Obesity is a complex problem that can carry a level of stigma. It often produces negative attitudes in others, and this can include healthcare providers. Researchers from the University of Pennsylvania School of Medicine carried out a study to examine whether obese patients received a lower quality of common outpatient care. Performance measures included diabetes care (eye examination, HbA1c and lipid screening), pneumococcal vaccination, influenza vaccination, breast screening mammograms, colorectal cancer screening and cervical cancer screening. The data were collected from over 69,000 patients within two nationwide US study populations: the Medicare Beneficiary Survey (1994-2006) and the Veterans Health Administration (2003-2004). After adjusting for sociodemographic factors, health status, clinical complexity and visit frequency, the researchers "found no evidence that obese or overweight patients were less likely to receive recommended care relative to normal-weight patients. Moreover, success rates were marginally higher for obese and/or overweight patients on several measures.” The researchers found the most notable results in diabetes care for Medicare patients. Obese patients with diabetes were in fact more likely to receive recommended care on lipid screening (72% vs 65%) and HbA1c testing (74% vs 62%), compared with normal weight patients. This report in 7 April, 2010 The Journal of the American Medical Association offers some reassurance that, despite prevailing attitudes, obese people, in the US at least, are not receiving inferior healthcare.