Obesity affects nursing-care facility admission among whites but not blacks.

OBJECTIVE This study examines whether obese individuals have a greater rate of nursing care facility admission than normal weight individuals. RESEARCH METHODS AND PROCEDURES Data from the National Health and Nutrition Examination Survey Epidemiological Follow-up Survey were analyzed. Cox proportional hazards models were used to examine the relationship between baseline weight status and subsequent time to first nursing home admission while adjusting for sex, age, race, marital status, height, presence of children, smoking status, education, region, urban residence, income, and physical activity. RESULTS Of 5960 adults 45 to 74 years old, 989 individuals were admitted to a nursing care facility over the subsequent 20 years. Body mass index (BMI) was studied using five categories: < 18.5, 18.5 to <25, 25.0 to <30, 30.0 to <35, > or =35 kg/m(2). The effects of BMI differed by race: compared with those with a BMI of 18.5 to < 25 kg/m(2), adults with a BMI > or =30 kg/m(2) or a BMI <18.5 kg/m(2) had a greater rate of nursing home admission in whites, whereas no relationship was found in blacks. The inclusion of time to death with nursing home admission as a joint outcome yielded similar results. DISCUSSION The large increase in the prevalence of obesity coupled with the rapid expansion of the number of older Americans will likely increase the demand for nursing facility use. More research is needed to understand differences in factors related to nursing home admission among ethnic groups.