The Obesity Epidemic in the Veterans Health Administration: Prevalence Among Key Populations of Women and Men Veterans
The Obesity Epidemic in the Veterans Health Administration: Prevalence Among Key Populations of Women and Men Veterans
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DOI：
10.1007/s11606-016-3962-1
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发表时间：
2017-04-01
影响因子：
5.7
通讯作者：
Frayne, SusanM.
中科院分区：
文献类型：
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作者：
Breland, Jessica Y.;Phibbs, Ciaran S.;Frayne, SusanM.
背景：大多数美国成年人超重或肥胖。了解各亚群肥胖患病率的差异可以促进体重管理服务的发展和传播。结论：为了告知退伍军人健康管理局（VHA）的体重管理举措，我们描述了VHA patients.DESIGN的亚群肥胖患病率：2014财年（FY 2014）国家VHA行政和临床数据的横断面描述性分析，按性别分层。参与者：退伍军人VHA初级保健患者，在2014财年第一次初级保健就诊的+/-365天内具有有效体重，并且具有有效身高。（98%的初级保健病人）。我们使用VHA生命体征数据来确定身高和体重，并计算体重指数，和基于费用的数据来识别基于社会人口统计学和共病的亚群。关键结果：在近500万初级保健患者中，肥胖患病率为41%（女性44%，男性41%），超重患病率为37%（女性31%，男性38%）。在VHA的140个设施中，肥胖患病率从28%到49%不等。在性别分层的亚群中，65岁以下的退伍军人肥胖患病率较高（18-44岁：女性40%，男性46%; 45-64岁：女性49%，男性48%）。肥胖患病率各不相同的种族/民族和comoreconomies亚群，与高肥胖患病率黑人妇女（51%），精神分裂症的妇女（56%），女性和男性糖尿病患者（68%，56%）。结论：超重和肥胖是常见的退伍军人服务的VHA。VHA的体重管理计划有可能避免肥胖相关疾病引起的长期发病率。高风险群体，如黑人女性退伍军人，患有精神分裂症的女性退伍军人，年轻的退伍军人，夏威夷原住民/其他太平洋岛民和美洲印第安人/阿拉斯加原住民退伍军人，可能需要特别关注，以确保在人口层面的系统改善工作不会无意中增加健康差距。
BACKGROUND: Most US adults are overweight or obese. Understanding differences in obesity prevalence across subpopulations could facilitate the development and dissemination of weight management services.OBJECTIVES: To inform Veterans Health Administration (VHA) weight management initiatives, we describe obesity prevalence among subpopulations of VHA patients.DESIGN: Cross-sectional descriptive analyses of fiscal year 2014 (FY2014) national VHA administrative and clinical data, stratified by gender. Differences >= 5% higher than the population mean were considered clinically significant.PARTICIPANTS: Veteran VHA primary care patients with a valid weight within +/-365 days of their first FY2014 primary care visit, and a valid height (98% of primary care patients).MAIN MEASURES: We used VHA vital signs data to ascertain height and weight and calculate body mass index, and VHA outpatient, inpatient, and fee basis data to identify sociodemographic- and comorbidity-based subpopulations.KEY RESULTS: Among nearly five million primary care patients (347,112 women, 4,567,096 men), obesity prevalence was 41% (women 44%, men 41%), and overweight prevalence was 37% (women 31%, men 38%). Across the VHA's 140 facilities, obesity prevalence ranged from 28% to 49%. Among gender-stratified subpopulations, obesity prevalence was high among veterans under age 65 (age 18-44: women 40%, men 46%; age 45-64: women 49%, men 48%). Obesity prevalence varied across racial/ethnic and comorbidity subpopulations, with high obesity prevalence among black women (51%), women with schizophrenia (56%), and women and men with diabetes (68%, 56%).CONCLUSIONS: Overweight and obesity are common among veterans served by the VHA. VHA's weight management initiatives have the potential to avert long-term morbidity arising from obesity-related conditions. High-risk groups-such as black women veterans, women veterans with schizophrenia, younger veterans, and Native Hawaiian/Other Pacific Islander and American Indian/Alaska Native veterans-may require particular attention to ensure that systems improvement efforts at the population level do not inadvertently increase health disparities.