Friday, September 20, 2019

America's Biggest Health Problem

Updated December 2019

Thanks to the Centers for Disease Control (CDC) we have a complete picture of America's biggest (pardon the pun) health problem; obesity.  While the latest data is current to 2017, if past performance is an indicator, relatively little will have changed over the past two years.

Let's start with a definition of body mass index or BMI.  BMI is defined as the body mass (weight) divided by the square of the body height and is usually measured using mass in kilograms (2.2 pounds equals one kilogram) and height in metres (3.28 feet equals one metre).  According to the National Heart, Lung and Blood Institute, BMI scores can be categorized as follows:

Underweight - BMI below 18.5

Normal - BMI between 18.5 and 24.9

Overweight - BMI between 25.0 and 29.9

Obese - BMI above 30.0

Obesity Class 1 - BMI between 30.0 and 34.9

Obesity Class 2 - BMI between 35.0 and 39.9

Extreme Obesity - BMI above 40.0

The higher your BMI the higher your risk for heart disease, high blood pressure, type 2 diabetes, certain cancers and breathing difficulties.  The risk for disease relative to normal weight and height is also related to waist circumference.  Men with waists in excess of 40 inches and women with waists in excess of 35 inches have the following risks of disease; "increased" for overweight individuals, "high" for Obesity Class I individuals, "very high" for Obesity Class 2 individuals and "extremely high" for extremely obese individuals as shown on this table:

Let's now look at the data from the CDC showing the state-by-state percentage of adults aged 18 and older who were obese in 2017:

Note that the data does not include respondents who weighed less than 50 pounds or more than 650 pounds (not particularly an exceptional weight given the number of subjects in the "My 600 Pound Life" television series).

Here are the top ten most obese states:

West Virginia - 38.1 percent
Mississippi - 37.3 percent
Oklahoma - 36.5 percent
Iowa - 36.4 percent
Alabama - 36.3 percent
Louisiana - 36.2 percent
Arkansas - 35.0 percent
Kentucky - 34.3 percent
Alaska - 34.2 percent
South Carolina - 34.1 percent

Here are the top ten least obese states:

Colorado - 22.6 percent
District of Columbia - 23.0 percent
Hawaii - 23.8 percent
California - 25.1 percent
Utah - 25.3 percent
Montana - 25.3 percent
New York - 25.7 percent
Massachusetts - 25.9 percent
Nevada - 26.7 percent
Connecticut - 26.9 percent

It is interesting to see that nearly one in four Americans are obese in the states with the lowest percentage of obese individuals and that nearly four in ten Americans are obese in the states with the highest percentage of obese individuals.

Here is one of the most concerning factors; the percentage of adults between the ages of 18 and 24 that are obese:

Once a child or younger adult is significantly overweight, it is extremely difficult to reverse the trend.  According to the CDC, data from 2015 to 2016 shows that nearly one in five school age children are obese.  Here is a map showing the state-by-state statistics for the percentage of high school students that were obese in 2017:

In closing, let's look at a comparison of obesity rates (from 2016) for the top ten most obese OECD nations:

As you can see, the obesity rate in the United States is well above that of Canada, its most direct comparator.  From the CIA World Factbook we find the following highest obesity rates among all nations:

Once again, the United States has among the highest adult obesity rates in the world.

While there is constant noise in Washington about the cost of health care including prescription drugs and hospital care, one of the simplest ways to reduce health care costs at an individual level is to reduce caloric intake and increase activity levels.  It is only through the reduction of American obesity rates that total health care costs will show meaningful reductions.

If you are interested, here is a link that you can use to calculate your own BMI using either metric or imperial measurements.  

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