Impact of being overweight in women with asthma
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Impact of being overweight in women with asthma Noreen Clark Center for Managing Chronic Disease University of Michigan
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Impact of being overweight in women with asthma
- 1. Noreen Clark, PhD Molly Gong, MD Melissa Valerio, MPH Sijian Wang, BS Xihong Lin, PhD William Bria, MD Timothy Johnson, MD Impact of Being Overweight in Women with Asthma University of Michigan School of Public Health
- 12. BMI Levels 26% Overweight (BMI 26-30) 20% Over Obese (BMI >35) 20% Obese (BMI 31-35) 31% Normal (BMI 19-25) 3% Underweight (BMI<19) Percent of Women
- 13. Association of BMI and Demographic Factors * 1=yes married, 0=otherwise **2=African American, 1=otherwise 0.0001 1.02 5.14 Ethnicity** 0.0471 0.65 -1.29 Marital status* 0.0001 0.68 -2.98 Education 0.0003 0.71 -2.6 Income 0.0652 0.02 0.04 Age P-Value Std Error Estimate
- 14. Association of BMI and Health Care Utilization for Asthma
- 15. Association of BMI and Asthma Symptoms & Severity
- 16. Association of BMI and Other Health Problems
- 17. Association of BMI, Self-esteem, Quality of Life & Social Support
Notes de l'éditeur
- In 2001, 9.1% of US women or 9.6 million had asthma. Increases in deaths from asthma between 1979 to 1996 was attributable to women, primarily those over 65 with Black women having the highest rates. Obesity is now seen as an epidemic in the United States.
- The purpose of this study was to examine factors associated with body mass index (BMI) and related asthma problems for women. Asthma related problems include an awareness of particular issues women with asthma face, health care utilization, self-management and physician/patient communication. Sex and gender related management issues were also studied including menstruation, PMS, sexual activity and household activities.
- The current study reports findings at baseline data collection for 652 women, 18 years and older with an asthma physician diagnosis. Women were recruited from the University of Michigan Asthma & Airways Clinic and the University of Michigan Health System.
- Data is collected via telephone in a 45 minute interview. The questionnaire includes demographics, asthma symptoms – frequency, both daytime and nighttime and trigger identification. Health care utilization – ED visits, hospitalization and physician office visits (both scheduled and unscheduled). Gender related management – including daily activity limitation (HH chores, social activities, day care activities, and sexual activity) Co-Morbidity – as self-reported by women Quality of life - Using the Juniper Adult questionnaire and selected Rosenberg self-esteem questions.
- Findings reported are from Multivariate linear regression models using BMI as the dependent variable and adjusting for age.
- About 50% of the participants were between 41 and 60 years of age. Twenty percent were 60 years of age and older and the remaining one fourth were 40 years and younger. .
- Twenty-six% of the participants were high school graduates, 21% reported completion of two-years of college, 30% completed 4-years of college, and 21% reported post graduate education.
- Eleven percent of the women have less than $20,000 annual household income. Eighteen % between 20,000 to 40,000. About 35% of the women reported in a range of 40,000 to 60,000 annual household income. 11% of the women did not report their income.
- 17% of the participants are minorities. 10% African-American and 2% Hispanic. This is representative of the population served by the UM Health System.
- Asthma severity was calculated using NAEPP criteria with 53% of the women were classified as having mild intermittent asthma while 47% had mild persistent to severe persistent asthma. 15% of the women were classified as severe persistent.
- BMI was calculated as weight divided by squared height. 33% of the women reported normal to underweight BMI levels. While 40% were obese or higher. And 26% were overweight.
- A woman’s BMI level was found to be significantly associated to age, income, education, marital status and ethnicity. Older women were more likely to have higher BMI. The lower the income and education levels the higher the probability for high BMI. Unmarried and African-American women were more likely to have higher BMI.
- Higher BMI was found to be significantly associated with health care utilization. The higher the BMI the more likely that women had hospitalizations, ED visits and visits for followup for an asthma attack.
- Higher BMI was found to be significantly associated with asthma symptoms and severity. The higher the BMI, the more likely to report increased frequency of dayttime symptoms, nighttime symptoms and more severe asthma.
- Higher BMI in women with asthma was found to be significantly associated with more comorbidity. Including migraines, reflux, and urinary incontinence.
- Women with asthma and higher BMI were more likely to have lower self-esteem, lower quality of life and reported utilizing more social support.
- Study limitations include: The study sample represents a proportionately higher number of women with high levels of education and income and an average age of 49 years. Data is also self-reported.
- Study conclusions: We found that Higher BMI among women with asthma was significantly associated with lower annual household income, a lower level of education, being unmarried, being African American, and being of older age. Higher BMI was significantly associated with more asthma symptoms and severe disease.
- Women with higher BMI were more likely to have more hospital admissions and more emergency department visits for asthma. Women with higher BMI were more likely to have other health problems such as migraines, reflux, and urinary incontinence.
- Higher BMI was significantly associated with lower self-esteem and quality of life, and with more social support. Overweight and obese women with asthma confront more problems with asthma than women with the disease of normal or lower weight.