Table 1.
Social, Behavioral, and Metabolic Risk Factors among Study Participants by Race and Ethnicity, NHANES 1999-2018*
| Characteristics | No. of participants with measured risk factors† |
All participants (N =50808) |
Self-reported Race/Ethnicity | |||
|---|---|---|---|---|---|---|
| Black (N = 10796) |
Hispanic (N = 12959) |
White (N = 22350) |
Other‡ (N = 4703) |
|||
| Age, mean (SE), years | 50808 | 47.3 (0.2) | 44.9 (0.2) | 41.3 (0.3) | 49.2 (0.2) | 44.6 (0.4) |
| Male, n (%) | 50808 | 25143 (48.7) | 5275 (45.5) | 6277 (51.0) | 11255 (48.8) | 2336 (48.7) |
| Social determinants of health | ||||||
| Unemployed, n (%) | 50770 | 11496 (19.1) | 2732 (25.6) | 3512 (24.4) | 4233 (16.7) | 1019 (21.5) |
| Family income-to-poverty ratio <300%, n (%) | 46217 | 29121 (50.5) | 6619 (67.8) | 8841 (75.6) | 11365 (42.9) | 2296 (51.8) |
| Marginal or lower food security, n (%)§ | 49630 | 13921 (21.2) | 3530 (34.6) | 5278 (42.8) | 4064 (14.7) | 1049 (21.4) |
| Not owning a home, n (%) | 50013 | 18716 (32.0) | 5155 (51.5) | 5719 (49.7) | 5957 (24.6) | 1885 (39.9) |
| Less than high school education, n (%) | 50727 | 13895 (17.6) | 2862 (24.1) | 6580 (42.6) | 3674 (11.7) | 779 (15.3) |
| No regular health care access, n (%) | 50803 | 11045 (20.1) | 2359 (23.6) | 3970 (34.7) | 3538 (16.0) | 1178 (25.4) |
| No private health insurance, n (%) | 50276 | 23511 (36.6) | 5435 (50.1) | 7928 (59.6) | 8116 (29.4) | 2032 (40.9) |
| Not married nor living with partner, n (%) | 50340 | 20402 (36.8) | 6004 (56.9) | 4556 (36.5) | 8286 (33.8) | 1556 (34.5) |
| No. of unfavorable social determinants, n (%) | ||||||
| 0 | 6453 | 6453 (21.6) | 872 (9.0) | 755 (7.3) | 4171 (26.7) | 655 (17.1) |
| 1 | 7380 | 7380 (20.4) | 1203 (12.6) | 1060 (10.0) | 4356 (23.8) | 761 (18.5) |
| 2 | 7133 | 7133 (16.4) | 1388 (14.3) | 1349 (12.7) | 3673 (17.2) | 723 (18.2) |
| 3 | 6879 | 6879 (13.6) | 1484 (15.6) | 1743 (15.4) | 2997 (12.8) | 655 (15.8) |
| 4 | 6635 | 6635 (11.8) | 1635 (17.7) | 2011 (18.1) | 2353 (9.5) | 636 (14.0) |
| 5 or more | 10566 | 10566 (16.1) | 2856 (30.9) | 4124 (36.5) | 2878 (10.0) | 708 (16.5) |
| Behavioral risk factors | ||||||
| Current smoking, n (%) | 50757 | 10780 (21.7) | 2715 (25.5) | 2202 (18.6) | 5133 (22.0) | 730 (19.1) |
| Healthy eating index <52, n (%)¶ | 42649 | 20779 (50.1) | 4863 (56.9) | 4840 (48.9) | 9783 (49.8) | 1293 (43.8) |
| No leisure-time physical activity, n (%) | 50755 | 25430 (42.9) | 5742 (50.7) | 7435 (52.3) | 10146 (39.7) | 2107 (43.4) |
| Sleeping duration <6 or >8 hours/day, n (%) | 37272 | 10476 (25.4) | 2790 (34.5) | 2525 (26.0) | 4038 (23.7) | 1123 (26.0) |
| No. of behavioral risk factors, n (%) | ||||||
| 0 | 6269 | 6269 (24.4) | 1009 (15.4) | 1319 (19.0) | 3052 (26.5) | 889 (27.5) |
| 1 | 10220 | 10220 (33.9) | 2059 (31.3) | 2817 (37.6) | 4290 (33.5) | 1054 (34.9) |
| 2 | 8731 | 8731 (27.1) | 2132 (32.6) | 2195 (29.8) | 3674 (25.9) | 730 (25.6) |
| 3 | 4018 | 4018 (11.8) | 1077 (16.6) | 862 (11.7) | 1819 (11.3) | 260 (9.6) |
| 4 | 919 | 919 (2.8) | 271 (4.2) | 121 (1.9) | 469 (2.8) | 58 (2.4) |
| Metabolic risk factors ∥ | ||||||
| Obesity, n (%) | 49773 | 18115 (35.4) | 4778 (45.6) | 4975 (38.7) | 7429 (34.3) | 933 (23.3) |
