Race Affects Weight Counseling For Obese

BALTIMORE, MD - When it comes to advising obese patients, blacks receive less weight 
reduction and exercise counseling from physicians than their white 
counterparts. This is according to a recent study conducted by 
researchers at the Johns Hopkins Bloomberg School of Public Health 
who examined the impact of patient and doctor race concordance on 
weight-related counseling. The results are featured in the January 
2011 online issue of Obesity.

"Contrary to our expectations, we did not observe a positive 
association between patient-physician race concordance and 
weight-related counseling," said Sara Bleich, PhD, lead author of the 
study and an assistant professor with the Bloomberg School's 
Department of Health Policy and Management. "Rather, black obese 
patients seeing white doctors were less likely to receive exercise 
counseling than white obese patients seeing white doctors. We also 
found that black obese patients seeing black doctors were less likely 
to receive weight reduction counseling than white obese patients 
seeing black doctors. This suggests that regardless of the 
physician's race, black obese patients receive less weight-related 
counseling than white obese patients. Our findings could be due to a 
number of factors such as negative physician perspectives towards 
black patients or a lack of sensitivity to the underlying levels of 
obesity risk for black patients as compared to white patients."

Obesity is defined as having a body mass index (BMI) greater than or 
equal to 30 kg/m2 and is an important risk factor for mortality and 
morbidity. In the U.S., blacks are disproportionately affected by 
obesity and are at an increased risk for a number of chronic diseases 
associated with obesity, such as cardiovascular disease, hypertension 
and diabetes.

Researchers analyzed National Ambulatory Medical Care Surveys (NAMCS) 
from 2005 to 2007, a nationally representative cross-sectional survey 
of physician office visits, among individuals ages 20 years and 
older. Using a sample size of 2,231 visits of black and white obese 
patients to their black and white physicians from the specialties of 
general/family practice and general internal medicine, Bleich and 
colleagues examined the relationship between doctor-patient race 
concordance and weight-related counseling (measured as weight 
reduction, diet/nutrition and exercise counseling). Logistic 
regression was used to model the outcome variables of interest. In 
addition, tests were used to statistically compare whether physicians 
of each race provided counseling at different rates for obese 
patients of different races.

"Previous studies have shown disparities in the proportion of black 
obese adults informed by physicians that they were overweight 
compared to white obese adults," said Lisa Cooper, MD, MPH, senior 
author of the study and a professor in the Bloomberg School's 
Department's of Epidemiology and Health, Policy and Management. "We 
now also see that black patients are receiving different medical 
counseling as well. Further research is needed to understand how to 
improve obese patient counseling, particularly among the black population."

"Impact of Patient-Doctor Race Concordance on Rates of Weight-Related 
Counseling in Visits by Black and White Obese Individuals" was 
written by Sara N. Bleich, Alan E. Simon and Lisa A. Cooper.