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Body Mass Index and Rural Status on Self-Reported Health in Older Adults: 2002-2012 Medicare Expenditure Panel Survey
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2 2018
Source: J Rural Health. 34(Suppl 1):s56-s64 -
Alternative Title:J Rural Health
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Personal Author:
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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.
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Pubmed ID:28295614
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Pubmed Central ID:PMC6454924
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