Østbye Truls, Taylor Donald H, Yancy William S, Krause Katrina M
Department of Community and Family Medicine, Duke University Medical Center, Durham, NC 27710, USA.
Am J Public Health. 2005 Sep;95(9):1623-30. doi: 10.2105/AJPH.2004.047803. Epub 2005 Jul 28.
Obese Americans, who receive more care for chronic diseases, may receive fewer preventive services. We evaluated the association between body mass index (BMI) and receipt of screening mammography and Papanicolaou tests among middle-aged women and the association between BMI and receipt of influenza vaccination among the elderly.
We analyzed 2 datasets: the Health and Retirement Study (4439 women aged 50-61 years) and the Asset and Health Dynamics Among the Oldest Old (AHEAD) Study (4045 women and 2154 men aged 70 years or more).
When BMI was greater than 18.5 kg/m2, we found an inverse dose-response relationship between BMI and receipt of screening mammography and Pap tests among White, but not Black, middle-aged women. We found a similar association between BMI and influenza vaccination among the elderly.
Higher BMI was associated with less frequent receipt of preventive services among middle-aged White women and elderly White women and men. The Healthy People 2010 clinical preventive service goals remain elusive, especially for overweight and obese White persons.
患有慢性疾病且接受更多护理的美国肥胖人群，可能接受较少的预防性服务。我们评估了中年女性体重指数（BMI）与接受乳腺钼靶筛查和巴氏试验之间的关联，以及老年人BMI与接受流感疫苗接种之间的关联。
我们分析了两个数据集：健康与退休研究（4439名年龄在50 - 61岁的女性）以及老年资产与健康动态研究（AHEAD研究，4045名女性和2154名年龄在70岁及以上的男性）。
当BMI大于18.5 kg/m²时，我们发现白人中年女性（而非黑人中年女性）的BMI与接受乳腺钼靶筛查和巴氏试验之间存在反向剂量反应关系。我们在老年人中发现BMI与流感疫苗接种之间也存在类似关联。
较高的BMI与中年白人女性以及老年白人女性和男性较少接受预防性服务有关。《健康人民2010》的临床预防服务目标仍然难以实现，尤其是对于超重和肥胖的白人。
