Body Mass Index and Rural Status on Self-Reported Health in Older Adults: 2002-2012 Medicare Expenditure Panel Survey

Details

• Alternative Title:
  J Rural Health
• Personal Author:
  Batsis, John A. ; Whiteman, Karen L. ; Lohman, Matthew C. ; Scherer, Emily A. ; Bartels, Stephen J.
• Description:
  Purpose:
  
  To ascertain whether rural status impacts self-reported health and whether the effect of rural status on self-reported health differed by obesity status.
  
  Methods:
  
  We identified 22,307 subjects aged≥60 from the Medical Expenditure Panel Survey 2003–2012. Body mass index (BMI) was categorized as underweight, normal, overweight, or obese. The physical and mental component scores of the Short Form-12 assessed self-reported health status. Rural/urban status was defined using metropolitan statistical area. Weighted regression models ascertained the relative contribution of predictors (including rural and BMI) on each subscale.
  
  Findings:
  
  Mean age was 70.8 years. Rural settings had higher proportions classified as obese (30.7 vs.27.6%;p<0.001). Rural residents had lower physical health status (41.7±0.3) than urban (43.4±0.1;p<0.001). Persons with obesity or underweight had lower physical health status (39.5±0.20 and 37.0±0.82, respectively) than normal (44.7±0.18) or overweight (44.6±0.16)[p<0.001]. BMI category stratification was associated with differences in physical health between rural/urban by BMI (obesity:38.4±0.4 vs.39.8±0.2;p=0.002; overweight:43.3±0.4 vs.44.9±0.2; p<0.001; normal:43.4±0.5 vs.45.0±0.2;p=0.007; and underweight:35.2±1.7 vs.37.4±0.9;p=0.26). Individuals classified as underweight or obese had lower physical health scores (−4.45±1.21;p<0.001 and −3.56±0.32;p<0.001) as compared to normal, while the differences were less pronounced for mental health (−2.36±0.81;p=0.004 and 0.91±0.25;p<0.001). No differences in mental health existed between rural/urban status. A BMI*rural interaction was significant for physical (5.19±2.60;p=0.047) but not mental health (−0.09±1.67;p=0.96).
  
  Conclusions:
  
  Rural residence leads to lower self-reported physical health status compared to urban residency, particularly in older adults who were obese or underweight. No interaction was observed between BMI and rural status.
  
  
• Subjects:
  Aged Aged, 80 And Over Analysis Of Variance Body Mass Index Cross-Sectional Studies Female Health Status Humans Male Medicare Quality Of Life Rural Population Self Report Socioeconomic Factors Surveys And Questionnaires United States

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• Keywords:
  Obesity Older Adults Rural Self-reported Health
• Source:
  J Rural Health. 34(Suppl 1):s56-s64
• Pubmed ID:
  28295614
• Pubmed Central ID:
  PMC6454924
• Document Type:
  Journal Article
• Funding:
  K23 AG051681/AG/NIA NIH HHSUnited States/ ; U48 DP005018/DP/NCCDPHP CDC HHSUnited States/ ; U48DP005018/ACL HHSUnited States/ ; UL1 TR001086/TR/NCATS NIH HHSUnited States/
• Volume:
  34
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:5815cab284f1da7d8a81714aee45142e97b1bcfa100cbaaaa9d6aa588e42a119
• Download URL:
  https://stacks.cdc.gov/view/cdc/77421/cdc_77421_DS1.pdf
• File Type:
  [PDF - 363.75 KB ]