Abstract
The past two decades have seen a dramatic increase in the prevalence of obesity in the US population. Although increasing obesity was observed in every sociodemographic group, at every point in time groups with lower education, African Americans and Native Americans, and women in lower income households had higher rates of obesity and related chronic conditions such as diabetes. Also noteworthy is the much faster increase of severe obesity compared with moderate obesity, which added further strain to the health care system and proved especially challenging to health care providers. We provide data on the populationwide trends in weight gain, economic consequences of health care cost growth and the socioeconomic disparities in obesity and diabetes. We further di scuss the socioeconomic and environmental changes that are likely underlying mechanisms for the obesity epidemic and related disparities. We conclude the chapter by discussing implications of these trends for the prevention and treatment of diabetes and challenges and opportunities faced by the health care system and providers.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Similar content being viewed by others
References
Hill JO, Peters JC. Environmental contributions to the obesity epidemic. Science 1998;280(5368): 1371–1374.
Hill JO, Wyatt HR, Reed GW, et al. Obesity and the environment: where do we go from here? Science 2003;299(5608): 853–855.
Popkin BM, Duffey K, Gordon-Larsen P. Environmental influences on food choice, physical activity and energy balance. Physiol Behav 2005;86:603–613.
Chang VW, Lauderdale DS. Income disparities in body mass index and obesity in the United States, 1971-2002. Arch Intern Med 2005; 165(18):2122–2128.
Truong KD, Sturm R. Weight gain trends across sociodemographic groups in the United States. Am J Public Health 2005;95(9): 1602–1606.
Flegal KM, Carroll MD, Ogden CL, et al. Prevalence and trends in obesity among US adults, 1999–2000. JAMA 2002;288(14): 1723–1727.
Gregg EW, Cheng YJ, Cadwell BL, et al. Secular trends in cardiovascular disease risk factors according to body mass index in US adults. JAMA 2005;293(15): 1868–1874.
National Center for Health Statistics. Health, United States. Hyattsville, MD: 2004.
Flegal KM, Carroll MD, Kuczmarski RJ, et al. Overweight and obesity in the United States: prevalence and trends, 1960–1994. Int J Obes Relat Metab Disord 1998;22(l):39–47.
Mokdad AH, Bowman BA, Ford ES, et al. The continuing epidemics of obesity and diabetes in the United States. JAMA 2001;286(10): 1195–1200.
Rose G. Sick individuals and sick populations. Int J Epidemiol 1985;14(l):32–38.
Sturm R. Increases in clinically severe obesity in the United States, 1986-2000. Arch Intern Med 2003;163(18):2146–2148.
Sturm R. The effects of obesity, smoking, and drinking on medical problems and costs. Obesity outranks both smoking and drinking in its deleterious effects on health and health costs. Health Aff (Millwood) 2002;21(2):245–253.
Andreyeva T, Sturm R, Ringel JS. Moderate and severe obesity have large differences in health care costs. Obes Res 2004;12(12): 1936–1943.
Encinosa WE, Bernard DM, Steiner CA, et al. Use and costs of bariatric surgery and prescription weight-loss medications. Health Aff (Millwood) 2005;24(4): 1039–1046.
Parchman ML, Burge SK. The patient-physician relationship, primary care attributes, and preventive services. Fam Med 2004;36(l):22–27.
Xu KT. Usual source of care in preventive service use: a regular doctor versus a regular site. Health Serv Res 2002;37(6): 1509–1529.
Newcomer JW. Abnormalities of glucose metabolism associated with atypical antipsychotic drugs. J Clin Psychiatry 2004;65Suppl 18:36–46.
Wirshing DA. Schizophrenia and obesity: impact of antipsychotic medications. J Clin Psychiatry 2004;65Suppl 18:13–26.
Robinson JP, Godbey GG. Time for Life: The Surprising Ways Americans Use Their Time. 2nd ed. Pennsylvania State University Press, University Park, PA: 1999.
Sturm R. The economics of physical activity: societal trends and rationales for interventions. Am J Prev Med 2004;27(3 Suppl): 126–135.
Sturm R. Childhood obesity—what we can learn from existing data on societal trends, part 1. Prev Chronic Dis 2005;2(l):A12.
23. National Household Transportation Survey. Summary of Travel Trends: 2001 National Household Travel Survey. Available at http://nhts.ornl.gov/2001/reports.shtml.
Sturm R. Childhood obesity—what we can learn from existing data on societal trends, part 2. Prev Chronic Dis 2005;2(2):A20.
Ewing R, Schmid T, Killingsworth R, et al. Relationship between urban sprawl and physical activity, obesity, and morbidity. Am J Health Promot 2003; 18(1):47–57.
Saelens BE, Sallis JF, Black JB, et al. Neighborhood-based differences in physical activity: an environment scale evaluation. Am J Public Health 2003;93(9): 1552–1558.
