Skip to main content

Advertisement

SpringerLink
Log in

A Demographic Profile of Obesity in the Adult and Veteran US Populations in 2008

  • Published:
Population Research and Policy Review Aims and scope Submit manuscript

Abstract

Obesity is increasing in the US population and seems to be disproportionately burdening disadvantaged groups. Veterans using the Veterans Healthcare System (VHS) tend to be more disadvantaged socioeconomically than the general population and in poorer health. It is important to understand how the veteran population differs from or is similar to the general population and whether the VHS is able to mediate obesity risk among veterans. This research assesses the sociodemographic, behavioral, and health risk factors for obesity in the US adult and veteran populations in 2008. We use data from the 2008 Behavioral Risk Factor Surveillance System (BRFSS) to empirically assess predictors of obesity risk. We find that women have lower odds of obesity than men once controls for sociodemographic, behavioral, and health conditions are included in our models. We also observe a veteran obesity disadvantage in the full adult sample when conducting bivariate tests, but no significant association with the odds of obesity in the logistic regression models among veterans and non-veterans. Gender specific models indicate that male veterans have increased odds of obesity compared to non-veterans, but no difference in obesity risks among veterans and non-veterans are noted for women, controlling for all variables. Further, we find no significant differences in the odds of obesity of veterans using VHS for all, some, or none of their health care needs; further no significant gender differences in obesity risk were observed among VHS usages and non-users. Based on the strong, positive association between the number of chronic health conditions and the odds of obesity, we suggest that health policy should focus efforts on weight management counseling for obese patients that have obesity related co-morbidities, and more targeted attention to male veterans would help to address the high level of obesity in this vulnerable population group.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Aday, L. A. (2001). At risk in America: The health and health care needs of vulnerable populations in the United States (2nd ed.). San Francisco, CA: Jossey-Bass.

    Google Scholar 

  • Agha, Z., Lofgren, R. P., VanRuiswyk, J. V., & Layde, P. M. (2000). Are patients at veterans affairs medical centers sicker? A comparative analysis of health status and medical resource use. Archives of Internal Medicine, 160(21), 3252–3257.

    Article  Google Scholar 

  • Akinnusi, M. E., Pineda, L. A., & El Solh, A. A. (2008). Effect of obesity on intensive care morbidity and mortality: A meta-analysis. Critical Care Medicine, 36(1), 151–158.

    Article  Google Scholar 

  • Almond, N., Kahwati, L., Kinsinger, L., & Porterfield, D. (2008). The prevalence of overweight and obesity among US military veterans. Military Medicine, 173(6), 544–549.

    Google Scholar 

  • An, A. B. (2002). Performing logistic regression on survey data with the new SURVEYLOGISTIC procedure. Paper presented at the proceedings of the twenty-seventh annual SAS® users group international conference, Orlando, Florida.

  • Bercault, N., Boulain, T., Kuteifan, K., Wolf, M., Runge, I., & Fleury, J. C. (2004). Obesity-related excess mortality rate in an adult intensive care unit: A risk-adjusted matched cohort study. Critical Care Medicine, 32(4), 998–1003.

    Article  Google Scholar 

  • Berg, A. O., Allan, J. D., Frame, P., Homer, C. J., Johnson, M. S., Klein, J. D., et al. (2003). Screening for obesity in adults: Recommendations and rationale. Annals of Internal Medicine, 139(11), 930–932.

    Google Scholar 

  • Beydoun, M. A., & Wang, Y. F. (2009). Gender-ethnic disparity in BMI and waist circumference distribution shifts in US adults. Obesity, 17(1), 169–176.

    Article  Google Scholar 

  • Centers for Disease Control and Prevention. (2008). Behavioral risk factor surveillance system survey data. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.

    Google Scholar 

  • Chou, S. Y., Grossman, M., & Saffer, H. (2004). An economic analysis of adult obesity: Results from the Behavioral Risk Factor Surveillance System. Journal of Health Economics, 23(3), 565–587.

