Body-mass index and mortality risk in US Blacks compared to Whites

Chandra L. Jackson, Nae Yuh Wang, Hsin Chieh Yeh, Moyses Szklo, Rosemary Dray-Spira, Frederick L. Brancati

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Objective To compare body-mass index (BMI)-related mortality risk in US Blacks vs. Whites as the relationship appears to differ across race/ethnicity groups. Methods Cross-sectional surveys of nationally representative samples of 11,934 Blacks and 59,741 Whites aged 35-75 in the National Health Interview Survey from 1997 to 2002 with no history of cardiovascular disease (CVD) or cancer were pooled. Mortality follow-up was available through 2006. BMI was calculated from self-reported height and weight. We used adjusted Cox regression analysis to adjust for potential confounders. Results Over 9 years of follow-up, there were 4303 deaths (1205 among never smokers). Age-adjusted mortality rates were higher in Blacks compared to Whites at BMI < 25 kg/m2 and showed no increase at higher levels of BMI. In men, adjusted hazard ratios for all-cause death rose in a similar fashion across upper BMI quintiles in Blacks and Whites; in women, however, BMI was positively associated with mortality risk in Whites, but inversely associated in Blacks (P interaction = 0.01). Racial disparities were amplified in subsidiary analyses that introduced a 12-month lag for mortality or focused on CVD mortality. Conclusions The relationship of elevated BMI to mortality appeared weaker in US Blacks than in Whites, especially among women.

Original languageEnglish (US)
Pages (from-to)842-851
Number of pages10
Issue number3
StatePublished - Mar 2014

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology
  • Nutrition and Dietetics


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