National Healthcare Disparities Report - LDI Health Economist

Effectiveness of Care
n In 5 out of the 7 years, current non-Hispanic White adult smokers were more likely to receive advice
to quit smoking than current Hispanic adult smokers.
Also, in the NHQR:
n From 2002 to 2008, adult current smokers ages 18-44 were less likely to receive advice to quit
smoking compared with other age groups.
Chapter 2 Lifestyle Modification
Prevention: Counseling Obese Adults About Exercise
Approximately one-third of adults are obese and about 17% of children and adolescents ages 2-19 are obese
(CDC, 2011e). A large proportion of individuals who are overweight or obese are from lower socioeconomic
groups, Black, or Mexican American, and women tend to have higher obesity rates than men (Truong &
Sturm, 2005). Obesity increases the risk for many chronic, often deadly conditions, such as hypertension,
cancer, diabetes, and CHD.
Although physician guidelines recommend that health care providers screen all adult patients for obesity
(USPSTF, 2003), obesity remains underdiagnosed among U.S. adults (Diaz, et al., 2004). Physicians have
direct access to many high-risk individuals, increasing the opportunity to educate patients about their
personal risks, as well as suggesting realistic and sustainable lifestyle changes that can lead to a healthier
weight and more active life (Manson, et al., 2004).
Physician-based exercise and diet counseling is an important component of effective weight loss
interventions (USPSTF, 2003). Such interventions have been shown to increase levels of physical activity
among sedentary patients, resulting in a sustained favorable body weight and body composition (Lin, et al.,
2010). Although every obese person may not need counseling about exercise and diet, many would likely
benefit from improvements in these activities.
Regular exercise and a healthy diet aid in maintaining normal blood cholesterol levels, weight, and blood
pressure, reducing the risk of heart disease, stroke, diabetes, and other comorbidities of obesity. Populations
at risk for overweight and obesity may not receive adequate advice about lifestyle changes for many reasons.
For instance, access to information, including physician knowledge of the latest recommendations, may be
limited. The 2008 Physical Activity Guidelines for Americans recommend that adults engage in 2 hours and
30 minutes a week of moderate-intensity physical activity or 1 hour and 15 minutes a week of vigorousintensity
aerobic physical activity. xxiv
In addition to physician-based exercise and diet counseling, many national endeavors encourage lifestyle
modification. For example, the President’s Challenge is a program of the President’s Council on Fitness,
Sports and Nutrition that promotes an active and fit lifestyle through a suite of recognition programs
available to anyone age 6 and over. Several initiatives have used the President’s Challenge Presidential Active
Lifestyle Award (PALA) to promote healthy lifestyles, including Box Tops for Education’s Family Fitness
Night and Let’s Move! xxv
xxiv More information about the 2008 Physical Activity Guidelines for Americans is available at
www.health.gov/paguidelines/guidelines/default.aspx.
xxv
For more information about the President’s Challenge, go to www.presidentschallenge.org/.
112 National Healthcare Disparities Report, 2011