    Article  Google Scholar 

  • Clarke, P., O’Malley, P. M., Johnston, L. D., & Schulenberg, J. E. (2009). Social disparities in BMI trajectories across adulthood by gender, race/ethnicity and lifetime socio-economic position: 1986–2004. International Journal of Epidemiology, 38(2), 499–509.

    Article  Google Scholar 

  • Curioni, C., Andre, C., & Veras, R. (2006). Weight reduction for primary prevention of stroke in adults with overweight or obesity. Cochrane Database of Systematic Reviews, 4, 1–19.

    Google Scholar 

  • Das, S. R., Kinsinger, L. S., Yancy, W. S., Wang, A., Ciesco, E., Burdick, M., et al. (2005). Obesity prevalence among veterans at veterans affairs medical facilities. American Journal of Preventive Medicine, 28(3), 291–294.

    Article  Google Scholar 

  • Demaris, A. (2004). Regression with social data: modeling continuous and limited response variables. Hoboken, NJ: Wiley.

    Google Scholar 

  • Deshpande, A. D., Dodson, E. A., Gorman, I., & Brownson, R. C. (2008). Physical activity and diabetes: Opportunities for prevention through policy. Physical Therapy, 88(11), 1425–1435.

    Article  Google Scholar 

  • Dorfman, L., & Yancey, A. K. (2009). Promoting physical activity and healthy eating: Convergence in framing the role of industry. Preventive Medicine, 49(4), 303–305.

    Article  Google Scholar 

  • Dossett, L. A., Dageforde, L. A., Swenson, B. R., Metzger, R., Bonatti, H., Sawyer, R. G., et al. (2009). Obesity and site-specific nosocomial infection risk in the intensive care unit. Surgical Infections, 10(2), 137–142.

    Article  Google Scholar 

  • Duan, Q. L., Dube, M. P., Frasure-Smith, N., Barhdadi, A., Lesperance, F., Theroux, P., et al. (2007). Additive effects of obesity and TCF7L2 variants on risk for type 2 diabetes among cardiac patients. Diabetes Care, 30(6), 1621–1623.

    Article  Google Scholar 

  • Egger, G., & Swinburn, B. (1997). An ‘‘ecological’’ approach to the obesity pandemic. British Medical Journal, 315(7106), 477–480.

    Google Scholar 

  • Emery, S. L., Szczypka, G., Powell, L. M., & Chaloupka, F. J. (2007). Public health obesity-related TV advertising—Lessons learned from tobacco. American Journal of Preventive Medicine, 33(4), S257–S263.

    Article  Google Scholar 

  • Fontaine, K. R., Faith, M. S., Allison, D. B., & Cheskin, L. J. (1998). Body weight and health care among women in the general population. Archives of Family Medicine, 7(4), 381–384.

    Article  Google Scholar 

  • Garcia-Rea, E., & LePage, J. P. (2008). Reliability and validity of World Health Organization Quality of Life-100 in homeless substance-dependent veteran population. Journal of Rehabilitation Research and Development, 45(4), 619–625.

    Article  Google Scholar 

  • Glass, T. A., Rasmussen, M. D., & Schwartz, B. S. (2006). Neighborhoods and obesity in older adults—The Baltimore Memory Study. American Journal of Preventive Medicine, 31(6), 455–463.

    Article  Google Scholar 

  • Gorber, S. C., Tremblay, M., Moher, D., & Gorber, B. (2007). Diagnostic in obesity comorbidities—A comparison of direct vs. self-report measures for assessing height, weight and body mass index: A systematic review. Obesity Reviews, 8(4), 307–326.

    Article  Google Scholar 

  • Groves, R. M., Fowler, F. J., Jr., Couper, M. P., Lepkowski, J. M., Singer, E., & Tourangeau, R. (2004). Survey methodology. Hoboken: Wiley.

    Google Scholar 

  • Gruber, J., & Frakes, M. (2006). Does falling smoking lead to rising obesity? Journal of Health Economics, 25(2), 183–197.