| Central obesity, n (%) | 47877 | 26560 (54.3) | 5889 (57.7) | 7069 (53.4) | 12094 (55.6) | 1508 (37.9) |
| Hypertension, n (%) | 48964 | 25949 (47.6) | 6484 (56.6) | 5712 (37.0) | 11666 (48.6) | 2087 (44.7) |
| Diabetes, n (%) | 48560 | 8296 (12.3) | 2164 (17.5) | 2440 (13.8) | 2918 (10.9) | 774 (15.2) |
| Total-to-HDL cholesterol ratio ≥5, n (%) | 47686 | 9826 (20.6) | 1315 (13.4) | 3108 (24.7) | 4569 (20.8) | 834 (20.9) |
| No. of metabolic risk factors, n (%) | ||||||
| 0 | 9634 | 9634 (25.4) | 1554 (20.4) | 2361 (26.2) | 4421 (25.3) | 1298 (31.8) |
| 1 | 10020 | 10020 (22.8) | 1943 (21.6) | 2467 (21.9) | 4556 (22.7) | 1054 (26.4) |
| 2 | 10109 | 10109 (22.3) | 1959 (22.3) | 2739 (23.4) | 4592 (22.3) | 819 (19.5) |
| 3 | 8815 | 8815 (18.7) | 2067 (22.6) | 2314 (17.8) | 3913 (18.7) | 521 (13.9) |
| 4 | 4688 | 4688 (9.2) | 1155 (11.1) | 1278 (9.0) | 2013 (9.2) | 242 (6.9) |
| 5 | 878 | 878 (1.9) | 200 (2.2) | 260 (1.9) | 373 (1.9) | 45 (1.5) |
SE=Standard error; NHANES=National Health and Nutrition Examination Survey.
The sample sizes and actual frequency numbers are unweighted but means (standard errors) or percentages are weighted. See Supplementary eTable1 for definition of social, behavioral, and metabolic risk factors.
Number (percentage) of participants with missing data: employment 38 (0.1%), family income-to-poverty ratio 4591 (9.0%), food security 1178 (2.3%), home ownership 795 (1.6%), education 81 (0.2%), regular health care access 5 (<0.1%), private health insurance 532 (1.0%), marital status 468 (0.9%), cigarette smoking 51 (0.1%), healthy eating index 8159 (16.1%), leisure-time physical activity 53 (0.1%), sleeping duration 13536 (26.6%), obesity 1035 (2.0%), central obesity 2931 (5.8%), hypertension 1844 (3.6%), diabetes 2248 (4.4%), and total-to-HDL cholesterol ratio 3122 (6.1%). Sleep data were only available in NHANES 2005-2018.
Non-Hispanic Asian was listed as a separate race/ethnicity group starting in NHANES 2011-2012. American Indian or Alaska Native and Native Hawaiian or Pacific Islander were not listed as separate race/ethnicity groups in National Health and Nutrition Examination Survey (NHANES) datasets.
Food insecurity was assessed with the 18-item US Food Security Survey Module with zero affirmative responses indicating high food security and ≥1 affirmative responses indicating marginal food security or food insecurity.
The Healthy Eating Index (HEI) uses a scoring system to assess how well a set of foods aligns with key recommendations of the Dietary Guidelines for Americans. The scores range from 0 to 100 with a higher score indicating greater consistency of the diet with the Dietary Guidelines for Americans. Median HEI score was 52 among NHANES 1999-2018 participants.
Obesity was defined as body mass index ≥30 kg/m2; central obesity was defined as waist circumference ≥102 cm in men and ≥88 cm in women; hypertension was defined as systolic blood pressure ≥130 mmHg and/or diastolic blood pressure ≥80 mmHg or use of antihypertensive medications; and diabetes was defined as fasting glucose ≥126 mg/dL or hemoglobin A1c ≥6.5% or diagnosed diabetes.