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AJPH First Look, published online ahead of print Jul 28, 2005
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September 2005, Vol 95, No. 9 | American Journal of Public Health 1623-1630
© 2005 American Public Health Association
DOI: 10.2105/AJPH.2004.047803

RESEARCH AND PRACTICE

Associations Between Obesity and Receipt of Screening Mammography, Papanicolaou Tests, and Influenza Vaccination: Results from the Health and Retirement Study (HRS) and the Asset and Health Dynamics Among the Oldest Old (AHEAD) Study

Truls Østbye, MD, PhD, MPH, MBA, Donald H. Taylor, Jr, PhD, MPA, William S. Yancy, Jr, MD, MHS and Katrina M. Krause, MA

Truls Østbye and Donald H. Taylor, Jr, are with the Department of Community and Family Medicine and the Center for Health Policy, Law, and Management, Duke University Medical Center, Durham, NC. Katrina M. Krause is with the Department of Community and Family Medicine, Duke University Medical Center, Durham. William S. Yancy, Jr, is with the Department of Medicine, Duke University Medical Center, and also with the Center for Health Services Research in Primary Care at the Department of Veterans’ Affairs Medical Center, Durham.

Correspondence: Requests for reprints should be sent to Truls Østbye, MD, PhD, MPH, MBA Box 2914, Duke University Medical Center, Durham, NC 27710 (e-mail: truls.ostbye{at}duke.edu).

Objectives. Obese Americans, who receive more care for chronic diseases, may receive fewer preventive services. We evaluated the association between body mass index (BMI) and receipt of screening mammography and Papanicolaou tests among middle-aged women and the association between BMI and receipt of influenza vaccination among the elderly.

Methods. We analyzed 2 datasets: the Health and Retirement Study (4439 women aged 50–61 years) and the Asset and Health Dynamics Among the Oldest Old (AHEAD) Study (4045 women and 2154 men aged 70 years or more).

Results. When BMI was greater than 18.5 kg/m2, we found an inverse dose-response relationship between BMI and receipt of screening mammography and Pap tests among White, but not Black, middle-aged women. We found a similar association between BMI and influenza vaccination among the elderly.

Conclusions. Higher BMI was associated with less frequent receipt of preventive services among middle-aged White women and elderly White women and men. The Healthy People 2010 clinical preventive service goals remain elusive, especially for overweight and obese White persons.






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