Multnomah County Health Department

Community Health Promotion, Partnerships and Planning

Office of Health Assessment And Evaluation

Community Health Assessment Quarterly

Volume 3, Issue 3 Fall 2008

Overweight and Obesity

Over the past 25 years the proportion of overweight
and obese persons in this country increased steadily in
all states, but in recent years this number appears to
have leveled off. In 2007, 26% of adult Americans over
the age of 18 years were obese and an additional 37%
were overweight1. The Healthy People 2010 target for
obesity is a prevalence of 15% or less.2
Individuals who are overweight or obese are at in-
creased risk for a number of chronic diseases including
type 2 diabetes, hypertension, high cholesterol, coro-
nary heart disease, stroke and certain types of cancer
(e.g. breast and colon cancer). These health problems
will have an adverse impact on quality of life and in-
crease the risk of premature mortality. In economic
terms, it is estimated that in Oregon in 1998-2000 obe-
sity and overweight and the associated health problems
cost $781 million in direct and indirect medical costs.3
This includes preventive, diagnostic, and treatment ser-
vices related to obesity as well as income lost from de-
creased productivity, restricted activity, absenteeism, and
the value of future income lost by premature death.
Over half the adults in Multnomah County
are either overweight or obese.
Since the early 1990s there has been a steady rise
in the total proportion of obese and overweight adults in
Multnomah County (body mass index greater than 25).
In 2006, 53% of residents over the age of 18
(approximately 239,000 adults) in the county were either
overweight or obese. The prevalence of obesity has
been rising since the early 1990s while the overweight
prevalence has remained relatively stable.
In 2006, the overall proportion of overweight and
obese adults in Oregon and the U.S. was 61% and 63%
respectively.

Obesity and overweight defined Overw eight and Obesity Prevalence in Multnom ah County Adults
60% 1993-2006
In this report obesity and over-
weight in adults are defined by
body mass index (BMI) which is 50%
calculated using a person’s height
and weight. Healthy weight is 40%
34%
defined as a BMI between 18.5 32%
and 24.9. Overweight is defined
30%
as a BMI between 25 and 29.9.
An adult is considered obese if his 21%
or her BMI is greater than 30. 20%
11%
Data on height and weight are 10%
collected at the county level
through a telephone survey of a
sample of Multnomah County 0%
residents. The survey is called 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
the Behavioral Risk Factor Sur-
Total Overweight/Obese BMI>=25
veillance System (BRFSS). Overweight (BMI >=25 and < 30)
Obese (BMI >= 30)
Source: Behavioral Risk Factor Surveillance System.
 V OLU ME 3, ISSUE 3 CO M MUNI TY HE AL TH A SSESSME N T QUA RTE RLY PAGE 2

Males and older adults are more likely to be overweight or obese in Multnomah County
In 2006, approximately 61% of adult males were overweight or obese (40% overweight, 21% obese) compared with
44% of adult females (26% overweight, 19% obese). The occurrence of overweight and obesity also differs by age
group. Adults between the ages of 55 and 74 years were more likely to be overweight or obese (almost 70% were
either overweight or obese) while 18 to 34 year-olds were less likely to be over a healthy weight (47% overweight or
obese).4

Overweight and obesity by gender, Overweight and obesity by age-group,

80% Multnomah County, 2006 80% Multnomah County, 2006
Obese
70% Obese 70%
Overweight
Overweight
60% 60%
27% 26%
50% 21%
50% 21%
20%
40% 13%
40% 20%
19%
30%
30%
20% 40% 42% 43%
40% 35% 35%
20% 27%
26% 10%
10%
0%
0% 18-34 35-44 45-54 55-64 65-74 75+ yrs
Male Female yrs yrs yrs yrs yrs

Adults 45 years and older who are over the Prevalence of High Blood Pressure & High
healthy weight range are more likely to suf- Cholesterol by Weight in Adults 45 years and
fer from diabetes, high blood pressure and older, Multnomah County, 2002-05
70%
high cholesterol
60% High Blood Pressure High Cholesterol
Analysis of data for 2002 through 2005 for Multnomah
County shows that chronic diseases including diabetes, 50%
high blood pressure and high cholesterol are associated
with overweight and obesity in adults 45 years and older. 40%
One out of four obese adults in this age group were diag-
nosed with diabetes. Further, over a third of overweight 30%
55%
adults and about half of obese adults in this age group 49% 46%
20%
were diagnosed with high blood pressure while 46% of 36% 35%
overweight adults and 55% of obese adults were diag- 23%
10%
nosed with high cholesterol. Obese and overweight
adults are also at greater risk for coronary heart disease. 0%

