in the U.S.: prevalent health conditions.Part I. Arch Phys Med Rehabil. 2008; 89: 210-218
CDC. National Health and Nutrition Examination Survey. Survey Questionnaires, Examination Components and Laboratory Components 1999-2000. 2012. www.cdc.gov/nchs/nhanes/nhanes1999-2000/questexam99_00.htm.
- Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults—the evidence report.Obes Res. 1998; 6: 51S-209S
- Analytic and reporting guidelines: The National Health and Nutrition Examination Survey (NHANES).National Center for Health Statistics, Hyattsville MD2005 (www.cdc.gov/nchs/data/nhanes/nhanes_03_04/nhanes_analytic_guidelines_dec_2005.pdf)
- Age adjustment using the 2000 projected U.S. population.Healthy People Statistical Notes. National Center for Health Statistics, Hyattsville MD2001
- Multiple imputation for nonresponse in surveys.Wiley, New York1987
- Physical disability and obesity.Nutr Rev. 2005; 63: 321-331
- The disease burden associated with overweight and obesity.JAMA. 1999; 282: 1523-1529
- Relationshiop between obesity and cardiovascular risk factors: findings from a multi-state screening project in the U.S..Curr Med Res Opin. 2005; 21: 1755-1761
- Carbohydrate and lipid metabolism in chronic spinal cord injury.J Spinal Cord Med. 2001; 24: 266-277
- Estimates of state-level health-care expenditures associated with disability.Public Health Rep. 2010; 125: 44-51
- Physical activity among adults with a disability—U.S., 2005.MMWR Morb Mortal Wkly Rep. 2007; 56: 1021-1024
- Barriers to exercise in African American women with physical disabilities.Arch Phys Med Rehabil. 2000; 81: 182-188
- Identifying barriers to participation in physical activity for women with disabilities.SCI Psychosoc Process. 2002; 15: 21-28
- Accessibility of fitness facilities for persons with physical disabilities using wheelchairs.Topics Spinal Cord Inj Rehabil. 2000; 6: 87-98
- Prevalence of obesity and trends in the distribution of body mass index among U.S. adults, 1999-2010.JAMA. 2012; 307: 491-497
U.S. Preventive Services Task Force. Screening for and management of obesity in adults. 2012. www.uspreventiveservicestaskforce.org/uspstf11/obeseadult/obesesum.htm.
2020 Healthy People. Nutrition and weight status objectives. 2012. www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=29.
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© 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
