Funding agencies: Dr. Brancati was supported by a grant from NIDDK (K24 DK62222). Drs. Yeh, Wang, and Brancati were supported by a Diabetes Research and Training Center grant, also from NIDDK (P60 DK079637). Dr. Wang was supported by a grant from NCATS (UL1 RR025005). Dr. Jackson was supported by a C. Sylvia and Eddie C. Brown Scholarship from the Johns Hopkins Bloomberg School of Public Health.
Body-mass index and mortality risk in US Blacks compared to Whites
Version of Record online: 11 FEB 2014
Copyright © 2013 The Obesity Society
Volume 22, Issue 3, pages 842–851, March 2014
How to Cite
Jackson, C. L., Wang, N.-Y., Yeh, H.-C., Szklo, M., Dray-Spira, R. and Brancati, F. L. (2014), Body-mass index and mortality risk in US Blacks compared to Whites. Obesity, 22: 842–851. doi: 10.1002/oby.20471
- Issue online: 5 MAR 2014
- Version of Record online: 11 FEB 2014
- Accepted manuscript online: 30 MAR 2013 03:03AM EST
- Manuscript Accepted: 15 MAR 2013
- Manuscript Revised: 14 MAR 2013
- Manuscript Received: 9 OCT 2012
To compare body-mass index (BMI)-related mortality risk in US Blacks vs. Whites as the relationship appears to differ across race/ethnicity groups.
Cross-sectional surveys of nationally representative samples of 11,934 Blacks and 59,741 Whites aged 35-75 in the National Health Interview Survey from 1997 to 2002 with no history of cardiovascular disease (CVD) or cancer were pooled. Mortality follow-up was available through 2006. BMI was calculated from self-reported height and weight. We used adjusted Cox regression analysis to adjust for potential confounders.
Over 9 years of follow-up, there were 4303 deaths (1205 among never smokers). Age-adjusted mortality rates were higher in Blacks compared to Whites at BMI < 25 kg/m2 and showed no increase at higher levels of BMI. In men, adjusted hazard ratios for all-cause death rose in a similar fashion across upper BMI quintiles in Blacks and Whites; in women, however, BMI was positively associated with mortality risk in Whites, but inversely associated in Blacks (P interaction = 0.01). Racial disparities were amplified in subsidiary analyses that introduced a 12-month lag for mortality or focused on CVD mortality.
The relationship of elevated BMI to mortality appeared weaker in US Blacks than in Whites, especially among women.