title: Change in Obesity Prevalence across the United States Is Influenced by Recreational and Healthcare Contexts, Food Environments, and Hispanic Populations.
abstract: OBJECTIVE
  To examine change in county-level adult obesity prevalence between 2004 and 2009 and identify associated community characteristics.
  
  
  METHODS
  Change in county-level adult (≥20 years) obesity prevalence was calculated for a 5-year period (2004-2009). Community measures of economic, healthcare, recreational, food environment, population structure, and education contexts were also calculated. Regression analysis was used to assess community characteristics associated (p<0.01) with change in adult obesity prevalence.
  
  
  RESULTS
  Mean±SD change in obesity prevalence was 5.1±2.4%. Obesity prevalence decreased in 1.4% (n = 44) and increased in 98% (n = 3,060) of counties from 2004-2009. Results showed that both baseline levels and increases in physically inactive adults were associated with greater increases in obesity prevalence, while baseline levels of and increases in physician density and grocery store/supercenter density were related to smaller increases in obesity rates. Baseline levels of the Hispanic population share were negatively linked to changing obesity levels, while places with greater Hispanic population growth saw greater increases in obesity.
  
  
  CONCLUSIONS
  Most counties in the U.S. experienced increases in adult obesity prevalence from 2004 to 2009. Findings suggest that community-based interventions targeting adult obesity need to incorporate a range of community factors, such as levels of physical inactivity, access to physicians, availability of food outlets, and ethnic/racial population composition.
authors: Pennington Biomedical Research Center, Baton Rouge, Louisiana, 70808, United States of America.
authors: Candice A
authors: CA
authors: Myers
authors: Department of Sociology, Louisiana State University, Baton Rouge, Louisiana, 70803, United States of America.
authors: Tim
authors: T
authors: Slack
authors: Pennington Biomedical Research Center, Baton Rouge, Louisiana, 70808, United States of America.
authors: Corby K
authors: CK
authors: Martin
authors: Pennington Biomedical Research Center, Baton Rouge, Louisiana, 70808, United States of America.
authors: Stephanie T
authors: ST
authors: Broyles
authors: Pennington Biomedical Research Center, Baton Rouge, Louisiana, 70808, United States of America.
authors: Steven B
authors: SB
authors: Heymsfield
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D005191:Family Characteristics; D005502:Food; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D010342:Patient Acceptance of Health Care; D011203:Poverty; D011998:Recreation; D012111:Residence Characteristics; D012307:Risk Factors; D014481:United States / Q000453:epidemiology / Q000208:ethnology