Variations in obesity rates between US counties: Impacts of activity access, food environments, and settlement patterns

Abstract

There is much ongoing research about the effect of the urban environment as compared with individual behaviour on growing obesity levels, including food environment, settlement patterns (e.g., sprawl, walkability, commuting patterns), and activity access. This paper considers obesity variations between US counties, and delineates the main dimensions of geographic variation inobesity between counties: by urban-rural status, by region, by area poverty status, and by majorityethnic group. Available measures of activity access, food environment, and settlement patterns arethen assessed in terms of how far they can account for geographic variation. A county level regressionanalysis uses a Bayesian methodology that controls for spatial correlation in unmeasured area riskfactors. It is found that environmental measures do play a significant role in explaining geographiccontrasts in obesity.