Study finds obesity on rise in state

JEFFERSON CITY, Mo. -- There's a lot of fat to be found in preliminary budget totals that forecast a decline in next year's projected budget spending for the first time in more than a decade.

As the state's expected revenue shortfall continues to increase, one of the reasons can be found in disclosure that one out of three Missourians is overweight and responsible for much of the medical and hospitalization costs related to cardiovascular disease, the leading cause of death and disability in the state.

Hospitalization relating to cardiovascular disease has cost Missouri more than $1 billion annually since 1997.

The prevalence of these CVD expenses -- heart disease and stroke -- can be blamed, according to a Missouri Department of Health study, on a finding that more than one-third of the state's population are either overweight or obese.

This latest statistic on overweight Missourians also reveals that the percentage of obesity in the Show-Me State has increased 78 percent since 1987.

Another weight and weight-loss survey in Missouri, this one published by the American Journal of Health Behavior, has found that more than half of all adults in the state are overweight.

Yet another study, conducted by the health agency's Division of Chronic Disease Prevention and Health Promotion, found the prevalence of overweight citizens to be slightly higher among males, African Americans, low-income individuals and those between the ages of 35 and 54.

These groups, according to officials, are "major contributors" to cardiovascular disease, diabetes and other chronic illnesses.

Dr. Maureen Dempsey, director of the Missouri Health Department, said doctors should take every opportunity "to advise their patients on weight issues."

"This could have a major impact on the health of Missourians," she said. "Recent studies indicate that even moderate physical activity, such as walking and gardening, can have positive health benefits."

Understanding needed

Dr. Eduardo Simoes, state epidemiologist, said doctors also must understand how state residents perceive weight issues.

"Understanding these different perceptions will allow the department to better serve the population in need of weight-loss programs," he said.

Major differences in weight-loss activities exist among racial, socioeconomic and gender groups. The study found that although women were less likely to be overweight than men, they were three times more likely to be attempting to lose weight and almost nine times more likely to desire to lose weight. This finding was particularly prevalent within the state's white population.

African-American women were more than twice as likely to be overweight than white women but were much less likely to indicate a desire or view a perceived need to lose weight. Since cardiovascular disease is the major killer in Missouri, and since treatment requires the expenditure of huge sums from the state's health, medical and hospital assistance programs, the overall prevalence of obesity serves to drain state revenue for these programs.

High CVD incidences

Impacting on Missouri's overall health portrait is the statistic that heart disease and stroke killed 174,640 Missourians between 1990 and 1997. Officials note that three regions in the state -- St. Louis, Kansas City and the Bootheel -- reported higher CVD-incidence rates than other areas of Missouri. These three areas have a higher overall prevalence of smoking, obesity, hypertension and unmonitored cholesterol than the rest of the state.

Officials noted that one particularly important finding was a negative perception among African-American females toward leisure-time physical activity and a healthy diet. This group experienced the greatest prevalence of obesity within the general population, a finding leading to higher CVD-illness rates for these women.

Recent findings in the Framington Heart Study, which was originated in 1948, reveal that about 13 percent of all Americans have higher-than-normal blood pressure and 23 percent have hypertension. The Missouri Behavioral Risk Factor Surveillance Survey indicated that 24 percent of the state's adults were diagnosed with hypertension in 1999. State program manager Diana Hawkins said older Missourians and African Americans have an increased risk for high blood pressure compared to other ages and races.

Health complications associated with asthma are evident in the amount of hospitalizations and emergency room visits between 1993 and 1999. There were 50,076 hospitalizations and 195,692 emergency room visits with asthma as the primary cause reported in the state survey. Asthma complications resulting in hospitalization, and requiring state fiscal participation, affect children and African Americans more than any other age group or racial segment of the population.