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. 2017 Apr;32(Suppl 1):11-17.
doi: 10.1007/s11606-016-3962-1.

The Obesity Epidemic in the Veterans Health Administration: Prevalence Among Key Populations of Women and Men Veterans

Jessica Y Breland  1   2 , Ciaran S Phibbs  3   4 , Katherine J Hoggatt  5   6 , Donna L Washington  5   7 , Jimmy Lee  3 , Sally Haskell  8   9   10 , Uchenna S Uchendu  11 , Fay S Saechao  3 , Laurie C Zephyrin  8   12 , Susan M Frayne  3   4
Affiliations

The Obesity Epidemic in the Veterans Health Administration: Prevalence Among Key Populations of Women and Men Veterans

Jessica Y Breland et al. J Gen Intern Med. 2017 Apr.

Abstract

Background: Most US adults are overweight or obese. Understanding differences in obesity prevalence across subpopulations could facilitate the development and dissemination of weight management services.

Objectives: To inform Veterans Health Administration (VHA) weight management initiatives, we describe obesity prevalence among subpopulations of VHA patients.

Design: Cross-sectional descriptive analyses of fiscal year 2014 (FY2014) national VHA administrative and clinical data, stratified by gender. Differences ≥5% higher than the population mean were considered clinically significant.

Participants: Veteran VHA primary care patients with a valid weight within ±365 days of their first FY2014 primary care visit, and a valid height (98% of primary care patients).

Main measures: We used VHA vital signs data to ascertain height and weight and calculate body mass index, and VHA outpatient, inpatient, and fee basis data to identify sociodemographic- and comorbidity-based subpopulations.

Key results: Among nearly five million primary care patients (347,112 women, 4,567,096 men), obesity prevalence was 41% (women 44%, men 41%), and overweight prevalence was 37% (women 31%, men 38%). Across the VHA's 140 facilities, obesity prevalence ranged from 28% to 49%. Among gender-stratified subpopulations, obesity prevalence was high among veterans under age 65 (age 18-44: women 40%, men 46%; age 45-64: women 49%, men 48%). Obesity prevalence varied across racial/ethnic and comorbidity subpopulations, with high obesity prevalence among black women (51%), women with schizophrenia (56%), and women and men with diabetes (68%, 56%).

Conclusions: Overweight and obesity are common among veterans served by the VHA. VHA's weight management initiatives have the potential to avert long-term morbidity arising from obesity-related conditions. High-risk groups-such as black women veterans, women veterans with schizophrenia, younger veterans, and Native Hawaiian/Other Pacific Islander and American Indian/Alaska Native veterans-may require particular attention to ensure that systems improvement efforts at the population level do not inadvertently increase health disparities.

Keywords: health disparities; obesity; population health; veterans; women.

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Conflict of interest statement

Contributors

The authors would like to thank Mr. Eric Berg, Dr. Hui Wang, Ms. Elon Hailu, and Mr. Jonathan Mendoza for technical expertise, and Dr. Jazmin Reyes-Portillo for her review of the manuscript.

Funders

This program evaluation work was supported by Women’s Health Services in the VA Central Office through the Women’s Health Evaluation Initiative, and by VHA’s Office of Health Equity through the Office of Health Equity-Quality Enhancement Research Initiative (QUERI) Partnered Evaluation Center. Dr. Breland was supported by the VA Office of Academic Affiliations and Health Services Research and Development Service (HSR&D) funds and a VA HSR&D Career Development Award (CDA 15-257) at the VA Palo Alto. Dr. Hoggatt was supported by a Department of Veterans Affairs HSR&D/QUERI Career Development Award (CDA 11-261) at the Greater Los Angeles VA. The views expressed in this article are those of the authors and the contents do not represent the views of the Department of Veterans Affairs or the United States government.

Conflict of Interest

All authors report no conflicts of interest.

Figures

Figure 1
Figure 1
BMI distribution among women and men veteran VHA primary care patients in fiscal year 2014. BMI: body mass index; VHA: Veterans Health Administration; normal weight (18.5 kg/m2 ≤ BMI < 25 kg/m2); overweight (25 kg/m2 ≤ BMI < 30 kg/m2); obesity (BMI ≥ 30 kg/m2).
See this image and copyright information in PMC

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