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美国肥胖干预措施对心血管代谢健康差异的微观模拟预测。

Microsimulation projections of obesity interventions on cardiometabolic health disparities in the United States.

机构信息

Behavioral and Policy Sciences, RAND Corporation, Pittsburgh, Pennsylvania, USA.

Pardee RAND Graduate School, Santa Monica, California, USA.

出版信息

Obesity (Silver Spring). 2022 Jan;30(1):62-74. doi: 10.1002/oby.23297.

Abstract

OBJECTIVE

The aim of this study was to estimate long-term impacts of health education interventions on cardiometabolic health disparities.

METHODS

The model simulates how health education implemented in the United States throughout 2019 to 2049 would lead to changes in adult BMI and consequent hypertension and type 2 diabetes. Health outcome changes by sex, racial/ethnic (non-Hispanic White, non-Hispanic Black, and Hispanic), and weight status (normal: 18.5 BMI < 25; overweight: 25 BMI < 30; and obesity: 30 BMI) subpopulations were compared under a scenario with and one without health education.

RESULTS

By 2049, the intervention would reduce average BMI of women with obesity to 27.7 kg/m (CI: 27.4-27.9), which would be 2.9 kg/m lower than the expected average BMI without an intervention. Education campaigns would reduce type 2 diabetes prevalence, but it would remain highest among women with obesity at 27.7% (CI: 26.2%-29.2%). The intervention would reduce hypertension prevalence among White women by 4.7 percentage points to 38.0% (CI: 36.4%-39.7%). For Black women in the intervention, the 2049 hypertension prevalence would be 52.6% (CI: 50.7%-54.5%). Results for men and women were similar.

CONCLUSIONS

Long-term health education campaigns can reduce obesity-related disease. All population groups benefit, but they would not substantially narrow cardiometabolic health disparities.

摘要

目的

本研究旨在评估健康教育干预对心血管代谢健康差异的长期影响。

方法

该模型模拟了 2019 年至 2049 年期间在美国实施的健康教育将如何导致成年人 BMI 变化以及随之而来的高血压和 2 型糖尿病。通过比较有和没有健康教育的情景下,按性别、种族/族裔(非西班牙裔白人、非西班牙裔黑人、西班牙裔)和体重状况(正常:18.5 BMI < 25;超重:25 BMI < 30;肥胖:30 BMI)亚人群的健康结果变化。

结果

到 2049 年,干预措施将使肥胖女性的平均 BMI 降低至 27.7 kg/m(置信区间:27.4-27.9),比没有干预措施的预期平均 BMI 低 2.9 kg/m。教育运动将降低 2 型糖尿病的患病率,但肥胖女性的患病率仍最高,为 27.7%(置信区间:26.2%-29.2%)。干预措施将使白人女性的高血压患病率降低 4.7 个百分点,至 38.0%(置信区间:36.4%-39.7%)。对于干预组中的黑人女性,2049 年的高血压患病率将为 52.6%(置信区间:50.7%-54.5%)。男性和女性的结果相似。

结论

长期的健康教育运动可以降低肥胖相关疾病的发病率。所有人群都受益,但不会显著缩小心血管代谢健康差异。

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