Prospective association between body mass index and receipt of preventive services: Results from the Central Pennsylvania Women's Health Study (CePAWHS)

Abstract

ObjectiveWe examine whether overweight and obesity are associated with disparities in clinical preventive services receipt in a unique, prospective, population-based cohort of reproductive-age women. MethodWe used data from the Central Pennsylvania Women's Health Study (CePAWHS) longitudinal survey of women ages 18–45. The baseline random-digit-dial telephone survey was conducted in 2004–2005 and a second telephone interview two years later; 1342 participants comprised the analytic sample. Dependent variables were seven preventive services identified at follow-up. In addition to baseline body mass index (BMI) category, independent variables were selected based on the behavioral model of health services utilization. ResultsForty-six percent of the sample was classified as normal weight, 28% as overweight, and 26% as obese. In adjusted analyses, women who were overweight and obese, compared to women with normal weight, were more likely to receive preventive counseling for diet/nutrition, physical activity, and weight management (p<0.01). Overweight and obese women received more cholesterol and diabetes screening (p<0.05 and p<0.01, respectively). However, there were no differences by BMI category in receipt of Pap testing or reproductive counseling. ConclusionOverall, we found that women with overweight and obesity were more likely to receive preventive services, especially services relevant for overweight and obese populations.