The Relationship Among Body Mass Index, Subjective Reporting of Chronic Disease, and the Use of Health Care Services in Newfoundland and Labrador, Canada

Abstract
The purpose of the study was to examine the association of body mass index (BMI) with the prevalence of chronic disease and health services use in adults living in Newfoundland and Labrador (NL). A cross-sectional analysis of 2345 adult respondents to the 2001 Canadian Community Health Survey was performed. Outcome measures included the prevalence of chronic disease and health services use. The sample comprised normal (37%), overweight (39%), obese (17%), and morbidly obese (6%) individuals. Obese and morbidly obese individuals were more likely to report the presence of a chronic disease. Adjusting for age and sex, increasing BMI category was significantly associated with a greater likelihood of cardiovascular, endocrine, and pulmonary diseases (excluding asthma). The majority of survey respondents in each category reported having a regular doctor (>75%), and there were no significant differences across categories. Compared to those with a normal BMI, obese and morbidly obese individuals reported a significantly higher number of visits to a family physician. There were no differences across BMI categories and the use of specialist or hospital services. Almost a quarter of the study sample in NL was classified as morbidly obese or obese. These individuals reported more chronic conditions and more visits to a family physician than the normal-weight group. The greater morbidity and the increased frequency of visits to family physicians suggests greater consideration should be given to channeling financial and human resources to the primary health care of this high-risk population.