Microsimulation projections of obesity interventions on cardiometabolic health disparities in the United States

Objective The aim of this study was to estimate long-term impacts of health education interventions on cardiometabolic health disparities. Methods The model simulates how health education implemented in the United States throughout 2019 to 2049 would lead to changes in adult BMI and consequent hypertension and type 2 diabetes. Health outcome changes by sex, racial/ethnic (non-Hispanic White, non-Hispanic Black, and Hispanic), and weight status (normal: 18.5 <= BMI < 25; overweight: 25 <= BMI < 30; and obesity: 30 <= BMI) subpopulations were compared under a scenario with and one without health education. Results By 2049, the intervention would reduce average BMI of women with obesity to 27.7 kg/m(2) (CI: 27.4-27.9), which would be 2.9 kg/m(2) lower than the expected average BMI without an intervention. Education campaigns would reduce type 2 diabetes prevalence, but it would remain highest among women with obesity at 27.7% (CI: 26.2%-29.2%). The intervention would reduce hypertension prevalence among White women by 4.7 percentage points to 38.0% (CI: 36.4%-39.7%). For Black women in the intervention, the 2049 hypertension prevalence would be 52.6% (CI: 50.7%-54.5%). Results for men and women were similar. Conclusions Long-term health education campaigns can reduce obesity-related disease. All population groups benefit, but they would not substantially narrow cardiometabolic health disparities.