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US obesity rates

Decline in US adult obesity rates for first time in a decade

Nine of the 11 states with the highest obesity rates are in the South and 22 of the 25 states with the highest rates of obesity are in the South and Midwest
In 2015, Louisiana has the highest adult obesity rate at 36.2 percent and Colorado has the lowest at 20.2 percent

Adult obesity rates in the US decreased in four states (Minnesota, Montana, New York and Ohio), increased in two (Kansas and Kentucky) and remained stable in the rest, between 2014 and 2015, according to The State of Obesity: Better Policies for a Healthier America, a report from the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF). This marks the first time in the past decade that any states have experienced decreases, aside from a decline in Washington, DC in 2010.

Despite these modest gains, obesity continued to put millions of Americans at increased risk for a range of chronic diseases, such as diabetes and heart disease, and costs the country between US$147 billion and US$210 billion each year. In 2015, Louisiana has the highest adult obesity rate at 36.2 percent and Colorado has the lowest at 20.2 percent. While rates remained steady for most states, they are still high across the board. The 13th annual report found that rates of obesity now exceed 35 percent in four states, are at or above 30 percent in 25 states and are above 20 percent in all states. In 1991, no state had a rate above 20 percent. The analyses are based on the US Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System (BRFSS).

The State of Obesity also found that:

  • Nine of the 11 states with the highest obesity rates are in the South and 22 of the 25 states with the highest rates of obesity are in the South and Midwest
  • Ten of the 12 states with the highest rates of diabetes are in the South
  • American Indian/Alaska Natives have an adult obesity rate of 42.3 percent.
  • Adult obesity rates are at or above 40 percent for Blacks in 14 states.
  • Adult obesity rates are at or above 30 percent in: 40 states and Washington DC for Blacks; 29 states for Latinos; and 16 states for Whites

Based on an analysis of new state-by-state data from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance Survey, adult obesity rates by state from highest to lowest were (note: 1 = Highest rate of adult obesity, 51 = lowest rate of adult obesity)

1. Louisiana (36.2); 2. (tie) Alabama (35.6), Mississippi (35.6) and West Virginia (35.6); 5. Kentucky (34.6); 6. Arkansas (34.5); 7. Kansas (34.2); 8. Oklahoma (33.9); 9. Tennessee (33.8); 10. (tie) Missouri (32.4) and Texas (32.4); 12. Iowa (32.1); 13. South Carolina (31.7); 14. Nebraska (31.4); 15. Indiana (31.3); 16. Michigan (31.2); 17. North Dakota (31.0); 18. Illinois (30.8); 19. (tie) Georgia (30.7) and Wisconsin (30.7); 21. South Dakota (30.4); 22. (tie) North Carolina (30.1) and Oregon (30.1); 24. (tie) Maine (30.0) and Pennsylvania (30.0); 26. (tie) Alaska (29.8) and Ohio (29.8); 28. Delaware (29.7); 29. Virginia (29.2); 30. Wyoming (29.0); 31. Maryland (28.9); 32. New Mexico (28.8); 33. Idaho (28.6); 34. Arizona (28.4); 35. Florida (26.8); 36. Nevada (26.7); 37. Washington (26.4); 38. New Hampshire (26.3); 39. Minnesota (26.1); 40. Rhode Island (26.0); 41. New Jersey (25.6); 42. Connecticut (25.3); 43. Vermont (25.1); 44. New York (25.0); 45. Utah (24.5); 46. Massachusetts (24.3); 47. California (24.2); 48. Montana (23.6); 49. Hawaii (22.7); 50. District of Columbia (22.1); 51. Colorado (20.2).

Figure 1: Obesity rates by US state based in BMI (please click on the map (above) to access the interactive map)

There is some evidence that the rate of increase has been slowing over the past decade. For instance, in 2005, 49 states experienced an increase; in 2008, 37 states did; in 2010, 28 states did; in 2011, 16 states did; in 2012, only one state did; and in 2014, only two states did. (Note: the methodology for BRFSS changed in 2011).

In addition, recent national data show that childhood obesity rates have stabilised at 17 percent over the past decade. Rates are declining among 2- to 5-year-olds, stable among 6- to 11-year-olds, and increasing among 12- to 19-year-olds. There are significant racial and ethnic inequities, with rates higher among Latino (21.9%) and Black (19.5%) children than among White (14.7%) children.

“Obesity remains one of the most significant epidemics our country has faced, contributing to millions of preventable illnesses and billions of dollars in avoidable health care costs,” said Richard Hamburg, interim president and CEO, TFAH. “These new data suggest that we are making some progress but there’s more yet to do. Across the country, we need to fully adopt the high-impact strategies recommended by numerous experts. Improving nutrition and increasing activity in early childhood, making healthy choices easier in people’s daily lives and targeting the startling inequities are all key approaches we need to ramp up.”

The report also includes a set of priority policy recommendations to accelerate progress in addressing obesity:

  • Invest in Obesity Prevention: Providing adequate funding for the Prevention and Public Health Fund and for the Centers for Disease Control and Prevention’s National Center for Chronic Disease Prevention and Health Promotion/Division of Nutrition, Physical Activity, and Obesity would increase support to state and local health departments.
  • Focus on Early Childhood Policies and Programs: Supporting better health among young children through healthier meals, physical activity, limiting screen time and connecting families to community services through Head Start; prioritizing early childhood education opportunities under the Every Student Succeeds Act (ESSA); and implementing the updated nutrition standards covering the Child and Adult Care Food Program.
  • School-Based Policies and Programs: Continuing implementation of the final “Smart Snacks” rule for improved nutrition for snacks and beverages sold in schools; eliminating in-school marketing of foods that do not meet Smart Snacks nutrition standards; and leveraging opportunities to support health, physical education and activity under ESSA.
  • Community-Based Policies and Programs: Prioritizing health in transportation planning to help communities ensure residents have access to walking, biking, and other forms of active transportation and promoting innovative strategies, such as tax credits, zoning incentives, grants, low-interest loans and public-private partnerships to increase access to healthy, affordable foods.
  • Health, Health Care and Obesity: Covering the full range of obesity prevention, treatment and management services under all public and private health plans, including nutrition counseling, medications and behavioral health consultation, along with encouraging an uptake in services for all eligible beneficiaries.

“This year’s State of Obesity report is an urgent call to action for government, industry, health care, schools, child care and families around the country to join in the effort to provide a brighter, healthier future for our children. It focuses on important lessons and signs of progress, but those efforts must be significantly scaled to see a bigger turn around,” said Risa Lavizzo-Mourey, president and CEO of RWJF. “Together, we can build an inclusive Culture of Health and ensure that all children and families live healthier lives.”

The State of Obesity report (formerly known as F as in Fat), with state rankings and interactive maps, charts and graphs, is available here

For 13 years, the annual report, The State of Obesity has raised awareness about the seriousness of the obesity epidemic, encouraged the creation of a national obesity prevention strategy and highlighted promising approaches for reversing the epidemic at the state and local level. The State of Obesity is a collaborative project of the Trust for America's Health and the Robert Wood Johnson Foundation and is supported by a grant from the Foundation.

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