Change in Obesity Prevalence across the United States Is Influenced by Recreational and Healthcare Contexts, Food Environments, and Hispanic Populations.

Candice A Myers,Steven B Heymsfield,Tim Slack,Stephanie T Broyles,Corby K Martin

doi:10.1371/journal.pone.0148394

Candice A Myers, Steven B Heymsfield + Show 3 more

Open Access

https://doi.org/10.1371/journal.pone.0148394

Copy DOI

Abstract

ObjectiveTo examine change in county-level adult obesity prevalence between 2004 and 2009 and identify associated community characteristics.MethodsChange in county-level adult (≥20 years) obesity prevalence was calculated for a 5-year period (2004–2009). Community measures of economic, healthcare, recreational, food environment, population structure, and education contexts were also calculated. Regression analysis was used to assess community characteristics associated (p<0.01) with change in adult obesity prevalence.ResultsMean±SD change in obesity prevalence was 5.1±2.4%. Obesity prevalence decreased in 1.4% (n = 44) and increased in 98% (n = 3,060) of counties from 2004–2009. Results showed that both baseline levels and increases in physically inactive adults were associated with greater increases in obesity prevalence, while baseline levels of and increases in physician density and grocery store/supercenter density were related to smaller increases in obesity rates. Baseline levels of the Hispanic population share were negatively linked to changing obesity levels, while places with greater Hispanic population growth saw greater increases in obesity.ConclusionsMost counties in the U.S. experienced increases in adult obesity prevalence from 2004 to 2009. Findings suggest that community-based interventions targeting adult obesity need to incorporate a range of community factors, such as levels of physical inactivity, access to physicians, availability of food outlets, and ethnic/racial population composition.

Highlights

Recent evidence indicates that growth trends in obesity prevalence among adults in the United States (U.S.) may be slowing down.[1]
Obesity prevalence decreased in 1.4% (n = 44) and increased in 98% (n = 3,060) of counties from 2004–2009
Results showed that both baseline levels and increases in physically inactive adults were associated with greater increases in obesity prevalence, while baseline levels of and increases in physician density and grocery store/supercenter density were related to smaller increases in obesity rates

Summary

Introduction

Recent evidence indicates that growth trends in obesity prevalence among adults in the United States (U.S.) may be slowing down.[1] despite this potential good news, obesity prevalence remains high in the U.S, especially in comparison to similar countries, and warrants continued monitoring.[1,2] Ecological obesity research has demonstrated the uneven geographic distribution of obesity across the U.S and identified a range of determinants associated with this geographic variation.[3,4] recent research has investigated obesity prevalence across various geographic delineations (i.e., counties and census tracts) and assessed the associated aggregate risk factors (e.g., socioeconomic status [SES]).[5,6] These studies provide an empirical foundation for considering the importance of spatial disparities in obesity prevalence as well as its ecological correlates. Insomuch as it is important to monitor trends in overall adult obesity prevalence, it is important to understand how the geography of adult obesity prevalence has changed in recent years across the U.S

Results

Discussion

Conclusion