Impact of being overweight in women with asthma
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Transcript of Impact of being overweight in women with asthma
Noreen Clark, PhD Molly Gong, MDMelissa Valerio, MPHSijian Wang, BSXihong Lin, PhDWilliam Bria, MD Timothy Johnson, MD
University of MichiganSchool of Public Health
Impact of Being Overweight in Women with Asthma
Background
Both asthma and obesity are common health problems and their prevalence continues to rise.
Recent studies indicate that asthma may be associated with overweight in women but not men (Guerra, et al. 2002,
Thomson, et al., 2003).
Purpose
To examine factors associated
with body mass index (BMI) and
related asthma problems for
women.
Study Participants
652 women 18 years and older Physician diagnosis Attending University of Michigan
Asthma & Airways Clinic and University of Michigan Health System
Data collection
Telephone interview
Demographics Asthma symptoms Health care utilization Gender-related management Co-morbidity Quality of life and self-esteem
Data Analyses
Multivariate linear regression models were conducted using BMI as dependent variable and adjusting for age.
Demographics: Age
13%
7% 9%
21%
26%
24%
18-30
31-40
41-50
51-60
61-70
>71
Demographics: Education
22%
2%
26%
21%29%
< High School
High School
2-year College
4-year College
Post Grad
Demographics: Income
5%6%
16%
18%
16%
13%
15%
11%<10,000
10,001-20,000
10,001-20,000
40,001-60,000
60,001-80,000
80,000-100,000
>100,000
Not reported
Demographics: Race/Ethnicity
2%1%2%
10%
2%
83%Caucasian/White
African American/Black
Asian/Pacific Islander
Hispanic/Latino
Native American
Other
Asthma Severity
Classified by NAEPP criteria, Guidelines and Diagnosis and Treatment of Asthma, 1997
Percent of Women
Mild intermittent 53%
Mild persistent 14%
Moderate persistent 18%
Severe persistent 15%
BMI Levels
Percent of Women
Underweight (BMI<19) 3%
Normal (BMI 19-25) 31%
Overweight (BMI 26-30) 26%
Obese (BMI 31-35) 20%
Over Obese (BMI >35) 20%
Association of BMI and Demographic Factors
Estimate Std Error P-Value
Age 0.04 0.02 0.0652
Income -2.6 0.71 0.0003
Education -2.98 0.68 0.0001
Marital status* -1.29 0.65 0.0471
Ethnicity** 5.14 1.02 0.0001
* 1=yes married, 0=otherwise**2=African American, 1=otherwise
Association of BMI and Health Care Utilization for Asthma
Number of timesin past 12months
Estimate Std Error P-Value
Hospitalization 1.13 0.26 0.0001
ED visits 0.25 0.08 0.0016
Unscheduledurgent visit to aclinic
0.09 0.06 0.1117
Regularlyscheduled visits
0.07 0.05 0.1506
Visits to follow-up an asthmaattack
0.06 0.04 0.1533
Association of BMI and Asthma Symptoms & Severity
Estimate Std Error P-Value
Days havingdaytimesymptoms
0.011 0.005 0.0332
Nightsymptomsinterferedsleep
0.018 0.006 0.0031
Severity 0.848 0.278 0.0024
Association of BMI and Other Health Problems
Ever suffered inpast 12 months
Estimate Std Error P-Value
Migraines 1.60 0.66 0.0156
Reflux 2.29 0.67 0.0007
Urinaryincontinence
3.48 0.64 0.0001
Association of BMI, Self-esteem, Quality of Life & Social Support
Estimate Std Error P-Value
Self-esteem -0.27 0.06 0.0001
Quality of Life -0.11 0.02 0.0001
Social Support 0.16 0.06 0.0001
Study Limitations
The study sample includes a number of women with high levels of education and income and an average age of 51 years.
Conclusions
1. Higher BMI among women with asthma was significantly associated with lower annual household income, a lower level of education, being unmarried, being African American, and being of older age.
2. Higher BMI was significantly associated with more asthma symptoms and severe disease.
Conclusions (con’t)
3. Women with higher BMI were more likely to have more hospital admissions and more emergency department visits for asthma.
4. Women with higher BMI were more likely to have other health problems such as migraines, reflux, and urinary incontinence.
Conclusions (con’t)
5. Higher BMI was significantly associated with lower self-esteem and quality of life, and with more social support.
6. Overweight and obese women with asthma confront more problems with asthma than women with the disease of normal weight.