Saelens BE, Sallis JF, Frank LD. Environmental correlates of walking and cycling: findings from the transportation, urban design, and planning literatures. Ann Behav Med 2003;25(2):80–91.
Sturm R, Cohen DA. Suburban sprawl and physical and mental health. Public Health 2004; 118(7): 488–496.
Drewnowski A. Obesity and the food environment: dietary energy density and diet costs. Am J Prev Med 2004;27(3 Suppl): 154–162.
Drewnowski A, Darmon N. The economics of obesity: dietary energy density and energy cost. Am J Clin Nutr 2005;82(l Suppl):265S–273S.
Ludwig DS. Dietary glycemic index and obesity. J Nutr 2000;130(2S Suppl):280S–283S.
Ludwig DS. The glycemic index: physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. JAMA 2002;287(18):2414–24123.
Ludwig DS. Dietary glycemic index and the regulation of body weight. Lipids 2003;38(2): 117–121.
Blisard N, Stewart H, Joliffe D. Low-Income Households’ Expenditures on Fruits and Vegetables. ERS Research Brief. Available online at http://www.ere.usda. gov/publications/aer833/aer833_researchbrief. pdf. US Department of Agriculture, May 2004.
Sturm R, Datar A. Body mass index in elementary school children, metropolitan area food prices and food outlet density. Public Health 2005;119(12): 1059–1068.
Buchanan TA, Xiang AH, Peters RK, et al. Preservation of pancreatic beta-cell function and prevention of type 2 diabetes by pharmacological treatment of insulin resistance in hi gh-riskhispanic women. Di abetes 2002;51(9): 2796–2803.
Chiasson JL, Josse RG, Gomis R, et al. Acarbose for prevention of type 2 diabetes mellitus: the STOPNIDDM randomised trial. Lancet 2002;359(9323):2072–2077.
Knowler WC, Barrett-Con nor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346(6):393–403.
Pan XR, Li GW, Hu YH, et al. Effects of diet and exercise in preventing NIDDM in people wi th impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care 1997;20(4):537–544.
Tuomilehto J, Lindstrom J, Eriksson JG, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001;344(18): 1343–1350.
Bellochs C, Carter AB. Building Primary Health Care in New York City’s Low-income Communities. Community Health Service Society of New York, New York: 1990.
Fosset JW, Peroff JD, Peterson JA, et al. Medicaid in the inner city: the case of maternity care in Chicago. Milbank Quarterly 1990;68:111–141.
Mitchell JB. Physician participation in Medicaid revisited. Med Care 1991;29(7):645–653.
Mitchell JB, Cromwell J. Large Medicaid practices and Medicaid mills. JAMA 1980;244(21):2433–2437.
Ashford A, Gemson D, Sheinfeld Gorin SN, et al. Cancer screening and prevention practices of innercity physicians. Am J Prev Med 2000;19(l):59–62.
Morland K, Wing S, Diez Roux A, et al. Neighborhood characteristics associated with the location of food stores and food service places. Am J Prev Med 2002;22(l):23–29.
Gomez JE, Johnson BA, Selva M, et al. Violent crime and outdoor physical activity among inner-city youth. Prev Med 2004;39(5):876–881.
Molnar BE, Gortmaker SL, Bull FC, et al. Unsafe to play? Neighborhood disorder and lack of safety predict reduced physical activity among urban children and adolescents. Am J Health Promot 2004;18(5):378–386.
House JS, Lepkowski JM, Kinney AM, et al. The social stratification of aging and health. J Health Soc Behav 1994;35(3):213–234.
Marmot MG, Smith GD, Stansfeld S, et al. Health inequalities among British civil servants: the Whitehall II study. Lancet 1991;337(8754): 1387–1393.
Finney Rutten LJ, Nelson DE, Meissner HI. Examination of population-wide trends in barriers to cancer screening from a diffusion of innovation perspective (1987–2000). Prev Med 2004;38(3):258–268.
Kenkel D. Health behavior, health knowledge, and schooling. J Polit Econ 1991;99(2):287–305.
Goldman DP, Smith JP. Can patient self-management help explain the SES health gradient? Proc Natl Acad Sci USA 2002;99(16): 10,929–10,934.
Truong KD, Sturm R. Weight gain trends across sociodemographic groups in the United States. Am J Pub Health 2005;95:1602–1606.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2007 Humana Press Inc., Totowa, NJ
About this chapter
Cite this chapter
Sturm, R., Bao, Y. (2007). Socioeconomics of Obesity. In: Kushner, R.F., Bessesen, D.H. (eds) Treatment of the Obese Patient. Contemporary Endocrinology. Humana Press. https://doi.org/10.1007/978-1-59745-400-1_9
Download citation
DOI: https://doi.org/10.1007/978-1-59745-400-1_9
Publisher Name: Humana Press
Print ISBN: 978-1-58829-735-8
Online ISBN: 978-1-59745-400-1
eBook Packages: MedicineMedicine (R0)