Memphis and Shelby County Behavioral Risk Factors Survey, 2004

EXECUTIVE SUMMARY

Since being branded as one of the unhealthiest cities in America, Memphis has decided to do something about it. The Healthy Memphis Common Table, Memphis’ health and healthcare improvement collaborative, is beginning its work to combat the growing epidemics of obesity and diabetes by seeking a better understanding of what is actually happening in Shelby County. This annual survey should help Memphis and Shelby County to track public awareness of the epidemic, the impact of prevention, screening and disease management efforts, and the success of employers in supporting lifestyle changes needed by their employees.

• Most Shelby County Residents are Overweight or Obese
• o About 2 out of every 3 adults in Memphis & Shelby County are overweight or obese, whether black, white, male, female, young or old
• Men more likely to be overweight, and women more likely to be extremely obese
• Middle-aged Memphians more likely to be obese or extremely obese
• Blacks more likely than whites to have a higher BMI.
• Many Memphis Adults already have Serious Weight-Related Diseases
1. o Almost 1 in 10 Memphians have diabetes, higher than the national average
2. o 1 in 3 adults have high blood pressure, higher than the national average
• Most Memphis Adults do not know their Body Mass Index (BMI)
1. o 84.7% of do not know their BMI
2. o 69.3% say they have never had their BMI checked
3. o Only 3% of those who thought they knew their BMI, actually knew their BMI
• Most Overweight and Obese Memphians are Trying to Lose Weight
1. o 35-49 year-olds, women, and those with higher BMIs are more likely to be trying to lose weight
2. o Blacks in Memphis are just as likely as whites to be trying to lose weight
1. o The most common barriers to exercising were:
• Lack of a convenient place to exercise (42.5%)
• Personal health reasons (29.8%)
• Safety concerns (17%), lack of time (16.6%) and lack of money (16.1%)

Selected excerpts from this report:

The developed world is experiencing a new epidemic, and the Memphis community is at ground zero. This new epidemic is called the metabolic syndrome and it already affects more than 47 million U.S. citizens. Metabolic syndrome isn't a disease, but a cluster of disorders of your body’s metabolism. Key components include insulin resistance, excess body weight, high blood pressure, and abnormal cholesterol levels. Each of these disorders, individually, is a risk factor for other diseases. In combination, they dramatically boost one’s chances of developing diabetes, heart disease or stroke. Although genetic makeup does play a role, development of the metabolic syndrome is largely lifestyle induced, with major risk factors being an unhealthy diet and lack of physical activity.

Our survey demonstrates that the prevalence of diabetes in Memphis and Shelby County in 2004 is 8.4%. This is statistically higher than the national average of 6.7%. It is statistically the same as the Tennessee average.

Doctors and other health experts use the body mass index (BMI) to tell if you are overweight. The BMI is usually the best way to determine your risk of developing illnesses related to being overweight or obese, like diabetes. The National Institutes of Health classifies a BMI of less than 19 as underweight; 19-24 as normal; 25-29 as overweight; 30-39 as obese; 40 or more as morbidly obese. The respondent’s body mass index is calculated using the body mass index table from the National Institutes of Health, using the respondent’s self-reported weight and height.

The survey reveals that about two in three adults are overweight, obese, or extremely obese.

The survey also shows that the vast majority of people in Memphis and Shelby County do not know they BMI. Specifically, we asked people if they knew their current body mass index (BMI): 84.7% reported that they did not know what their body mass index was, and 69.3% reported they never had their body mass index checked. We also compared self-reported BMI with our estimate of their BMI. Only 3 percent of respondents came within 5 points of their self-reported BMI. This suggests that extremely few people actually know their BMI. Quite clearly, the BMI is an unknown quantity for most people.

Health professionals will need to provide much education about the BMI statistic if they hope to use the BMI to help people to healthier living in Memphis and Shelby County. Respondents were asked whether they were trying to lose weight. Cross-tabulations were calculated to examine differences by gender, age, race, and body mass index. Of particular note, the majority of those who are obese or very obese are currently trying to lose weight. This suggests that a large portion of the Memphis and Shelby County residents at highest risk of weight-related disease would benefit from assistance with weight management efforts.

Implications

This survey of behavioral risk factors raises a number of questions about the health of people in Memphis and Shelby County. We suggest the following key points:

• There is a need for continued efforts to increase public awareness regarding the metabolic syndrome and its risk factors.
• It is important to increase public awareness that the metabolic syndrome and its risk factors are modifiable with lifestyle changes.
• Physicians and other health providers need to educate patients about BMI and its relationship to the risk of developing disease.
• More Memphians need to take charge of their health. Patients should ask their physicians to tell them their BMI and discuss what it means with them.
• Since many Memphians are trying to lose weight, easily accessible places for support and education need to be available (church, school, hospital, clinic, etc.).
• Memphians could use more opportunities for physical activity and/or instruction on how to be physically active where they live and work.

(For more information, contact Deborah Gibson, 901-448-2561)