    Article  Google Scholar 

  • Hardcastle, S., Taylor, A., Bailey, M., & Castle, R. (2008). A randomised controlled trial on the effectiveness of a primary health care based counselling intervention on physical activity, diet and CHD risk factors. Patient Education and Counseling, 70(1), 31–39.

    Article  Google Scholar 

  • He, W., Sengupta, M., Velkoff, V. A., DeBarros, K. A., & U.S. Census Bureau. (2005). 65+ in the United States: 2005. Current Population Reports, P23-209. Washington, DC: U.S. Government Printing Office.

  • Hensrud, D. D., & Klein, S. (2006). Extreme obesity: A new medical crisis in the United States. Mayo Clinic Proceedings, 81(10), S5–S10.

    Google Scholar 

  • Houston, D. K., Cai, J., & Stevens, J. (2009). Overweight and obesity in young and middle age and early retirement: The ARIC study. Obesity, 17(1), 143–149.

    Article  Google Scholar 

  • Ingelsson, E., Sullivan, L. M., Fox, C. S., Murabito, J. M., Benjamin, E. J., Polak, J. F., et al. (2007). Burden and prognostic importance of subclinical cardiovascular disease in overweight and obese individuals. Circulation, 116(4), 375–384.

    Article  Google Scholar 

  • Joffe, A., & Wood, K. (2007). Obesity in critical care. Current Opinion in Anesthesiology, 20(2), 113–118.

    Article  Google Scholar 

  • Kaplan, M. S., Huguet, N., Newsom, J. T., McFarland, B. H., & Lindsay, J. (2003). Prevalence and correlates of overweight and obesity among older adults: Findings from the Canadian National Population Health Survey. Journals of Gerontology Series A—Biological Sciences and Medical Sciences, 58(11), 1018–1030.

    Google Scholar 

  • Keenan, P. S. (2009). Smoking and weight change after new health diagnoses in older adults. Archives of Internal Medicine, 169(3), 237–242.

    Article  Google Scholar 

  • Kim, S., & Popkin, B. M. (2006). Commentary: Understanding the epidemiology of overweight and obesity—A real global public health concern. International Journal of Epidemiology, 35(1), 60–67.

    Article  Google Scholar 

  • Klein, S., Allison, D. B., Heymsfiield, S. B., Kelley, D. E., Leibel, R. L., Nonas, C., et al. (2007). Waist circumference and cardiometabolic risk: A consensus statement from shaping America’s health: Association for weight management and obesity prevention; NAASO, The Obesity Society; The American Society for Nutrition; And the American Diabetes Association. Obesity, 15(5), 1061–1067.

    Article  Google Scholar 

  • Koepsell, T. D., Forsberg, C. W., & Littman, A. J. (2009). Obesity, overweight, and weight control practices in US veterans. Preventive Medicine, 48(3), 267–271.

    Article  Google Scholar 

  • Krul, A. J., Daanen, H. A. M., & Choi, H. (2010). Self-reported and measured weight, height and body mass index (BMI) in Italy, the Netherlands and North America. European Journal of Public Health (Published Online January 20, 2010), 1–6.

  • Lahti-Koski, M., Pietinen, P., Heliovaara, M., & Vartiainen, E. (2002). Associations of body mass index and obesity with physical activity, food choices, alcohol intake, and smoking in the 1982–1997 FINRISK studies. American Journal of Clinical Nutrition, 75(5), 809–817.

    Google Scholar 

  • Lemon, C. C., Lacey, K., Lohse, B., Hubacher, D. O., & Klawitter, B. (2004). Outcomes monitoring of health, behavior, and quality of life after nutrition intervention in adults with type 2 diabetes. Journal of the American Dietetic Association, 104(12), 1805–1815.

    Article  Google Scholar 

  • Leon-Munoz, L. M., Guallar-Castillon, P., Lopez-Garcia, E., Banegas, J. R., Gutierrez-Fisac, J. L., & Rodriguez-Artalejo, F. (2005). Relationship of BMI, waist circumference, and weight change with use of health services by older adults. Obesity Research, 13(8), 1398–1404.

