Abstract

High-income countries have greater rates of obesity than middle- and low-income countries (1). Countries that develop wealth also develop obesity; for instance, with economic growth in China and India, obesity rates have increased by several-fold (1). The international trend is that greater obesity tracks with greater wealth (2,3). The U.S. is one of the wealthiest countries in the world and accordingly has high obesity rates; one-third of the population has obesity plus another third is overweight. The situation is predicted to worsen; rising childhood obesity rates forewarn of worsening statistics (4). While it is agreed that both individual factors such as genetic susceptibility and behavior are important in life-long weight gain, evidence is ill-defined with respect to the nature of the environmental influences that impact obesity (5). In 2010, 15.1% of Americans lived in poverty based upon family income census data (6). With the economic downturn, the number of people in the U.S. living in poverty rose to 46 million people—the greatest number in more than 50 years (6). Are poverty and obesity associated? Poverty rates and obesity were reviewed across 3,139 counties in the U.S. (2 …

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