High Rates of Multimorbidity Reported Among People of Color Despite Healthy Weight

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Abstract
Purpose: Weight management is one of the most cited levers for preventing and managing many chronic conditions, particularly those considered to be “lifestyle modifiable.” However, it is unclear how much weight is a driver of illness burden among people of color. This article sought to examine whether people of color are more likely to develop “lifestyle-modifiable” conditions, including diabetes, kidney disease, heart disease, lung disease, and hypertension, both individually and in combination (multimorbidity), in the absence of being obese. Methods: Using data from the 2019 Behavioral Risk Factors Surveillance System survey, we examined the risk of having these conditions among Black, Asian, Native American, Latino/a, and White respondents who reported being “normal weight” (n=86,682), while also controlling for age, gender, smoking history, physical activity, and diet. Results: For each individual condition, White respondents almost always had the lowest risk. On the other hand, Latino/a respondents had the highest rates of diabetes and kidney disease. Native American respondents had the highest rates of heart and lung disease. Black respondents had the highest rates of hypertension. Despite an otherwise healthy weight, Native American, Black, and Latino/a people were 2.5, 2.3, and 1.8 times, respectively, more likely to develop multiple chronic conditions that are typically considered “lifestyle modifiable,” compared to White people. Conclusion: Disease prevention and management guidelines driven by the clinical experience of White people are insufficient for addressing the considerable illness burden that people of color continue to experience.

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