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Healthy People 2010 – Women's and Men's Health: A Comparison of Select Indicators

Preventive Behaviors

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Heart disease, cancer, stroke, and chronic lower respiratory disease — the four leading causes of death in the United States — are all chronic conditions.¹¹ Many of the related illnesses resulting in these deaths have been linked to habitual, sometimes harmful, ways of living.²¹ Preventive behaviors addressing the six objectives discussed below could have a positive effect on overall health and well-being and may also be instrumental in reducing premature disability, illness, and death.

Obesity

More than one-third of U.S. adults were obese in 2005 — 2006, including 33 percent of men and 35 percent of women.²² Good nutrition and physical activity are essential elements in preventing obesity and reducing its risks among both women and men. Experts agree that the best way to lose weight is to follow a sensible eating plan and engage in regular physical activity.²³

Obesity is a subset of overweight. For adults, overweight and obesity ranges are determined by calculating the body mass index (BMI), a measure of body fat based on height and weight. Individuals with a BMI of 25 — 29.9 are considered overweight, while individuals with a BMI of 30 or more are considered obese.²⁴

Obesity is associated with increased deaths from cardiovascular disease, the major cause of death in the United States, but is not associated with cancer deaths or with noncancer, noncardiovascular disease deaths.²⁴ Obesity and overweight combined are associated with increased deaths from diabetes and kidney disease and decreased deaths from other noncancer, noncardiovascular disease causes.²⁴

Between 1988 — 1994 and 2003 — 2006, the proportion of adults who were obese increased from 23 percent to 33 percent, moving away from the Healthy People 2010 target of 15 percent (figure 12). Although data from 2005 — 2006 show that the rate appears to be leveling off, it is alarmingly high, with more than 72 million obese persons.²²

Figure 12. Persons Aged 20 Years and Older Who Are Obese, by Gender (1988 — 94, 1999 — 2002, and 2003 — 06)

Healthy People 2010 Target (15%)*

Age-adjusted percent	1988-94	1999-2002	2001-04	2003-06
Women	25	33	33	34
Men	20	27	29	32

95% confidence interval

* The Healthy People 2010 target calls for a decrease in this measure.
Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey.

In 1988 — 1994, women were more likely than men to be obese. However, by 2003 — 2006, the difference between obesity rates for women and men had declined — in large part because the obesity rate for men increased at a faster rate than the rate for women. Male obesity rose by 60 percent, from 20 percent in 1988 — 1994 to 32 percent in 2003 — 2006. Female obesity increased by 36 percent during this period, from 25 to 34 percent. In 2003 — 2006, the age-adjusted rates of obesity among women and men were more than twice the Healthy People 2010 target of 15 percent.

Among race and ethnicity and gender groups, black non-Hispanic women had the highest obesity rate in 2003 — 2006 (figure 13). The age-adjusted obesity rates for black non-Hispanic and Mexican American women (53 percent and 42 percent, respectively) were substantially higher than the rates for black non-Hispanic men (35 percent), white-non-Hispanic women and men (32 percent each), and Mexican American men (28 percent).

Figure 13. Persons Aged 20 Years and Older Who Are Obese, by Race/Ethnicity and Gender (2003 — 06)

Healthy People 2010 Target (15%)*

Race/ethnicity	White non-Hispanic	Black non-Hispanic	Mexican American
Men	32	35	28
Women	32	53	42

95% confidence interval

* The Healthy People 2010 target calls for a decrease in this measure.
Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey.

Women and men aged 45 to 64 years had higher obesity rates than their older and younger counterparts. Poor and near-poor women had higher obesity rates than middle/high-income women and poor and near-poor men. There were no income-related differences in men's obesity rates.

Physical Activity

Research shows that virtually all individuals benefit from regular physical activity.²⁵ Physical activity is associated with decreased risk of premature death and reduced risks of coronary heart disease, hypertension, colon cancer, and diabetes mellitus.²⁵ Regular participation in physical activity also appears to reduce depression and anxiety, improve mood, and enhance ability to perform daily tasks throughout the life span.²⁵ There is also evidence that physical activity is associated with a reduced risk of breast cancer²⁶ and with improved survival after breast cancer diagnosis.²⁷ Other benefits of active lifestyles include the following:²⁵

• Improved mood and feelings of well-being.
• Better control of body weight, blood glucose, blood pressure, and cholesterol.
• Enhanced independent living among older adults.
• Increased quality of life for all persons.

Despite the benefits of an active lifestyle, women have historically reported lower rates of physical activity than men (figure 14).

Figure 14. Persons Aged 18 Years and Older Who Exercise Regularly, by Gender (1997 — 2006)

Healthy People 2010 Target (50%)*

Age-adjusted percent	1997	1998	1999	2000	2001	2002	2003	2004	2005	2006
Women	29	26	27	28	29	29	31	29	29	29
Men	35	34	34	35	35	35	35	31	32	33

95% confidence interval

* The Healthy People 2010 target calls for an increase in this measure.
Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.

