Why are some U.S. cities more obese than others?

Kathryn Hawkins

Americans are getting unhealthier every year: According to the Centers for Disease Control and Prevention, obesity has more than doubled in children and tripled in teenagers over the past three decades. And more than one-third of adults are considered to be obese, according to the BMI scale. For instance, an adult who is 5 feet 9 inches tall and weighs 203 pounds or more has a BMI of 30, which meets the "obese" classification.

obesity in AmericaPeople who are significantly overweight are at increased risk for diseases such as heart disease, stroke, Type 2 diabetes, and certain types of cancers.

So what factors can combat the obesity epidemic? A new Gallup study of the most and least obese cities in the nation may provide a few clues.

In the study, Boulder, Colorado was the least obese city, with just 12.5 percent of the population considered obese. The highest percentage was in McAllen-Edinburg-Mission, Texas, with 38.5 percent of its residents considered obese.

Why are some U.S. cities more obese than others?

Here are 3 characteristics that may play a part in the vast differences in residents' physical health:

1. Household income and obesity

Boulder, Colorado has a highly educated workforce, with a high average income: The median household income in the city is $57,112. In contrast, McAllen-Edinburg-Mission has the lowest average income in the country, with a median household income of $24,863. This disparity accounts for a number of other differences between residents' options in the two regions.

2. Access to healthy food

Low-income areas frequently lack access to full-service grocery stores where they can purchase healthful foods such as fruits and vegetables, and may be limited to buying fast-food and packaged food from convenience stores.

"The term ‘food desert' is used to describe the fact that healthy foods aren't available in these areas," says Shari Portnoy, a registered dietitian in New York. "Fruits and vegetables are less available in low-income areas."

Individuals on limited incomes also tend to purchase higher-calorie foods, such as packaged cheeses and processed meats because they are more filling than the amount of fruits and vegetables they could purchase for the same amount of money, according to a 2010 study.

Boulder has an affluent population with many health-focused "farm to table" restaurants and markets, providing its population with many options for eating nutritious food.

Access to exercise

Another major difference between the two cities is residents' access to exercise and outdoor activities.

The Texas region tends to get very hot in summer, with average temperatures approaching 100 degrees, making it difficult to pursue free outdoor activities such as walking, running or bicycling. Additionally, the region does not have as many public recreation areas as most higher-income communities: A study found that a higher poverty rate is associated with reduced availability of sports arenas, parks and green spaces, and bike paths. Moving from a low- to a high-income area is associated with a 50 percent increase in physical fitness opportunities.

In contrast, Boulder, Colorado is a temperate region where temperatures rarely reach above the high 80s, providing a great climate for outdoor activities all year round. The city has heavily invested in outdoor activities by building bike lanes throughout the city, and developing many hiking trails in the surrounding mountain regions. These outdoor attractions have made the city a top destination for young, physically active people.

How obesity influences health insurance costs

People who are obese have significantly higher medical costs than people of average weight: Annual medical costs are more than $1,400 higher for people with obesity, according to a 2008 HealthAffairs study; a total of $147 billion in increased spending by public and private insurance plans to treat obesity-related health conditions.

These increased costs result in higher insurance premiums for everyone, because insurance companies include such risk factors when calculating their rates for all customers.

Employers of obese workers and overweight people on individual plans may also pay more for their specific insurance plans: A report by eHealthInsurance found that individual obese policyholders paid an average of 22 percent more in premiums than those of average weight. Some employers are working to address the issue by telling overweight employees that they will need to pay higher premium co-payments unless they take specific steps to address their health problems, such as joining a Weight Watchers group or participating in an employer-provided wellness program.

5 tips on how to prevent obesity

In order to reduce obesity in communities like McAllen-Edinburg-Mission, Texas, it's important to help young children develop healthy habits. One in five children is overweight or obese by age six, and many carry unhealthy habits with them throughout their lives.

In order to prevent children from gaining an unhealthy amount of weight, Nemours Children's Health System recommends these five steps:

  1. Engage your child in one to two hours of physical activity each day, such as soccer or playground time
  2. Limit TV time to no more than one to two hours per day.
  3. Serve fruits and vegetables at every meal, and eating meals together as a family.
  4. Provide access to water at every meal, and avoiding sugary drinks like soda.
  5. Provide infants with access to stored breast milk if their mothers wish to continue breastfeeding. (Babies who are fed formula gain weight more rapidly than breastfed babies, increasing their likelihood of obesity at a later age.)

By helping children understand the benefits of a healthy lifestyle from a young age, Americans can help stop the obesity epidemic in its tracks—regardless of where they live.