United States Long-Term Trends in Adult BMI (1959-2018): Unraveling the Roots of the Obesity Epidemic.

The escalating rates of obesity since the 1950s poses a critical public health challenge across all age groups in the United States. While numerous studies have examined cross-sectional disparities across racial, ethnic, and socioeconomic groups, there has been limited research on long-term trends. To address this gap, we analyzed average adult body mass index (BMI) trends from 1959 to 2018, using data from the National Health and Nutrition Examination Survey (NHANES) and the National Health Examination Survey (NHES). Employing time series analysis, we evaluated BMI trends across income, education, and race/ethnicity. The results revealed a consistent upward trajectory in average BMI across all groups over the six-decade period, with no significant differences by income or education levels among high school graduates. However, individuals with less than a high school education displayed a more gradual increase in BMI. Racial disparities were also evident, with Black adults showing higher BMI growth rates compared to White adults, while Hispanic and other racial groups experienced slower increases. These findings underscore the need for systemic interventions to address the ongoing obesity epidemic, emphasizing the importance of research to identify trends over time and a system-thinking approach to inform effective population-level interventions and policy decisions.

Racial/Ethnic and Educational Disparities in the Impact of Diabetes on Population Health Among the U.S.-Born Population.

OBJECTIVES: This study examines total life expectancies (TLEs) for both healthy and diabetic U.S.-born populations and 2 measures capturing quality of life: (a) the proportion of remaining life to be spent without either other chronic conditions or activities of daily living disabilities (ADLs) and (b) the proportion of remaining life to be spent with ADLs for U.S.-born diabetic populations by race/ethnicity and educational attainment. METHODS: Using the 1998-2014 waves of the Health and Retirement Study (n = 16,983), we apply a Bayesian multistate life table method to calculate these quantities from the constructed life tables. RESULTS: TLE at age 50 is shorter for diabetic individuals than healthy individuals, for non-Hispanic Blacks than members of other racial/ethnic groups, and for less-educated individuals. Gaps in TLE at age 50 between healthy and diabetic populations range from 6.3 to 8.8 years across sex-race combinations and from 5.6 to 9.2 years across sex-education combinations. Among the diabetic population, those with at least a college degree on average have a higher proportion of remaining life to be spent without either other chronic conditions or ADLs. Hispanics and those without a college degree have a particularly high proportion of remaining life to be spent with ADLs. Although diabetic women on average live longer than men, their quality of life tends to be lower. DISCUSSION: The impact of diabetes on population health varies across racial/ethnic and educational groups. The findings support targeted interventions for vulnerable groups, such as people of color, women, and less-educated individuals.