The Duke study showed that, for a sample of white middle-aged women, as body mass index (BMI) went up, the odds of receiving mammograms and Pap smears went down. BMI is a measurement of body fatness based on weight adjusted for height. In data gathered in 2000, a white woman of normal weight was more than 50 percent more likely to receive a mammogram than a severely obese white woman (BMI greater than 40), the study showed.
The researchers found a similar inverse correlation between obesity and flu shots among elderly white women and men. However, they found no significant association between obesity and all three preventive services among black study participants.
"Despite knowing that obese women have a higher risk of breast and cervical cancer, and the obese elderly have a higher risk of complications from flu, obese people are less likely to receive clinical preventive services," said Truls Ostbye, M.D., Ph.D., lead study author and a professor in Duke's department of community and family medicine.
Based on their analyses, Ostbye and his co-authors found that income, education and access to health care were not important reasons for the discrepancies in care. The researchers suggest that significant causes may include social stigma, avoidance of health care by patients and bias by health care providers.
The results of the Duke study were published in the September 2005 issue of the American Journal of Public Health. The study was funded by the National Institute on Aging and the National Institute of Diabetes and Digestive and Kidney Diseases, both part of the National Institutes of Health.