The geographic concentration of us adult obesity prevalence and associated social, economic, and environmental factors

Abstract

Objective: This study used spatial statistical methods to test the hypotheses that county-level adult obesity prevalence in the United States is (1) regionally concentrated at significant levels, and (2) linked to local-level factors, after controlling for state-level effects. Methods: Data were obtained from the Centers for Disease Control and Prevention and other secondary sources. The units of analysis were counties. The dependent variable was the age-adjusted percentage of adults who were obese in 2009 (body mass index >30 kg/m 2 ). Results: The prevalence of county-level obesity varied from 13.5% to 47.9% with a mean of 30.3%. Obesity prevalence across counties was not spatially random: 15.8% belonged to high-obesity regions and 13.5% belonged to low-obesity regions. Obesity was positively associated with unemployment, outpatient healthcare visits, physical inactivity, female-headed families, black populations, and less education. Obesity was negatively correlated with physician numbers, natural amenities, percent 65 years, Hispanic populations, and larger population size. A number of variables were notable for not reaching significance after controlling for other factors, including poverty and food environment measures.Conclusions: The findings demonstrate the importance of local-level factors in explaining geographic variation in obesity prevalence, and thus hold implications for geographically targeted interventions to combat the obesity epidemic.

Educational strategies for the prevention of diabetes, hypertension, and obesity

“…[48][49][50][51] However, the high cost of healthier foods has made the access more difficult by economically disadvantaged populations. 52 Meanwhile, the supply and demand for low-cost foods with lower nutritional value has increased, particularly in educational institutions for children and young people. 53 Therefore, greater control and supervision of foods is essential in society in order to contain the advance of chronic diseases.…”

Age and gender differential relationship between employment status and body mass index among middle-aged and elderly adults: a cross-sectional study

“…33 The effect of retirement on obesity has been on debate also. [5][6][7][8][9][10] The calorie expenditure of jobs, food away from home and the psychological effect of retirement were all assumed to be factors that could affect an individual's obesity status. For example, retirement could increase BMI because not working could decrease physical activity.…”

Ethnic density and obesity: Evidence from fixed-effects models

“…We also control for the inflationadjusted median family income (in constant 2004 dollars), the proportion of the MSA or county with college degrees, and the proportion of the MSA or county that is unemployed (cf. Slack et al, 2013). Finally, to control for trends in both ethnic density and obesity, we include a continuous indicator of the number of years since the initial 1981 observation.…”