Healthy weight Overweight Obese

Some ethnic and racial groups have a
higher proportion of persons who are over-
weight or obese
Data from the 2004-05 Behavioral Risk Factor Surveil-
lance System (BRFSS) show disparities in the preva-
lence of overweight and obesity among adults in Mult-
nomah County. Asian Americans had the lowest propor-
tion of overweight and obesity while those identifying
themselves as Native Americans/Alaska Natives or His-
panics had the highest proportions of overweight and
obesity. The prevalence of obesity and overweight in
various racial and ethnic groups in Multnomah County
did not always reflect national data. Some of the more
notable differences are as follow:
• The prevalence of obesity in Multnomah County in
2004-05 among African Americans was lower than
the prevalence in the same population nationwide
in 2005 ( 28% countywide vs. 34% nationally);
• The proportion of Asian Americans who were
obese was higher in Multnomah County in 2004-05
compared with the same population nationwide;
 V OLU ME 3, ISSUE 3 CO M MUNI TY HE AL TH A SSESSME N T QUA RTE RLY
• The proportion of obese Hispanic residents in Mult-
nomah County in 2004-05 was higher than the pro-
portion in the same population nationwide in 2005
(30% countywide vs. 24% nationally ).
Most adults do not meet nutrition and physi-
cal activity recommendations
The most important factors in maintaining a healthy
weight are nutrition and physical activity. The BRFSS
data for 2005 indicates that only 26% of overweight and
27% of obese adults in Multnomah County met the rec-
ommended 5 daily servings of fruits and vegetables. In
comparison, over 31% of residents within the healthy
weight range met this nutritional recommendation. Re-
gardless of weight status, most of the survey respondents
did not eat the recommended amount of fruits and vege-
tables.
Multnomah County residents at a healthy weight were
more likely to meet recommendations for moderate or
vigorous physical activity than overweight and obese indi-
viduals. In 2005, 48% of those in the healthy weight
range met the physical activity recommendation while
only 32% of overweight individuals and 17% of obese in-
dividuals met the recommendation.
Overweight youth are also a concern
According to data from the 2005-06 Oregon Healthy Teen
survey, about 10% of Multnomah County 8th grade and
11th grade students were overweight. An additional 15%
of 8th graders and 13% of 11th graders were at risk for
becoming overweight.5 The county and statewide preva-
lence of overweight youth and those at risk of becoming
overweight are very similar.
When asked about soda consumption, 84% of 8th grad-
ers and 78% of 11th grade students reported that they
had consumed a soft drink at least once during the previ-
ous week; approximately 10% of students in both grades
had consumed a soda at least once a day during the pre-
vious week.
During the same period, 55% of 8th graders and 40% of
11th graders reported engaging in 60 minutes of physical
activity on 5 or more days in the previous week (the rec-
ommended amount of activity for adolescents). Compara-
ble national data are available from a similar survey
known as the Youth Risk Behavior Survey (YRBS) which
is administered to a sample of high school students. The
2007 YRBS data indicate that about 35% of students
meet the recommended level of physical activity nation-
wide.
PAGE 3
Public Health efforts to combat overweight
and obesity include actions focused on in-
dividuals and the social environment
Public health education efforts at national, state, and
local levels have encouraged individuals to increase
their intake of fruits and vegetables and to adopt an
exercise regimen that meets the Centers for Disease
Control and Preventions (CDC) recommendation of 30
minutes of moderate physical activity most days of the
week. CDC’s website provides suggestions for ways to
incorporate healthy diets and regular physical activity in
our daily lives.6
Other public health efforts focus on changing our living
environment, such as encouraging walking and bicy-
cling friendly communities. Multnomah County Health
Department has adopted a chain restaurant nutrition
labeling policy that will require larger restaurant chains
to list the nutritional content of their menu items. By
providing nutrition information to customers at the time
of ordering, restaurants will enable the public to make
informed choices about what they eat. The rules to im-
plement this policy are expected to take effect in Janu-
ary 2009. Multnomah County became the fifth jurisdic-
tion in the United States to adopt menu labeling require-
ments. Similar laws are already in effect in New York
City, San Francisco, and Seattle/King County.
Healthy weight in 8th and 11th graders
Multnomah County 2005-06 and Oregon
2006
80%
70%
60%
50%
40% 77%
74% 74% 75%
30%
20%
10% 26% 23% 26% 25%
0%
8th grade 11th grade 8th grade 11th grade
Multnomah County Oregon
Healthy weight Overweight & at risk for overweight
Source: Oregon Healthy Teen survey, 2005-06
 V OLU ME 3, ISSUE 3 CO M MUNI TY HE AL TH A SSESSME N T QUA RTE RLY PAGE 4

References
1. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Behavioral Risk
Factor Surveillance System fact sheet on obesity prevalence in the United States in 2007. Online:
http://apps.nccd.cdc.gov/BRFSS/list.asp?cat=OB&yr=2007&qkey=4409&state=UB. Accessed on 09/15/2008.
2. U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion, Healthy
People 2010. Online: http://www.healthypeople.gov/Document/HTML/Volume2/19Nutrition.htm#_Toc490383123.
Accessed on 09/15/2008.
3. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Overweight and
obesity. Online: http://www.cdc.gov/nccdphp/dnpa/obesity/economic_consequences.htm. Accessed on
09/15/2008.
4. Oregon Department of Human Services, Public Health Division, Center for Health Statistics. Behavioral Risk
Factor Surveillance System data for 1993 through 2006.
5. Oregon Department of Human Services, Public Health Division, Center for Health Statistics. Oregon Healthy
Teen 2007 tables. Online: http://www.dhs.state.or.us/dhs/ph/chs/youthsurvey/ohtdata.shtml#2007. Accessed on
09/15/2008.
6. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Division of Nutri-
tion and Physical Activity. Online: http://www.cdc.gov/nccdphp/dnpa/index.htm. Accessed 09/15/2008.

Note: All graphs in this report are based on BRFSS data collected between 1993 and 2006 except as noted.

Community Health Assessment

Quarterly is published four times per year, by Multnomah County Health Department
Health Assessment and Evaluation Office
426 SW Stark St 9th Floor, Portland OR 97204. If you have questions or comments, please email Maya Bhat at
maya.bhat@ co.multnomah.or.us or by phone at 503-988-3663 x29055.
This publication is available online at:
http://www.mchealth.org/hra/haq/