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在一项具有全国代表性的调查中探索肥胖管理药物使用方面的种族和民族差异。

Exploring Racial and Ethnic Differences in Utilization of Medications for Obesity Management in a Nationally Representative Survey.

作者信息

Narain Kimberly, Scannell Christopher

机构信息

UCLA Division of General Internal Medicine and Health Services, Research (GIM/HSR), 1100 Glendon Ave., Suite 850, Los Angeles, CA, 90024, USA.

UCLA Iris Cantor Women's Health Center, University of California, Los Angeles, CA, USA.

出版信息

J Racial Ethn Health Disparities. 2024 Dec 17. doi: 10.1007/s40615-024-02248-x.

Abstract

BACKGROUND

The burden of obesity falls disproportionately on some racial and ethnic minority groups.

OBJECTIVE

To assess for racial and ethnic differences in the utilization of obesity-management medications among clinically eligible individuals.

DESIGN

Medical Expenditure Panel Survey (2011-2016, 2018 and 2020) data and a cross-sectional study design was used to assess for racial and ethnic differences in obesity-management medication utilization. Descriptive statistics and multivariable logistic regression models were used to identify the association of race and ethnicity with obesity-management medication utilization. Adjusted models controlled for demographics, socioeconomic status, obesity class, diabetes status, number of chronic conditions, insurance status, and geographic region.

PARTICIPANTS

Adults with a BMI ≥ 30 kg/m and individuals with a BMI ≥ 27 kg/m with ≥ 1 weight-related condition.

MAIN MEASURES

The primary outcome measure was utilization of an FDA-approved medication for obesity-management during the study period. The primary independent predictor was race and ethnicity. Separate indicator variables were created for each racial and ethnic group (Non-Hispanic Asian, Non-Hispanic Black, Hispanic, and Non-Hispanic White (reference group)).

KEY RESULTS

In adjusted analyses, Asian (aOR, 0.36; 95% CI, 0.16 to 0.77; P < 0.01), Black (aOR, 0.51; 95% CI, 0.39 to 0.68; P < 0.001) and Hispanic individuals (aOR, 0.70; 95% CI, 0.49 to 0.98; P = 0.04) had significantly lower odds of utilizing obesity-management medications compared to White individuals.

CONCLUSIONS

The results of this study suggest that there are racial and ethnic disparities in the use of obesity-management medications.

摘要

背景

肥胖负担在一些种族和少数族裔群体中分布不均。

目的

评估临床符合条件的个体在使用肥胖管理药物方面的种族和族裔差异。

设计

使用医疗支出面板调查(2011 - 2016年、2018年和2020年)数据及横断面研究设计,以评估肥胖管理药物使用方面的种族和族裔差异。采用描述性统计和多变量逻辑回归模型来确定种族和族裔与肥胖管理药物使用之间的关联。调整后的模型对人口统计学、社会经济地位、肥胖等级、糖尿病状况、慢性病数量、保险状况和地理区域进行了控制。

参与者

体重指数(BMI)≥30 kg/m²的成年人以及BMI≥27 kg/m²且患有≥1种与体重相关疾病的个体。

主要测量指标

主要结局指标是研究期间使用美国食品药品监督管理局(FDA)批准的肥胖管理药物的情况。主要独立预测因素是种族和族裔。为每个种族和族裔群体(非西班牙裔亚裔、非西班牙裔黑人、西班牙裔和非西班牙裔白人(参照组))创建了单独的指标变量。

关键结果

在调整分析中,与白人相比,亚裔(调整后比值比[aOR],0.36;95%置信区间[CI],0.16至0.77;P < 0.01)、黑人(aOR,0.51;95% CI,0.39至0.68;P < 0.001)和西班牙裔个体(aOR,0.70;95% CI,0.49至0.98;P = 0.04)使用肥胖管理药物的几率显著较低。

结论

本研究结果表明,在肥胖管理药物的使用方面存在种族和族裔差异。

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