The Role of Weight, Race, and Health Care Experiences in Care Use among Young Men and Women

OBJECTIVE: Increases in overweight and obesity (O/O)-related morbidities and health care costs raise questions about how weight influences patients’ health care use and care experiences. Past research has been inconsistent; however, prior study designs and samples have limited exploration of how this association might be influenced by gender, race, and the joint impact of these factors. DESIGN: This analysis of 1,036 young, relatively healthy, ethnically diverse, insured adults assessed the influence of O/O, gender, and race on, and the role of health care experiences in primary and preventive care use over a 12-month period. RESULTS: The association of weight status with care use differed by gender. O/O men used more primary care visits; O/O women used fewer preventive care visits than their healthy weight counterparts. O/O men had poorer health care experiences than healthy weight men. African-American women reported poorer experiences, but those who were O/O reported greater trust in their provider. Care experience ratings did not explain the associations between BMI and care use. CONCLUSION: Gender, race and visit type together provide a context for O/O patient’s care that may not be explained by care experiences. This context must be considered in efforts to encourage appropriate use of services.