Okobi Okelue E, Beeko Papa Kwame Antwi, Nikravesh Elham, Beeko Maame Akosua E, Ofiaeli Chika, Ojinna Blessing T, Okunromade Omolola, Dick Anthony I, Sulaiman Adenike R, Sowemimo Ayomide
Family Medicine, Medficient Health Systems, Laurel, USA.
Family Medicine, Lakeside Medical Center, Belle Glade, USA.
Cureus. 2023 Jul 6;15(7):e41432. doi: 10.7759/cureus.41432. eCollection 2023 Jul.
Across the globe, obesity stands as a prominent public health concern, linked to a heightened susceptibility to a range of metabolic and cardiovascular disorders. This study reveals a disproportionate impact of obesity on African American (AA) communities, irrespective of socioeconomic status. Structural racism plays a critical role in perpetuating healthcare disparities between AA and other racial/ethnic groups in the United States. These disparities are reflected in limited access to nutritious food, safe exercise spaces, health insurance, and medical care, all of which significantly influence healthcare outcomes and obesity prevalence. Additionally, both conscious and unconscious interpersonal racism adversely affect obesity care, outcomes, and patient-healthcare provider interactions among Blacks.
This study aims to analyze and compare obesity-related mortality rates among AAs, Whites, and other racial groups.
We queried the CDC WONDER dataset, incorporating all US death certificates. During data extraction, various ICD 10 codes were used to denote different obesity categories: E66.1 (drug-induced obesity), E66.2 (severe obesity with alveolar hypoventilation), E66.3 (overweight), E66.8 (other forms of obesity), E66.9 (unspecified obesity), E66.0 (obesity due to excess calorie intake), E66.01 (severe obesity due to excess calories), and E66.09 (other forms of obesity caused by excess calorie intake). Our study encompassed decedents aged ≥15 years, with obesity-related diseases as the underlying cause of death from 2018 to 2021. Sex- and race-specific obesity-related mortality rates were examined for AAs, Whites, and other races. Resultant mortality trends were computed and presented as ratios comparing AA and White populations.
This study reveals lower obesity-related mortality rates in AAs compared to Whites. Furthermore, women exhibited higher rates than men. In the 15 to 24 age bracket, males comprised 60.11% of the 361 deaths, whereas females made up 39.89%. In this demographic, 35.46% of deaths were among Blacks, with 64.54% among Whites. Within the 25 to 34 age group, females constituted 37.26% of the 1943 deaths, and males 62.74%. Whites made up 62.94% of the fatalities, Blacks 33.40%, with other racial groups accounting for the remainder. These trends extended through the 35-44, 45-54, 55-64, 65-74, and 75+ age categories, with variations in death proportions among genders and races. Whites consistently accounted for the highest death percentages across all age groups, followed by Blacks. Our data indicate that obesity-related mortality tends to occur earlier in life.
Our results corroborate previous studies linking elevated mortality risk to obesity and overweight conditions. The uniformity of our findings across age groups, as well as genders, supports the proposal for applying a single range of body weight throughout life. Given the ongoing rise in obesity and overweight conditions across the United States, excess mortality rates are projected to accelerate, potentially leading to decreased life expectancy. This highlights the urgency for developing and implementing effective strategies to control and prevent obesity nationwide.
在全球范围内，肥胖是一个突出的公共卫生问题，与一系列代谢和心血管疾病的易感性增加有关。这项研究表明，无论社会经济地位如何，肥胖对非裔美国人（AA）社区的影响都不成比例。结构性种族主义在美国非裔与其他种族/族裔群体之间的医疗保健差距长期存在方面起着关键作用。这些差距体现在获得营养食品、安全的运动空间、医疗保险和医疗服务的机会有限，所有这些都显著影响医疗保健结果和肥胖患病率。此外，有意识和无意识的人际种族主义对黑人的肥胖护理、结果以及患者与医疗保健提供者的互动产生不利影响。
本研究旨在分析和比较非裔美国人、白人和其他种族群体中与肥胖相关的死亡率。
我们查询了疾病控制与预防中心（CDC）的WONDER数据集，该数据集包含了美国所有的死亡证明。在数据提取过程中，使用了各种国际疾病分类第10版（ICD 10）代码来表示不同的肥胖类别：E66.1（药物性肥胖）、E66.2（伴有肺泡低通气的重度肥胖）、E66.3（超重）、E66.8（其他形式的肥胖）、E66.9（未指定的肥胖）、E66.0（由于热量摄入过多导致的肥胖）、E66.01（由于热量过多导致的重度肥胖）以及E66.09（由热量摄入过多引起的其他形式的肥胖）。我们的研究涵盖了年龄≥15岁、在2018年至2021年期间以与肥胖相关的疾病作为潜在死亡原因的死者。对非裔美国人、白人和其他种族按性别和种族划分的与肥胖相关的死亡率进行了检查。计算了由此产生的死亡率趋势，并以比较非裔美国人和白人人口的比率形式呈现。
这项研究表明，与白人相比，非裔美国人中与肥胖相关的死亡率较低。此外，女性的死亡率高于男性。在15至24岁年龄组中，在361例死亡病例中男性占60.11%，而女性占39.89%。在这个年龄段中，35.46%的死亡病例为黑人，64.54%为白人。在25至34岁年龄组中，在1943例死亡病例中女性占37.26%，男性占62.74%。白人占死亡人数的62.94%，黑人占33.40%，其他种族群体占其余部分。这些趋势贯穿了35 - 44岁、45 - 54岁、55 - 64岁、65 - 74岁和75岁及以上年龄类别，不同性别和种族的死亡比例存在差异。在所有年龄组中，白人始终占死亡百分比最高，其次是黑人。我们的数据表明，与肥胖相关的死亡往往在生命早期发生。
我们的结果证实了先前将较高的死亡风险与肥胖和超重状况联系起来的研究。我们在各年龄组以及不同性别中的研究结果具有一致性，这支持了在一生中应用单一体重范围的提议。鉴于美国肥胖和超重状况持续上升，预计超额死亡率将加速上升，可能导致预期寿命下降。这凸显了在全国范围内制定和实施有效策略来控制和预防肥胖的紧迫性。
