More than one in three adults in America are obese (1). The prevalence of obesity grew dramatically throughout the 1990s, and has slowly levelled off over the early 2000s. Obesity is one of the biggest and most controversial public health issues of our time, with about 78 million adult Americans at risk for heart disease, stroke, some types of cancer, and type II diabetes due to obesity (2).
But, which states currently have the highest prevalence of obesity in the United States?
A new report, ‘The State of Obesity: Better Policies for a Healthier America 2015’, presents the most recent data on the prevalence of obesity in the United States, using data from the CDC Behavioral Risk Factor Surveillance Survey (3).
In 2015, Arkansas has the highest rate of obesity, at 35.6% of the adult population. Colorado has the lowest rate, at 21.3% of the adult population (3). Three states have obesity rates over 35% of the population: Arkansas, West Virginia, and Mississippi. Of the 25 states with the highest obesity rates, 23 are in the South and the Midwest (3).
Interestingly, the geographic pattern of obesity somewhat matches the geographic pattern of poverty in America. Arkansas, West Virginia, and Mississippi – the three most obese states – are three of the poorest states (4, 5). Access to health care is also the poorest in South and Midwest states, with people in these regions most frequently reporting that they do not access care when they need it (4).
Obesity is also highly racialized in the United States, with the highest prevalence in Hispanic and non-Hispanic black adults, especially in poor regions. Below are three maps, showing the prevalence of obesity by state in non-Hispanic white, non-Hispanic black, and Hispanic adults. The differences in obesity prevalence and geographic trends in obesity prevalence by ‘race’ are visually striking. While media surrounding the report highlights that three states have an obesity prevalence over 35%, this figure obscures that 33 states have a prevalence over 35% for non-Hispanic black adults.
Obesity is an intersecting issue of both ‘race’ and poverty in America, with complex structural causes that affect people’s abilities and decisions regarding their health and lifestyle. Understanding the geographic distribution of obesity is important to help us understand the structural drivers of obesity, and to identify areas where political efforts must be directed. This obesity ‘epidemic’ is an example of the social determinants of health in action. The health of the public cannot be isolated to the public health sector, and obesity is certainly no exception.
1. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA 2014;311:806-14.
2. CDC. Adult obesity facts. http://www.cdc.gov/obesity/data/adult.html (accessed 28 September 2015).
3. Levi J, Rayburn J, Segal LM, Martin A. The State of Obesity: Policies for a Healthier America 2015. The Robert Wood Johnson Foundation and Trust for America’s Health; 2015.
4. Grusky DB, Mattingly MJ, Varner C. State of the States: The Poverty and Inequality Report. Stanford Center on Poverty and Inquality; 2015.
5.DeNavas-Walt C, Proctor DB. Income and Poverty in the United States: 2014: Current Population Reports. United States Census Bureau; 2015.