Living Well in Prince George's County
Tuesday, June 10, 2014

Obesity: Know Your Place

Most of us think that our health is determined by our genes, our behaviors, and the healthcare we receive. While all of those play critical roles, there is another very important determinant of our health—place.  In public health circles and amongst a growing segment of the medical community, there is mounting evidence that where we live can determine up to one half of our health status. Being in the wrong zip code can actually endanger your health. That means that even if you have the genetic make-up of a superhero and do all the right things (avoid smoking, practice safer sex, wear a seatbelt, and get your annual pap smear), you may not have the same opportunity to be healthy as someone living in a neighboring city or community.

The importance of place to our health could not be more apparent than when we examine the nation’s obesity epidemic. U.S. obesity statistics are staggering. According to the Centers for Disease Control and Prevention, 34% of adults and 17% of children are obese. But the data become particularly alarming when we look at obesity rates for African Americans adults that top 49% and for Latino adults at 39%. Similarly, African American and Latino girls have significantly higher rates of obesity compared to their white counterparts; 41%, 38%, and 26% respectively. Specifically because of obesity, for the first time in our history, the next generation is expected to live shorter lives and have a lower quality of life than their parents.

The crisis becomes even clearer when we look at obesity rates by place. Communities with large populations of Latinos and African Americans have significantly higher rates of obesity than predominantly white communities. While some people look at the data and assume that high rates of obesity amongst communities of color are because of genetic factors and personal behavioral choices (diet and exercise), scientific evidence shows that disproportionate rates of obesity in communities of color indicate a convergence of challenging neighborhood conditions (i.e., housing, education, transportation, the physical environment, the availability of affordable, healthy food, etc.) that limit opportunities for people of color to achieve and maintain healthy weight.

Communities that have food deserts (area with limited access to affordable fruits, vegetables, and other healthy foods) and those with food swamps (area with high concentration of unhealthy, high-energy foods) suffer from higher rates of obesity and obesity-related disease such as diabetes and hypertension. Frequently, residents of communities of color that suffer from high rates of obesity are paradoxically considered “food insecure” due to a lack of access to healthy, affordable foods. The challenges in the food environment encourage and at times necessitate nutritional behaviors such as meal-skipping (which has been shown to slow metabolism and promote weight gain) and consumption of processed foods that tend to be calorie-dense, high in fat, and high in sodium—all of which are a recipe for poor health and high rates of obesity as well as chronic disease.

While our food environment plays a big role in our nutritional behavior, the physical environment can do a lot to decide how we spend our time and live our lives. Unsafe neighborhoods determine whether we participate in outdoor activities. Neighborhoods that have sidewalks and bike-friendly roads encourage us to fore go our cars and instead take a brisk walk or ride to carry out our daily activities. Being active to a level that staves off weight gain and promotes weigh loss requires more than a gym membership.

While our genetic make-up is out of our control and we each have responsibility for our health behaviors, we must start to consider what we can do in our neighborhoods to create conditions that support healthy weight. It is time to fight the obesity epidemic in communities of color with new approaches that support individuals (including our children) to live active lifestyles fuelled by healthy foods, all of which should be available, accessible, and affordable. To get your community involved in creating a “weight-healthy” place, check out these resources: The First Lady’s initiative “Let’s Move” at www.letsmove.com; the NAACP Childhood Obesity Advocacy Manual at http://bit.ly/ph6atM; the Place Matters Initiative at www.jointcenter.org; and www.commonhealthaction.org to learn more about what communities are doing to create healthy places around the country.

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