1. Obesity among Hispanics - a brief demographic account Rodolfo Valdez, Ph.D., M. Sc. Division of Diabetes Translation Centers for Disease Control and Prevention Atlanta, GA

2. Introduction Hispanics are at increased risk for obesity. The population of Hispanics in the United States increased from 22.4 million in 1990 to 35.3 million in 2000. There is a need for identifying modifiable risk factors associated with the excess prevalence of obesity among Hispanics.

3. Objectives To assess the prevalence of obesity in Puerto Rico and several states of the U.S. with large Hispanic populations. To examine the association between obesity and some demographic variables in these populations.

4. Methods I Comparison of frequencies obtained from CDC’s Behavioral Risk Factor Surveillance System (BRFSS). Software: SAS, SUDAAN. The BRFSS uses telephone health surveys designed to continuously monitor the risk behaviors for chronic disease, injuries, and death in the U.S. population, state by state.

5. Methods II Populations selected were from Puerto Rico and six states (NY, NJ, IL, FL, TX, CA) that represent the high density and the diversity of origins of the Hispanic population in the United States. Sample size: five years of the BRFSS (1998-2002), n = 134,802. Results are the weighted average over five years. Age-standardization: U.S. Census 2000.

7. Definition of Obesity Body Mass Index [weight (kg)/height (m) 2 ] BMICategory Lean<18.5Underweight 18.5 – 24.9Normal weight Overweight25.0 – 29.9Overweight Obesity30.0 – 34.9Obesity (Class 1) 35.0 – 39.9Obesity (Class 2) 40+Extreme Obesity

8. Hispanic population in 6 states and Puerto Rico as a percentage of the total U.S. Hispanic population and of the total intra-state population (U.S. 2000 Census)

9. Age distribution of Hispanic and non-Hispanic white BRFSS participants from six states (NY, NJ, IL, FL, TX, CA) and Puerto Rico (BRFSS 1998-2002).

10. Prevalence of obesity in adults by age and ethnicity in six states (NY, NJ, IL, FL, TX, CA) and Puerto Rico (pooled data)

11. Crude prevalence of obesity in adults by ethnicity in six states and Puerto Rico (BRFSS 1998-2002).

12. Age-standardized prevalence of obesity in adults by ethnicity in six states and Puerto Rico (BRFSS 1998-2002).

13. Distribution of educational attainment in U.S. Hispanic and non-Hispanic white from six states (NY, NJ, FL, IL, TX, CA) BRFSS 1998-2002

14. Age-standardized prevalence of obesity in adults by ethnicity and educational attainment in six states (NY, NJ, FL, IL, TX, CA) and Puerto Rico. Pooled data. (BRFSS 1998-2002).

15. Distribution of U.S. Hispanic and non-Hispanic white adult populations by income in six states (NY, NJ, FL, IL, TX, CA) (Pooled data, BRFSS 1998-2002).

16. Age-standardized prevalence of obesity in adults by ethnicity and income in six states (NY, NJ, IL, FL, TX, CA) and Puerto Rico (Pooled data, BRFSS 1998-2002).

17. Percentage distribution of the Duncan Socioeconomic Index in adults (25-64 years) by ethnicity (The San Antonio Heart Study). Wei M et al. Ann Epidemiol 1996; 6: 307-313

18. Prevalence of diabetes in Mexican American adults (25-64 years) by migration and acculturation status (NHANES III, adjusted for age and education). Sundquist J & Winkleby MA. Am J Public Health 1999; 89: 723-730

19. Percentage of adult women (25-64 years) with no leisure- time activity during the past month by ethnicity and years of education (NHANES III). Winkleby MA et al. JAMA 1998; 280: 356-362

20. Age- and sex-adjusted prevalence of obesity in U.S. adolescents (7th-12th grade) by generation of birth (National Longitudinal Study of Adolescent Health). Popkin BM & Udry JR.. Journal of Nutrition 1998; 128:701-706.

21. Summary The prevalence of obesity varies among the different Hispanic groups. Income and education are inversely associated with obesity rates in both Hispanics and non-Hispanic whites. Hispanics outnumber non-Hispanic whites at the high-risk end of the income and education distributions.

22. Conclusions Hispanics in the U.S. and Puerto Rico are undergoing a health transition. The transition involves over exposure to social factors that seem to favor the development of obesity. As the social condition of Hispanics improves, the high prevalence of obesity among them may recede. Prevention campaigns may accelerate the health transition