Microsimulation projections of obesity interventions on cardiometabolic health disparities in the United States

Abstract

Objective: The aim of this study was to estimate long-term impacts of health education interventions on cardiometabolic health disparities.

Methods: The model simulates how health education implemented in the United States throughout 2019 to 2049 would lead to changes in adult BMI and consequent hypertension and type 2 diabetes. Health outcome changes by sex, racial/ethnic (non-Hispanic White, non-Hispanic Black, and Hispanic), and weight status (normal: 18.5 $\le$ BMI < 25; overweight: 25 $\le$ BMI < 30; and obesity: 30 $\le$ BMI) subpopulations were compared under a scenario with and one without health education.

Results: By 2049, the intervention would reduce average BMI of women with obesity to 27.7 kg/m² (CI: 27.4-27.9), which would be 2.9 kg/m² lower than the expected average BMI without an intervention. Education campaigns would reduce type 2 diabetes prevalence, but it would remain highest among women with obesity at 27.7% (CI: 26.2%-29.2%). The intervention would reduce hypertension prevalence among White women by 4.7 percentage points to 38.0% (CI: 36.4%-39.7%). For Black women in the intervention, the 2049 hypertension prevalence would be 52.6% (CI: 50.7%-54.5%). Results for men and women were similar.

Conclusions: Long-term health education campaigns can reduce obesity-related disease. All population groups benefit, but they would not substantially narrow cardiometabolic health disparities.