Although NHANES III data show that the prevalence of overweight and obesity is much higher in African-American and Mexican-American women than in white women or in men, these data provide ethnicity-specific estimates of overweight and obesity prevalence for only three racial-ethnic groups: non-Hispanic whites, non-Hispanic blacks, and Mexican-Americans. Examination survey data indicating a high overweight and obesity prevalence in other ethnic groups (e.g., for Puerto Ricans and Cuban-Americans) are available from the Hispanic HANES (HHANES) (1982-1984) (27) and for American Indians (26) and Pacific-Islander Americans (50), from smaller population-specific studies (see Appendix III).
The prevalence of overweight and obesity is generally higher for men and women in racial-ethnic minority populations than in U.S. whites, with the exception of Asian-Americans, for whom overweight and obesity prevalence is lower than in the general population (51). In the 1982-1984 HHANES, the age-adjusted prevalence of a BMI of 27.3 in Puerto Rican women was 40 percent (27). The Strong Heart Study reported the average prevalence of overweight using BMI 27.8 or 27.3 for men and women, respectively, in three groups of American Indians studied during 1988 and1989 as follows: in Arizona, 67 percent of the men and 80 percent of the women; in Oklahoma, 67 percent of the men and 71 percent of the women; and in South Dakota and North Dakota, 54 percent of the men and 66 percent of the women (52).
Women in the United States with low incomes or low education are more likely to be obese than those of higher socioeconomic status; the association of socioeconomic status with obesity is less consistent in men (53). Obesity is less common after the age of 70 among both men and women, possibly due to a progressive decrease in BMI with increasing age past the fifth decade or to an excess in mortality associated with increasing BMI in the presence of increasing age (1).