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NWS-9 Data Details

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NWS-9 Reduce the proportion of adults who are obese
LHI

Leading Health Indicators are a subset of Healthy People 2020 objectives selected to communicate high-priority health issues.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

Data Source: 
National Health and Nutrition Examination Survey
Changed Since the Healthy People 2020 Launch: 
Yes
Measure: 
percent (age adjusted—see Comments)
Baseline (Year): 
33.9 (2005–08)
Target: 
30.5
Target-Setting Method: 
10 percent improvement
Numerator: 

Number of persons aged 20 years and over with a body mass index (BMI) equal to or greater than 30.0

Denominator: 

Number of persons aged 20 years and over

Comparable Healthy People 2010 Objective: 
Retained from HP2010 objective
Data Collection Frequency: 
Periodic
Leading Health Indicator:
Methodology Notes: 

    The NHANES obtains measured weights in examination gowns and heights without shoes. BMI is calculated by dividing weight in kilograms by the square of height in meters.

    In 1997, a Consultation on Obesity convened by the World Health Organization recommended standardizing the classification of overweight and obesity. Obesity was defined as a BMI of 30.0 or greater. Further classification of obesity was made as follows: 30.0-34.9 was defined as Class I obesity, 35.0-39.9 as Class II, and 40.0 or greater as Class III. The Expert Panel on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, convened by NIH in 1998 adopted general concepts of the World Health Organization classification system and it has now been endorsed by more than 50 professional medical societies, consumer groups, and government agencies. For this objective, therefore, a BMI cut point of 30.0 was chosen for adults aged 20 years and older.

    Pregnant women are excluded from the numerator and denominator.

    Age Adjustment Notes: 

    This Indicator uses Age-Adjustment Groups for four-year data:

    • Total: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
    • Sex: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
    • Race/Ethnicity: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
    • Educational Attainment: 25-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
    • Family Income (percent poverty threshold): 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
    • Country of Birth: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
    • Disability Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
    • Health Insurance Status: 20-29, 30-39, 40-49, 50-59, 60-64
    • Arthritis Status: 20-49, 50-59, 60-69, 70-79, 80+
    • Diabetes Status: 20-49, 50-59, 60-69, 70-79, 80+
    • Hypertension Status: 20-49, 50-59, 60-69, 70-79, 80+
    • Marital Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+
    • Veteran Status: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80+

    This Indicator uses Age-Adjustment Groups for two-year data:

    • Total: 20-39, 40-59, 60+
    • Sex: 20-39, 40-59, 60+
    • Race/Ethnicity: 20-39, 40-59, 60+
    • Educational Attainment: 25-39, 40-59, 60+
    • Family Income (percent poverty threshold): 20-39, 40-59, 60+
    • Country of Birth: 20-39, 40-59, 60+
    • Disability Status: 20-39, 40-59, 60+
    • Health Insurance Status: 20-39, 40-59, 60-64
    • Arthritis Status: 20-39, 40-59, 60+
    • Diabetes Status: 20-39, 40-59, 60+
    • Hypertension Status: 20-39, 40-59, 60+
    • Marital Status: 20-39, 40-59, 60+
    • Veteran Status: 20-39, 40-59, 60+
Caveats and Limitations: 
BMI will be used as a proxy for obesity in adults until a better marker to identify increased health risk associated with increased relative weight is developed.
Trend Issues: 
Two-year data are used as a placeholder to provide the latest data available and will be replaced with four-year data when available. Two-year and four-year data are not comparable. Different age adjustment groups are used for the two year and four year data. Two-year estimates are generally less stable and reliable than four-year estimates.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch: 
In 2012, the original baseline was revised from 34.0 to 33.9 percent due to a change in the methodology. Obesity was originally coded based on the calculated BMI variable which is rounded in NHANES and had an error in the 2007-08 dataset. To be consistent with NHANES reports, instead of using the calculated BMI variable, BMI is now computed directly from the weight and height variables. The target was proportionately adjusted from 30.6 to 30.5 percent based on the original target setting method.

References

Additional resources about the objective

  1. National Institutes of Health. Clinical guideline on the identification, evaluation and treatment of overweight and obesity in adults - The Evidence Report. NIH. Obesity Research 6 (Suppl. 2):51S-209S, 1998.
  2. World Health Organization. Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation on Obesity, Geneva, June 1997. Geneva, Switzerland: WHO, 1998.