Disparities in Healthcare Utilization Among Adults with Obesity in the United States, Findings from the NHIS: 2006–2015

Abstract

Few studies of disparities consider logistical hurdles faced by adults with obesity in obtaining needed healthcare. This study compared adults with obesity to adults without obesity on self-reported practical aspects of receiving healthcare including ease of seeing a doctor and wait times for appointments. Serious psychological distress and chronic health conditions are prevalent in adults with obesity. Because serious psychological distress and number of chronic health conditions can act as confounders in any observed differences between the adults with and without obesity in their use of healthcare, we have examined these differences independent of serious psychological distress and chronic health conditions. Adults 18 to 64 years sampled from the 2006-2015 National Health Interview Survey (NHIS) (n = 74,598) were examined on five self-reported indicators: does not need a doctor, waited too long in the doctor's office, and to get an appointment, year since having seen a doctor, and saw a doctor ten times or more in the last 12 months. Multivariable models adjusted for serious psychological distress, chronic health conditions, gender, age, race/ethnicity, income, health coverage, and survey year demonstrated that adults with obesity were more likely to wait too long to get an appointment, and in the waiting room. Adults with obesity report not needing doctors despite seeing doctors frequently. Greater attention is needed to understand barriers to health care utilization in adults with obesity.

Challenges Faced by Acutely Ill COVID 19 Patients with Obesity: A Narrative Review

“…Physiological factors include compromised respiratory reserve, underlying hypercoagulability, coexistence of multiple other comorbidities and ongoing adiposity related chronic inflammation 12 . As evidenced in a study utilizing a sample of adults from the 2006-2015 National Health Interview Survey, sociological factors including underutilization of preventive care services, prior negative experiences in reception of acute care negatively impacted the health of this population independent of underlying major mental health problems and chronic health conditions 13 . These factors act synergistically to exacerbate the health disparities experienced by obese individuals.…”

Inequities in routine preventive care utilization among persons with overweight/obesity in the United States: An analysis of nativity, racial and ethnic identity, and socioeconomic status

“…The stigmatization of obesity, however, acts as impediments to access and utilization of health services for persons with overweight/obesity [ 4 ]. Several studies assessed preventive care utilization in relation to overweight and obesity, and reported certain barriers and disparities faced by adults with overweight/obesity condition [ [5] , [6] , [7] , [8] ]. These studies, however, were primarily focused on the general population.…”

Clinical, economic, and health‐related quality of life outcomes in patients with overweight or obesity in the United States: 2016–2018

“…[14][15][16][17] Current literature describes characteristics of persons in the US with overweight (OW) or obesity (BMI ≥25 kg/m 2 ). [18][19][20][21][22][23] However, there is a lack of current, nationally representative estimates of health outcomes, and clinical and behavioral characteristics such as the utilization of weight-related interventions (e.g., diet, exercise, surgery, AOMs). A current assessment of the health and economic outcomes in persons with OW or obesity is necessary to understand the scale of unmet needs and to inform obesity-related health policy.…”

“…Current literature describes characteristics of persons in the US with overweight (OW) or obesity (BMI ≥25 kg/m 2 ) 18‐23 . However, there is a lack of current, nationally representative estimates of health outcomes, and clinical and behavioral characteristics such as the utilization of weight‐related interventions (e.g., diet, exercise, surgery, AOMs).…”