    Article  Google Scholar 

  • Liebman, M., Pelican, S., Moore, S. A., Holmes, B., Wardlaw, M. K., Melcher, L. M., et al. (2003). Dietary intake, eating behavior, and physical activity-related determinants of high body mass index in rural communities in Wyoming, Montana, and Idaho. International Journal of Obesity, 27(6), 684–692.

    Article  Google Scholar 

  • Liebman, M., Pelican, S., Moore, S. A., Holmes, B., Wardlaw, M. K., Melcher, L. M., et al. (2006). Dietary intake-, eating behavior-, and physical activity-related determinants of high body mass index in the 2003 Wellness IN the Rockies cross-sectional study. Nutrition Research, 26(3), 111–117.

    Article  Google Scholar 

  • Link, B. G., & Phelan, J. (1995). Social conditions as fundamental causes of disease. Journal of Health and Social Behavior, Extra Issue 80–94.

  • Link, B. G., & Phelan, J. C. (2002). McKeown and the idea that social conditions are fundamental causes of disease. American Journal of Public Health, 92(5), 730–732.

    Article  Google Scholar 

  • Littman, A. J., Forsberg, C. W., & Koepsell, T. D. (2009). Physical activity in a national sample of veterans. Medicine and Science in Sports and Exercise, 41(5), 1006–1013.

    Article  Google Scholar 

  • Lovasi, G. S., Hutson, M. A., Guerra, M., & Neckerman, K. M. (2009). Built environments and obesity in disadvantaged populations. Epidemiologic Reviews, 31(1), 7–20.

    Article  Google Scholar 

  • Ma, J., Urizar, G. G., Alehegn, T., & Stafford, R. S. (2004). Diet and physical activity counseling during ambulatory care visits in the United States. Preventive Medicine, 39(4), 815–822.

    Article  Google Scholar 

  • Ma, J., Xiao, L., & Stafford, R. S. (2009). Adult obesity and office-based quality of care in the United States. Obesity, 17(5), 1077–1085.

    Article  Google Scholar 

  • McAuley, P., Myers, J., Abella, J., & Froelicher, V. (2007). Body mass, fitness and survival in veteran patients: Another obesity paradox? American Journal of Medicine, 120(6), 518–524.

    Article  Google Scholar 

  • Mihalynuk, T. V., Knopp, R. H., Scott, C. S., & Coombs, J. B. (2004). Physician informational needs in providing nutritional guidance to patients. Family Medicine, 36(10), 722–726.

    Google Scholar 

  • Narayan, K. M. V., Boyle, J. P., Thompson, T. J., Gregg, E. W., & Williamson, D. F. (2007). Effect of BMI on lifetime risk for diabetes in the US. Diabetes Care, 30(6), 1562–1566.

    Article  Google Scholar 

  • National Center for Health Statistics. (2006). Health, United States, 2006 with chartbook on trends in the health of Americans (Vol. DHHS publication number 2006–1232). Hyattsville, MD: Department of Health and Human Services.

    Google Scholar 

  • National Center for Health Statistics. (2007). Health, United States, 2007 with chartbook on trends in the health of Americans (Vol. DHHS publication number 2007–1232). Hyattsville, MD: Department of Health and Human Services.

    Google Scholar 

  • National Center for Health Statistics. (2009). Health, United States, 2008 with Chartbook. Hyattsville, MD: U.S. Department of Health and Human Services.

    Google Scholar 

  • Nelson, K. M. (2006). The burden of obesity among a national probability sample of veterans. Journal of General Internal Medicine, 21(9), 915–919.

    Article  Google Scholar 

  • Nonnemaker, J., Finkelstein, E., Engelen, M., Hoerger, T., & Farrelly, M. (2009). Have efforts to reduce smoking really contributed to the obesity epidemic? Economic Inquiry, 47(2), 366–376.