Although some progress has been made, rates for both women and men remain well below the Healthy People 2010 target of 50 percent of adults aged 18 years and older engaging in regular leisure-time exercise. Between 1997 and 2006, the proportion of women who exercised fluctuated between 26 percent and 31 percent, while the proportion of men exercising fluctuated between 31 percent and 35 percent.

Among racial and ethnic and gender groups, black non-Hispanic and Hispanic women were least likely to exercise regularly (19 percent and 20 percent, respectively, in 2004 — 2006). White non-Hispanic women were most likely to exercise (33 percent in 2004 — 2006). At 23 percent, Hispanic men had the lowest rate of regular physical exercise among male population groups.

No one is too old to enjoy the benefits of regular physical activity. Of special interest to older adults is evidence that muscle-strengthening exercises can reduce the risk of falling and fracturing bones and can improve the ability to live independently.²⁵ Unfortunately, participation in regular exercise decreases with age. As figure 15 shows, women aged 65 years and older were considerably less likely to exercise (19 percent in 2004 — 2006) than men of their own age (25 percent) and younger persons. Young men aged 18 to 24 years were the most likely to exercise (42 percent).

Figure 15. Persons Aged 18 Years and Older Who Exercise Regularly, by Age and Gender (2004 — 06)

Healthy People 2010 Target (50%)*

Age in years	65+	45 — 64	25 — 44	18 — -24
Men	25	30	33	42
Women	19	29	32	33

95% confidence interval

* The Healthy People 2010 target calls for an increase in this measure.
Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.

Socioeconomic differences are associated with physical activity. In 2004 — 2006, both poor and near-poor men and women were less likely to exercise regularly (18 percent of poor women and 24 percent of poor men) than middle/high-income persons (33 percent of women and 35 percent of men).

Population density is a factor, too. Men and women living in urban areas were more likely to participate in regular exercise than persons in rural areas in 2004 — 2006. Thirty percent of urban women exercised regularly, compared with 26 percent of rural women. For men, the rates were 33 percent and 27 percent, respectively.

Alcohol and Illicit Drugs

Substance abuse has a major impact on adults and adolescents, their families, and their communities. The effects of substance abuse are cumulative, contributing to costly social, physical, mental, and public health problems. This section summarizes results for three drug- and alcohol-related measures: the proportion of adolescents not using alcohol or illicit drugs, the proportion of adults using illicit drugs, and the proportion of adults who binge drink.

Females have better rates than males for all three measures. Even so, the risks of heavy alcohol use are serious, especially for young women. Drinking alcohol affects women differently than it does men. Women who drink heavily face greater risks than men who drink heavily. They are more prone to liver disease, heart damage, and brain damage. Studies show that women with alcoholism are up to twice as likely as men to die from alcohol-related causes such as suicide, accidents, and illnesses.²⁸

Drug and alcohol use in early adolescence affects the development of the adolescent brain.²⁹ Early use of alcohol is a risk factor for later alcohol-related problems, including alcohol dependence. The highest rate of alcohol dependence is among persons aged 18 to 20 years.²⁹

The Maternal, Infant, and Child Health focus area of Healthy People 2010 addresses the adverse effects of substance-related prenatal exposure. Due to issues of data comparability, only two data points are currently available to assess progress toward these objectives. Between 2002 — 2003 and 2004 — 2005, the proportions of pregnant women abstaining from binge drinking and illicit drugs in the past month were stable at 96 percent (the Healthy People 2010 target is 100 percent). During the same period, the proportion of pregnant women abstaining from alcohol in the past month declined from 90 percent to 88 percent, moving away from the Healthy People 2010 target of 95 percent.¹

Adolescents' use of alcohol and illicit drugs. The proportion of persons aged 12 to 17 years who abstained from alcohol and illicit drug use in the past 30 days was stable between 2002 and 2006 (78 percent and 79 percent). The proportions were well below the Healthy People 2010 target of 91 percent; boys and girls did not differ (figure 16).

Figure 16. Persons Aged 12 to 17 Years Who Have Not Used Alcohol or Illicit Drugs in the Past 30 Days, by Gender (2002 — 06)

Healthy People 2010 Target (91%)*

Age in years	2002	2003	2004	2005	2006
Girls	78	78	78	78	79
Boys	78	79	79	80	79

95% confidence interval

* The Healthy People 2010 target calls for an increase in this measure.
Source: Substance Abuse and Mental Health Services Administration, National Survey on Drug Use and Health.

Adults' illicit drug use. Men are more likely than women to use illicit drugs (figure 17). Between 2002 and 2006, the proportion of men using illicit drugs was stable at 10 percent. The proportion of women remained stable at 6 percent.

