The relationship between body mass index and quality of life in community-living older adults living in the United States.

BACKGROUND: Carrying excess weight is associated with various chronic conditions especially in older adults, and can have a negative influence on the quality of life of this population. OBJECTIVE: The objective of this study was to estimate the independent (i.e. adjusted for demographic, socioeconomic and health status differences) impact of Body Mass Index (BMI) on health-related quality of life. DESIGN: A mail survey was sent to 60,000 older adults living in 10 states. METHODS: The survey assessed quality of life using the average physical component scores (PCS) and mental component scores (MCS) obtained from the Veterans Rand 12-item (VR-12) health status tool embedded in the survey. Ordinary least squares (OLS) regression techniques were used to estimate the independent impact of each BMI category on quality of life, compared to the impact of other chronic conditions. RESULTS: A total of 22,827 (38%) eligible sample members responded to the survey. Of those, 2.2% were underweight, 38.5% had a normal BMI, 37.0% were overweight, 18.5% were obese and 1.9% were morbidly obese. Following OLS regression techniques, respondents' PCS values were statistically significantly lower for the underweight, overweight, obese and morbidly obese BMI categories, compared to the normal BMI group. Compared with all other chronic conditions, being morbidly obese (-6.0 points) had the largest negative impact on the PCS. Underweight was the only BMI category with a statistically significantly lower MCS value. CONCLUSIONS: The greatest negative impacts of the various BMI categories on quality of life were on physical rather than mental aspects, especially for those in the underweight, obese and morbidly obese categories, more so than many other chronic conditions.

The association of health risks with workers' compensation costs.

The purpose of this study was to investigate the association between health risks and workers' compensation (WC) costs. The 4-year study used Health Risk Appraisal data and focused on 1996-to-1999 WC costs among Xerox Corporation's long-term employees. High WC costs were related to individual health risks, especially Health Age Index (a measure of controllable risks), smoking, poor physical health, physical inactivity, and life dissatisfaction. WC costs increased with increasing health risk status (low-risk to medium-risk to high-risk). Low-risk employees had the lowest costs. In this population, 85% of WC costs could be attributed to excess risks (medium- or high-risk) or non-participation. Among those with claims, a savings of $1238 per person per year was associated with Health Risk Appraisal participation. Addressing WC costs by focusing on employee health status provides an important additional strategy for health promotion programs.

A case study of 10-year health risk appraisal participation patterns in a comprehensive health promotion program.

Between 1990 and 1999, cumulative participation in a health risk appraisal (HRA) reached 79%, and participation in any health promotion program reached 94% of employees employed continuously by the Progressive Corporation during that time period. Participation rates in the HRA per year ranged from 14% to 36%. First time participants reached no higher than 2.6% after the sixth year. Non-participants tended to have higher mean but lower median costs.

Self-reported utilization of preventive health services by retired employees age 65 and older.

OBJECTIVES: Increased utilization of preventive services among the aging has been associated with improved health status and decreased medical costs. We sought to examine the use of the Health Risk Appraisal (HRA) in benchmarking compliance and characterizing those retired employees who met preventive service guidelines. DESIGN: A retrospective cohort study of retired employees age 65 and older. SETTING: Nation-wide health promotion program offered by General Motors Corporation. PARTICIPANTS: 59,670 retired General Motors employees age 65 and older who participated in a nationwide mailed HRA health promotion program. MEASUREMENTS: Preventive health services compliance was measured using selected HRA questions. Gender, HRA participation patterns, overall health risk status, medical plan selection and disease status were examined as predictors of increased compliance. Multivariate logistic regression models were developed to test the relative contributions of participant characteristics to increased utilization. RESULTS: The self-reported HRA data indicated that compliance levels were higher than national averages. The Healthy People 2000 goals for the preventive services studied were met and exceeded (with the exception of tetanus immunization). Higher compliance was associated with being male, younger than 70 years, multiple-year HRA participation, overall low risk status and HMO insurance plan selection. CONCLUSION: The results from the HRA indicated that this population participated at a higher level than a comparable national sample exceeding goals set by Healthy People 2000.

Intratesticular site of aromatization in the human.

To determine the intratesticular site of aromatization, homogenates of separated seminiferous tubules and intact tissue from human testes were incubated with [3H] androstenedione or [3H] testosterone. [3H] Estrogens were isolated and identified, and the amounts synthesized were expressed as pmol/mg protein incubated. In testicular tissue from the three adult subjects investigated, the total estrogen per mg protein was 1.5-2.7 times greater in intact tissue than in isolated seminiferous tubules. This suggests that the major site of aromatization in human testes is the interstitial tissue. Estradiol was by far the major estrogenic product. No differences were observed in the amount of estrogens synthesized whether the substrate was androstenedione or testosterone.