Obesity on the Rise in More Than Half of States, Report Finds

June 29, 2010
by Jane Norman
Congressional Quarterly HealthBeat

Public health leaders and first lady Michelle Obama have targeted the obesity health crisis among America's children, but a new study released Tuesday shows that the adults who shop for and prepare those kids' meals are struggling with their weight as well -- particularly in the South.

The "F as in Fat" report by the Trust for America's Health and the Robert Wood Johnson Foundation found that adult obesity rates increased last year in 28 states, with the only decline reported in the District of Columbia.

Colorado was the one state to report an obesity rate of less than 20 percent. And Mississippi claimed first place for adult obesity rates for the sixth year in a row, at 33.8 percent. It also has the highest rate of inactivity and hypertension and the second-highest rate of diabetes.

The other seven states with obesity rates topping 30 percent are in a swath that cuts through the South and Southeast: West Virginia, Kentucky, Tennessee, Arkansas, Oklahoma, Alabama and Louisiana. Those states also are home to many low-income people and to many blacks and Hispanics, all of who tend to have higher obesity rates.

Obesity rates for blacks and Hispanics were higher than those for whites in at least 40 states and the District -- in nine states, the obesity rate for blacks topped 40 percent. Obesity rates also were higher for Americans earning less than $15,000 a year as opposed to those earning more than $50,000.

This packing on of the pounds is a recent phenomenon, the report's authors said. No states had obesity rates of more than 20 percent in 1991, just 19 years ago. Obesity is defined by the government as a body mass index of 30 or more, which would be 30 extra pounds on a 5'4 individual.

The rates were based on three-year rolling averages and reflected data from 2007 through 2009, said Jeff Levi, executive director of the trust. While some promising policy responses and ideas have emerged in recent years to battle America's flabbiness, including prevention and wellness initiatives in the health care law, "our response as a nation has yet to fully match the magnitude of the problem," he said.

Economics play a big role because healthy foods cost more and many low-income people live in places where they don't have access to grocery stores with affordable fruits and vegetables, said Angela Glover Blackwell, founder and CEO of the advocacy group PolicyLink. The focus for policy makers should be on communities where the need for change is greatest, she said.

"We have a lot of poverty in the South, and there is a correlation between income and obesity," she said.

Jim Marks of the Robert Wood Johnson Foundation said that "just like night follows day," that also means higher rates of hypertension and diabetes in the South.

Marks said he's hoping that a requirement in the health care law that chain restaurants post calorie counts on their menus will help people avoid the most fattening items, particularly parents picking out food for their children. And Levi said states and localities that have required calorie counts have found restaurants change the makeup of their offerings when calories have to be posted. "They know they will start losing customers if they don't make these changes," he said.