In this episode, researchers Arch G. Mainous III, PhD, and Frank A. Orlando, MD, discuss their recently published study, “Body Mass Index vs Body Fat Percentage as a Predictor of Mortality in Adults Aged 20-49 Years." The study found that body fat percentage is a stronger predictor of 15-year mortality risk among U.S. adults than body mass index (BMI). Although BMI is widely used in clinics as the standard measure of body composition, it can potentially misclassify muscular individuals as overweight and miss cases of "normal-weight obesity," masking serious metabolic and heart disease risks. The study findings support reexamining how body composition is measured in clinical settings.

Other studies mentioned in the episode:

2016 study: "Prevalence of Prediabetes and Abdominal Obesity Among Healthy-Weight Adults: 18-Year Trend

2022 study: Body fat and risk of all-cause mortality: a systematic review and dose-response meta-analysis of prospective cohort studies

In this episode, researchers Ann Sinéad Doherty, PhD, and Emma Wallace, PhD discuss their recently published study, “Prescribing Cascades Among Older Community-Dwelling Adults: Application of Prescription Sequence Symmetry Analysis to a National Database in Ireland.” The study identified five potential prescribing cascades in Ireland’s national population of older adults, highlighting yet another contributor to potentially inappropriate prescribing.

Primary care improves the health of communities and decreases health inequities, yet workforce shortages have worsened in the United States. This study, titled "Neighborhood Determinants of Primary Care Access in Virginia," aimed to identify geographic disparities of the primary care workforce in Virginia and identify factors associated with primary care physician (PCP) access. In this episode, authors Hannah Shadowen, third-year medical student, and Alexander Krist, MD, MPH discuss the study in detail.

Researchers used the 2019 Virginia All-Payers Claims Database to identify PCPs and the number of patients seen by each physician. They then measured how many PCPs each census tract could reach within a 30‑minute drive, flagging tracts with too few as having poor access. Associations between PCP access and predisposing (age, race), enabling (income, insurance), need and structural (rurality, segregation) factors were assessed.

Main Results:

• Nearly half (44%) of Virginia’s census tracts lacked adequate PCP access.
• Racial segregation and rurality had the greatest associations with PCP access: tracts with higher proportions of Black residents had significantly greater PCP access than those with higher proportions of White residents, while rural tracts had significantly less access.