Weighing down America: 2020 Update a Community Approach against Obesity

Abstract

The economic and social cost of obesity in America is at an all-time high and continues to rise. We estimate its cost to be roughly 6.76 percent of gross domestic product (GDP) in 2018 compared to 5.57 percent in 2014, or in dollar terms, $1.389 trillion in 2018 compared to $0.976 trillion in 2014. The current pandemic is likely to raise this cost even higher.Although Black and Hispanic populations, and individuals of all races aged 40-59 are most at risk, the latest statistics show noticeable growth in obesity prevalence, from 2014 to 2018, within the male population, especially white males and males of all races aged 20-59. In contrast, the data look more encouraging for women. The obesity rates among Hispanic women and all women aged 40-59 show a marked decline during the same period.Obesity impacts segments of the US population differently based on their behavioral and socioeconomic profiles. The Milken Institute COVID-19 Community Explorer sorts US counties around eight profiles of communities that share common patterns across behavioral, economic, and social factors. This report uses these communities and identifies which of the 26 factors considered are systemically correlated with high obesity rates for each community. This report identifies three groupings that matter for a large part of the US population:• Social and behavioral factors, such as unemployment, excessive drinking, smoking, post-secondary education, and single-parent households, have the strongest association with obesity prevalence across all eight communities' profiles.• Urban-rural factors, including rurality, housing concerns, population density, metropolitan area, violent crime rate, and the number of fast-food establishments per 100,000 people, have the second strongest association with obesity prevalence across four communities, representing 78 percent of the US population.• The Black population factor has the third strongest association with obesity prevalence across four communities. These communities represent 61 percent of the US population.The analysis combines health, behavioral, economic, and social data sets and suggests that some aspects of the obesity epidemic would be better addressed at the local level, while others would benefit from a federal initiative. It also identifies factors for each community to consider when coordinating national and local authorities and other partners such as health-care professionals, business and community leaders, school, and child care. Finally, our analysis shows that the data sets collected need to be properly combined, processed, and analyzed to inform policy in a meaningful and actionable manner.