How Unhealthy is Unhealthy Weight?: Variation in BMI-associated Premature Mortality by Gender, Race, and Education

• In Event: 539 - Regular Session. Methodological Challenges of Research on Mortality and Morbidity

Abstract

While the obesity epidemic continues to pose a serious risk to both individual and public health, the relationship between body weight and mortality remains somewhat unclear. Most current research speaks to the strong association between having an underweight or obese weight status and higher mortality, as well as the “protective” effect of being overweight for some population groups. However, limited research has examined the consistency of this “J”- or “U”-shaped BMI-associated mortality curve when stratified by race, gender, and education. Further, few studies have examined the implications of BMI-associated premature mortality for middle-aged adults (30-65) as opposed to older adults. Using Cox proportional hazard modeling and integrated National Health Interview Survey data from 1997-2012, this study attempts to address these unexplored questions by examining variation in the shape and magnitude of the BMI-premature mortality risk curve for different sociodemographic population groups. Results indicate that there are gender, racial, and educational differences in the strength of the BMI-premature mortality relationship that both support and contradict previous research. Being overweight is highly associated with the lowest mortality risk among black respondents with lower levels of education, while being white and having higher levels of education significantly increases mortality risk among severely obese individuals. These findings suggest that weight status, specifically higher body weight, poses a greater relative health risk in more sociodemographically advantaged groups (white, and highly educated), while other health-related conditions are likely to be more closely associated with mortality for black and lower-educated individuals.

Author

• Iliya Gutin, The University of North Carolina-Chapel Hill