Obesity and Body Mass Index: Differences between Canadian and American Adults: Findings from the Joint Canada/United States Survey of Health (JCUSH)

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Obesity and Body Mass Index Differences between
Canadian and American AdultsFindings from the
Joint Canada/United States Survey of Health
(JCUSH)

• Jane F. Gentleman, Ph.D.,
• Debra L. Blackwell, Ph.D.,
• and Michael Martinez, MPH, MHSA
• National Center for Health Statistics
• Centers for Disease Control and Prevention
• The findings and conclusions in this paper are
  those of the authors and do not necessarily
  represent the views of the National Center for
  Health Statistics, Centers for Disease Control
  and Prevention.

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• From the Winnipeg Sun and Edmonton Sun, June 3,
  2004
• Yank Women Fatter
• Ottawa When it comes to obesity, American
  women tip the scales compared with their Canadian
  sisters, a cross border health study confirms for
  the first time. Overall, 21 of Americans were
  obese compared with 15 of Canadians, says the
  study released yesterday by Statistics Canada and
  the U.S. National Center for Health Statistics.
• continued..

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• Previous research has suggested obesity may be
  more prevalent in the United States, but this is
  the first definitive confirmation, said Diane
  Finegood, a scientific director of the Canadian
  Institutes for Health Research (CIHR).
• Whenever I go down there I think, God, there
  really is a difference, but this is in fact the
  first data Im aware of where a survey was done
  at the same time in Canada and the United States
  with the same question and the same methodology
  by the same people, said Finegood. (Emphasis
  added.)

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Today

• Comparisons (obesity rates Body Mass Index)
• Canadians vs. Americans
• Women vs. men
• Women vs. women
• Focus on race/ethnicity differences
• What other factors might explain the differences
  for women?

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Body Mass Index (BMI)

• BMI Weight / Height2
• (in kilograms and meters)

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DEFINITIONS

• Underweight BMI lt 18.5 Normal
  weight 18.5 BMI lt 25Overweight 25
  BMI lt 30 Obese 30 BMI
• based on World Health Organization (WHO)
  standards

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Obesity rates in JCUSH
Canada Canada United States United States
Weight categories
Men, 18 years of age Under/Normal Overweight Obese 39.9 40.9 17.8 37.7 41.4 19.6
Women, 18 years of age Under/Normal Overweight Obese 57.3 24.9 11.9 48.8 24.3 20.0
Blue font statistically significant difference
between Canada and U.S. (at 0.05 level)
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Distribution of BMI for Canadian men
X-axis BMI metric Y-axis Proportion
(weighted) of population
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Distribution of BMI for U.S. men
X-axis BMI metric Y-axis Proportion
(weighted) of population
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Distribution of BMI for Canadian men (black)
U.S. men (blue)
Legend U.S. men Canadian men
X-axis BMI metric Y-axis Proportion
(weighted) of population
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Distribution of BMI for Canadian women
X-axis BMI metric Y-axis Proportion
(weighted) of population
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Distribution of BMI for U.S. women
X-axis BMI metric Y-axis Proportion
(weighted) of population
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Distribution of BMI for Canadian women (green)
U.S. women (red)
Legend U.S. women Canadian women
X-axis Y-axis
X-axis BMI metric Y-axis Proportion
(weighted) of population
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Distribution of BMI for U.S. women U.S. men
Legend U.S. women U.S. men
X-axis BMI metric Y-axis Proportion
(weighted) of population
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Distribution of BMI for Canadian women Canadian
men
Legend Canadian women Canadian men
X-axis BMI metric Y-axis Proportion
(weighted) of population
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overweight and obese, by race, women only
Canadian women (race) Overweight Obese
White Other 27.2 21.5 12.5 13.8
U.S. women (race)
White Other 24.7 30.0 19.2 28.3
U.S. women (race/ethnicity) Non-Hispanic white Hispanic Non-Hispanic black Non-Hispanic other 33.3 44.9 30.8 28.0 19.3 20.1 33.2 18.2
Blue font statistically significant difference between Canada and U.S.
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Results of multivariate analysis, women onlyOdds
ratios for being obese, by race/ethnicity
Characteristic Odds Ratios Odds Ratios
Race (Canada) Canada U.S.
White (ref) Other 1.00 1.25 na na
Race/ethnicity (U.S.)
Non-Hispanic white (ref) Hispanic Non-Hispanic black Non-Hispanic other na na na na 1.00 0.95 2.53 0.68
Blue font statistically significant
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Distribution of BMI for Canadian white women
X-axis BMI metric Y-axis Proportion
(weighted) of population
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Distribution of BMI for Canadian other women
X-axis BMI metric Y-axis Proportion
(weighted) of population
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Distribution of BMI for Canadian women by race
Legend White women Other women
X-axis BMI metric Y-axis Proportion
(weighted) of population
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Distribution of BMI for U.S. Non-Hispanic white
women
X-axis BMI metric Y-axis Proportion
(weighted) of population
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Distribution of BMI for U.S. Non-Hispanic black
women
X-axis BMI metric Y-axis Proportion
(weighted) of population
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Distribution of BMI for U.S. Non-Hispanic other
women
X-axis BMI metric Y-axis Proportion
(weighted) of population
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Distribution of BMI for U.S. Hispanic women
X-axis BMI metric Y-axis Proportion
(weighted) of population
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Distribution of BMI for U.S. women, by
race/ethnicity
Legend Hispanic women NH-white women NH-black
women NH-other women
X-axis BMI metric Y-axis Proportion
(weighted) of population
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Distribution of BMI for Canadian women and U.S.
NH-white women
Legend Canadian women U.S. NH-white women
X-axis BMI metric Y-axis Proportion
(weighted) of population
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Distribution of BMI for Canadian women U.S.
NH-black women
Legend Canadian women U.S. NH-black women
X-axis BMI metric Y-axis Proportion
(weighted) of population
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Distribution of BMI for Canadian women and U.S.
Hispanic women
Legend Canadian women U.S. Hispanic women
X-axis BMI metric Y-axis Proportion
(weighted) of population
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Other big differencesassociated with
obesitybetween Canadian American women

• Age
• Education
• Income
• Self-reported health status
• Leisure-time physical activity
• Having a regular medical doctor