    Article  Google Scholar 

  • Office of the Assistant Deputy Under Secretary of Health for Policy and Planning. (2004). 2003 Survey of Veteran Enrollees’ Health and Reliance Upon VA with Selected Comparisons to the 1999 and 2002 Surveys: Executive Summary, from http://www1.va.gov/vhareorg/Docs/SOE2003_ReportES.pdf

  • Ogden, C. L., Carroll, M. D., Curtin, L. R., McDowell, M. A., Tabak, C. J., & Flegal, K. M. (2006). Prevalence of overweight and obesity in the United States, 1999–2004. Jama-Journal of the American Medical Association, 295(13), 1549–1555.

    Article  Google Scholar 

  • Ostbye, T., Taylor, D. H., Yancy, W. S., & Krause, K. M. (2005a). 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. American Journal of Public Health, 95(9), 1623–1630.

    Article  Google Scholar 

  • Ostbye, T., Yarnall, K. S. H., Krause, K. M., Pollak, K. I., Gradison, M., & Michener, J. L. (2005b). Is there time for management of patients with chronic diseases in primary care? Annals of Family Medicine, 3(3), 209–214.

    Article  Google Scholar 

  • Pearson, T. A. (2007). The prevention of cardiovascular disease: have we really made progress? Health Affairs, 26(1), 49–60.

    Article  Google Scholar 

  • Power, M. L., Cogswell, M. E., & Schulkin, J. (2006). Obesity of US prevention and treatment practices obstetrician-gynecologists. Obstetrics and Gynecology, 108(4), 961–968.

    Article  Google Scholar 

  • Ramsey, P. W., & Glenn, L. L. (2002). Obesity and health status in rural, urban, and suburban Southern women. Southern Medical Journal, 95(7), 666–671.

    Google Scholar 

  • Rana, J. S., Nieuwdorp, M., Jukema, J. W., & Kastelein, J. J. P. (2007). Cardiovascular metabolic syndrome—An interplay of, obesity, inflammation, diabetes and coronary heart disease. Diabetes Obesity & Metabolism, 9(3), 218–232.

    Article  Google Scholar 

  • Rogers, A. C. (1997). Vulnerability, health and health care. Journal of Advanced Nursing, 26(1), 65–72.

    Article  Google Scholar 

  • Schoenborn, C. A. (2004). Marital status and health: United States, 1999–2002. Adv Data, 351, 1–32.

  • Shi, L., & Stevens, G. D. (2005). Vulnerable population in the United States. San Francisco, CA: Jossey-Bass.

    Google Scholar 

  • Stafford, R. S., Farhat, J. H., Misra, B., & Schoenfeld, D. A. (2000). National patterns of physician activities related to obesity management. Archives of Family Medicine, 9(7) 631–+.

    Google Scholar 

  • Wang, A., Kinsinger, L. S., Kahwati, L. C., Das, S. R., Gizlice, Z., Harvey, R. T., et al. (2005). Obesity and weight control practices in 2000 among veterans using VA facilities. Obesity Research, 13(8), 1405–1411.

    Google Scholar 

  • Wardle, J., Waller, J., & Jarvis, M. J. (2002). Sex differences in the association of socioeconomic status with obesity. American Journal of Public Health, 92(8), 1299–1304.

    Article  Google Scholar 

  • Zeber, J. E., Copeland, L. A., McCarthy, J. F., Bauer, M. S., & Kilbourne, A. M. (2009). Perceived access to general medical and psychiatric care among veterans with bipolar disorder. American Journal of Public Health, 99(4), 720–727.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Demography and Organization Studies, University of Texas at San Antonio, 501 West Durango Street, San Antonio, TX, 78207, USA

    P. Johnelle Sparks & Mary Bollinger

  2. VERDICT REAP, STVHCS (11C6), 7400 Merton Minter Blvd, San Antonio, TX, 78229-4404, USA

    Mary Bollinger

Authors
  1. P. Johnelle Sparks
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mary Bollinger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to P. Johnelle Sparks.

Additional information

The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Johnelle Sparks, P., Bollinger, M. A Demographic Profile of Obesity in the Adult and Veteran US Populations in 2008. Popul Res Policy Rev 30, 211–233 (2011). https://doi.org/10.1007/s11113-010-9186-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11113-010-9186-x

Keywords

Search

Navigation