Figure 17. Persons Aged 18 Years and Older Who Have Used Illicit Drugs in the Past 30 Days, by Gender (2002 — 06)

Healthy People 2010 Target (3.2%)*

Percent	2002	2003	2004	2005	2006
Women	6	6	5.6	5.7	5.8
Men	10	9.8	9.8	10.3	10.6

95% confidence interval

* The Healthy People 2010 target calls for a decrease in this measure.
Source: Substance Abuse and Mental Health Services Administration, National Survey on Drug Use and Health.

Adults' binge drinking. Men are twice as likely to engage in binge drinking as women (figure 18). Between 2002 and 2006, the proportion of men who reported binge drinking at least once in the past 30 days was about 33 percent. The proportion of women was about 16 percent. These rates have remained stable since 2002.

Figure 18. Persons Aged 18 Years and Older Who Engaged in Binge Drinking* of Alcoholic Beverages in the Past 30 Days, by Gender (2002 — 06)

Healthy People 2010 Target (13.4%)†

	2002	2003	2004	2005	2006
Women	15.7	15.4	15.4	15.8	15.8
Men	33.7	33.4	33.5	33	33.8

95% confidence interval

* Binge drinking is defined as consuming five or more drinks at the same time or within a couple of hours of each other.
† The Healthy People 2010 target calls for a decrease in this measure.
Source: Substance Abuse and Mental Health Services Administration, National Survey on Drug Use and Health.

Smoking

Tobacco use is associated with various adverse health consequences:

• Cigarette smoking remains the leading preventable cause of death in the United States.³⁰ One in every five deaths each year in the United States is smoking related.³¹
• Smoking is associated with significantly increased risk of heart disease, stroke, lung cancer, and chronic lung diseases.³¹
• Smoking during pregnancy is linked to adverse pregnancy outcomes and child health. These include low birth weight, intrauterine growth retardation, miscarriage, and SIDS as well as other negative consequences for child health and development.^{31, 32}
• Men are more likely to smoke than women.³²

Cigarette smoking has declined since the early 1990s. However, the current smoking rates for men and women are still well above the Healthy People 2010 target of 12 percent. Between 1992 and 2005, the proportion of women who were current smokers declined from 25 percent to 18 percent, remaining at that level through 2006 (figure 19). For men, the rate declined from 28 percent to 24 percent.

Figure 19. Persons Aged 18 Years and Older Who Currently Smoke Cigarettes, by Gender (1990 — 2006)

Healthy People 2010 Target (12%)*

Age-adjusted percent	1990	1991	1992	1993	1994	1995	1996	1997	1998	1999	2000	2001	2002	2003	2004	2005	2006
Women	23		25	23	23	23		22	22	22	21	21	20	19	19	18	18
Men	28		28	27	28	27		27	26	25	25	25	25	24	23	23	24

* The Healthy People 2010 target calls for a decrease in this measure.
Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.

Asian and Hispanic women have achieved the Healthy People 2010 target, with smoking rates of 5 percent and 10 percent in 2004 — 2006, respectively (figure 20). Rates for all other racial and ethnic and gender groups are well above the target. Smoking rates are lowest for persons aged 65 years and older. Women in this age group had an 8 percent smoking rate, while men had a rate of 11 percent in 2004 — 2006 (figure 21).

Figure 20. Persons Aged 18 Years and Older Who Currently Smoke Cigarettes, by Race/Ethnicity and Gender (2004 — 06)

Healthy People 2010 Target (12%)*

Race/ethnicity†	White non- Hispanic	Black non-Hispanic	Hispanic	2 or more races	Asian	American Indian Alaska Native
Men	24	25	19	30	19	32
Women	21	17	10	26	5	23

95% confidence interval

* The Healthy People 2010 target calls for a decrease in this measure.
† Data for the Native Hawaiian or Other Pacific Islander population do not meet the criteria for statistical reliability, data quality, or confidentiality.
Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.

Figure 21. Persons Aged 18 and Over Who Currently Smoke Cigarettes, by Age and Gender (2004 — 06)

Healthy People 2010 Target (12%)*

Age in years	65+	45-64	25-44	18-24
Men	11	25	26	27
Women	8	19	21	21

95% confidence interval

* The Healthy People 2010 target calls for a decrease in this measure.
Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.

Women and men living in rural areas are more likely to smoke than those living in urban areas. In 2004 — 2006, 24 percent of rural women smoked, compared with 17 percent of urban women. The comparable figures for men were 28 percent and 22 percent, respectively.

Poor and near-poor persons are more likely to smoke than those with a middle/high income. In 2004 — 2006, 26 percent of poor women and 22 percent of near-poor women smoked, compared with 16 percent of middle/high-income women. Men's smoking rates for the same period were 32 percent for poor men, 30 percent for near-poor, and 21 percent for men with a middle/high income.

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Content last updated July 1, 2009.

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